Ngatidzidzei nezveNecrotizing Enterocolitis (NEC), chirwere chakakomba chemudumbu chinowanzoonekwa muvana vacheche vasati vasvika nguva.

Mwana wako akazvarwa nguva isati yakwana here? Tinoziva kuti amai kana baba vanogona kutyisa uye kunetseka sei kana vaine mwana nguva isati yakwana. Kunyanya kana mwana ari muNICU ( Neonatal Intensive Care Unit), kunzwa ikoko kunowedzera. Kana chiremba akangoerekana auya okuudza kuti mwana wako ane dambudziko guru remudumbu, chirwere chinonzi NEC (Necrotizing Enterocolitis), zvakaoma kutaura kuti zvinonzwa sei. Nhasi tiri kutaura nezvechirwere ichi chinonzi NEC, icho vanaamai navanababa vazhinji vanotya, asi chakakosha kuziva nezvacho.

Zvichitaurwa zviri nyore, chii chinonzi NEC iyi?

Necrotizing Enterocolitis (NEC) chirwere chakakomba chekugaya chikafu chinonyanya kubata vana vacheche vasati vasvika nguva. Panyaya iyi, nyama dzemudumbu dzemwana dzinokuvara, dzinozvimba, uye dzinotanga kufa. Izwi rekuti "necrotizing" rinoreva "kufa kwenyama." "Enterocolitis" zvinoreva kuzvimba kwemudumbu.

Funga nezvazvo, ura hwedu hausi chubhu chete. Inhengo yakaoma yakagadzirwa nenyama mhenyu inobatsira kugaya chikafu uye kupinza zvinovaka muviri. MuNEC, madziro eura uhwu anoshaya simba, anokuvara, uye dzimwe nguva anotoboborwa . Kana buri rakadaro rikaitika, utachiona, hwakadai semabhakitiriya, huri mukati meura hunogona kupinda mudumbu remwana kana muropa. Ichi chirwere chine njodzi zvikuru.

NEC inowanzo itika pakati pemavhiki maviri nematanhatu mushure mekuzvarwa. Mune vamwe vacheche, inenge iri nyore uye inova nani. Mune vamwe, inogona kuva yakanyanya uye inogona kuisa hupenyu panjodzi.

Ndiani ari panjodzi huru yekuva nechirwere ichi?

Pavana gumi vanotanga NEC, 9 vanozvarwa nguva isati yakwana . Kashoma kuti vana vanozvarwa panguva yakakwana vabatwe nayo. Vanotevera ndivo vari panjodzi huru:

• Vana vanozvarwa vasati vasvika mavhiki makumi matatu nemanomwe epamuviri: Njodzi yacho yakanyanya kukura kuvana vanozvarwa vasati vasvika mavhiki makumi matatu nemaviri.
• Vana vanoberekwa vaine huremu hwakaderera: Vana vanorema pasi pe2.5 kg (5.5 pounds) pakuzvarwa ndivo vari panjodzi huru. Vana vanorema pasi pe1 kg (2.2 pounds) ndivo vari panjodzi huru.
• Kune vacheche vanodyiswa kuburikidza nechubhu (kudya kwemukati): Nekuti vana vacheche vasati vasvika nguva yekuyamwa vane mukana mudiki wekusveta, mukaka unopihwa kuburikidza nechubhu inopinzwa nemhino mudumbu.
• Kune vacheche vaiva nematambudziko pakuzvarwa: Semuenzaniso, vacheche vaiva nematambudziko akadai sekutadza kufema zvakanaka kana chirwere chemwoyo.

Anenge mumwe chete pavana 1,000 vakaberekwa nguva isati yakwana anowana NEC. Zvisinei, chirwere ichi chinoitika muvana 10,000 vakaberekwa nguva yakazara. Saka zvine musoro kutaura kuti ichi chirwere chinowanzoonekwa nevana vakaberekwa nguva isati yakwana.

Ndeapi marudzi makuru eNECs?

Vanachiremba vanopatsanura chirwere ichi mumhando dzakasiyana-siyana, zvichienderana nenguva inotanga zviratidzo uye chikonzero chechirwere chacho.

Dzimwe nguva, pave nemishumo yekuti vana vakawanda vanotanga NEC panguva imwe chete muNICU ( Neonatal Intensive Care Unit). Muzviitiko zvakadaro, chikonzero chingave hutachiona hwebhakitiriya hwakaita seE. Coli.

Sei NEC iyi ichiitika? Chii chinokonzera?

Kutaura zvazviri, vanachiremba havasati vawana chikonzero chimwe chete cheNEC. Vanotenda kuti izvi zvinokonzerwa nezvinhu zvakawanda.

Pfungwa huru ndeidzi:

1. Matumbu asati akura: Matumbu emwana asati akura haasati akura zvakakwana. Ane hunyoro uye haana simba. Saka, anonetseka nekugaya chikafu.

