Ngaba wakha wakhathazeka kancinci okanye wakhathazeka malunga nokuphefumla komntwana wakho emva kokuba ezelwe? Ngamanye amaxesha, iintsana ezisandul’ ukuzalwa zinokuba neengxaki ezinkulu zokuphefumla. Namhlanje siza kuthetha ngesinye sezifo ezinzulu kangaka, kodwa kubalulekile ukuba siqaphele. Oku ngokwezonyango kubizwa ngokuba yi-Persistent Pulmonary Hypertension of the Newborn, okanye i-PPHN ngamafutshane.
Kalula nje, yintoni i-PPHN?
Ukuze sikuqonde oku, kufuneka siqale siqonde umahluko kwindlela umntwana aphefumla ngayo esesibelekweni sikanina nasemva kokuzalwa.
Cinga ngale nto, xa umntwana wakho esesiswini sakho, ufumana ioksijini ayifunayo kuwe ngentambo yosana. Ngelo xesha, imiphunga yomntwana ayisebenzi. Ngenxa yoko, imithambo yegazi eya emiphungeni (esiyibiza ngokuba yimithambo yemiphunga) idla ngokuba lukhuni kwaye ivalekile. Igazi lidla ngokudlula imiphunga liye emzimbeni wonke.
Kodwa utshintsho olukhulu kufuneka lwenzeke kwangoko nje ukuba umntwana abelekwe aze aphefumle okokuqala . Njengoko imiphunga yomntwana izaliswe ngumoya, loo mithambo yegazi eyayixinzelelekile ngaphambili kufuneka ivuleke. Kulapho ke kuphela apho igazi linokuthi liye emiphungeni, lithathe ioksijini, lize lithwale elo gazi lizele yioksijini liye emzimbeni wonke, ingakumbi ingqondo, intliziyo, kunye nezintso.
Kwimeko ebizwa ngokuba yi-PPHN, akwenzeki loo nto. Nasemva kokuba umntwana ezelwe, imithambo yegazi emiphungeni yakhe ayivuli kakuhle. Ihlala iqinile. Emva koko, ngenxa yokuba igazi linganeli ukuya emiphungeni, amalungu omntwana awafumani ioksijini ayidingayo.
I-PPHN yingxaki yezonyango enzulu kakhulu, esongela ubomi enokwenzeka kusana olusandul’ ukuzalwa. Idla ngokuvela emva nje kokuzalwa.
Ixhaphake kangakanani le meko?
Esi asiyongxaki ixhaphakileyo. Malunga nesibini (2) kwi-1,000 yokuzalwa okuphilayo sisengozini yokuhlaselwa yi-PPHN. Sixhaphake kakhulu kwiintsana ezizelwe ngexesha lokuzala (phakathi kweeveki ezingama-37 nezingama-42) nakwiintsana ezizelwe emva kweeveki ezingama-42. Nangona kunjalo, akunakwenzeka ukuba kwenzeke kwiintsana ezizelwe ngaphambi kwexesha.
Zithini iimpawu ze-PPHN?
Kubaluleke kakhulu ukuzazi ezi mpawu, kuba ukuba uzibona, kufuneka ufune iingcebiso zonyango ngokukhawuleza.
| Uphawu | Ingcaciso elula |
|---|---|
| Ubunzima bokuphefumla | Izinto ezifana nokuphefumla ngokukhawuleza okanye kancinci, isandi sokuphefumla xa uphefumla, kunye nokutsala isifuba. |
| Ukunyuka kwesantya sentliziyo | Intliziyo ebetha kakhulu ngendlela engaqhelekanga kumntwana. |
| Ukutshintsha kombala wesikhumba oluhlaza okwesibhakabhaka/ongwevu (iCyanosis) | Xa i-oksijini inganele egazini, ulusu lomntwana, ingakumbi imilebe, ulwimi, kunye neminwe yakhe, lunokuba luhlaza okwesibhakabhaka okanye lube ngwevu. |
| Uxinzelelo lwegazi oluphantsi (iHypotension) | Uxinzelelo lwegazi lomntwana luphantsi ngendlela engaqhelekanga. |
| Ukuncipha kwamanqanaba eoksijini egazini | Inqanaba le-oksijini egazini lomntwana liphantsi kakhulu xa lilinganiswa ngezixhobo zonyango. |
| Izandi zentliziyo ezingaqhelekanga (iHeart Murmur) | Ukuva isandi esingaqhelekanga okanye esingaqhelekanga esivela entliziyweni xa ugqirha esihlola nge-stethoscope. |
Zithini izizathu kunye nezinto ezibangela umngcipheko we-PPHN?
