Matenda opatsirana a Neonatal

Matenda opatsirana a Neonatal kupuma (RDS) ndi vuto lomwe nthawi zambiri limawoneka mwa makanda asanakwane. Vutoli limapangitsa kuti zikhale zovuta kuti mwana apume.

Neonatal RDS imachitika mwa makanda omwe mapapu awo sanakule bwino.

Matendawa amayamba makamaka chifukwa chosowa choterera m'mapapu otchedwa surfactant. Izi zimathandiza kuti mapapu adzaze ndi mpweya ndikusunga matumba amlengalenga kuti asaduke. Surfactant amapezeka pomwe mapapu amakula bwino.

Neonatal RDS itha kukhalanso chifukwa cha zovuta zamatenda ndi kukula kwamapapu.

Matenda ambiri a RDS amapezeka mwa ana obadwa asanakwane milungu 37 mpaka 39. Mwana akamakhwima msanga, amakhala ndi mwayi waukulu wa RDS atabadwa. Vutoli si lachilendo kwa ana obadwa mokwanira (pambuyo pa milungu 39).

Zinthu zina zomwe zingapangitse chiopsezo cha RDS ndizo:

• Mbale kapena mlongo yemwe anali ndi RDS
• Matenda a shuga mwa mayi
• Kubereka kwaareya kapena kupatsidwa ntchito mwana asanabadwe
• Mavuto pakubereka omwe amachepetsa magazi kupita kwa mwana
• Kutenga mimba kangapo (mapasa kapena kupitilira apo)
• Ntchito yofulumira

Nthawi zambiri, zizindikiro zimawoneka patangopita mphindi zochepa kuchokera pakubadwa. Komabe, mwina samawoneka kwa maola angapo. Zizindikiro zimaphatikizapo:

• Mtundu wabuluu wakhungu ndi ntchofu (cyanosis)
• Kupuma pang'ono (kupuma)
• Kuchepetsa mkodzo
• Mphuno ikuwombera
• Kupuma mofulumira
• Kupuma pang'ono
• Kupuma pang'ono ndi kumveka kovutikira mukamapuma
• Kusuntha kosazolowereka (monga kubwereranso m'chifuwa ndi kupuma)

Mayesero otsatirawa amagwiritsidwa ntchito kuti azindikire vutoli:

• Kusanthula mpweya wamagazi - kumawonetsa mpweya wochepa komanso asidi owonjezera m'madzi amthupi.
• X-ray pachifuwa - imawonetsa mawonekedwe a "galasi yapansi" m'mapapu omwe ndimatendawa. Izi nthawi zambiri zimayamba pakadutsa maola 6 mpaka 12 mwana atabadwa.
• Mayeso a labu - amathandizira kuthetsa matenda ngati vuto la kupuma.

Ana omwe sanabadwe msanga kapena ali ndi zikhalidwe zina zomwe zimawapangitsa kuti akhale pachiwopsezo chachikulu amafunika kuthandizidwa pakubadwa ndi gulu lazachipatala lomwe limagwiritsa ntchito mavuto opumira kumene.

Makanda adzapatsidwa mpweya wabwino wofunda. Komabe, chithandizochi chikuyenera kuyang'aniridwa mosamala kuti mupewe mavuto obwera chifukwa cha mpweya wochuluka.

Kupatsa wowonjezera wothandizira mwana wodwala kwawonetsedwa kukhala kothandiza. Komabe, wogwira ntchitoyo amaperekedwa mwachindunji panjira yopita kwa mwanayo, motero ngozi zina zimakhudzidwa. Kafukufuku wowonjezerabe akuyenera kuchitidwa kuti ndi ana ati omwe akuyenera kulandira mankhwalawa ndi kuchuluka kwa momwe angagwiritsire ntchito.

Mpweya wothandizira wokhala ndi makina opumira (makina opumira) atha kupulumutsa moyo kwa ana ena. Komabe, kugwiritsa ntchito makina opumira kumatha kuwononga minofu yam'mapapo, chifukwa chake mankhwalawa ayenera kupewedwa ngati zingatheke. Ana angafunikire chithandizo ichi ngati ali ndi:

• Mkulu wa kaboni dayokisaidi m'magazi
• Mpweya wotsika magazi
• Magazi ochepa pH (acidity)
• Kubwereza mobwerezabwereza pakupuma

Chithandizo chomwe chimatchedwa kuti positive positive airway pressure (CPAP) chitha kulepheretsa kufunika kothandizidwa ndi mpweya wabwino kapena wogwirizira mwa ana ambiri. CPAP imatumiza mpweya m'mphuno kuti zithandizire kuti mayendedwe apansi atseguke. Itha kuperekedwa ndi makina opumira (pamene mwana akupuma pawokha) kapena ndi chida china cha CPAP.

