Ingabe ingane yakho inale nkinga enkulu yamathumbu? (Necrotizing Enterocolitis - NEC) Ake sixoxe ngalokhu!

O, ngezinye izikhathi lapho kuzalwa izingane ezincane, ziba nezinkinga zempilo ezahlukahlukene, akunjalo? Ikakhulukazi izingane ezizalwa zisencane kakhulu ekukhulelweni. Namuhla sizokhuluma ngesifo samathumbu esibi esingaba naso leso zingane. Lokhu kubizwa ngokuthi i-necrotizing enterocolitis, noma i-NEC ngamafuphi. Ungesabi uma uzwa leli gama, masiliqonde kalula.

Iyini le nhlobo ye-necrotizing enterocolitis (NEC)?

Kalula nje, i-NEC (Necrotizing Enterocolitis) yisifo samathumbu esibi esithinta amathumbu ezinsana, ikakhulukazi izingane ezizalwa ngaphambi kwesikhathi . Kulesi simo, izicubu zamathumbu ziyavuvukala bese ziqala ukufa. Cabanga ngakho njengesilonda esibangela ukuba izicubu ziwohloke ngaphakathi kwamathumbu.

Lokhu kungaba yingozi ngoba ngezinye izikhathi imbobo (ukubhoboka) ingakheka emathunjini. Uma lokhu kwenzeka, amagciwane , njengebhaktheriya, angaphuma ngembobo, aye esiswini noma egazini. Lokhu kuvame ukwenzeka phakathi kwamasonto amabili kuya kwayisithupha ngemva kokuzalwa komntwana.

Kwabanye abantwana, i-NEC yisimo esithambile esingasongela impilo. Kwabanye abantwana, ingaba nzima futhi isongela impilo . Siyibiza ngokuthi "nek-ruh-tiz-ing n-ter-o-ko-ly-tis."

Iyini ithumbu?

Amathumbu amancane namathumbu amakhulu yizingxenye ezimbili ezibaluleke kakhulu zesimiso sethu sokugaya ukudla . Asisiza ukugaya ukudla esikudlayo, amunce izakhamzimba, futhi asuse imfucuza. Le mfucuza ekugcineni ikhishwa njengendle.

Ubani okungenzeka kakhulu ukuthi athole i-NEC? Kuvamile kangakanani lokhu?

Eqinisweni, izingane ezingu-9 kwezingu-10 ezithola i-NEC zizalwa ngaphambi kwesikhathi . Okusho ukuthi, izingane ezizalwa ngaphambi kwamasonto angu-37 okukhulelwa. Ngokuqondile:

• Kwabantwana abazalwa ngaphambi kwamasonto angu-37 ( izingane ezizalwa ngaphambi kwesikhathi ).
• Kubantwana abanceliswa ngepayipi elifakwa esiswini sabo ( ukudla okunomsoco ). Lokhu kwenziwa ngoba abanye abantwana banenkinga yokuthatha ubisi ngomlomo.
• Kubantwana abanesisindo esingaphansi kwamakhilogremu angu-5 1/2 ngesikhathi bezalwa.

I-NEC iyisifo samathumbu esivamile phakathi kwezingane ezizalwa ngaphambi kwesikhathi. Uma sikhuluma nje, sithinta cishe ingane eyodwa kweziyi-1,000 ezizalwa ngaphambi kwesikhathi. Ingozi iphezulu kakhulu ezinganeni ezinesisindo esingaphansi kwamakhilogremu amabili lapho zizalwa.

Kodwa-ke, izinsana zesikhathi esigcwele azivamile ukuba ne-NEC. Cishe eyodwa kuphela kwezingu-10,000 ezizoba ne-NEC.

Ingabe kunezinhlobo ezahlukene zama-NEC?

