So woahaw kakra anaa woahaw wo ho wɔ wo ba ketewa no home ho pɛn wɔ wɔn awo akyi? Ɛtɔ mmere bi a, nkokoaa a wɔawo wɔn foforo betumi anya ɔhome mu haw a emu yɛ den. Ɛnnɛ yɛbɛka tebea biako a anibere wom a ɛte saa ho asɛm, nanso akyinnye biara nni ho sɛ ɛho hia sɛ wohu. Wɔfrɛ eyi wɔ aduruyɛ mu sɛ Persistent Pulmonary Hypertension of the Newborn, anaasɛ PPHN tiawa.
Sɛ yɛbɛka no tiawa a, dɛn ne PPHN?
Sɛ yɛbɛte eyi ase a, ɛsɛ sɛ yedi kan te nsonsonoe a ɛwɔ sɛnea akokoaa home bere a ɔwɔ ɛna no awotwaa mu ne n’awo akyi no ase.
Susuw ho hwɛ, sɛ wo ba no wɔ wo yafunu mu a, ɔnam awotwaa mu hama no so nya mframa pa a ohia fi wo hɔ. Saa bere no, akokoaa no ahurututu ntumi nyɛ adwuma. Enti, mogya ntini a ɛkɔ ahurututu mu (yɛfrɛ no ahurututu mu ntini) no taa yɛ den na esiw. Mogya dodow no ara twa ahurututu no ho kɔ nipadua no fã a aka no mu.
Nanso ɛsɛ sɛ nsakrae kɛse ba bere a wɔwo akokoaa no na ɔhome nea edi kan ara pɛ . Bere a mframa hyɛ akokoaa no ahurututu mu ma no, ɛsɛ sɛ saa mogya ntini a kan no na ayɛ mmerɛw no bue. Ɛno ansa na mogya no betumi akɔ ahurututu mu, akɔfa mframa pa, na ɛde saa mogya a mframa pa ahyɛ mu ma no akɔ nipadua no nyinaa mu, titiriw amemene, koma, ne asaabo.
Wɔ tebea bi a wɔfrɛ no PPHN mu no, ɛnyɛ saa na ɛba. Wɔawo akokoaa no akyi mpo no, mogya ntini a ɛwɔ n’ahurututu mu no mmue yiye. Wɔkɔ so yɛ den. Afei, esiane sɛ mogya a ɛdɔɔso nkɔ ahurututu mu nti, akokoaa no akwaa no nnya mframa pa a ehia no.
PPHN yɛ aduruyɛ mu ntɛmpɛ a emu yɛ den yiye, a ɛde ne nkwa to asiane mu a ebetumi aba akokoaa a wɔawo no foforo mu. Ɛtaa ba wɔ awo akyi bere tiaa bi.
Saa tebea yi abu so dɛn?
Eyi nyɛ tebea a ɛtaa ba. Awo a wɔte ase 1,000 biara mu bɛyɛ baanu (2) wɔ asiane mu sɛ wobenya PPHN. Ɛtaa ba nkokoaa a wɔwo wɔn bere a wɔn mfe akɔ anim (wɔ adapɛn 37 kosi 42 ntam) ne nkokoaa a wɔwo wɔn wɔ adapɛn 42 akyi no mu. Nanso, ɛntaa mma wɔ nkokoaa a wɔawo wɔn ntɛm so.
Dɛn ne PPHN ho sɛnkyerɛnne ahorow?
