Intraventricular hemorrhage yemwana achangozvarwa

Intraventricular hemorrhage (IVH) yemwana achangozvarwa iri kubuda ropa munzvimbo dzinozadzwa nemvura (ma ventricles) mukati meuropi. Mamiriro acho anowanzoitika muvacheche vanozvarwa nekukurumidza (nguva isati yakwana).

Vacheche vanozvarwa anodarika gumi gumi mavhiki vari panjodzi huru yerudzi urwu rwekubuda ropa. Izvo zvidiki uye zvinowedzera nguva isati yasvika mucheche, inowedzera njodzi yeIVH. Izvi imhaka yekuti tsinga dzeropa muuropi dzevacheche vasati vazvarwa hadzisati dzakwana zvakakwana. Ivo havana kusimba semhedzisiro. Tsinga dzeropa dzinosimba mumavhiki gumi apfuura ekuzvitakura.

IVH inowanzoitika muvana vasati vasvika vane:

• Kufema kunetseka chirwere
• Ropa risina kugadzikana
• Zvimwe zvehutano panguva yekuzvarwa

Dambudziko rinogona zvakare kuitika mune vamwe vana vane hutano vakazvarwa nekukurumidza. Kazhinji, IVH inogona kukura mumwana akazara-kwenguva.

IVH haiwanzo kuvepo pakuzvarwa. Inoitika kazhinji mumazuva ekutanga ehupenyu. Mamiriro acho haawanzoitika mushure memwedzi wekutanga zera, kunyangwe kana mwana akazvarwa achiri mudiki.

Kune mhando ina dze IVH. Aya anonzi "mamakisi" uye akavakirwa padanho rekubuda ropa.

• MaGrade 1 ne2 anosanganisira mashoma ekubuda ropa. Kazhinji yenguva, hapana matambudziko enguva refu semhedzisiro yekubuda ropa. Giredhi 1 inonziwo germinal matrix hemorrhage (GMH).
• Magiredhi 3 ne4 anosanganisira kubuda ropa kwakanyanya. Ropa rinodzvinyirira pa (giredhi 3) kana rinonanga zvakananga (giredhi 4) huropi turu. Giredhi 4 inonziwo intraparenchymal hemorrhage. Ropa rakagwamba rinogona kuumba uye kudzivirira kuyerera kwecerebrospinal fluid. Izvi zvinogona kutungamira mukuwedzera kwemvura muuropi (hydrocephalus).

Panogona kunge pasina zviratidzo. Zviratidzo zvakajairika zvinoonekwa muvacheche vasati vasvika zvinosanganisira:

• Kufema kunombomira (apnea)
• Shanduko muropa uye kurova kwemoyo
• Kupera kwemhasuru toni
• Kupera kwekufungisisa
• Kurara zvakanyanya
• Lethargy
• Suck isina simba
• Kufenda uye kumwe kufamba kushoma

Vese vacheche vanozvarwa pamberi pemasvondo makumi matatu vanofanirwa kuve neiyo ultrasound yemusoro kutarisisa IVH. Muedzo unoitwa mu1 kusvika kumavhiki maviri ehupenyu. Vacheche vanozvarwa pakati pemasvondo makumi matatu kusvika makumi matatu nemana vanogona kunge vaine kuongororwa kweiyo ultrasound kana vaine zviratidzo zvechinetso.

Yechipiri yekuongorora Ultrasound inogona kuitwa panguva iyo mwana anga achitarisirwa kutanga kuzvarwa (zuva rakatarwa).

Iko hakuna nzira yekumira kubuda ropa kwakabatana neIVH. Chikwata chekuchengetedza hutano chichaedza kuchengetedza mucheche kugadzikana uye kubata chero zviratidzo izvo mwana angave ave nazvo. Semuenzaniso, kuwedzerwa ropa kunogona kupihwa kusimudzira BP uye kuwanda kweropa.

Kana fluid ikawanda kusvika padanho rekuti pane kunetsekana nezve kumanikidzwa pauropi, pombi yepinhaini inogona kuitwa kudurura mvura uye kuyedza kudzikamisa. Kana izvi zvichibatsira, kuvhiya kungangodikanwa kuisa chubhu (shunt) muuropi kuti ubudise mvura.

Kunyatsoita mwana mucheche kunoenderana nekukurumidzira kwemwana uye giredhi reropa. Asingasviki hafu yevana vacheche vane giredhi repazasi kubuda ropa vane matambudziko enguva refu Nekudaro, kubuda ropa kwakanyanya kunowanzo kutungamira mukuvandudza kunonoka uye matambudziko ekudzora kufamba. Kusvikira chikamu chimwe muzvitatu chevacheche vane kubuda ropa kwakanyanya vanogona kufa.

Zviratidzo zvehutano kana kupisa mumucheche ane shunt munzvimbo inogona kuratidza kuvhara kana hutachiona. Mwana anoda kurapwa pakarepo kana izvi zvikaitika.

Zvizhinji zvevacheche vanochengetwa zvakanyanya (NICUs) vane chirongwa chekutevera kuti vanyatsocherechedza vacheche vane chirwere ichi kusvika vasvitsa makore matatu.

Mumatunhu mazhinji, vacheche vane IVH vanokodzerawo kupindira kwekutanga (EI) masevhisi kubatsira neyakajairika budiriro.

Vakadzi vane pamuviri vari panjodzi huru yekusununguka nekukurumidza vanofanirwa kupihwa mishonga inonzi corticosteroids. Iyi mishonga inogona kubatsira kudzikisa njodzi yemwana yeIVH.

Vamwe vakadzi vari pamishonga inobata njodzi dzekubuda ropa vanofanirwa kuwana vhitamini K vasati vasununguka.

Vacheche vasati vazvarwa vane tambo dzembilical dzisina kusungwa ipapo vane njodzi shoma yeIVH.

Vana vasati vaberekwa vanozvarwa muchipatara neNICU uye havafanirwe kutakurwa mushure mekuberekwa vanewo njodzi shoma yeIVH.

IVH - achangoberekwa; GMH-IVH

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Dlamini N, deVebar GA. Chirwere chevana. Mune: Kliegman RM, St. Geme JW, Blum NJ, Shah SS, Tasker RC, Wilson KM, eds. Nelson Chinyorwa chePediatrics. 21st ed. Philadelphia, PA: Elsevier; 2020: chitsiko 619.

Mweya JS, Ment LR. Kukuvadza kune inokura preterm uropi: intraventricular hemorrhage uye chena nyaya kukuvara. Mune: Swaiman KF, Ashwal S, Ferriero DM, et al, eds. Swaiman's Pediatric Neurology. 6th ed. Philadelphia, PA: Elsevier; 2017: chitsiko 22.