2. Kusasimba kwedziviriro yemuviri: Dziviriro yemuviri inorwisa zvirwere zvevana vacheche vasati vasvika nguva yakakwana haisati yakura zvakakwana. Nokudaro, kunyangwe hutachiona hudiki muura hunogona kuoma kuti muviri urwise.

3. Kuderera kweropa rinoyerera muura: Nzira yeropa yevana vacheche vasati vasvika nguva yekutanga inotungamira pakutumira ropa kunhengo dzinokosha dzakadai seuropi nemoyo. Munguva dzekushushikana (semuenzaniso, kushomeka kweokisijeni), muviri unoderedza huwandu hweropa rinoyerera muura. Kana ropa richiyerera zvishoma, nyama dziri muura hadzigamuchire okisijeni yadzinoda. Nekuda kweizvozvo, nyama idzodzo dzinokuvara dzotanga kufa.

Kana zvinhu izvi zvikabatana, madziro emudumbu anoshaya simba, zvichiita kuti mabhakitiriya akure ipapo, zvichikonzera kuzvimba uye zvichikonzera NEC.

Ndezvipi zviratidzo zveNEC?

Vanachiremba nevanamukoti vanogara vachitarisa mwana ari muNICU. Saka, kunyangwe vakaona chiratidzo chidiki cheNEC, vanoita chimwe chinhu nekukurumidza. Semubereki, zvakakosha kuti uzive nezvezviratidzo izvi.

Zviratidzo zvinogona kuoneka zvishoma nezvishoma kwemazuva akati wandei, kana kuti zvinogona kuoneka kamwe kamwe mumwana anenge apora.

• Kuzvimba nekurwadziwa mudumbu: Dumbu remwana rinonzwa rakaoma kana rabatwa, mwana anochema kana akaiswa pariri, uye dumbu rinoita serakaguta.
• Kuramba kunwa mukaka: Mwana anga achinwa mukaka zvakanaka anongoerekana aramba kunwa mukaka, zvichisiya zvasara mudumbu.
• Kurutsa: Kurutsa, kunyanya girini kana yero, kunogona kuva chiratidzo chekuvharika kwedumbu.
• Kuchinja kwekufamba kwetsvina: Kuchinja kwekufamba kwetsvina, tsvina yakaita semanyoka, uye ropa riri mutsvina .
• Kuchinja kwehutano hwese:
• Kurova kwemoyo wemwana kunoderera kana kuwedzera.
• Mwero wekufema unochinja, dzimwe nguva unomira kufema kwechinguva (apnea).
• Kuderera kweropa.
• Tembiricha yemuviri haigone kuchengetwa.
• Mwana wacho aneta zvikuru uye anoita seasina hupenyu.

Kana chimwe chezviratidzo izvi chikaonekwa, vashandi veNICU vachabva vaongorora.

Vanachiremba vanozviwana sei izvi?

Chinhu chekutanga chichaita chiremba wemwana wako ndechekunyatsoongorora mwana wako. Vachaongorora kana akazvimba uye akapfava. Vachaitawo bvunzo shoma kuti vasimbise chirwere chacho.

• X-ray yedumbu:Iyi ndiyo bvunzo inonyanya kukosha. Inogona kutarisa maburi egasi mukati memadziro emudumbu. Izvi zvinonzi `pneumatosis intestinalis`. Zvakare, kana ura hwakaboorwa, unogona kuona mweya wakasununguka mukati medumbu.
• Kuongororwa kweropa: Izvi zvinoongorora hutachiona (mabhakitiriya) muropa, huwandu hushoma hwemasero machena eropa, uye matambudziko ekugwamba kweropa.
• Kuongororwa kwetsvina: Kuongororwa uku kunobatsira kuona ropa riri mutsvina risingaonekwe neziso.

Ndezvipi zvinetso zvinogona kuitika nekuda kweNEC?

Nekuti NEC chirwere chakakomba, matambudziko anogona kuitika mushure mayo.

• Peritonitis: Kana paine buri muura, mabhakitiriya anogona kupinda mudumbu okonzera hutachiona hwakakomba (peritonitis). Izvi zvinogona kutungamira kuchirwere chinotyisidzira hupenyu chinonzi sepsis , umo mabhakitiriya anopararira mumuviri wese.
• Kuoma kweMatumbu: Mushure mekunge NEC yapora, chikamu cheura chakakuvara chinogona kuva nemavanga uye kutetepa pachiri kupora. Izvi zvinoita kuti zviome kudya. Izvi zvingada kuvhiyiwa pane imwe nguva.
• Chirwere cheMatumbu Mapfupi: Kana chikamu chikuru chemudumbu chikafa nekuda kweNEC uye chichifanira kubviswa nekuvhiyiwa, chikamu chasara chemudumbu hachina kukwana kuti chiwane zvinovaka muviri zvakanaka. Chirwere ichi chinonzi chirwere chematumbu mapfupi (short gut) . Vacheche vane chirwere ichi vachada kutarisirwa zvakanyanya pakudya kwemuviri wavo wese.
• Kunonoka Kukura Nekukura: Vacheche vakambobatwa neNEC, kunyanya avo vakavhiyiwa, vanogona kusangana nekunonoka kukura nekukura kwehuropi gare gare muhupenyu hwavo. Nokudaro, zvakakosha zvikuru kuchengetedza vana ava pasi pekutarisirwa nachiremba nguva dzose.

