Ingaba umntwana wakho unale ngxaki imbi yamathumbu? (Necrotizing Enterocolitis - NEC) Masithethe ngale nto!

Owu, ngamanye amaxesha xa kuzalwa iintsana ezincinci, ziba neengxaki ezahlukeneyo zempilo, akunjalo? Ingakumbi iintsana ezizalwa zisezikhundleni eziphantsi kokukhulelwa. Namhlanje siza kuthetha ngesifo samathumbu esinzulu esinokuphuhliswa ziintsana ezinjalo. Oku kubizwa ngokuba yi-necrotizing enterocolitis, okanye i-NEC ngamafutshane. Musa ukoyika xa usiva eli gama, masiliqonde ngokulula.

Yintoni le enterocolitis ebulala iintsholongwane (NEC)?

Ngamafutshane, i-NEC (Necrotizing Enterocolitis) sisifo samathumbu esibi esichaphazela amathumbu eentsana, ingakumbi abantwana abasandula kuzalwa . Kule meko, izicubu zamathumbu ziyadumba zize ziqale ukufa. Cinga ngayo njengenxeba elibangela ukuba izicubu ziwohloke ngaphakathi emathunjini.

Oku kunokuba yingozi kuba ngamanye amaxesha umngxuma (ukugqobhoka) unokwenziwa emathunjini. Ukuba oku kuyenzeka, iintsholongwane , ezifana neebhaktheriya, zinokuphuma ngomngxuma, ziye esiswini okanye ziye egazini. Oku kudla ngokuvela phakathi kweeveki ezimbini ukuya kwezintandathu emva kokuba umntwana ezelwe.

Kwabanye abantwana, i-NEC yimeko ebuthathaka enokuba yingozi ebomini. Kwabanye abantwana, inokuba yingozi kwaye ibeke ubomi esichengeni . Siyibiza ngokuthi "nek-ruh-tiz-ing n-ter-o-ko-ly-tis."

Yintoni amathumbu?

Amathumbu amancinci kunye namathumbu amakhulu zizinto ezimbini ezibalulekileyo kwinkqubo yethu yokugaya ukutya . Zisinceda ekugayeni ukutya esikutyayo, zifunxe izondlo, kwaye zisuse inkunkuma. Ezi nkunkuma ekugqibeleni zikhutshwa njengendle.

Ngubani onokuthi abe ne-NEC? Ixhaphake kangakanani?

Enyanisweni, iintsana ezili-9 kwezili-10 eziphuhlisa i-NEC zizalwa ngaphambi kwexesha . Oko kukuthi, iintsana ezizalwa ngaphambi kweeveki ezingama-37 zokukhulelwa. Ngokukodwa:

• Kubantwana abazelwe ngaphambi kweeveki ezingama-37 ( iintsana ezizelwe ngaphambi kwexesha ).
• Isondlo se-Enteral sinikwa iintsana ngetyhubhu efakwe esiswini. Oku kwenziwa kuba ezinye iintsana zinobunzima bokuthatha ubisi ngomlomo.
• Kwiintsana ezinobunzima obungaphantsi kweekhilogram ezi-5 1/2 xa zizalwa.

I-NEC sisifo esixhaphakileyo samathumbu phakathi kweentsana ezizelwe ngaphambi kwexesha. Xa sithetha nje, sichaphazela malunga ne-1 kwi-1000 leentsana ezizelwe ngaphambi kwexesha. Umngcipheko uphezulu kakhulu kwiintsana ezinobunzima obungaphantsi kweekhilogram ezimbini xa zizalwa.

Nangona kunjalo, iintsana ezizelwe ixesha elizeleyo zinqabile kakhulu ukuba zibe ne-NEC. Malunga nenye kuphela kwiintsana ezili-10,000 eziza kuba ne-NEC.

Ngaba kukho iintlobo ezahlukeneyo ze-NEC?

