Loaʻa i kāu pēpē kēia pilikia ʻōpū koʻikoʻi? (Necrotizing Enterocolitis - NEC) E kamaʻilio kākou e pili ana i kēia!

ʻAuē, i kekahi manawa ke hānau ʻia nā pēpē liʻiliʻi, loaʻa iā lākou nā pilikia olakino like ʻole, ʻeā? ʻOi aku hoʻi nā pēpē i hānau ʻia i ka wā hāpai haʻahaʻa. I kēia lā e kamaʻilio mākou e pili ana i kahi maʻi ʻōpū koʻikoʻi e hiki ai i kēlā mau pēpē ke ulu. Ua kapa ʻia kēia ʻo necrotizing enterocolitis, a i ʻole NEC no ka pōkole. Mai makaʻu i kou lohe ʻana i kēia inoa, e hoʻomaopopo maʻalahi kākou.

He aha kēia necrotizing enterocolitis (NEC)?

I ka ʻōlelo maʻalahi, ʻo NEC (Necrotizing Enterocolitis) kahi maʻi ʻōpū koʻikoʻi e hoʻopilikia i nā ʻōpū o nā pēpē, ʻoiai nā pēpē hānau mua ʻia . I kēia kūlana, pehu nā ʻiʻo ʻōpū a hoʻomaka e make. E noʻonoʻo iā ia e like me kahi ʻeha e hōʻino ai i nā ʻiʻo i loko o ka ʻōpū.

Hiki ke lilo kēia i mea weliweli no ka mea i kekahi manawa hiki ke hana ʻia kahi lua (perforation) i loko o ka ʻōpū. Inā hana ʻia kēia, hiki i nā germs , e like me ka bacteria, ke pakele ma o ka lua, i loko o ka ʻōpū a i ʻole i loko o ke koko. Hana pinepine ʻia kēia ma waena o ʻelua a me ʻeono pule ma hope o ka hānau ʻana o ka pēpē.

No kekahi mau pēpē, he ʻano maʻalahi ka NEC e hiki ke hoʻoweliweli i ke ola. I kekahi mau pēpē, hiki ke koʻikoʻi a hoʻoweliweli i ke ola . Ke haʻi aku nei mākou iā ia he "nek-ruh-tiz-ing n-ter-o-ko-ly-tis."

He aha ka ʻōpū?

ʻO ka ʻōpū liʻiliʻi a me ka ʻōpū nui ʻelua mau ʻāpana koʻikoʻi o kā mākou ʻōnaehana hoʻoheheʻe . Kōkua lāua iā mākou e hoʻoheheʻe i ka meaʻai a mākou e ʻai ai, e omo i nā meaolaola, a hoʻopau i nā huahana ʻōpala. Hoʻokuʻu ʻia kēia mau huahana ʻōpala ma ke ʻano he feces.

ʻO wai ka mea i ʻoi aku ka paʻakikī ke loaʻa iā NEC? Pehea ka maʻamau?

ʻO ka ʻoiaʻiʻo, 9 o 10 mau pēpē i loaʻa iā NEC i hānau mua ʻia . ʻO ia hoʻi, nā pēpē i hānau ʻia ma mua o 37 mau pule o ka hāpai ʻana. ʻO ke kikoʻī:

• No nā pēpē i hānau ʻia ma mua o 37 mau pule ( nā pēpē hānau mua ʻole ).
• No nā pēpē i hānai ʻia ma o kahi ʻōmole i kau ʻia i loko o ko lākou ʻōpū ( enteral nutrition ). Hana ʻia kēia no ka mea he paʻakikī i kekahi mau pēpē ke lawe i ka waiū ma ka waha.
• No nā pēpē i emi ke kaumaha ma mua o 5 1/2 paona i ka wā hānau.

He maʻi ʻōpū maʻamau ka NEC i waena o nā pēpē hānau mua. Ma ke ʻano kikoʻī, hoʻopilikia ia ma kahi o 1 i loko o 1,000 mau pēpē hānau mua. He kiʻekiʻe loa ka pilikia no nā pēpē i emi ke kaumaha ma mua o 2 paona i ka wā hānau.

Eia nō naʻe, he mea kakaikahi loa nā pēpē hānau piha e loaʻa iā NEC. Hoʻokahi wale nō i loko o 10,000 mau pēpē e loaʻa iā NEC.

Aia kekahi mau ʻano NEC like ʻole?