Yebo, odokotela bahlukanisa i-NEC ngokusekelwe esikhathini sokuqala kwezimpawu kanye nembangela yesifo. Kunezinhlobo eziningana eziyinhloko:

• I-NEC yakudala:Lolu uhlobo oluvame kakhulu. Luvame ukuthinta izingane ezizalwe ngaphambi kwamasonto angama-28 okukhulelwa. Luvela phakathi kwamasonto amathathu kuya kwayisithupha ngemva kokuzalwa. Ngokuvamile, lesi simo senzeka ngokuzumayo, ngaphandle kwesixwayiso , lapho umntwana ephilile futhi ezinzile.
• I-NEC ehlobene nokumpontshelwa igazi: Ezinye izingane zidinga ukumpontshelwa igazi ngoba zine -anemia , ukuntuleka kwamaseli abomvu egazi. Cishe ingane eyodwa kwezingu-3 ezizalwa ngaphambi kwesikhathi iba ne-NEC zingakapheli izinsuku ezintathu ngemva kokumpontshelwa igazi.
• I-NEC engavamile: Akuvamile kakhulu, i-NEC ingakhula phakathi nesonto lokuqala lokuphila noma ngisho nangaphambi kokuba ingane inceliswe okokuqala.
• I-NEC ezinsaneni ezizalwa ngesikhathi sokubeletha: Uma umntwana ezalwa ngesikhathi sokubeletha, kuvame ukubangelwa ukukhubazeka kokuzalwa . Isibonelo, isimo senhliziyo esizalwa naso , i-gastroschisis , noma amazinga aphansi omoya-mpilo lapho ezalwa.

Ngezinye izikhathi, i-NEC ingasakazeka emayunithi okunakekelwa okujulile kwezingane ezisanda kuzalwa (ama-NICU) . Yilapho izingane eziningana zithola i-NEC ngesikhathi esisodwa. Amabhaktheriya afana ne -E. coli noma amanye amagciwane angabangela lokhu kusakazeka. Kodwa lokhu futhi akuvamile kakhulu.

Kungani le NEC yenzeka? Ziyini izimbangela?

Odokotela abakakazi kahle ukuthi yini ebangela i-NEC, kodwa siyazi ukuthi izingane ezizalwa ngaphambi kwesikhathi zinesimiso somzimba esibuthakathaka. Isimiso somzimba yisona esilwa nezifo.

Futhi, izinhlelo zokugaya ukudla zalezi zinsana zibuthakathaka kakhulu futhi azikakhuli ngokugcwele. Ngakho-ke, uma ingane ezelwe ngaphambi kwesikhathi ithola ukutheleleka kwamathumbu, kunzima ukuthi amasosha omzimba ayo kanye nohlelo lokugaya ukudla lulwe nakho.

Enye into ukuthi izingane ezizalwa ngaphambi kwesikhathi zingase zibe nokugeleza kwegazi okuncane okuthwalwa umoya-mpilo emathunjini azo. Lokhu kwehla kokugeleza kwegazi kungalimaza izicubu zamathumbu. Lo monakalo uvumela amabhaktheriya ukuba aphume emathunjini angene emgodini wesisu noma egazini.

Ziyini izimpawu ze-NEC?

I-NEC ivame ukuvela phakathi kwamasonto amabili kuya kwayisithupha ngemva kokuzalwa. Ingahluka kuye ngohlobo kanye nembangela yalesi simo. Izimpawu zingakhula kancane kancane ezinsukwini eziningana, noma zingavela ngokuzumayo enganeni ephilile.

Ngenxa yokuthi i-NEC iyinkinga evamile phakathi kwezinsana ezise -NICU (i-Neonatal Intensive Care Unit) , odokotela nabahlengikazi lapho bahlala beqaphela lokhu.

Izimpawu eziyinhloko ze-NEC yilezi:

• Ubuhlungu besisu nokuvuvukala.
• Isilinganiso senhliziyo, umfutho wegazi, izinguquko ekushiseni komzimba kanye nendlela yokuphefumula.
• Uhudo oluhambisana nendle enegazi .
• Ukuhlanza okuluhlaza noma okuphuzi.
• Ingane iyozela futhi ayinampilo ( ukudinwa ).
• Ukwenqaba ukuphuza ubisi kanye nokungakhuli kahle.

Uthola kanjani ukuthi une-NEC?

Udokotela owelapha ingane yakho uzohlola ingane yakho futhi ahlole noma yikuphi ukuvuvukala noma ezinye izimpawu ze-NEC.