Ɛho hia paa sɛ wuhu saa sɛnkyerɛnne ahorow yi, efisɛ sɛ wuhu a, ɛsɛ sɛ wohwehwɛ aduruyɛfo afotu ntɛm ara.
| Nsɛnkyerɛnne a ɛkyerɛ | Nkyerɛkyerɛmu a ɛnyɛ den |
|---|---|
| Ɔhome a ɛyɛ den | Nneɛma te sɛ ahome a ɛyɛ ntɛmntɛm anaa brɛoo paa, nnyigyei a ɛyɛ hu bere a ɔrehome, ne koko a ɛtwetwe kɔ mu. |
| Koma a ɛbɔ a ɛkɔ soro | Koma a ɛbɔ kɛse wɔ akokoaa no mu wɔ ɔkwan a ɛnteɛ so. |
| Honam ani kɔla a ɛsakra bruu/akuturuku (Cyanosis) . | Sɛ oxygen a ɛdɔɔso nni mogya no mu a, akokoaa no honam ani, titiriw n’ano, tɛkrɛma, ne ne nsateaa ano betumi adan bruu anaa fitaa. |
| Mogya mmoroso a ɛba fam (Hypotension) . | Akokoaa no mogya so tew wɔ ɔkwan a ɛnteɛ so. |
| Oxygen dodow a ɛso tew wɔ mogya no mu | Sɛ wɔde aduruyɛ mfiri susuw akokoaa no mogya mu oxygen dodow sua koraa. |
| Koma mu nnyigyei a ɛnteɛ (Heart Murmur) . | Nnyigyei foforo anaa soronko a wɔte fi koma no mu bere a oduruyɛfo no de afiri a wɔde tie asɛm hwehwɛ mu no. |
Dɛn ne nneɛma a ɛde PPHN ba ne asiane ahorow?
Nhwehwɛmufo nnya nhuu biribi pɔtee a ɛde eyi bae , nanso wogye di sɛ ebia mogya ntini a ɛwɔ akokoaa no ahurututu mu no ntumi nnyin yiye, anaasɛ akokoaa no a ontumi mfa ne ho nhyɛ abɔnten wiase no mu (mmue) wɔ n’awo akyi.
Ɛwom sɛ wonnim nea ɛde ba ankasa de, nanso nneɛma bi betumi ama asiane a ɛwɔ hɔ sɛ obi benya PPHN no ayɛ kɛse.
| Asiane a ɛde ba | Dɛn na ɛba wɔ eyi ho? |
|---|---|
| Meconium Apɛde a Wɔde Yɛ Adwuma | Nsu a ɛyɛ ahabammono tuntum (meconium) a ɛyɛ den a ɛyɛ akokoaa no nsu a edi kan no tumi hyɛn akokoaa no ahurututu mu. Eyi betumi asɛe ahurututu no na ama PPHN aba. |
| Nyarewa a wɔde nyarewa ba | Nyarewa a emu yɛ den te sɛ ahurututu mu yare te sɛ ahurututu mu yare anaa mogya mu awuduru. |
| Ɔhome mu Ahokyere (RDS) . | Mpɛn pii no, ɔhome mu yɛ den wɔ nkokoaa a wɔawo wɔn ntɛm mu efisɛ wɔn ahurututu nnyinii koraa. |
| Awo mu Asphyxia | Oxygen a enni amemene ne nipadua no mu ansa na wɔrewo anaasɛ bere a wɔrewo no. |
| Diaphragmatic Hernia a Ɛyɛ Akisikuru | Tokuru bi a ɛwɔ diaphragm (ntini a ɛtetew koko ne yafunu mu) mu no ma akwaa a ɛwɔ yafunu no mu no pue kɔ koko no mu. Eyi siw ahurututu no nkɔso kwan. |
| Awo mu dɛmdi afoforo | Ɔhaw afoforo te sɛ ahurututu mu yare a awo mu anaasɛ koma no mu ntini a asiw. |
| Nnuru bi a wɔnom bere a wɔyem | Nnuru bi a wɔde kum ɛyaw (NSAID) ne nnuru bi a wɔde kum adwenemhaw (SSRI) a wɔnom wɔ nyinsɛn no fã a etwa to mu no betumi aka eyi. |
So PPHN betumi de nkɛntɛnso a ɛtra hɔ kyɛ aba?
