Sepsis wachinyamata

Neonatal sepsis ndimatenda amwazi omwe amapezeka mwa khanda osakwana masiku 90. Sepsis yoyambirira kumawoneka sabata yoyamba yamoyo. Sepsis womachedwa mochedwa amapezeka pambuyo pa sabata limodzi mpaka miyezi itatu.

Matenda a Neonatal amatha kuyambitsa mabakiteriya monga Escherichia coli (E coli), Listeria, ndi mitundu ina ya streptococcus. Gulu la streptococcus (GBS) lakhala vuto lalikulu la sepsis yobereka. Komabe, vutoli lacheperako chifukwa azimayi amawayezetsa ali ndi pakati. Matenda a herpes simplex (HSV) amathanso kuyambitsa matenda akulu mwa mwana wakhanda. Izi zimachitika kawirikawiri pamene mayi ali ndi kachiromboka kumene.

Sepsis yoyambirira kumene kumene kumene kumabadwa nthawi zambiri imawonekera pakadutsa maola 24 mpaka 48 kuchokera pakubadwa. Mwana amatenga matendawa kuchokera kwa mayi ake asanabadwe kapena panthawi yobereka. Zotsatirazi zikuwonjezera chiopsezo cha khanda la sepsis yoyambilira ya bakiteriya:

• Kulamulira kwa GBS panthawi yapakati
• Kutumiza koyambirira
• Kusweka kwa madzi (kutuluka kwa nembanemba) kupitilira maola 18 asanabadwe
• Kutenga kwa ziwalo za m'mimba ndi amniotic fluid (chorioamnionitis)

Ana omwe ali ndi sepsis omwe akuchedwa kubadwa kumene amatenga kachilombo atabereka. Zotsatirazi zikuwonjezera chiopsezo cha khanda kwa sepsis atabereka:

• Kukhala ndi catheter mumtsuko wamagazi kwa nthawi yayitali
• Kukhala mchipatala kwanthawi yayitali

Makanda omwe ali ndi sepsis wakhanda akhoza kukhala ndi izi:

• Kutentha kwa thupi kumasintha
• Mavuto opumira
• Kutsekula m'mimba kapena kuchepa kwa matumbo
• Shuga wamagazi ochepa
• Kuchepetsa mayendedwe
• Kuchepetsa kuyamwa
• Kugwidwa
• Kuchedwa kapena kuthamanga kwa mtima
• Malo otupa amimba
• Kusanza
• Khungu lachikaso ndi azungu amaso (jaundice)

Mayeso a labu atha kuthandizira kuzindikira sepsis wakhanda komanso kuzindikira chomwe chimayambitsa matendawa. Kuyezetsa magazi kungaphatikizepo:

• Chikhalidwe chamagazi
• Mapuloteni othandizira C
• Kuwerengera kwathunthu kwa magazi (CBC)

Ngati mwana ali ndi zizindikilo za sepsis, kupindika kwa lumbar (tapu ya msana) kumachitika kuti ayang'ane msana wamtsempha wa mabakiteriya. Zikopa, chopondapo, ndi mkodzo zitha kuchitidwa ndi matenda a herpes, makamaka ngati mayi ali ndi mbiri yokhudzana ndi matenda.

X-ray ya m'chifuwa idzachitika ngati mwana ali ndi chifuwa kapena kupuma movutikira.

Mayeso achikhalidwe cha mkodzo amachitidwa mwa ana okulirapo kuposa masiku ochepa.

Ana ochepera milungu isanu ndi inayi omwe ali ndi malungo kapena zizindikilo zina za kachilombo amayambitsidwa ndi mankhwala ophera ma virus (IV) nthawi yomweyo. (Zitha kutenga maola 24 mpaka 72 kuti mupeze zotsatira za labu.) Ana ongobadwa kumene omwe amayi awo anali ndi chorioamnionitis kapena omwe angakhale pachiwopsezo pazifukwa zina amapezanso maantibayotiki a IV poyamba, ngakhale atakhala kuti alibe zisonyezo.

