Ingaba ingqondo yomntwana wakho ayinayo ioksijini? Masifunde nge-HIE eyingozi (Hypoxic-Ischemic Encephalopathy)!

Amazwi awanakuchaza uvuyo oluvayo xa ubona umntu omtsha kusapho lwakho. Kodwa ngamanye amaxesha, ngokungalindelekanga, aba bantwana banokuba neengxaki zempilo. Namhlanje, siza kuthetha ngemeko enokuchaphazela iintsana ezisandul’ ukuzalwa, enzulu kancinci, kodwa ekufuneka sonke siyiqaphele. Leyo yi-HIE, okanye i-hypoxic-ischemic encephalopathy.

Yintoni i-HIE (Hypoxic-Ischemic Encephalopathy)? Masiyiqonde kakuhle.

Ngamafutshane, i-HIE (Hypoxic-Ischemic Encephalopathy) kukwenzakala kwengqondo okubangelwa kukungabikho kweoksijini kunye nokunikezelwa kwegazi engqondweni. Cinga nje, njengalo lonke ilungu emzimbeni wethu, ingqondo nayo ifuna ioksijini kunye nezondlo ukuze isebenze. Ezi zithunyelwa engqondweni ngegazi. Ukuba olu kunikezelwa luphazamisekile nangayiphi na indlela, iiseli zengqondo ziqala ukonakala. Yile nto i-HIE iyiyo.

Le meko idla ngokuchaphazela iintsana ezisandul’ ukuzalwa , ingakumbi ukuba kukho iingxaki ngexesha lokubeleka. Nangona kunjalo, ngamanye amaxesha abantwana abadala kunye nabantu abadala banokuba ne-HIE ukuba kukho ingxaki enkulu yokuphefumla, njengokutshona .

Eyona nto ibalulekileyo kukuba i-HIE yimeko embi kakhulu, enokuba yingozi ebomini . Ngoko ke ukuba ucinga ukuba umntwana wakho uneempawu ze-HIE, kufuneka ufune ingcebiso kagqirha ngoko nangoko.

Usenokuba ukhe weva ugqirha wakho esebenzisa amanye amagama kule meko ye-HIE. Umzekelo:

• Ukuphelelwa ngamandla kokuzalwa
• I-encephalopathy yeentsana ezisandul' ukuzalwa
• I-hypoxia yokukhulelwa ngexesha lokukhulelwa

Nokuba ubiza liphi igama oku, imeko iyafana.

Ngaba kukho iintlobo ezahlukeneyo ze-HIE? Uvavanya njani ubunzulu bemeko?

Ewe, oogqirha bahlulahlula i-HIE ngokwesimo somntwana. Ezi zahlulwe ngokubanzi zibe ziindidi ezintathu : ezithambileyo, eziphakathi, nezinzima . Olu hlu lunokumisela indlela inkqubo yemithambo-luvo yomntwana eza kuchaphazeleka ngayo.

Kodwa khumbula, nokuba i-HIE incinci, yingxamiseko yezonyango . Kuba unyango olukhawulezileyo lubalulekile ukuthintela iingxaki ezisongela ubomi. Ugqirha uya kukwazi ukukunika ingcaciso engcono ngemeko yomntwana wakho. Emva koko ungenza isigqibo kwaye uqhubeke phambili.

Ixhaphake kangakanani le meko?

Ngokwezibalo, i-HIE ichaphazela phakathi kosana olunye nolunye kwi-1,000 nganye ezelweyo . Kwanakwilizwe elifana ne-United States, malunga ne-9,000 ukuya kwi-12,000 yeentsana ezisandul’ ukuzalwa zijongana nale meko minyaka le. Nangona kunzima ukufumana izibalo ezichanekileyo eSri Lanka, le ayisiyongxaki inokungahoywa.

Zithini iimpawu ze-HIE? Kuthekani ngosana olusandul' ukuzalwa?

Ukuba umntwana osandul’ ukuzalwa une-HIE encinci okanye ephakathi, unokufumana iimpawu ezifana nezi:

• Umzimba ubuthathaka kwaye awunabomi (`hypotonia`) okanye uqinile kwaye uxinezelekile (`hypertonia`) .
• Ubunzima bokusela ubisi.
• Ndisoloko ndibonisa isimo sengqondo sokudinwa.
• Ukuhlala ukhala ngaphandle kwesizathu, ukungazinzi.
• Ukulila ngokubuthathaka.
• Umbala okhanyayo, oluhlaza okwesibhakabhaka, okanye ongwevu (`cyanosis`) kulusu, kwiminwe, nakwimilebe.