Ana omwe ali ndi RDS amafunikira chisamaliro chapafupi. Izi zikuphatikiza:

• Kukhala ndi bata
• Kusamalira mofatsa
• Kukhala pa kutentha kwa thupi
• Kusamalira mosamala madzi ndi zakudya
• Kuchiza matenda nthawi yomweyo

Vutoli limakula masiku awiri kapena anayi mwana atabadwa ndipo limakula pang'onopang'ono pambuyo pake. Ana ena omwe ali ndi matenda opuma opuma amafa. Izi zimachitika kwambiri pakati pa masiku 2 ndi 7.

Zovuta zazitali zitha kukhala chifukwa cha:

• Oxygen wambiri.
• Kuthamanga kwakukulu kumaperekedwa m'mapapu.
• Matenda owopsa kapena kusakhwima. RDS imatha kuphatikizidwa ndi kutupa komwe kumawononga mapapu kapena ubongo.
• Nthawi zomwe ubongo kapena ziwalo zina sizinapeze mpweya wokwanira.

Mpweya kapena mpweya ungapangire:

• Danga lozungulira mapapo (pneumothorax)
• Malo omwe ali pachifuwa pakati pa mapapo awiri (pneumomediastinum)
• Dera pakati pamtima ndi thumba lochepa lomwe lazungulira mtima (pneumopericardium)

Zina zomwe zimakhudzana ndi RDS kapena kusakhwima kwambiri zitha kuphatikizira izi:

• Kutuluka magazi muubongo (kutulutsa magazi m'mimba mwa mwana wakhanda)
• Kuthira magazi m'mapapu (m'mapapo mwanga kukha mwazi; nthawi zina kumalumikizidwa ndi kugwiritsa ntchito mafunde osagwiritsa ntchito)
• Mavuto ndi kukula kwamapapu ndi kukula (bronchopulmonary dysplasia)
• Kukula kwakuchedwa kapena kulumala mwanzeru komwe kumakhudzana ndi kuwonongeka kwa ubongo kapena kutuluka magazi
• Mavuto pakukula kwamaso (retinopathy of prematurity) ndi khungu

Nthawi zambiri, vutoli limayamba atangobadwa kumene mwanayo akadali mchipatala. Ngati mwaberekera kunyumba kapena kunja kwa chipatala, pitani kuchipatala ngati mwana wanu akupuma movutikira.

Kuchita njira zopewera kubadwa msanga kungathandize kupewa ma RDS akhanda. Kusamalira bwino amayi asanabadwe komanso kuwunika pafupipafupi kuyambira pomwe mayi apeza kuti ali ndi pakati kumathandiza kupewa kubadwa msanga.

Chiwopsezo cha RDS amathanso kuchepetsedwa ndi nthawi yoyenera yobereka. Kutumiza kochititsa chidwi kapena kubisala kungafunike. Kuyezetsa labu kumatha kuchitika asanabadwe kuti aone ngati mapapo a mwana ali okonzeka. Pokhapokha ngati pakufunika chithandizo chamankhwala, kutumizidwa kapena kubisala mwaulesi kuyenera kuchedwa mpaka masabata osachepera 39 kapena mpaka mayeso atawonetsa kuti mapapo a mwana akhwima.

Mankhwala otchedwa corticosteroids atha kuthandizira kufulumizitsa kukula kwa mapapo mwana asanabadwe. Nthawi zambiri amapatsidwa kwa amayi apakati pakati pa masabata 24 mpaka 34 omwe ali ndi pakati omwe amawoneka kuti angathe kubereka sabata yamawa. Kafufuzidwe kafukufuku amafunika kudziwa ngati corticosteroids itha kupindulitsanso ana omwe ali ochepera 24 kapena kupitilira milungu 34.

Nthawi zina, kutheka kupereka mankhwala ena kuti achedwetse kugwira ntchito ndi kubereka mpaka mankhwala a steroid atakhala ndi nthawi yogwira ntchito. Mankhwalawa atha kuchepetsa kuopsa kwa RDS. Zitha kuthandizanso kupewa zovuta zina zakubadwa msanga. Komabe, sichidzachotsa zoopsa zonse.

Matenda a Hyaline nembanemba (HMD); Matenda opatsirana amwana; Matenda opatsirana mwa makanda; RDS - makanda

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