Mphuno ya msinkhu

Mpweya umatanthauza "wopanda mpweya" ndipo umatanthauza kupuma komwe kumachedwetsa kapena kuyimitsa pazifukwa zilizonse. Apnea wa prematurity amatanthauza kupuma pang'ono mwa ana omwe adabadwa asanakwane milungu 37 ya mimba (kubadwa msanga).

Ana ambiri obadwa masiku asanakwane amakhala ndi vuto la kubanika chifukwa dera lomwe ubongo wawo umalamulira kupuma likadali kukula.

Pali zifukwa zingapo zomwe ana obadwa kumene, makamaka omwe adabadwa koyambirira, amatha kukhala ndi vuto la kupuma, kuphatikizapo:

• Malo am'magazi ndi njira zamitsempha zomwe zimayendetsa kupuma zikadali kukula.
• Minofu yomwe imatsegulira poyenda ndiyochepa komanso siyolimba monga momwe idzakhalire m'moyo wamtsogolo.

Mavuto ena mwa mwana wodwala kapena wobadwa msanga amatha kukulitsa matenda obanika kutulo, kuphatikiza:

• Kuchepa kwa magazi m'thupi
• Mavuto akudya
• Mavuto amtima kapena am'mapapo
• Matenda
• Magulu otsika a oxygen
• Mavuto a kutentha

Njira yopumira ya ana obadwa kumene sikhala yanthawi zonse ndipo imatha kutchedwa "kupuma kwakanthawi." Chitsanzochi chimachitika makamaka kwa ana obadwa kumene koyambirira (adani). Zimakhala ndi zigawo zazifupi (pafupifupi masekondi atatu) za kupuma pang'ono kapena kusiya kupuma (apnea). Ndime izi zimatsatiridwa ndi nthawi yopumira pafupipafupi masekondi 10 mpaka 18.

Kupuma mokhazikika kumayembekezereka mwa ana osakhwima pang'ono. Koma kapumidwe ndi msinkhu wa mwana zonsezo ndizofunikira posankha momwe mwanayo akudwalira.

Ndime za "apnea" kapena "zochitika" zomwe zimatenga nthawi yayitali kuposa masekondi 20 zimawonedwa ngati zazikulu. Mwanayo amathanso kukhala ndi:

• Ikani kugunda kwa mtima. Kutsika kwa kugunda kwa mtima kumeneku kumatchedwa bradycardia (komwe kumatchedwanso "brady").
• Ikani mpweya (oxygen saturation). Izi zimatchedwa desaturation (amatchedwanso "desat").

Ana onse asanakwane osakwana masabata 35 amatenga nawo gawo pathupi amaloledwa kuzipinda zosamalidwa kumene, kapena malo osamalira ana apadera, omwe ali ndi oyang'anira apadera chifukwa ali pachiwopsezo chachikulu chobanika. Makanda achikulire omwe amapezeka kuti ali ndi magawo obanika m'maso adzawayikanso oyang'anira mchipatala. Mayeso enanso adzachitika ngati mwanayo sanabadwe msanga ndipo akuwoneka kuti sakupeza bwino.

• Oyang'anira amayang'anira kupuma, kuthamanga kwa mtima, komanso kuchuluka kwa mpweya.
• Kutsika kwa kupuma, kugunda kwa mtima, kapena kuchuluka kwa oxygen kumatha kuyambitsa ma alarm pazoyang'anira izi.
• Oyang'anira ana omwe agulitsidwa kuti agwiritse ntchito kunyumba si ofanana ndi omwe amagwiritsidwa ntchito kuchipatala.

Ma alarm amatha kupezeka pazifukwa zina (monga kudutsa chopondapo kapena kuyenda mozungulira), chifukwa chake kuwunika koyang'anira kumawunikiridwa pafupipafupi ndi gulu lazachipatala.

Momwe matenda am'mimba amathandizidwira zimadalira:

• Choyambitsa
• Zimachitika kangati
• Kukula kwa magawo

Ana omwe ali ndi thanzi labwino ndipo amakhala ndi zigawo zazing'ono zimangoyang'aniridwa. Zikatero, zigawozi zimatha ana akakhudzidwa pang'ono kapena "kutakasika" munthawi yopuma.

Ana omwe ali bwino, koma omwe adakali achichepere komanso / kapena omwe ali ndi magawo obanika amatha kupatsidwa khofiine. Izi zithandiza kupuma kwawo pafupipafupi. Nthawi zina, namwino amasintha malo a mwana, amagwiritsa ntchito kuyamwa kuchotsa madzimadzi kapena mamina mkamwa kapena mphuno, kapena kugwiritsa ntchito thumba ndi chigoba kuthandiza kupuma.

Kupuma kumatha kuthandizidwa ndi:

• Kuyika koyenera
• Pang'ono kudyetsa nthawi
• Mpweya
• Kupitirizabe kuthamanga kwa ndege (CPAP)
• Makina opumira (makina opumira) nthawi zovuta

Ana ena omwe amapitirizabe kubanika koma ali okhwima komanso athanzi amatha kutulutsidwa kuchipatala ndikuwonetsetsa kuti apnea ali ndi nyumba, ali ndi caffeine kapena alibe, mpaka atapuma pang'ono.

Apnea amapezeka kawirikawiri kwa ana asanakwane. Kuwonongeka kofatsa sikuwoneka ngati kumakhala ndi zotsatira zazitali. Komabe, kupewa magawo angapo kapena owopsa ndibwino kwa mwanayo kwa nthawi yayitali.

Nthawi zambiri matenda obanika kutulo amabadwa mwana akamayandikira "nthawi yake". Nthawi zina, monga makanda omwe adabadwa asanakwane kapena ali ndi matenda am'mapapo, kupuma kumatha kupitilira milungu ingapo.

Apnea - akhanda; AOP; Monga ndi Bs; A / B / D; Matsenga a buluu - ana obadwa kumene; Zolemba za Dusky - ana obadwa kumene; Spell - ana obadwa kumene; Apnea - wakhanda

Ahlfeld luso ndi ndani. Matenda a kupuma. Mu: Kliegman RM, St. Geme JW, Blum NJ, Shah SS, Tasker RC, Wilson KW, olemba. Nelson Textbook of Pediatrics. Wolemba 21. Philadelphia, PA: Elsevier; 2020: chap 122.

Martin RJ. Pathophysiology ya matenda obanika kutulo asanakhwime. Mu: Polin RA, Abman SH, Rowitch DH, Benitz WE, Fox WW, olemba. Physiology ya Fetal ndi Neonatal. 5th ed. Philadelphia, PA: Elsevier; 2017: mutu 157.

Patrinos INE. Apnea ya Neonatal komanso maziko a kupuma. Mu: Martin RJ, Fanaroff AA, Walsh MC, olemba., Eds. Fanaroff ndi Martin's Neonatal-Perinatal Medicine. 11th ed. Philadelphia, PA: Elsevier; 2020: chap 67.