Ewe, oogqirha bahlulahlula i-NEC ngokwexesha lokuqalisa kweempawu kunye nesizathu sesifo. Kukho iintlobo ezininzi eziphambili:

• I-NEC yakudala:Olu lolona hlobo luxhaphakileyo. Ludla ngokuchaphazela abantwana abazelwe ngaphambi kweeveki ezingama-28 zokukhulelwa. Luvela phakathi kweeveki ezintathu ukuya kwezintandathu emva kokuzalwa. Ngokuqhelekileyo, le meko yenzeka ngequbuliso, ngaphandle kwesilumkiso , xa umntwana ephilile kwaye ezinzile.
• I-NEC enxulumene notofelo-gazi: Ezinye iintsana zifuna utofelo-gazi kuba zine -anemia , ukungabikho kweeseli ezibomvu zegazi. Malunga ne-1 kwiintsana ezi-3 ezizelwe ngaphambi kwexesha ziba ne-NEC kwiintsuku ezintathu emva kotofelo-gazi.
• I-NEC engaqhelekanga: Kunqabile kakhulu, i-NEC inokukhula kwiveki yokuqala yobomi okanye nangaphambi kokuba umntwana ancanciswe okokuqala.
• I-NEC kwiintsana ezisandul’ ukuzalwa: Xa umntwana ezalwa ngexesha lokuzala, idla ngokubangelwa sisiphene sokuzalwa . Umzekelo, imeko yentliziyo yokuzalwa , i-gastroschisis , okanye amanqanaba aphantsi eoksijini ekuzalweni.

Ngamanye amaxesha, i-NEC inokusasazeka kwiiyunithi zokhathalelo oluphezulu lweentsana (ii-NICU) . Kulapho iintsana ezininzi zifumana i-NEC ngaxeshanye. Iibhaktheriya ezifana ne -E. coli okanye ezinye iintsholongwane zinokubangela oku kusasazeka. Kodwa oku kunqabile kakhulu.

Kutheni le NEC isenzeka? Zithini izizathu?

Oogqirha abakayazi kakuhle into ebangela i-NEC, kodwa siyazi ukuba iintsana ezizelwe ngaphambi kwexesha zinenkqubo yomzimba yokuzikhusela ebuthathaka. Inkqubo yomzimba yokuzikhusela yiyo elwa nezifo.

Kwakhona, iinkqubo zokwetyisa zezi ntsana zibuthathaka kakhulu kwaye azikakhuli ngokupheleleyo. Ngoko ke, ukuba umntwana ozelwe ngaphambi kwexesha ufumana usulelo lwamathumbu, kunzima ukuba amasosha omzimba akhe kunye nenkqubo yokwetyisa balwe nalo.

Enye into kukuba iintsana ezizelwe ngaphambi kwexesha zinokuba nokuhamba kwegazi okuncinci okuthutha ioksijini ukuya emathunjini azo. Oku kuncipha kokuhamba kwegazi kunokonakalisa izicubu zamathumbu. Lo monakalo uvumela iintsholongwane ukuba ziphume emathunjini zingene kwisisu okanye egazini.

Zithini iimpawu ze-NEC?

I-NEC idla ngokubonakala phakathi kweeveki ezimbini ukuya kwezintandathu emva kokuzalwa. Ingahluka ngokuxhomekeke kuhlobo kunye nesizathu semeko. Iimpawu zinokuvela kancinci kancinci kwiintsuku ezimbalwa, okanye zinokuvela ngequbuliso kumntwana osempilweni.

Ngenxa yokuba i-NEC yingxaki eqhelekileyo phakathi kweentsana ezikwi -NICU (iYunithi yoKhathalelo oluNzulu lweZifo eziSandulelayo) , oogqirha kunye nabongikazi apho bahlala beyazi le nto.

Iimpawu eziphambili ze-NEC zezi:

• Intlungu yesisu kunye nokudumba.
• Isantya sentliziyo, uxinzelelo lwegazi, utshintsho kubushushu bomzimba kunye nendlela yokuphefumla.
• Urhudo olunendle enegazi .
• Ukuhlanza okuluhlaza okanye okumthubi.
• Usana luyozela kwaye alunabomi ( ukudinwa ).
• Ukwala ukusela ubisi kunye nokungatyebi.

Ufumanisa njani ukuba unayo i-NEC?

Ugqirha onyanga umntwana wakho uza kumhlola umntwana wakho aze ajonge ukuba akukho nakuphi na ukudumba okanye ezinye iimpawu ze-NEC.