Ngaphezu kwalokho, kungenzeka ukwenza izivivinyo ezifana nalezi:

• Ukuhlolwa kwegazi: Hlola igazi ukuze ubone ukuthi alinawo yini amagciwane noma ezinye izimpawu zokutheleleka.
• Ukuhlolwa kwendle: Hlola indle yengane yakho ukuthi ayinalo igazi. Ngezinye izikhathi kungase kube negazi esindle esingaliboni, futhi lokhu kuhlolwa kungayithola.
• Ama-X-ray: Kuthathwa i-X-ray yesisu ukuze kubhekwe amabhamuza egesi azungeze amathumbu noma emgodini wesisu. Lawa mabhamuza egesi abonisa ukuthi amathumbu onakele noma anembobo.

Yiziphi izinkinga ezingaba khona ze-NEC?

Ingane ene-NEC nayo isengozini yezinye izinkinga. Ezinye zalezi zinkinga zifaka:

• Ukutheleleka kwesisu: Ezinye izingane ziba nembobo odongeni lwamathumbu azo. Lo mbobo ungavumela amagciwane ukuthi angene emgodini wesisu. Lokhu kungabangela ukutheleleka okukhulu okubizwa ngokuthi i-peritonitis . Lo mbobo ukhulisa ingozi yokuthola i-sepsis , ukutheleleka kwegazi okusongela impilo.
• Ukuqina kwamathumbu: Cishe ingane eyodwa kwezingu-3 ezine-NEC izoncipha amathumbu kamuva ekuphileni. Lokhu kuvame ukwenzeka ezinyangeni ezimbalwa ngemva kokuba ingane isilulame ku-NEC. Lapho amathumbu encipha, kuba nzima ukuthi ukudla nokuphuza kudlule. Ezinye izingane zingadinga ukuhlinzwa ukuze kwandiswe amathumbu anciphile.
• Isifo samathumbu amafushane (SBS): Lesi simo singase senzeke uma ingxenye yamathumbu amancane yonakele noma yonakele ngenxa ye-NEC. Lokhu kuholela ekutheni umzimba ungakwazi ukumunca uketshezi nezakhamzimba ngendlela efanele ( ukungamuncwa kahle ). Izingane ezine-SBS zidinga ukunakekelwa okukhethekile ukuqinisekisa ukuthi zithola ukudla okunempilo impilo yazo yonke. Ezinye izingane zingadinga ukuphakelwa ngepayipi ( ukuphakelwa kwamathumbu ).
• Ukwehluleka kokukhula kanye nokubambezeleka kokukhula: Lezi yizinkinga ezibalulekile zesikhathi eside. Le ngozi iphezulu kakhulu ezinganeni eziye zahlinzwa. Imiphumela yokukhula kanye nokuthuthukiswa kwezinzwa zezingane ezinjalo kufanele ihlolwe njalo.

Iphathwa kanjani i-NEC?

Amathumbu engane adinga ukuphumula nokuphola. Ngakho into yokuqala okufanele uyenze lapho welapha i-NEC ukuyeka ukuncelisa ngepayipi noma ngomlomo. Esikhundleni salokho, ingane inikezwa izakhamzimba noketshezi oluyidingayo nge-intravenous (IV) , okufana nosawoti ofakwa emithanjeni.

Ngaphezu kwalokho, umntwana angathola ukwelashwa okufana nalokhu:

• Ipayipi le-Nasogastric: Udokotela ufaka ipayipi elide, elincane ngekhala (ngezinye izikhathi ngomlomo) esiswini ukuze akhiphe umoya ongaphezulu kanye noketshezi esiswini.
• Ama-antibiotic: Lawa asiza ekulweni nokutheleleka ngamagciwane.

Cishe ingane eyodwa kwezine izodinga ukuhlinzwa ukuze kususwe izingxenye zamathumbu ezifile futhi kulungiswe noma yiziphi izimbobo. Udokotela angenza nenqubo ebizwa ngokuthi i-ostomy . Lokhu kuhlinzwa:

• Kudalwa imbobo encane, ebizwa ngokuthi i-stoma, esiswini somntwana.
• Amathumbu amakhulu axhumene nalesi stoma.
• Bese indle iphuma emzimbeni ngale stoma, iye esikhwameni esingaphandle komzimba.