ʻAe, hoʻokaʻawale nā ​​kauka iā NEC ma muli o ka manawa o ka hoʻomaka ʻana o nā hōʻailona a me ke kumu o ka maʻi. Aia kekahi mau ʻano nui:

• NEC Kuʻuna:ʻO kēia ke ʻano maʻamau. Hoʻopilikia pinepine ia i nā pēpē i hānau ʻia ma mua o 28 mau pule o ka hāpai ʻana. ʻIke ʻia ma waena o ʻekolu a me ʻeono pule ma hope o ka hānau ʻana. ʻO ka hapa pinepine, hiki koke mai kēia ʻano, me ka ʻole o ka ʻōlelo aʻo , i ka wā e olakino a paʻa ai ka pēpē.
• NEC e pili ana i ka hoʻoili koko: Pono kekahi mau pēpē i ka hoʻoili koko no ka mea he anemia ko lākou, kahi nele o nā hunaola koko ʻulaʻula. Ma kahi o 1 i loko o 3 mau pēpē hānau mua e loaʻa iā NEC i loko o ʻekolu lā o ka loaʻa ʻana o ka hoʻoili koko.
• NEC Atypical: He mea kākaʻikahi loa, hiki i ka NEC ke ulu i loko o ka pule mua o ke ola a i ʻole ma mua o ka hānai ʻia ʻana o ka pēpē i ka waiū no ka manawa mua.
• NEC i nā pēpē manawa: Ke hānau ʻia kahi pēpē i ka manawa, pinepine ia e kahi kīnā hānau . No ka laʻana, kahi maʻi puʻuwai hānau , gastroschisis , a i ʻole nā ​​​​pae oxygen haʻahaʻa i ka wā hānau.

I kekahi manawa, hiki i ka NEC ke laha i loko o nā keʻena mālama koʻikoʻi neonatal (NICUs) . ʻO kēia ka manawa e loaʻa ai i kekahi mau pēpē ka NEC i ka manawa like. Hiki i nā bacteria e like me E. coli a i ʻole nā ​​​​​​huakini ʻē aʻe ke hana i kēia laha. Akā he mea kākaʻikahi loa kēia.

No ke aha i hana ʻia ai kēia NEC? He aha nā kumu?

ʻAʻole maopopo loa i nā kauka ke kumu o NEC, akā ʻike mākou he nāwaliwali ka ʻōnaehana pale o nā pēpē hānau mua. ʻO ka ʻōnaehana pale ka mea e hakakā nei i nā maʻi.

Eia kekahi, ua nāwaliwali loa nā ʻōnaehana hoʻoheheʻe o kēia mau pēpē a ʻaʻole i hoʻomohala piha ʻia. No laila, inā loaʻa i kahi pēpē hānau mua kahi maʻi ʻōpū, he paʻakikī i kā lākou ʻōnaehana pale a me ka ʻōnaehana hoʻoheheʻe ke pale aku iā ia.

ʻO kekahi mea ʻē aʻe, ʻo nā pēpē i hānau mua ʻole ʻia, ʻoi aku ka liʻiliʻi o ke kahe koko e lawe ana i ka oxygen i ko lākou mau ʻōpū. Hiki i kēia kahe koko i emi iho ke hōʻino i nā ʻiʻo ʻōpū. ʻAe kēia hōʻino i nā bacteria e pakele mai nā ʻōpū a komo i loko o ka lua ʻōpū a i ʻole ke koko.

He aha nā hōʻailona o ka NEC?

ʻIke pinepine ʻia ʻo NEC ma waena o ʻelua a me ʻeono pule ma hope o ka hānau ʻana. Hiki ke ʻokoʻa ma muli o ke ʻano a me ke kumu o ke kūlana. Hiki ke ulu mālie nā hōʻailona i kekahi mau lā, a i ʻole hiki ke ʻike koke ʻia i loko o kahi pēpē i olakino maikaʻi ʻole.

No ka mea he pilikia maʻamau ka NEC i waena o nā pēpē ma kahi NICU (Neonatal Intensive Care Unit) , ʻike mau nā kauka a me nā kahu maʻi ma laila i kēia.

ʻO nā hōʻailona nui o NEC:

• ʻEha ʻōpū a me ka pehu.
• Ka helu o ka puʻuwai, ke koko, nā loli i ka mahana o ke kino a me ke ʻano hanu.
• Ka maʻi kahe me ka ʻōpala koko .
• Luaʻi ʻōmaʻomaʻo a melemele paha.
• Ua hiamoe ke pēpē a make ( lethargy ).
• Ka hōʻole ʻana e inu i ka waiū a me ka nele o ke kaumaha.

Pehea e ʻike ai inā loaʻa iā ʻoe ka NEC?

E nānā ke kauka e mālama ana i kāu pēpē i kāu pēpē a nānā i kekahi pehu a i ʻole nā ​​​​hōʻailona ʻē aʻe o NEC.