Aane. Eyi yɛ tebea a emu yɛ den, efisɛ ebetumi de nkɛntɛnso a ɛtra hɔ kyɛ aba esiane mframa pa a enni amemene no ne akwaa afoforo mu nti. Nkokoaa bɛyɛ 4 biara mu 1 (25%) a wonya nkwa wɔ PPHN mu no benya dɛmdi bi.
Wɔne:
- Nkɔso a ɛkyɛ
- Aso a ɛyɛ mmerɛw anaa asotiw
- Adesua mu nsɛnnennen
- Tumi a wɔde yɛ apɔw-mu-teɛteɛ a ɛso tew
Ɔkwan bɛn so na wohu PPHN?
Sɛ nnuruyɛfo susuw sɛ akokoaa bi wɔ saa yare yi a, wɔbɛyɛ nhwehwɛmu ahorow pii de akyerɛ sɛ wɔahu yare no.
| Sɔhwɛ | Dɛn na wuhu wɔ eyi mu? |
|---|---|
| Mogya Dodow a Edi Mu (CBC) . | Mogya mu nkwammoaa fitaa, mogya mu nkwammoaa kɔkɔɔ, ne mogya mu nkwammoaa a ɛwɔ mogya no mu dodow a wosusuw. Eyi betumi aboa ma wɔahu sɛ ɔyare mmoawa bi wɔ hɔ anaa. |
| Pulse Oximetry (Nantwi a Ɛma Apɔw-mu-teɛteɛ) . | Wɔde afiri ketewaa bi bata akokoaa no nsateaa anaa ne nan ho na ɛkɔ so susuw mframa pa dodow a ɛwɔ mogya no mu. |
| Mogya a Ɛma Ntini Mu Mframa (ABG) . | Fa mogya na susuw oxygen ne carbon dioxide dodow a ɛwɔ mu no pɛpɛɛpɛ. |
| Koko so X-ray a wɔyɛ | Sɛnea ɛbɛyɛ a wɔbɛhwɛ sɛ koma no ayɛ kɛse anaasɛ ahurututu mu tebea foforo bi wɔ hɔ anaa. |
| Echocardiogram (Echo) . | Eyi yɛ koma no mu nhwehwɛmu. Ɛho hia sɛ wɔhwehwɛ mogya a ɛkɔ koma ne ahurututu mu no mu na wosi PPHN tebea no so dua. |
| Ti Ultrasound (ti scan) . | Hwɛ sɛ mogya retu wɔ amemene no mu esiane oxygen a enni amemene no mu nti. |
Ɔkwan bɛn so na wɔsa PPHN?
PPHN ayaresa botae titiriw ne sɛ ɛbɛma oxygen dodow a ɛkɔ akokoaa no akwaa mu no ayɛ kɛse . Eyi betumi aboa ma wɔasiw nsɛnnennen a anibere wom ano. Wɔde akwan pii a wɔfa so sa yare di dwuma ma eyi.
| Ɔkwan a wɔfa so sa yare | Dɛn na ɛba wɔ eyi ho? |
|---|---|
| Oxygen a wɔde ma | Akokoaa no oxygen 100% a wɔde bɛma no denam afiri ketewa bi a wɔde abata hwene ho, akataso, anaa oxygen hood so. |
| Mfiri a Wɔde Ma Mframa Mu | Wɔde afiri bi hyɛ akokoaa no mframa afiri mu na wɔde mframa a wɔde home ma akokoaa no home. |
| Nnuru a wɔde siw mogya mmoroso ano | Nnuru a wɔde bɛma de ama mogya mmoroso asan aba denam saline (IV) so. |
| Nitric Oxide a wɔde yɛ nneɛma | Eyi yɛ gas. Sɛ wɔde mframa yi fa afiri a wɔde home mu ma a, ɛboa ma mogya ntini a ayɛ mmerɛw wɔ ahurututu no mu no trɛw. |
| ECMO (Oxygen a Wɔde Ma Ntini a Ɛwɔ Nipadua Akyi) . | Eyi yɛ ayaresa a ɛyɛ den yiye a wɔde di dwuma sɛ ɔkwan a etwa to. Sɛ akokoaa no koma ne n’ahurututu di huammɔ a, ECMO afiri no gye mogya fi nipadua no mu, de mframa pa ka ho, na ɛsan de kɔ nipadua no mu. Ɛte sɛ koma ne ahurututu a ɛwɔ akyi. |
Bere tenten ahe na egye ansa na akokoaa no ho atɔ no?