Ukongeza, kunokwenzeka ukwenza iimvavanyo ezifana nezi:

• Uvavanyo lwegazi: Jonga igazi ukuze ubone ukuba kukho iintsholongwane okanye ezinye iimpawu zosulelo.
• Uvavanyo lwendle: Jonga indle yomntwana wakho ukuba ayinagazi na. Ngamanye amaxesha kunokubakho igazi kwindle esingaliboniyo, kwaye olu vavanyo lunokuyifumanisa.
• Ii-X-reyi: Kuthathwa i-X-reyi yesisu ukuze kukhangelwe amaqamza egesi ajikeleze amathumbu okanye kwisisu. La maqamza egesi abonisa ukuba amathumbu onakele okanye anomngxuma.

Ziziphi iingxaki ezinokubakho ze-NEC?

Usana olune-NEC nalo lusengozini yezinye iingxaki. Ezinye zezi ngxaki ziquka:

• Usulelo lwesisu: Abanye abantwana bakhula umngxuma eludongeni lwamathumbu abo. Lo mngxuma unokuvumela iintsholongwane ukuba zingene kwisisu. Oku kunokubangela usulelo olunzima olubizwa ngokuba yi-peritonitis . Le peritonitis yonyusa umngcipheko wokuba ne -sepsis , usulelo lwegazi olusongela ubomi.
• Ukuqina kwamathumbu: Malunga nomntwana omnye kwabathathu abane-NEC uya kukhula ukuncitshiswa kwamathumbu kamva ebomini. Oku kudla ngokukwenzeka kwiinyanga ezimbalwa emva kokuba umntwana ephilile kwi-NEC. Xa amathumbu encitshiswa, kuba nzima ukuba ukutya nokusela kudlule. Abanye abantwana banokufuna utyando ukuze kwandiswe amathumbu ancitshisiweyo.
• Isifo samathumbu amafutshane (SBS): Le meko inokwenzeka ukuba inxalenye yamathumbu amancinci yonakele okanye yonakele ngenxa ye-NEC. Oku kubangela ukuba umzimba ungakwazi ukufunxa ulwelo kunye nezondlo ngokufanelekileyo ( malabsorption ). Abantwana abane-SBS badinga ukhathalelo olukhethekileyo ukuqinisekisa ukuba bafumana isondlo esifanelekileyo ubomi babo bonke. Abanye abantwana banokufuna ukondliwa ngetyhubhu ( enteral feedings ).
• Ukungaphumeleli kokukhula kunye nokulibaziseka kokukhula: Ezi ziingxaki ezibalulekileyo zexesha elide. Lo mngcipheko uphezulu kakhulu kwiintsana eziye zenziwa utyando. Iziphumo zokukhula kunye nophuhliso lwemithambo-luvo lwazo kufuneka zijongwe rhoqo.

Iphathwa njani i-NEC?

Amathumbu omntwana kufuneka aphumle aze aphile. Ngoko ke into yokuqala ekufuneka yenziwe xa unyanga i-NEC kukuyeka ukondla ngetyhubhu okanye ngomlomo. Endaweni yoko, umntwana unikwa izondlo kunye nolwelo aludingayo ngemithambo yegazi (IV) , okufana netyuwa emithanjeni.

Ukongeza, umntwana angafumana unyango olufana nolu:

• Umbhobho weNasogastric: Ugqirha ufaka umbhobho omde, obhityileyo ngempumlo (ngamanye amaxesha ngomlomo) esiswini ukuze akhuphe umoya ogqithisileyo kunye nolwelo oluphuma esiswini.
• Ii-antibiotics: Ezi zinceda ekulweni nosulelo lweentsholongwane.

Malunga nosana olunye kwabane luza kufuna utyando lokususa iindawo ezifileyo zamathumbu nokulungisa nayiphi na imingxunya. Ugqirha unokwenza inkqubo ebizwa ngokuba yi-ostomy . Olu tyando:

• Kuvela umngxuma omncinci, obizwa ngokuba yi-stoma, esiswini somntwana.
• Amathumbu amakhulu adibene nale stoma.
• Emva koko indle iphuma emzimbeni ngale stoma, iye kwisingxobo esingaphandle komzimba.

