Matenda a retinopathy asanakwane

Matenda a retinopathy of prematurity (ROP) ndikukula kwa mitsempha yamagazi mu diso la diso. Zimachitika mwa makanda omwe amabadwa mofulumira kwambiri (asanakwane).

Mitsempha yamagazi ya diso (kumbuyo kwa diso) imayamba kukula pafupifupi miyezi itatu kuchokera pathupi. Nthawi zambiri, amakula bwino panthawi yobadwa bwino. Maso sangakule bwino ngati mwana wabadwa msanga. Zombozi zimatha kusiya kukula kapena kukula modabwitsa kuchokera ku diso kupita kumbuyo kwa diso. Chifukwa zotengera ndizofooka, zimatha kutuluka ndikupangitsa magazi kutuluka m'maso.

Minyewa ingayambe ndikukoka diso kuchokera mkatikati mwa diso (gulu la retinal). Pazovuta kwambiri, izi zitha kubweretsa kutaya kwa masomphenya.

M'mbuyomu, kugwiritsa ntchito mpweya wambiri pochiza ana asanakwane kunapangitsa kuti zotengera zikule modabwitsa. Njira zabwino tsopano zilipo zowunikira mpweya. Zotsatira zake, vutoli lacheperanso, makamaka m'maiko otukuka. Komabe, pakadalibe kusatsimikizika pamlingo woyenera wa mpweya wa ana akhanda asanabadwe azaka zosiyanasiyana. Ochita kafukufuku akuphunzira zinthu zina kupatula mpweya womwe umawoneka kuti ungayambitse chiopsezo cha ROP.

Masiku ano, chiopsezo chotenga ROP chimadalira kukula kwa msinkhu. Ana ocheperako omwe ali ndi mavuto azachipatala ali pachiwopsezo chachikulu.

Pafupifupi ana onse omwe amabadwa asanakwane milungu 30 kapena olemera makilogalamu ochepera atatu (1500 gramu kapena 1.5 kilogalamu) akabadwa amawunikidwa kuti adziwe izi. Ana ena omwe ali pachiwopsezo chachikulu omwe amalemera mapaundi 3 mpaka 4.5 (1.5 mpaka 2 kilogalamu) kapena omwe amabadwa patatha milungu 30 ayeneranso kuwunikidwa.

Kuphatikiza pa kusakhwima msanga, zifukwa zina zowopsa zingaphatikizepo:

• Kupuma pang'ono (kupuma)
• Matenda a mtima
• Mpweya wabwino wa carbon dioxide (CO2) m'magazi
• Matenda
• Asidi wamagazi ochepa (pH)
• Mpweya wotsika magazi
• Mavuto a kupuma
• Kugunda kwa mtima pang'ono (bradycardia)
• Kuika anthu magazi

Kuchuluka kwa ROP mwa ana akhanda asanakwane kwatsika kwambiri m'maiko otukuka pazaka makumi angapo zapitazi chifukwa cha chisamaliro chabwino kuchipatala cha ana osabadwa kumene (NICU). Komabe, ana ambiri obadwa molawirira kwambiri tsopano amatha kukhala ndi moyo, ndipo makanda obadwa kumene asanakwane ali pachiwopsezo chachikulu cha ROP.

Kusintha kwa mitsempha yamagazi sikuwoneka ndi diso lamaliseche. Kuyezetsa diso kwa dotolo wamaso ndikofunikira kuti awulule zovuta zotere.

Pali magawo asanu a ROP:

• Gawo I: Pali kuchepa kwa chotengera chamagazi.
• Gawo II: Kukula kwa chotengera chamagazi sikokwanira kwenikweni.
• Gawo lachitatu: Kukula kwa chotengera chamagazi kumakhala kosazolowereka.
• Gawo IV: Kukula kwa chotengera chamagazi kumakhala kosazolowereka kwambiri ndipo pali diso lowonera pang'ono.
• Gawo V: Pali gulu lonse la retina.

Khanda lomwe lili ndi ROP amathanso kuwerengedwa kuti ali ndi "kuphatikiza matenda" ngati mitsempha yachilendo imafanana ndi zithunzi zomwe zimagwiritsidwa ntchito pozindikira vutoli.