Ukuba i-HIE inzima, iimpawu ziba nzima ngakumbi:

• Akukho mpendulo phantse nokuba uyichukumisa okanye wenza isandi.
• I-reflexes ebuthathaka kakhulu.
• Iindlela zokuphefumla ezingaqhelekanga (umz., ukuphefumla ngokukhawuleza, ukuphefumla kancinci).
• Ukubetha kwentliziyo okungaqhelekanga okanye okucothayo kakhulu.
• Ukuxhuzula .
• Ukulahlekelwa yingqondo.

Kubalulekile: Ukuba umntwana wakho ubonakalisa naziphi na kwezi mpawu, mse esibhedlele esikufutshane okanye utsalele umnxeba ku-911 ngoko nangoko . Nokuba i-HIE ibonakala incinci, yingxamiseko. Unyango olukhawulezileyo yeyona nto ibalulekileyo.

Zithini izizathu ze-HIE?

Eyona nto ibangela i-HIE kukunqongophala kweoksijini kunye nokunikezelwa kwegazi engqondweni. Zininzi iindlela ezinokwenzeka ngayo oku.

I-HIE inokwenzeka ngexesha lophuhliso losana olusesibelekweni ngenxa yezi zinto zilandelayo:

• Uphuhliso okanye ukusebenza okungaqhelekanga kwentliziyo okanye imiphunga yosana olusandul’ ukuzalwa.
• Umama unesifo (esifana ne-toxoplasmosis okanye i-CMV).
• Ukunyuka okanye ukwehla kakhulu koxinzelelo lwegazi kumama okhulelweyo.
• Ukwehla kwamanqanaba eoksijini egazini lomama okhulelweyo.

Ukuba kukho naziphi na iingxaki ngexesha lokukhulelwa okanye lokubeleka, umntwana usemngciphekweni omkhulu wokufumana i-HIE. Umzekelo:

• Intambo yomntwana, ephuma kwisini ngaphambi kokuba umntwana azalwe (`intambo yomntwana`).
• Ukucinezelwa kwentambo yomlomo okanye ukuyeka ukuhamba kwegazi kuyo.
• Ukuqhawuka kwe-placenta.
• Ukuqhambuka kwesibeleko.
• I-Placenta previa (egubungela umlomo wesibeleko).

Izizathu ze-HIE (ubunzima bokuphefumla) kubantwana abadala nakubantu abadala:

• Ukuphazamiseka kwesingqisho sentliziyo (`Arrhythmia`).
• Ukufuthanisela (umz. ukurhaxwa, ukukrwitshwa - `ukufuthanisela`).
• Ukugqithisa amayeza okanye amayeza.
• Ityhefu (umz. ityhefu yemercury).
• Ndingena kwingxaki.

Ngubani osengozini enkulu ye-HIE?

Usana olusandul’ ukuzalwa lunokuba semngciphekweni omkhulu we-HIE ukuba:

• Ukuzalwa unobunzima obuphantsi .
• Ungcoliseko lolwelo lwelungu lobufazi.
• Ukukhula okulibazisekileyo komntwana ongekazalwa (ingakumbi uphuhliso olungaphelelanga kwamanye amalungu omzimba, njengemiphunga).

Umama okhulelweyo usengozini enkulu yokufumana iingxaki ngexesha lokubeleka, eneemeko ezifana nezi:

• Uxinzelelo lwegazi oluphezulu ngexesha lokukhulelwa (`Preeclampsia`).
• Isifo seswekile sokukhulelwa.
• Umsebenzi ohlala ixesha elide.
• Ukusetyenziswa kweziyobisi.

Ziziphi iingxaki ezinokubakho ze-HIE? Ngaba ezi ziyingozi?

I-HIE yimeko embi kakhulu, mhlawumbi ide ibulale. Ukongeza, umonakalo osisigxina engqondweni unokukhokelela kwiingxaki ezahlukeneyo zexesha elide. Ezinye zazo zezi:

• Ukulibaziseka kokukhula : Ukulibaziseka kwizinto ezifana nokuthetha nokuhamba.
• Iingxaki zokukhula.
• Ukuphazamiseka kokuva okanye ukubona.
• Iingxaki zomsebenzi wokuqonda, ukukhubazeka kwengqondo .
• Ubunzima bokugxila.
• Isifo sokuwa .
• Umvakalelo yokitazo .
• Usulelo oluqhelekileyo.

Uninzi lwezi ngxaki azibonakali kwangoko. Zisenokubonakala kuphela xa umntwana wakho eqala isikolo. Ukuba umntwana wakho akafikeleli kwimigangatho yophuhliso ngokobudala bakhe, okanye unengxaki yokufunda eklasini, bonana nogqirha ngoko nangoko.

Oogqirha bayixilonga njani ngokuchanekileyo i-HIE?