PPHN dodow no ara gyae wɔ dapɛn biako anaa abien ntam, nanso nkokoaa binom betumi agye asram pii ansa na wɔn ho atɔ wɔn koraa. Saa bere yi mu no, ɛho hia sɛ wobɔ wo ba no ho ban fi atiridiinini, atiridiinini, ne ɔyare mmoawa afoforo ho.
- Hohoro wo nsa yiye.
- Kwati sɛ wode akokoaa no bɛkɔ mmeae a nnipa ahyɛ hɔ ma.
- Ma akokoaa no ntwe ne ho mfi nnipa a wɔyare ho.
- Ɛsɛ sɛ obiara a ɔwɔ fie hɔ no nya afe afe atiridiinini aduru no.
Afei nso, ɛho hia sɛ wɔkɔ ayaresabea wɔ nna a wɔahyɛ ato hɔ no mu hwɛ sɛ akokoaa no nyin ne ne nyin yɛ nea ɛfata anaa.
Bere bɛn na ɛsɛ sɛ mekɔ oduruyɛfo nkyɛn?
Sɛ wo ba fi ayaresabea ba fie wie a, ɛsɛ sɛ wohwɛ yiye paa. Sɛ wuhu sɛnkyerɛnne ahorow a edidi so yi mu biara a, kɔ ayaresabea ntɛm ara. Fa wo ba no kɔ Emergency Department (ETU) a ɛwɔ ayaresabea a ɛbɛn wo no.
- se akokoaa no nya atiridii a.
- se wonnom nufusuo a edɔɔso a.
- se wotwe wo koko mu bere a worehome anaase wohome a wo hwene abue.
- se wote abɛn anaase abubuo nnyigyei bere a worehome a.
- se akokoaa no were fi ase dan bruu anaase fitaa bio a.
Sɛ wuhu sɛ wo ba no wɔ PPHN a, ebia wobɛte nkate pii te sɛ awerɛhow, ehu, abufuw, ne adwene a ɛyɛ basaa. Eyi yɛ ade a ɛfata. Ade a eye sen biara a wubetumi ayɛ ne sɛ wubesua tebea no ho ade pii sɛnea wubetumi afi nnuruyɛfo ne ayarehwɛfo a wɔrehwɛ wo ba no hɔ. Eyi bɛboa wo ma woate tebea no ase yiye. Bere kɔ so no, wobɛyɛ w’ankasa wo ba no tebea ho ɔbenfo. Wobɛte ahotoso nka sɛ woreyɛ nea wubetumi biara ama wo ba no.
Nkrasɛm a Wɔde Kɔ Fie
- PPHN yɛ ɔhome ho haw a emu yɛ den, nanso wotumi sa, wɔ mmofra a wɔawo wɔn foforo mu.
- Eyi yɛ aduruyɛ mu tebea a egye ntɛmpɛ a ɛhwehwɛ sɛ wɔde obi kɔ ayaresabea ntɛm ara na wɔsa no yare.
- Hwɛ yiye bere nyinaa sɛ wubehu kɔkɔbɔ nsɛnkyerɛnne te sɛ wo ba no honam ani hwɛbea a ɛbɛyɛ bruu na ɔrehome ntɛmntɛm.
- Botae titiriw a ɛwɔ ayaresa mu ne sɛ ɛbɛma akokoaa no amemene ne akwaa afoforo anya mframa pa a ɛdɔɔso.
- Bere a akokoaa no ho atɔ no mpo no, ɛho hia yiye sɛ wo ne oduruyɛfo no di nkitaho daa de hwɛ sɛnea akokoaa no nyin bere tenten.
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