Bronchopulmonary dysplasia

Bronchopulmonary dysplasia (BPD) ndi matenda am'mapapo a nthawi yayitali (okhalitsa) omwe amakhudza ana obadwa kumene omwe amapakidwa makina opumira atabadwa kapena adabadwa molawirira (asanakwane).

BPD imapezeka mwa ana odwala kwambiri omwe amalandira mpweya wabwino kwa nthawi yayitali. BPD amathanso kuchitika mwa makanda omwe anali pamakina opumira (mpweya wabwino).

BPD imafala kwambiri kwa makanda obadwa msanga (msanga), omwe mapapu awo sanakule bwino atabadwa.

Zowopsa ndi izi:

• Matenda amtima obadwa nawo (vuto la kapangidwe ka mtima ndi magwiridwe antchito omwe amapezeka pakubadwa)
• Kutha msinkhu, nthawi zambiri makanda omwe amabadwa asanakwane masabata 32 asanabadwe
• Matenda opuma kapena am'mapapo

Kuopsa kwa BPD yayikulu kwatsika m'zaka zaposachedwa.

Zizindikiro zimatha kuphatikizira izi:

• Mtundu wa khungu la Bluish (cyanosis)
• Tsokomola
• Kupuma mofulumira
• Kupuma pang'ono

Mayeso omwe angachitike kuti athe kupeza matenda a BPD ndi awa:

• Magazi amitsempha yamagazi
• Chifuwa cha CT
• X-ray pachifuwa
• Kutulutsa oximetry

KUCHIPATALA

Makanda omwe ali ndi vuto la kupuma nthawi zambiri amaikidwa pa mpweya. Awa ndimakina opumira omwe amatumiza kukakamiza m'mapapu a mwana kuti akhale ndi mpweya wabwino komanso kuti apereke oxygen yambiri. Pamene mapapo a mwana amakula, kupanikizika ndi mpweya zimachepetsedwa pang'onopang'ono. Mwanayo amuletsa kuyamwa mwa mpweya wabwino. Mwanayo amatha kupitiliza kulandira mpweya mwa kubisa kapena chubu chammphuno kwa milungu ingapo kapena miyezi.

Makanda omwe ali ndi BPD nthawi zambiri amadyetsedwa ndimachubu zolowetsedwa m'mimba (NG chubu). Ana awa amafunikira ma calories owonjezera chifukwa cha kuyesetsa kupuma. Pofuna kuti mapapu awo asadzaze madzi, kumwa kwawo kumafunikira kuchepa. Amathanso kupatsidwa mankhwala (okodzetsa) omwe amachotsa madzi mthupi. Mankhwala ena atha kuphatikizira corticosteroids, bronchodilators, ndi ma surfactant. Surfactant ndi yoterera, yonga sopo m'mapapu yomwe imathandizira m'mapapu kudzaza ndi mpweya ndikusunga matumba ampweya kuti asasweke.

Makolo a ana awa amafunikira kuwalimbikitsa. Izi ndichifukwa choti BPD imatenga nthawi kuti ikhale bwino ndipo khanda limafunikira kukhala mchipatala kwanthawi yayitali.

KUNYUMBA

Makanda omwe ali ndi BPD angafunike chithandizo cha oxygen kwa milungu ingapo mpaka miyezi atatuluka kuchipatala. Tsatirani malangizo a omwe akukuthandizani kuti muwonetsetse kuti mwana wanu amapeza chakudya chokwanira panthawi yomwe akuchira. Mwana wanu angafunikire kuyamwa kwamachubu kapena njira zina zapadera.

Ndikofunika kwambiri kuteteza mwana wanu kuti asatenge chimfine ndi matenda ena, monga kupuma kwa syncytial virus (RSV). RSV imatha kuyambitsa matenda am'mapapo, makamaka mwana wakhanda yemwe ali ndi BPD.