Mwanayo amalandira maantibayotiki kwa milungu itatu ngati mabakiteriya amapezeka m'magazi kapena mumtsempha wamtsempha. Chithandizo chidzakhala chachifupi ngati palibe mabakiteriya omwe amapezeka.

Mankhwala a antiviral otchedwa acyclovir adzagwiritsidwa ntchito pamagulu omwe angayambitsidwe ndi HSV. Makanda achikulire omwe amakhala ndi labu wabwinobwino ndipo ali ndi malungo okha sangapatsidwe mankhwala opha tizilombo. M'malo mwake, mwanayo amatha kuchoka mchipatala ndikubwerako kuti akapimidwe.

Ana omwe amafunikira chithandizo ndipo amapita kunyumba atabadwa nthawi zambiri amaloledwa kupita nawo kuchipatala kukawunika.

Ana ambiri omwe ali ndi matenda a bakiteriya adzachira kwathunthu ndipo sangakhale ndi mavuto ena. Komabe, sepsis ya neonatal ndi yomwe imayambitsa imfa ya makanda. Khanda likalandira chithandizo mwachangu, zotsatira zake zimakhala zabwino.

Zovuta zingaphatikizepo:

• Kulemala
• Imfa

Funani chithandizo chamankhwala nthawi yomweyo kwa mwana wakhanda yemwe akuwonetsa zizindikiritso za khanda.

Amayi oyembekezera angafune maantibayotiki ngati ali ndi:

• Chorioamnionitis
• Gulu lazolowera gulu B
• Kubadwa m'mbuyomu kwa mwana yemwe ali ndi sepsis yoyambitsidwa ndi mabakiteriya

Zinthu zina zomwe zingathandize kupewa sepsis ndi monga:

• Kupewa ndi kuchiza matenda mwa amayi, kuphatikizapo HSV
• Kupereka malo oyera obadwira
• Kubereka mwana pasanathe maola 12 mpaka 24 kuchokera nthawi yomwe zimagwirira ntchito (Kubereka kwa Osereya kuyenera kuchitidwa mwa azimayi mkati mwa maola 4 mpaka 6 kapena nembanemba zikangoyamba.)

Sepsis neonatorum; Septicemia yobereka; Sepsis - khanda

Komiti Yamatenda Opatsirana, Komiti Yokhudza Khanda ndi Khanda; Baker CJ, Byington CL, Polin RA. Ndondomeko ya mfundo - malingaliro othandizira kupewa matenda a perinatal group B streptococcal (GBS). Matenda. 2011; 128 (3): 611-616. PMID: 21807694 www.ncbi.nlm.nih.gov/pubmed/21807694. (Adasankhidwa)

Matenda amabakiteriya a Esper F. Mu Martin RJ, Fanaroff AA, Walsh MC, olemba. Fanaroff ndi Martin's Neonatal-Perinatal Medicine. 11th ed. Philadelphia, PA: Elsevier; 2020: chap 48.

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

Jaganath D, Yemweyo RG. Microbiology ndi matenda opatsirana. Mu: Chipatala cha Johns Hopkins; Hughes HK, Kahl LK, okonza. Buku la Harriet Lane. Wolemba 21. Philadelphia, PA: Elsevier; 2018: mutu 17.

Polin R, Randis TM. Matenda a Perinatal ndi chorioamnionitis. Mu Martin RJ, Fanaroff AA, Walsh MC, olemba. Fanaroff ndi Martin's Neonatal-Perinatal Medicine. 11th ed. Philadelphia, PA: Elsevier; 2020: chap 25.

Verani JR, McGee L, Schrag SJ; Kugawika kwa Matenda a Bakiteriya, National Center for Katemera ndi Matenda Opuma, Malo Olimbana ndi Kupewa Matenda (CDC). Kupewa kwa gulu la perinatal B streptococcal matenda - malangizo owunikiridwa kuchokera ku CDC, 2010. Malangizo a MMWR Rep. 2010; 59 (RR-10): 1-36. PMID: 21088663 www.ncbi.nlm.nih.gov/pubmed/21088663.