Inorapwa sei?

Kana NEC yangofungidzirwa, vanachiremba vanotanga kurapwa. Chinangwa chikuru ndechekupa ura zororo rakakwana .

1. Kurega kuyamwisa: Chinhu chekutanga chekuita kurega zvachose kuyamwisa mwana nemuromo kana nechubhu. Izvi zvinopa zororo mumatumbu uye zvinotanga kupora.

2. Kudya Kwemwana Nemudumbu: Zvese zvinovaka muviri nemvura zvinodiwa nemwana zvinopihwa kuburikidza nesaline (IV fluids) zvakananga mutsinga.

3. Kuiswa kwechubhu yeNasogastric: Chubhu (chubhu yenasogastric) inopinzwa nemhino mudumbu, ichiburitsa mweya nemvura zvinenge zvaungana mudumbu. Izvi zvinoderedza kuzvimba mudumbu uye zvinoderedza kumanikidzwa kwedumbu.

4. Mishonga inorwisa mabhakitiriya: Kurwisa hutachiona uye kudzivirira kupararira kwehutachiona, mishonga inorwisa mabhakitiriya yakasimba inopihwa netsinga.

5. Kugara uchitarisa:Mwana anotariswa zvakanyanya. Kuongororwa kweropa uye X-ray zvinoitwa nguva nenguva kuti vaone kana mamiriro acho ari kuvandudzika kana kuti ari kuipa.

Kuvhiyiwa kunodiwa rini?

Mwana mumwe chete pavana vana angada kuvhiyiwa. Kuvhiyiwa kunoitwa kuti:

• Kana pakaboorwa muura.
• Kana mamiriro emwana asingavandudzike nekurapwa nemishonga.

Panguva yekuvhiyiwa, chiremba anobvisa chikamu chakafa cheura obatanidzazve zvikamu zviviri zvine hutano zveura. Dzimwe nguva, kana ura hwakazvimba zvakanyanya, zvinonetsa kuhubatanidzazve nekukasika. Muzviitiko zvakadaro, kuvhiyiwa kunonzi ostomy kunoitwa.

Kana mwana ari mudiki zvakanyanya kana kuti achirwara zvakanyanya zvekuti haakwanise kuvhiyiwa, chiremba anogona kuisa chubhu diki (drain) mudumbu kuti abudise mvura nemhepo zvine utachiona zvakaungana mudumbu. Izvi zvinoderedza zviratidzo. Gare gare, kana mwana akura zvishoma uye ava neutano hwakanaka, kuvhiyiwa kuchaitwa.

Remangwana remwana ane NEC nderei?

Kunyange hazvo NEC iri chirwere chinotyisa, chinorapika. Vana vasere pavana gumi vane NEC vanorarama. Kunyange hazvo vamwe vevana ava vangava nematambudziko ehutano kwenguva refu, vazhinji vavo vanorarama hupenyu hwakajairika, hwakazara.

Pane nzira dzekudzivirira izvi here?

Kunyangwe zvisingagone kudzivirirwa zvachose, pane zvinhu zvakati wandei zvaunogona kuita kuderedza njodzi yeNEC.

• Kudzivirira kusununguka nguva isati yakwana: Zvakanaka kuchengeta mwana mudumbu kwenguva yakareba sezvinobvira. Kuti uite izvi, tevera mazano akakodzera echiremba panguva yekuzvitakura.
• Majekiseni eCorticosteroid: Vanachiremba vanopa vanaamai vari panjodzi yekusununguka nguva isati yakwana jekiseni rinonzi corticosteroid. Izvi zvinobatsira kuti mapapu neura hwemwana zvikure.
• Kuyamwisa: Kuyamwisa ndiyo nzira yakanakisisa yekudzivirira mwana asati azvarwa. Mukaka wezamu une simba rinoshamisa rekuderedza njodzi yeNEC. Zvinhu zvinosimudzira immune system zviri mumukaka wezamu zvinodzivirira ura hwemwana.
• Mapurobiotic: Dzimwe ongororo dzakaratidza kuti kuwedzera mapurobiotic (mabhakitiriya akanaka) mumukaka wemuzamu kana mufomura yemukaka kunogona kuderedza njodzi yeNEC. Zvisinei, unofanira kutaura nachiremba wemwana wako usati waita izvi.

Zvinogona kushamisa vabereki kana paine dambudziko rakaita sereNEC mwana wavo ari muNICU. Asi yeukai, vanachiremba nevanamukoti muNICU vakadzidziswa kuziva nekurapa zvirwere izvi nekukurumidza. Vimbai navo. Taurai navo nezvemibvunzo kana zvinokunetsai.