Zizindikiro za ROP yayikulu ndizo:

• Kusuntha kwamaso kosazolowereka
• Maso owoloka
• Kuwona mozama kwambiri
• Ophunzira owoneka oyera (leukocoria)

Ana omwe amabadwa asanakwane milungu 30, amalemera ochepera magalamu 1,500 (pafupifupi mapaundi atatu kapena 1.5 kilogalamu) pobadwa, kapena ali pachiwopsezo chachikulu pazifukwa zina ayenera kukhala ndi mayeso am'mbuyomu.

Nthawi zambiri, mayeso oyamba amayenera kukhala mkati mwa masabata 4 mpaka 9 atabadwa, kutengera zaka zakubala za mwana.

• Ana obadwa patatha milungu 27 kapena kupitilira apo amayesedwa mayeso ali ndi zaka zinayi.
• Omwe amabadwa koyambirira nthawi zambiri amakhala ndi mayeso pambuyo pake.

Mayeso otsatira amatsata pazotsatira za mayeso oyamba. Makanda safunikira mayeso ena ngati mitsempha yamagazi m'maso onse atakwanitsa kukula bwino.

Makolo ayenera kudziwa mayeso omwe akutsatiridwa omwe amafunikira mwana asanatuluke ku nazale.

Chithandizo choyambirira chawonetsedwa kuti chithandiza mwana kukhala ndi mwayi wowona bwino. Chithandizo chikuyenera kuyamba mkati mwa maola 72 kuchokera kuyesa kwa diso.

Ana ena omwe ali ndi "kuphatikiza matenda" amafunikira chithandizo mwachangu.

• Mankhwala a Laser (photocoagulation) atha kugwiritsidwa ntchito popewa zovuta za ROP zapamwamba.
• Laser imasiya mitsempha yachilendo kuti isakule.
• Mankhwalawa amatha kuchitika nazale pogwiritsa ntchito zida zonyamula. Kuti zigwire bwino ntchito, ziyenera kuchitika diso lisanachite zipsera kapena kutuluka m'diso lonse.
• Mankhwala ena, monga kubaya jakisoni yemwe amalepheretsa VEG-F (chotengera chotengera magazi) m'maso, akuwerengedwabe.

Kuchita opaleshoni kumafunika ngati diso likutha. Kuchita opaleshoni sikumabweretsa masomphenya abwino nthawi zonse.

Makanda ambiri omwe ali ndi vuto lakuthwa kwa masomphenya okhudzana ndi ROP amakhala ndi mavuto ena okhudzana ndi kubadwa msanga. Afunika chithandizo chamankhwala osiyanasiyana.

Pafupifupi mwana m'modzi mwa khumi yemwe amasintha msanga amayamba kudwala kwambiri. Kulimbitsa ROP kumatha kubweretsa zovuta zazikulu zamaso kapena khungu. Chofunikira pazotsatira ndikutulukiridwa koyambirira ndi chithandizo.

Zovuta zimatha kuphatikizira kuyandikira kwambiri kapena khungu.

Njira yabwino yopewera vutoli ndikutenga njira zopewera kubadwa msanga. Kupewa mavuto ena amisala kumathandizanso kupewa ROP.

Retrolental fibroplasia; CHITSANZO

Achinyamata WM; Gawo la American Academy of Pediatrics pa Ophthalmology; American Academy of Ophthalmology; American Association for Pediatric Ophthalmology ndi Strabismus; American Association of Orthoptists Ovomerezeka. Kuunikira ana akhanda asanakwane kuti adziwe matendawa asanabadwe. Matenda. 2018; 142 (6): e20183061. Matenda. 2019; 143 (3): 2018-3810. (Adasankhidwa) PMID: 30824604 www.ncbi.nlm.nih.gov/pubmed/30824604. (Adasankhidwa)

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Thanos A, Drenser KA, Capone AC. Matenda a retinopathy a msinkhu. Mu: Yanoff M, Duker JS, olemba. Ophthalmology. 5th ed. Philadelphia, PA: Elsevier; 2019: chaputala 6.21.