Abaphandi abakafumani sizathu sithile soku , kodwa kukholelwa ukuba le meko isenokuba ibangelwa yimithambo yegazi emiphungeni yomntwana engakhuli kakuhle, okanye kukungakwazi komntwana ukuziqhelanisa (ukuvuleka) nehlabathi langaphandle emva kokuzalwa.
Nangona unobangela ochanekileyo ungaziwa, izinto ezithile zinokunyusa umngcipheko wokufumana i-PPHN.
| Into enobungozi | Kwenzeka ntoni ngale nto? |
|---|---|
| Ukuphefumlelwa kweMeconium | Indle etyebileyo neluhlaza okwesibhakabhaka (i-meconium), eyindle yokuqala yomntwana, ingangena emiphungeni yomntwana. Oku kungonakalisa imiphunga kwaye kubangele i-PPHN. |
| Iintsholongwane | Izifo ezinzulu ezifana nezifo zemiphunga ezifana ne-pneumonia okanye ukutyhefwa kwegazi. |
| Isifo Soxinzelelo Lokuphefumla (RDS) | Ubunzima bokuphefumla budla ngokuvela kwiintsana ezizelwe ngaphambi kwexesha kuba imiphunga yazo ayikakhuli ngokupheleleyo. |
| Ukuphelelwa yi-Asphyxia yokuzalwa | Ukungabikho kooksijini engqondweni nasemzimbeni ngaphambi okanye ngexesha lokuzalwa. |
| I-Hernia ye-Diaphragmatic | Umngxuma kwi-diaphragm (umsipha owahlula isifuba nesisu) uvumela amalungu asesiswini ukuba aphume esifubeni. Oku kuphazamisa uphuhliso lwemiphunga. |
| Ezinye iziphene zokuzalwa | Ezinye iingxaki ezifana nokukhubazeka kwemiphunga yokuzalwa okanye ukuvaleka kwevalvu yentliziyo. |
| Amanye amayeza athathwayo ngexesha lokukhulelwa | Ezinye ii-painkillers (NSAIDs) kunye nezinye ii-antidepressants (SSRIs) ezithathwa kwisiqingatha sokugqibela sokukhulelwa zinokuchaphazela oku. |
Ngaba i-PPHN ingabangela iziphumo zexesha elide?
Ewe. Le yimeko enzima, njengoko inokubangela iziphumo ezihlala ixesha elide ngenxa yokunqongophala kweoksijini engqondweni nakwamanye amalungu omzimba. Malunga ne-1 kwi-4 (25%) yeentsana ezisinda kwi-PPHN ziya kuba nokukhubazeka okuthile.
Bazi:
- Ukulibaziseka kophuhliso
- Ukungakwazi ukuva okanye ukungeva
- Ubunzima bokufunda
- Ukunciphisa amandla okwenza imisebenzi yomzimba
Ifunyaniswa njani i-PPHN?
Ukuba oogqirha bacinga ukuba umntwana unale meko, baya kwenza iimvavanyo ezininzi ukuqinisekisa ukuba unesifo.
| Uvavanyo | Ubona ntoni kule nto? |
|---|---|
| Inani elipheleleyo legazi (i-CBC) | Ukulinganisa inani leeseli ezimhlophe zegazi, iiseli ezibomvu zegazi, kunye neeplatelets egazini. Oku kunokunceda ekuqinisekiseni ukuba kukho usulelo na. |
| I-Pulse Oximetry (i-Pulse Ox) | Isixhobo esincinci sincamathiselwa emnweni okanye emlenzeni womntwana kwaye sihlala silinganisa inqanaba leoksijini egazini. |
| Igesi Yegazi Eyi-Arterial (ABG) | Thatha isampuli yegazi uze ulinganise ngokuchanekileyo amanqanaba ayo eoksijini kunye nekhabhoni dayokhsayidi. |
| I-X-reyi yesifuba | Ukujonga ukuba intliziyo ikhulu na okanye kukho naziphi na ezinye iingxaki zemiphunga. |
| I-Echocardiogram (I-Echo) | Olu luvavanyo lwentliziyo. Kubalulekile ukuvavanya ukuhamba kwegazi ukuya entliziyweni nasemiphungeni nokuqinisekisa imeko ye-PPHN. |
| I-Head Ultrasound (i-head scan) | Ukujonga ukuba akukho gazi engqondweni ngenxa yokunqongophala kweoksijini engqondweni. |
Iphathwa njani i-PPHN?