Xa umntwana esomelele kancinci, ugqirha uya kuphinda afake amathumbu aze awafake esiswini.

Ngamanye amaxesha, ukuba umntwana mncinci kakhulu (unobunzima obungaphantsi kwe-1 pound) okanye ugula kakhulu ukuba angatyandwa, ugqirha unokubeka ityhubhu encinci ( i-drain/catheter ) esiswini. Le tyhubhu isetyenziselwa ukukhupha ulwelo olunobungozi nomoya osulelekileyo esiswini nokunciphisa iimpawu. Kamva, xa umntwana ekhulile kancinci kwaye engcono, utyando lunokwenziwa.

Ngaba i-NEC ingathintelwa?

Ukuba usemngciphekweni wokuba nomntwana ngaphambi kwexesha, ugqirha wakho angakunika inaliti ye -corticosteroid . Eli yeza lisebenza ukuphucula impilo yomntwana osesiswini. Linganciphisa umngcipheko weengxaki zemiphunga namathumbu omntwana.

Ukongeza, ukuncancisa kufunyenwe kunciphisa umngcipheko we-NEC. Ezinye izifundo zibonisa ukuba ukongeza iiprobiotics , okanye iibhaktheriya eziluncedo, kubisi lwebele okanye kwifomyula nako kunokunceda.

Kuza kwenzeka ntoni kumntwana ukuba i-NEC iphuhliswa? (Imbono)

Xa sithetha nje, iintsana ezisi-8 kwezili-10 eziphuhliswa yi-NEC ziyasinda. Nangona kunjalo, ezinye zezi ntsana zinokuba neengxaki zempilo zexesha elide ngenxa ye-NEC.

Kubalulekile: Xa umntwana wakho ozelwe ngaphambi kwexesha ebonakala ephilile aze ngequbuliso abe nengxaki efana ne-NEC, ungaziva ulusizi kwaye ukhathazekile. Oku kuqhelekile. Oogqirha kunye nabongikazi kwi-NICU baqeqeshwe ukuba baqaphele ezi ngxaki baze benze ngokukhawuleza. Abanye abantwana bayaphila ngaphandle konyango oluncinci. Nokuba sele betyandiwe, uninzi lweentsana luyaphila kwaye luphila ubomi obuqhelekileyo. Nangona kunjalo, ezinye iintsana zinokuba neengxaki zokugaya ukutya eziqhubekayo.

Izinto onokuzibuza ugqirha/ugqirha wakho

Ukuba umntwana wakho une-NEC, kungcono ukubuza ugqirha wakho ngezinto ezifana nezi:

• Kutheni umntwana wam efumene i-NEC?
• Luhlobo luni lwe-NEC olunalo umntwana wam?
• Yeyiphi indlela engcono yonyango kumntwana wam?
• Zithini iingxaki zonyango?
• Zithini iziphumo ze-NEC zexesha elide?
• Ngaba kufuneka ndinike umntwana wam ukutya okukhethekileyo?
• Zeziphi iingxaki ekufuneka ndiziqaphele xa ndizisa umntwana wam ekhaya?

Okokugqibela, eyona nto ibalulekileyo

I-NEC yimeko enzima kakhulu, ingakumbi xa ichaphazela abantwana bethu abancinci. Kodwa khumbula, isayensi yezonyango iphucuke kakhulu namhlanje. Oogqirha, abahlengikazi, kunye nabasebenzi kwi -NICU (iYunithi yoKhathalelo oluNzulu lweZinsana) basebenza nzima kakhulu ukusindisa aba bantwana.

Kulungile ukuba nezinto ezilula ezifana nokuncancisa zinokunciphisa lo mngcipheko. Ukuba umntwana wakho unesi sifo, ungoyiki, kwaye landela icebiso likagqirha wakho . Thetha naye ngononophelo kwaye umbuze yonke imibuzo onayo. Ndikunqwenelela ukuchacha ngokukhawuleza!

I- necrotizing enterocolitis, i-NEC, iintsana ezingekafiki ixesha, usulelo lwamathumbu, impilo yomntwana, i-NICU, inkqubo yokwetyisa