Ngenxa yokuba i-HIE yimeko engxamisekileyo yezonyango, oogqirha bayaziqaphela iimpawu zale meko ngaphambi nasemva kokuba umntwana ezelwe. Oku kukuqinisekisa ukuba ingqondo yomntwana ifumana ioksijini negazi elaneleyo. Ukuba kukho ubunzima ngexesha lokubeleka, oogqirha bakulungele ukunyanga le meko ngaphambi kokuba umntwana afunyaniswe ngokusemthethweni.

Ukuze axilonge i-HIE, ugqirha uya kwenza uvavanyo olupheleleyo lomzimba. Baza kukhangela iimpawu baze bacele iimvavanyo ezininzi ukuqinisekisa ukuxilongwa.

Kwi-HIE kwiintsana ezisandul’ ukuzalwa, olu vavanyo lunokwenziwa ngaphambi nasemva kokuba umntwana ezelwe:

• Ukujonga intliziyo yomntwana ongekazalwa.
• Uvavanyo lwegazi lwe-placental.
• Uvavanyo lwempilo yosana olusandul' ukuzalwa ( `Apgar score` ).
• Ukuvavanya amanqanaba egazi negesi kwi-umbilical cord.
• Uvavanyo lokufota olufana ne -'Ultrasound' okanye i-'MRI' (iMagnetic Resonance Imaging) .
• Uvavanyo lwe-EEG (i-Electroencephalogram) (ukulinganisa umsebenzi wombane wengqondo).

Uvavanyo lwegazi olongezelelweyo lunceda oogqirha baqonde indlela i-HIE echaphazela ngayo amanye amalungu omzimba omntwana.

Zithini iindlela zonyango lwe-HIE? (Unyango)

Oogqirha banyanga i-HIE ngeendlela ezilandelayo:

• Ukupholisa umzimba womntwana (i-hypothermia enyangwayo) uze uwubuyisele kubushushu obuqhelekileyo kunokunceda ukuthintela umonakalo ongakumbi engqondweni.
• Ngelixa umntwana esesibhedlele , i-EEG isetyenziselwa ukujonga ukuba umntwana akaxhuzuli na, kwaye kunikwa amayeza okuthintela ukuxhuzula.
• Ukuphucula ukuhamba kwegazi kunye neoksijini ukuya engqondweni,Unyango oluxhasayo lwesizathu esiyintloko (umz., ukubonelela ngeoksijini eyongezelelweyo ngemaski yobuso okanye i-canal cannula).

Ukuba kuvela iingxaki njengoko umntwana ekhula, uncedo olongezelelweyo lunokufuneka. Oku kuquka:

• Unyango lomzimba okanye unyango lomsebenzi.
• Unyango lokuthetha.
• Iinkqubo zemfundo yabantwana abancinci.
• Izixhobo zokuncedisa ezifana neeglasi okanye izixhobo zokuva.

Ngaba kukho iziphumo ebezingalindelekanga ezivela kunyango?

Amayeza okuxhuzula anokuba nemiphumo emibi. Oku kuyahluka ngokuxhomekeke kuhlobo lwamayeza anikwayo. Ngaphambi kokuba uqale unyango, thetha nogqirha womntwana wakho malunga nale miphumo emibi kunye neempawu ekufuneka uziqaphele. ``Therapeutic hypothermia`` (unyango lokupholisa umzimba) lunokubangela nemiphumo emibi, efana neeplatelets ezisezantsi zegazi.

Kuza kuthatha ixesha elingakanani ukuba umntwana aphile emva konyango?

Iintsana ezineempawu ezingephi kwaye ezingenamonakalo engqondweni zihlala ziphila ngokupheleleyo kwiiveki ezimbini. Nangona kunjalo, ukuba imeko inzima, iingxaki zobomi bonke zinokubakho, ezifuna unyango lwexesha elide.

Ukuba umntwana wam une-HIE, ndimele ndilindele ntoni? Injani imbono yakhe?

Ubunzima bemeko ye-HIE bumisela ikamva lomntwana. Uphando lubonisa ukuba phakathi kwama-20% nama-50% eentsana ezine-HIE ziyafa . Kwakhona, phakathi kwama-25% nama-60% ziba neengxaki zemithambo-luvo okanye ukukhubazeka kokufunda ixesha elide, njenge-cerebral palsy okanye i-epilepsy .

Nangona kunjalo, kwezinye iimeko, i-HIE inokunyangeka ngokupheleleyo. Okukhona i-HIE inyangwa ngokukhawuleza kwaye umonakalo wobuchopho uthintelwa, kokukhona iziphumo ziba ngcono. Nangona kunjalo, kufuneka siqonde ukuba ayingomntwana ngamnye oya kuphila ngokupheleleyo.