Injongo ephambili yonyango lwe-PPHN kukunyusa ubungakanani beoksijini efikelela kumalungu omzimba omntwana . Oku kunokunceda ekuthinteleni iingxaki ezinkulu. Iindlela ezahlukeneyo zonyango zisetyenziselwa oku.
| Indlela yonyango | Kwenzeka ntoni ngale nto? |
|---|---|
| Ukubonelela ngeoksijini | Ukunika umntwana i-oxygen eyi-100% ngetyhubhu encinci enamathele empumlweni, imaski, okanye isiciko se-oxygen. |
| Umoya woomatshini | Kufakwa ityhubhu kumbhobho womoya womntwana kwaye kusetyenziswa isixhobo somoya ukuphefumla umntwana. |
| Amayeza okulawula uxinzelelo lwegazi | Ukunika amayeza okubuyisela uxinzelelo lwegazi nge-saline (IV). |
| I-Nitric Oxide | Le yigesi. Ukukhupha le gesi ngomatshini wokuphefumla kunceda ukwandisa imithambo yegazi emiphungeni. |
| I-ECMO (i-Oxygenation ye-Extracorporeal Membrane) | Olu lunyango oluntsonkothileyo kakhulu olusetyenziswa njengesisombululo sokugqibela. Ukuba intliziyo nemiphunga yomntwana ayisebenzi, umatshini we-ECMO uthatha igazi emzimbeni, wongeze ioksijini kuwo, uze ulibuyisele emzimbeni. Kufana nentliziyo nemiphunga yangaphandle. |
Kuthatha ixesha elingakanani ukuba umntwana aphile?
Uninzi lweemeko ze-PPHN ziyaphela kwiveki okanye ezimbini, kodwa ezinye iintsana zingathatha iinyanga ukuba ziphile ngokupheleleyo. Ngeli xesha, kubalulekile ukukhusela umntwana wakho kwiingqele, umkhuhlane, kunye nezinye izifo ezibangelwa yintsholongwane.
- Hlamba izandla zakho kakuhle.
- Kuphephe ukusa umntwana kwiindawo ezinabantu abaninzi.
- Gcina umntwana kude nabantu abagulayo.
- Wonke umntu ekhaya kufuneka afumane ugonyo lomkhuhlane lonyaka.
Kwakhona, kubalulekile ukuya kwiikliniki ngemihla emiselweyo ukuze ubone ukuba ukukhula nophuhliso lomntwana kuqhelekile na.
Ndifanele ndimbone nini ugqirha?
Emva kokuba umntwana wakho ebuyile esibhedlele, kufuneka ulumke kakhulu. Ukuba ubona naziphi na kwezi mpawu zilandelayo, funa uncedo lwezonyango ngokukhawuleza. Yisa umntwana wakho kwiSebe leNgxamiseko (ETU) lesibhedlele esikufutshane.
- Ukuba umntwana unomkhuhlane.
- Ukuba awuseli ubisi olwaneleyo.
- Ukuba isifuba sakho sitsalwa ngaphakathi xa uphefumla okanye ukuba uphefumla uvulekile impumlo yakho.
- Ukuba uva isandi sokukhala okanye sokuncwina xa uphefumla.
- Ukuba ulusu lomntwana luqala ukuba luhlaza okwesibhakabhaka okanye ngwevu kwakhona.
Xa ufumanisa ukuba umntwana wakho une-PPHN, unokuziva uneemvakalelo ezininzi, ezinje ngosizi, uloyiko, umsindo, kunye nokudideka. Oku kuqhelekile. Eyona nto ingcono onokuyenza kukufunda okuninzi kangangoko unako malunga nale meko koogqirha kunye nabongikazi abanyanga umntwana wakho. Oku kuya kukunceda uyiqonde ngcono imeko. Ekuhambeni kwexesha, uya kuba yingcali yakho kwimeko yomntwana wakho. Uya kuziva uqinisekile ukuba wenza konke okusemandleni akho kumntwana wakho.
Umyalezo Wokuya Ekhaya
- I-PPHN yingxaki yokuphefumla enzima, kodwa enyangekayo, kwiintsana ezisandul’ ukuzalwa.
- Le yingxamiseko yezonyango efuna ukulaliswa esibhedlele ngokukhawuleza kunye nonyango.
- Hlala ujonge iimpawu ezilumkisayo ezifana nokuba ulusu lomntwana wakho luba luhlaza okwesibhakabhaka kwaye luphefumla ngokukhawuleza.
- Injongo ephambili yonyango kukubonelela ngeoksijini eyaneleyo engqondweni yomntwana nakwezinye izitho zomzimba.
- Kwanasemva kokuba umntwana ephilile, kubaluleke kakhulu ukuhlala unxibelelana rhoqo nogqirha ukuze kujongwe uphuhliso lwakhe olude.
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