Uma umntwana eqina kancane, udokotela uxhumanisa amathumbu futhi awafake esiswini.

Ngezinye izikhathi, uma ingane incane kakhulu (inesisindo esingaphansi kwekhilogremu elilodwa) noma igula kakhulu ukuba ingahlinzwa, udokotela angase afake ipayipi elincane ( i-drain/catheter ) esiswini. Leli payipi lisetshenziselwa ukukhipha uketshezi oluyingozi, olunegciwane kanye nomoya esiswini nokunciphisa izimpawu. Kamuva, lapho ingane isikhulile futhi ingcono, ukuhlinzwa kungenziwa.

Ingabe i-NEC ingavinjelwa?

Uma usengozini yokuthola umntwana ngaphambi kwesikhathi, udokotela wakho angakunika umjovo we -corticosteroid . Lo muthi usebenza ukuthuthukisa impilo yengane esibelethweni. Unganciphisa ingozi yezinkinga ngamaphaphu namathumbu engane.

Ngaphezu kwalokho, ukuncelisa kutholakale ukuthi kunciphisa ingozi ye-NEC. Ezinye izifundo ziphakamisa ukuthi ukufaka ama-probiotic , noma amabhaktheriya awusizo, ebisini lebele noma efomini nakho kungasiza.

Kuzokwenzekani enganeni uma i-NEC ikhula? (I-Outlook)

Uma sikhuluma nje, izingane ezingu-8 kwezingu-10 ezithola i-NEC ziyasinda. Kodwa-ke, ezinye zalezi zingane zingase zibe nezinkinga zempilo zesikhathi eside ngenxa ye-NEC.

Okubalulekile: Uma ingane yakho ezelwe ngaphambi kwesikhathi ibonakala iphilile futhi ngokuzumayo iba nenkinga efana ne-NEC, ungase uzizwe udabuke kakhulu futhi ukhathazekile. Lokhu kuvamile. Odokotela nabahlengikazi e-NICU baqeqeshwe ukuqaphela lezi zinkinga futhi bathathe isinyathelo ngokushesha. Ezinye izingane ziyalulama ngokwelashwa okuncane. Ngisho nangokuhlinzwa, izingane eziningi ziyalulama futhi ziphile impilo evamile. Kodwa-ke, ezinye izingane zingase zibe nezinkinga zokugaya ukudla eziqhubekayo.

Izinto okufanele uzibuze udokotela/udokotela wakho

Uma ingane yakho ine-NEC, kuwumqondo omuhle ukubuza udokotela wakho ngezinto ezifana nalezi:

• Kungani ingane yami ithole i-NEC?
• Hlobo luni lwe-NEC ingane yami enalo?
• Yikuphi ukwelashwa okungcono kakhulu kwengane yami?
• Yiziphi izinkinga zokwelashwa?
• Iyini imiphumela yesikhathi eside ye-NEC?
• Ingabe ngidinga ukunikeza ingane yami ukudla okukhethekile?
• Yiziphi izinkinga okufanele ngiziqaphele lapho ngiletha ingane yami ekhaya?

Okokugcina, into ebaluleke kakhulu

I-NEC iyisimo esibucayi kakhulu, ikakhulukazi uma sithinta izingane zethu ezincane. Kodwa khumbula, isayensi yezokwelapha ithuthuke kakhulu namuhla. Odokotela, abahlengikazi, kanye nabasebenzi e -NICU (i-Neonatal Intensive Care Unit) basebenza kanzima kakhulu ukusindisa lezi zingane.

Kuhle ukuthi ngisho nezinto ezilula njengokuncelisa ingane zinganciphisa le ngozi. Uma ingane yakho iba nalesi simo, ungesabi, futhi ulandele iseluleko sikadokotela wakho . Khuluma nayo ngokucophelela bese uyibuza yonke imibuzo onayo. Ngikufisela ukululama okusheshayo!

I- enterocolitis ebulala amagciwane, i-NEC, izinsana ezingaphambi kwesikhathi, ukutheleleka kwamathumbu, impilo yengane, i-NICU, uhlelo lokugaya ukudla