Kutuluka kwamitsempha m'mimba mwa mwana wakhanda

Kutuluka kwamitsempha kwapakati (IVH) kwamwana wakhanda kumataya magazi m'malo amadzimadzi (ma ventricles) mkati mwa ubongo. Vutoli limachitika kawirikawiri mwa ana omwe amabadwa msanga (asanakwane).

Makanda obadwa masabata opitilira 10 koyambirira ali pachiwopsezo chachikulu chotaya magazi. Khanda laling'ono komanso msanga msanga ndilo, chiopsezo chachikulu cha IVH. Izi ndichifukwa choti mitsempha yamagazi muubongo wa ana akhanda asanakwane sinakule bwino. Zotsatira zake ndizosalimba. Mitsempha yamagazi imakula kwambiri m'masabata 10 omaliza ali ndi pakati.

IVH imafala kwambiri kwa ana asanakwane omwe ali ndi:

• Matenda opweteka
• Kuthamanga kwa magazi kosakhazikika
• Matenda ena pakubadwa

Vutoli limathanso kupezeka mwa ana athanzi omwe amabadwa msanga. Kawirikawiri, IVH imatha kukhala ndi ana obadwa nthawi zonse.

IVH sapezeka kawirikawiri pobadwa. Zimapezeka kawirikawiri m'masiku angapo oyamba amoyo. Vutoli limapezeka kawirikawiri pamwezi woyamba, ngakhale mwana atabadwa molawirira.

Pali mitundu inayi ya IVH. Izi zimatchedwa "grade" ndipo zimatengera kuchuluka kwa magazi.

• Mayeso 1 ndi 2 amakhudzana ndi magazi ochepa. Nthawi zambiri, palibe zovuta zazitali chifukwa chotuluka magazi. Gawo 1 limatchedwanso kuti germinal matrix hemorrhage (GMH).
• Maphunziro a 3 ndi 4 amaphatikizapo kutuluka magazi kwambiri. Magazi amaponderezedwa (giredi 3) kapena amatenga mwachindunji (giredi 4) minofu yaubongo. Kalasi yachinayi imadziwikanso kuti kutaya magazi kwa intraparenchymal. Kuundana kwamagazi kumatha kupanga ndikuletsa kutuluka kwa madzi amadzimadzi. Izi zitha kubweretsa kuchuluka kwamadzimadzi muubongo (hydrocephalus).

Sipangakhale zizindikiro. Zizindikiro zomwe zimawoneka mwa makanda asanakwane ndi awa:

• Kupuma kaye (matenda obanika kutulo)
• Kusintha kwa kuthamanga kwa magazi ndi kugunda kwa mtima
• Kuchepetsa kuchepa kwa minofu
• Kuchepetsa malingaliro
• Kugona mokwanira
• Kukonda
• Kuyamwa kofooka
• Khunyu ndi mayendedwe ena achilendo

Ana onse obadwa asanakwane milungu 30 ayenera kukhala ndi mutu wam'mutu kuti ayesere IVH. Kuyesaku kumachitika m'masabata 1 mpaka 2 amoyo. Ana obadwa pakati pa masabata 30 mpaka 34 amathanso kuyezetsa magazi ngati ali ndi vuto la vutoli.

Kuwonanso kwachiwiri kwa ultrasound kumatha kuchitika nthawi yomwe mwana amayenera kubadwa (tsiku loyenera).

Palibe njira yoletsa kutuluka magazi yokhudzana ndi IVH. Gulu lazachipatala lidzayesetsa kuti khandalo likhazikike ndikuthana ndi zomwe mwana amakhala nazo. Mwachitsanzo, kuthiridwa magazi kumatha kuperekedwa kuti magazi aziyenda bwino komanso kuchuluka kwa magazi.

Ngati madzimadzi amafika mpaka kufika poti pali nkhawa yokhudza kukakamizidwa kwaubongo, mpope wamtsempha ungachitike kuti athetse madzi ndikuyesera kuti athetse kupsinjika. Izi zikathandiza, pangafunike opaleshoni kuti ayike chubu (shunt) muubongo kuti atulutse madzi.

Momwe khanda limakhalira bwino zimadalira momwe mwana wakhanda amafikira msinkhu komanso kuchuluka kwa magazi. Ana ochepera theka la ana omwe ali ndi magazi otsika amakhala ndi mavuto kwakanthawi. Komabe, kutuluka magazi kambiri nthawi zambiri kumabweretsa kuchedwa kwakukula ndi mavuto olamulira kuyenda. Pafupifupi gawo limodzi mwa atatu mwa ana aliwonse omwe ali ndi magazi kwambiri amatha kufa.

Zizindikiro zamitsempha kapena malungo mwa mwana yemwe ali ndi shunt m'malo mwake zitha kuwonetsa kutsekeka kapena matenda. Mwanayo amafunika kupita kuchipatala nthawi yomweyo izi zikachitika.

Makampani ambiri osamalira odwala (NICUs) ali ndi pulogalamu yotsatira yowunika ana omwe ali ndi vutoli mpaka atakwanitsa zaka zitatu.

M'mayiko ambiri, makanda omwe ali ndi IVH amayeneranso kuthandizidwa mwachangu (EI) kuti athandizire pakukula.

Amayi apakati omwe ali pachiopsezo chotenga msanga kubereka ayenera kupatsidwa mankhwala otchedwa corticosteroids. Mankhwalawa amatha kuthandiza kuchepetsa chiopsezo cha mwana ku IVH.

Amayi ena omwe ali ndi mankhwala omwe amakhudza ziwopsezo zotaya magazi ayenera kulandira vitamini K asanabadwe.

Ana obadwa masiku asanakwane omwe zingwe zawo za umbilical sizimangidwe nthawi yomweyo amakhala pachiwopsezo chotenga IVH.

Ana asanakwane omwe amabadwira kuchipatala ndi NICU ndipo sayenera kunyamulidwa akabadwa amakhalanso ndi chiopsezo chochepa cha IVH.

IVH - wakhanda; GMH-IVH

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Dlamini N, deVebar GA. Sitiroko ya 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: mutu 619.

Moyo JS, Lent LR. Kuvulala kwaubongo womwe ukukula msanga: kukha magazi m'mitsempha yam'mimba komanso kuvulaza zoyera. Mu: Swaiman KF, Ashwal S, Ferriero DM, et al, olemba. Swaiman's Pediatric Neurology. Lachisanu ndi chimodzi. Philadelphia, PA: Elsevier; 2017: mutu 22.