Eia kekahi, hiki ke hana i nā hoʻokolohua e like me:

• Nā hoʻāʻo koko: E nānā i ke koko no ka bacteria a i ʻole nā ​​​​hōʻailona ʻē aʻe o ka maʻi.
• Hoʻāʻo ʻōpala: E nānā i ka ʻōpala o kāu pēpē no ke koko. I kekahi manawa aia paha ke koko i loko o ka ʻōpala i ʻike ʻole ʻia, a hiki i kēia hoʻāʻo ke ʻike.
• Nā kukuna X: Lawe ʻia kahi kukuna X o ka ʻōpū e nānā i nā pehu kinoea a puni nā ʻōpū a i ʻole i loko o ka lua ʻōpū. Hōʻike kēia mau pehu kinoea ua hōʻino ʻia nā ʻōpū a i ʻole he lua.

He aha nā pilikia e hiki ke loaʻa mai ka NEC?

Aia kekahi pēpē me NEC i ka pilikia no nā pilikia ʻē aʻe. ʻO kekahi o kēia mau pilikia:

• ʻO ka maʻi ʻōpū: Hoʻomohala kekahi mau pēpē i kahi lua ma ka paia o ko lākou ʻōpū. Hiki i kēia lua ke ʻae i ka bacteria e komo i loko o ka lua ʻōpū. Hiki i kēia ke hana i kahi maʻi koʻikoʻi i kapa ʻia ʻo peritonitis . Hoʻonui kēia peritonitis i ka pilikia o ka loaʻa ʻana o ka sepsis , kahi maʻi koko e hoʻoweliweli i ke ola.
• ʻO ke koʻikoʻi o ka ʻōpū: Ma kahi o 1 i loko o 3 mau pēpē me NEC e loaʻa i kahi ʻōpū haiki ma hope o ke ola. Hana pinepine kēia i kekahi mau mahina ma hope o ka hoʻōla ʻana o ke pēpē mai NEC. Ke haiki ka ʻōpū, lilo ia i mea paʻakikī no ka meaʻai a me ka mea inu ke hele. Pono paha kekahi mau keiki i ke ʻoki ʻana e hoʻonui i ka ʻōpū haiki.
• ʻO ka maʻi ʻōpū pōkole (SBS): Hiki ke loaʻa kēia ʻano inā ua luku ʻia a hōʻino ʻia paha kekahi hapa o ka ʻōpū liʻiliʻi ma muli o NEC. ʻO ka hopena, ʻaʻole hiki i ke kino ke omo pono i nā wai a me nā meaʻai ( malabsorption ). Pono nā keiki me SBS i ka mālama kūikawā e hōʻoia i ka loaʻa ʻana o ka meaʻai kūpono i ko lākou ola. Pono paha kekahi mau keiki e hānai ʻia ma o kahi paipu ( nā hānai ʻana i loko o ka enteral ).
• Ka hāʻule ʻana o ka ulu ʻana a me ka lohi o ka ulu ʻana: He mau pilikia koʻikoʻi kēia no ka wā lōʻihi. Kiʻekiʻe loa kēia pilikia i nā pēpē i hana ʻia i ke ʻoki kino. Pono e nānā mau ʻia ka ulu ʻana a me nā hopena neurodevelopmental o ia mau pēpē.

Pehea e mālama ʻia ai ka NEC?

Pono nā ʻōpū o ka pēpē e hoʻomaha a ho'ōla. No laila, ʻo ka mea mua e hana ai i ka wā e mālama ai iā NEC, ʻo ia ke hoʻōki i ka hānai ʻana ma o kahi paipu a i ʻole ma ka waha. Akā, hāʻawi ʻia ka pēpē i nā meaʻai a me nā wai e pono ai lākou ma ke ʻano intravenous (IV) , e like me ka saline i loko o kahi aʻa.

Eia kekahi, hiki i ke pēpē ke loaʻa nā lāʻau lapaʻau e like me:

• ʻO ka paipu Nasogastric: Hoʻokomo ke kauka i kahi paipu lōʻihi a lahilahi ma o ka ihu (i kekahi manawa ma o ka waha) i loko o ka ʻōpū e hoʻokahe i ka ea keu a me nā wai mai ka ʻōpū.
• Nā lāʻau lapaʻau: Kōkua kēia i ka hakakā ʻana i nā maʻi bacteria.

Ma kahi o 1 i loko o 4 mau pēpē e pono ai ke ʻoki ʻana e wehe i nā ʻāpana make o ka ʻōpū a hoʻoponopono i nā lua. Hiki i ke kauka ke hana i kahi kaʻina hana i kapa ʻia he ostomy . ʻO kēia ʻoki ʻana:

• Hoʻokumu ʻia kahi lua liʻiliʻi, i kapa ʻia he stoma, i loko o ka ʻōpū o ke pēpē.
• Ua pili ka ʻōpū nui i kēia stoma.
• A laila haʻalele ke ʻōpala i ke kino ma o kēia stoma, i loko o kahi ʻeke ma waho o ke kino.