Njira yosavuta yothandizira kupewa matenda a RSV ndiyo kusamba m'manja nthawi zambiri. Tsatirani izi:

• Sambani m'manja ndi madzi ofunda ndi sopo musanakhudze mwana wanu. Uzani ena kuti asambe m'manja, nawonso, musanakhudze mwana wanu.
• Funsani ena kuti asamayanjane ndi mwana wanu ngati ali ndi chimfine kapena malungo, kapena afunseni kuti avale chinyawu.
• Dziwani kuti kumpsompsona mwana wanu kumatha kufalitsa RSV.
• Yesetsani kusunga ana aang'ono kutali ndi mwana wanu. RSV ndiyofala kwambiri pakati pa ana aang'ono ndipo imafalikira mosavuta kuchokera kwa mwana kupita kwa mwana.
• MUSASUTE m'nyumba, m'galimoto, kapena paliponse pafupi ndi mwana wanu. Kukhudzana ndi utsi wa fodya kumawonjezera ngozi ya matenda a RSV.

Makolo a ana omwe ali ndi BPD ayenera kupewa khamu pakabuka RSV. Matendawa nthawi zambiri amafotokozedwa ndi atolankhani akumaloko.

Wopereka mwana wanu akhoza kukupatsani mankhwala palivizumab (Synagis) kuti muteteze matenda a RSV mwa mwana wanu. Tsatirani malangizo amomwe mungaperekere mwana wanu mankhwalawa.

Ana omwe ali ndi BPD amakhala bwino pang'onopang'ono pakapita nthawi. Thandizo la oxygen lingafunike kwa miyezi yambiri. Ana ena amakhala ndi vuto lakumapapo kwa nthawi yayitali ndipo amafunikira mpweya komanso kuthandizira kupuma, monga makina opumira. Ana ena omwe ali ndi vutoli sangakhale ndi moyo.

Ana omwe ali ndi BPD ali pachiwopsezo chachikulu chotenga matenda opuma mobwerezabwereza, monga chibayo, bronchiolitis, ndi RSV zomwe zimafuna kuti agonekere kuchipatala.

Mavuto ena omwe angakhalepo mwa ana omwe ali ndi BPD ndi awa:

• Mavuto otukuka
• Kukula kosauka
• Kuthamanga kwa magazi m'mapapo (kuthamanga kwa magazi m'mitsempha yamapapu)
• Mavuto am'mapapo komanso kupuma kwakanthawi monga mabala kapena bronchiectasis

Ngati mwana wanu ali ndi BPD, yang'anani mavuto aliwonse opuma. Itanani woyang'anira mwana wanu ngati muwona zizindikiro zilizonse za matenda opuma.

Kuthandiza kupewa BPD:

• Pewani kubereka msanga ngati zingatheke. Ngati muli ndi pakati kapena mukuganiza zokhala ndi pakati, pitani kuchipatala kuti akuthandizeni kukhala wathanzi.
• Ngati mwana wanu akupuma, funsani wothandizirayo kuti mwana wanu atha kuyamwa kuyamwa posachedwa.
• Mwana wanu atha kulandira mawonekedwe othandizira kuti mapapu atseguke.

BPD; Matenda a m'mapapo - ana; CLD - ana

Kamath-Rayne BD, Jobe AH. Kukula kwamapapo a fetal komanso womvera. Mu: Resnik R, Lockwood CJ, Moore TR, Greene MF, Copel JA, Silver RM, olemba. Creasy ndi Resnik's Maternal-Fetal Medicine: Mfundo ndi Kuchita. 8th ed. Philadelphia, PA: Elsevier; 2019: mutu 16.

[Adasankhidwa] McGrath-Morrow SA, Collaco JM. Bronchopulmonary dysplasia. Mu: Kliegman RM, St. Geme JW, Blum NJ, Shah SS, Tasker RC, Wilson KM, olemba. Nelson Textbook of Pediatrics. Wolemba 20th. Philadelphia, PA: Elsevier; 2020: chap 444.

Roosevelt GE. Zadzidzidzi za kupuma kwa ana: matenda am'mapapo. Mu: Makoma RM, Hockberger RS, Gausche-Hill M, eds. Rosen's Emergency Medicine: Concepts and Clinical Practice. 9th ed. Philadelphia, PA: Elsevier; 2018: mutu 169.