Necrotizing enterocolitis

Necrotizing enterocolitis (NEC) ndi imfa ya minofu m'matumbo. Zimachitika nthawi zambiri makanda asanakwane kapena odwala.

NEC imachitika pomwe chimango cha khoma la m'mimba chifa. Vutoli nthawi zambiri limayamba mwa khanda lomwe limadwala kapena lisanakwane. Zitha kuchitika khanda likadali mchipatala.

Zomwe zimayambitsa vutoli sizikudziwika. Kutsika kwa magazi mpaka m'matumbo kumatha kuwononga minofu. Mabakiteriya m'matumbo amathanso kuwonjezera vuto. Komanso, makanda akhanda msanga amakhala ndi chitetezo chamthupi chosakhazikika pazinthu monga mabakiteriya kapena kutsika kwa magazi. Kusalinganika kwa chitetezo cha mthupi kumawoneka kuti kukukhudzidwa ndi NEC.

Ana omwe ali pachiwopsezo chachikulu cha vutoli ndi awa:

• Makanda asanakwane
• Makanda omwe amadyetsedwa mkaka m'malo mwa mkaka wamunthu. (Mkaka waumunthu uli ndi zinthu zokula, ma antibodies ndi maselo amthupi omwe angathandize kupewa vutoli.)
• Makanda kumalo osungira ana kumene kubuka kwachitika
• Makanda omwe alandila magazi kapena adwala kwambiri

Zizindikiro zimatha kubwera pang'onopang'ono kapena mwadzidzidzi, ndipo zingaphatikizepo:

• Kutupa m'mimba
• Magazi pansi
• Kutsekula m'mimba
• Mavuto akudya
• Kupanda mphamvu
• Kutentha kosakhazikika kwa thupi
• Kupuma kosakhazikika, kugunda kwa mtima, kapena kuthamanga kwa magazi
• Kusanza

Mayeso atha kuphatikiza:

• X-ray m'mimba
• Chopondapo poyesa magazi amatsenga (guaiac)
• CBC (kuwerengera magazi kwathunthu)
• Magulu a Electrolyte, mpweya wamagazi ndi mayeso ena amwazi

Kuchiza kwa mwana yemwe angakhale ndi NEC nthawi zambiri kumaphatikizapo:

• Kudyetsa zoperekera (GI thirakiti)
• Othandiza mpweya m'matumbo poyika chubu m'mimba
• Kupereka madzi amtundu wa IV komanso zakudya zopatsa thanzi
• Kupereka maantibayotiki a IV
• Kuwunika vutoli ndi ma x-ray m'mimba, kuyesa magazi, ndi kuyeza kwamagesi amwazi

Khanda lidzafunika kuchitidwa opaleshoni ngati pali bowo m'matumbo kapena kutupa kwa khoma la m'mimba (peritonitis).

Pochita opaleshoniyi, adokotala:

• Chotsani minofu yakufa yakufa
• Pangani colostomy kapena ileostomy

Matumbo amatha kulumikizidwanso pakatha milungu ingapo kapena miyezi ingapo matenda atachira.

Necrotizing enterocolitis ndi matenda akulu. Mpaka 40% ya makanda omwe ali ndi NEC amamwalira. Chithandizo choyambirira, chankhanza chingathandize kusintha zotsatira.

Zovuta zingaphatikizepo:

• Matenda a m'mimba
• Sepsis
• Kutsekemera kwam'mimba
• Kukhazikika m'mimba
• Mavuto a chiwindi chifukwa cholephera kulekerera zakudya zam'mimba ndikusowa kwa zakudya za parenteral (IV)
• Matenda amfupi ngati matumbo atayika

Pezani chithandizo chamankhwala mwadzidzidzi ngati pali zizindikiro zina za necrotizing enterocolitis. Makanda omwe agonekedwa mchipatala chifukwa chodwala kapena asanakhwime ali pachiwopsezo chachikulu cha NEC. Amayang'anitsitsa vutoli asanawatumize kwawo.

• Matumbo a makanda

Caplan M. Neonatal necrotizing enterocolitis. Mu: Martin RJ, Fanaroff AA, Walsh MC, olemba., Eds. Fanaroff ndi Martin's Neonatal-Perinatal Medicine. 10th ed. Philadelphia, PA: Elsevier Saunders; 2015: chap 94.

Greenberg JM, Haberman B, Narendran V, Nathan AT, Schibler K. Neonatal zoopsa zoyambira kubadwa. 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 73.

PC Yambewu. Ma microbiome ndi thanzi la ana. Mu: Kliegman RM, St. Geme JW, Blum NJ, Shah SS, Tasker RC, Wilson KM, olemba. Nelson Textbook of Pediatrics. Wolemba 21. Philadelphia, PA: Elsevier; 2020: chap 196.