Ke ikaika iki aʻe ka pēpē, hoʻopili hou ke kauka i nā ʻōpū a waiho iā lākou i loko o ka ʻōpū.

I kekahi manawa, inā liʻiliʻi loa ke pēpē (ʻoi aku ke kaumaha ma mua o 1 paona) a maʻi loa paha e hana ʻia ke ʻoki kino, hiki i ke kauka ke kau i kahi ʻōmole liʻiliʻi ( drain/catheter ) i loko o ka ʻōpū. Hoʻohana ʻia kēia ʻōmole e hoʻokahe i nā wai ʻino a me ka ea mai ka ʻōpū a hōʻemi i nā hōʻailona. Ma hope mai, i ka wā e ʻoi iki aʻe ai ka pēpē a ʻoi aku ka maikaʻi, hiki ke hana ʻia ke ʻoki kino.

Hiki ke pale ʻia ka NEC?

Inā ʻoe e pilikia ana i ka loaʻa ʻana o kahi pēpē hānau mua ʻole, hiki i kāu kauka ke hāʻawi iā ʻoe i kahi inikini o kahi corticosteroid . Hana kēia lāʻau lapaʻau e hoʻomaikaʻi i ke olakino o ka pēpē i loko o ka ʻōpū. Hiki iā ia ke hōʻemi i ka pilikia o nā pilikia me nā māmā a me nā ʻōpū o ka pēpē.

Eia kekahi, ua ʻike ʻia ka hānai ʻana i ka waiū e hōʻemi i ka pilikia o NEC. Manaʻo kekahi mau noiʻi e hiki nō hoʻi i ka hoʻohui ʻana i nā probiotics , a i ʻole nā ​​bacteria maikaʻi, i ka waiū umauma a i ʻole ka waiū waiū.

He aha ka mea e hiki mai ana i ka pēpē inā ulu ʻo NEC? (Outlook)

Ma ke ʻano maʻamau, 8 o 10 mau pēpē i loaʻa iā NEC e ola. Eia nō naʻe, hiki i kekahi o kēia mau pēpē ke loaʻa i nā pilikia olakino lōʻihi ma muli o NEC.

He mea nui: Ke ʻike ʻia kāu pēpē hānau mua ʻana ua maikaʻi a loaʻa koke kahi pilikia e like me NEC, hiki iā ʻoe ke kaumaha a hopohopo nui. He mea maʻamau kēia. Ua aʻo ʻia nā kauka a me nā kahu maʻi ma ka NICU e ʻike i kēia mau pilikia a hana koke. Hoʻōla kekahi mau pēpē me ka mālama liʻiliʻi. ʻOiai me ke ʻoki ʻana, hoʻōla ka nui o nā pēpē a ola i nā ola maʻamau. Eia nō naʻe, loaʻa paha i kekahi mau pēpē nā pilikia hoʻoheheʻe mau.

Nā mea e nīnau aku ai i kāu kauka/kauka

Inā loaʻa i kāu pēpē ka NEC, he mea maikaʻi e nīnau i kāu kauka e pili ana i nā mea e like me:

• No ke aha i loaʻa ai i kaʻu pēpē ka NEC?
• He aha ke ʻano o ka NEC a kaʻu pēpē?
• He aha ka lāʻau lapaʻau maikaʻi loa no kaʻu pēpē?
• He aha nā pilikia o ka mālama ʻana?
• He aha nā hopena lōʻihi o NEC?
• Pono anei iaʻu e hāʻawi i kaʻu pēpē i kahi meaʻai kūikawā?
• He aha nā pilikia e pono iaʻu e makaʻala ai i ka wā e lawe mai ai au i kaʻu pēpē i ka home?

ʻO ka mea hope loa, ʻo ka mea nui loa

He maʻi koʻikoʻi loa ʻo NEC, ʻoiai inā pili ia i kā mākou poʻe liʻiliʻi. Akā e hoʻomanaʻo, ua holomua loa ka ʻepekema lapaʻau i kēia lā. Hana nui nā kauka, nā kahu maʻi, a me nā limahana ma ka NICU (Neonatal Intensive Care Unit) e hoʻopakele i kēia mau pēpē.

He mea maikaʻi ia hiki i nā mea maʻalahi e like me ka hānai waiū ke hōʻemi i kēia pilikia. Inā loaʻa i kāu pēpē kēia maʻi, mai hopohopo, a e hahai i nā ʻōlelo aʻo a kāu kauka . E kamaʻilio pono me lākou a nīnau iā lākou i nā nīnau a pau āu e loaʻa ai. Ke makemake nei iā ʻoe e ho'ōla koke!

ʻO ka enterocolitis necrotizing, NEC, nā pēpē hānau mua, ka maʻi ʻōpū, ke olakino o ka pēpē, NICU, ʻōnaehana hoʻoheheʻe