Ukuba i-HIE inzima, ixesha lokuphila komntwana linokuncitshiswa. Usana olunomonakalo omkhulu engqondweni lunokusweleka lusengumntwana okanye lusengumntwana. I-HIE ethambileyo ayidli ngokuyichaphazela ixesha lokuphila. I-HIE ephakathi isenokuchaphazela okanye ingachaphazeli ixesha lokuphila. Uninzi lweentsana ezine-HIE ethambileyo nephakathi zinexesha lokuphila eliqhelekileyo. Kukho unyango oluxhasayo oluya kunciphisa iziphumo ezisongela ubomi.

Ngaba zikho iindlela zokuthintela i-HIE?

Ngelishwa, i-HIE ayinakuthintelwa rhoqo.

Nangona kunjalo, unganciphisa umngcipheko wakho wokuba ne-HIE ngokufumana uhlolo rhoqo ngexesha lokukhulelwa . Ugqirha wakho uza kukunika iingcebiso malunga nendlela yokuhlala ukhuselekile kwaye ugcine impilo yakho intle. Nangona kunjalo, nokuba usempilweni kangakanani ngexesha lokukhulelwa, i-HIE isenokwenzeka.

Kwakhona, ukulawula ukusetyenziswa kweziyobisi kubaluleke kakhulu ukuthintela iingxaki ezinokuchaphazela wena nomntwana wakho.

Kubantwana abadala kunye nabantu abadala, unokunceda ekuthinteleni i-HIE ngokuthatha amanyathelo okhuseleko ngaphambi kokuba wenze imisebenzi enokuba yingozi. Umzekelo, ukuba uya kudada, kukubhukuda kuphela apho kukho umlindi wobomi okunokunceda ekuthinteleni ukurhaxwa.

Ndifanele ndibonane nogqirha nini?

Ukuba umntwana wakho akafikeleli kwinqanaba lokukhula elihambelana nobudala bakhe, okanye ukuba ubonisa iimpawu zeengxaki njengoko ekhula, bona ugqirha womntwana wakho. Ukuba umntwana wakho unengxaki yokuncancisa, bona ugqirha.

Ufanele uye nini kwiYunithi yoNyango oluNgxamisekileyo (i-ETU) ?

Ukuba wena, umntwana wakho, okanye umntu omaziyo unezi mpawu ze-HIE, fowunela u-911 ngoko nangoko uze uye kwigumbi likaxakeka elikufutshane:

• Ubunzima bokuphefumla.
• Ukuxhuzula.
• Ukuba ulusu lubonakala lumhlophe, luluhlaza okwesibhakabhaka, okanye lungwevu.
• Ukulahlekelwa yingqondo (ukutyhafa).

Ndingayibuza yiphi imibuzo ugqirha?

Ungabuza ugqirha wakho imibuzo efana nale:

• Ibaluleke kangakanani i-HIE?
• Ingaba ingqondo yomntwana wam yonakele?
• Zeziphi iingxaki ekufuneka ndiziqaphele?
• Ngaba kukho naziphi na iziphumo ebezingalindelekanga zonyango?
• Umntwana wam uza kukwazi nini ukuphuma esibhedlele?
• Ndifanele ndize nini emva koko ukuze ndijonge impilo yomntwana wam?

Ekugqibeleni, umyalezo omncinci oya ekhaya kubazali

Ndiyayiqonda indlela umama okanye utata avakalelwa ngayo luloyiko nokukhathazeka xa efumanisa ukuba usana olusandul’ ukuzalwa lune-HIE (Hypoxic-Ischemic Encephalopathy). Ungaziva ungenakunceda njengoko iqela lezonyango lisebenza nzima imini yonke ukuqinisekisa ukuba ingqondo yomntwana ifumana ioksijini negazi elaneleyo.

Ngeli xesha, ugqirha wakho uza kukugcina unolwazi ngemeko yomntwana wakho . Bakho ukuphendula nayiphi na imibuzo onokuba nayo. Kwakhona, zingqonge neqela elinamandla lenkxaso, njengosapho lwakho kunye nabahlobo, ukukunceda kule meko inzima. Ukuba kuyimfuneko, ukuthetha nomcebisi wezempilo yengqondo nako kunokuba luncedo olukhulu. Khumbula ukuba awuwedwa.

I- Hypoxic-ischemic encephalopathy, i-HIE, ukuncipha kweoksijini engqondweni, ukuncipha kokunikezelwa kwegazi engqondweni, iintsana ezisandul' ukuzalwa, ukuphelelwa ngamandla kokuzalwa, umonakalo wobuchopho, ukulibaziseka kokukhula