Ingabe ubuchopho bomntwana wakho buntula umoya-mpilo? Ake sifunde nge-HIE eyingozi (Hypoxic-Ischemic Encephalopathy)!

Amazwi awakwazi ukuchaza injabulo oyizwayo uma ubona umuntu omusha emndenini wakho. Kodwa ngezinye izikhathi, ngokungalindelekile, laba bantwana bangaba nezinkinga zempilo. Namuhla, sizokhuluma ngesimo esingathinta izinsana ezisanda kuzalwa, esingathi sína kancane, kodwa sonke okudingeka sisiqaphele. Leso yi-HIE, noma i-hypoxic-ischemic encephalopathy.

Iyini i-HIE (Hypoxic-Ischemic Encephalopathy)? Ake siyiqonde kahle.

Kalula nje, i-HIE (Hypoxic-Ischemic Encephalopathy) ukulimala kobuchopho okubangelwa ukuntuleka komoya-mpilo kanye nokunikezwa kwegazi ebuchosheni. Cabanga nje, njengazo zonke izitho emzimbeni wethu, ubuchopho budinga nomoya-mpilo kanye nezakhamzimba ukuze busebenze. Lokhu kulethwa ebuchosheni ngegazi. Uma lokhu kunikezwa kuphazamiseka nganoma iyiphi indlela, amangqamuzana obuchopho aqala ukonakala. Yilokhu i-HIE eyikho.

Lesi simo sivame ukuthinta izingane ezisanda kuzalwa , ikakhulukazi uma kunezinkinga ngesikhathi sokubeletha. Kodwa-ke, ngezinye izikhathi izingane ezindala kanye nabantu abadala bangaba ne-HIE uma kunenkinga enkulu yokuphefumula, njengokuminza .

Into ebaluleke kakhulu ukuthi i-HIE iyisimo esibucayi, esingasongela impilo . Ngakho-ke uma ucabanga ukuthi ingane yakho inezimpawu ze-HIE, kufanele ufune iseluleko sezokwelapha ngokushesha.

Kungenzeka ukuthi uke wezwa udokotela wakho esebenzisa amanye amagama kulesi simo se-HIE. Isibonelo:

• Ukuphelelwa umoya ngesikhathi sokuzalwa
• I-encephalopathy yezingane ezisanda kuzalwa
• I-hypoxia ye-perinatal

Kungakhathaliseki ukuthi ubiza liphi igama lokhu, isimo siyafana.

Ingabe kunezinhlobo ezahlukene ze-HIE? Uhlola kanjani ubucayi besimo?

Yebo, odokotela bahlukanisa i-HIE ngokwesimo somntwana. Lokhu kuhlukaniswe kakhulu ngezigaba ezintathu : okuncane, okuphakathi, kanye nokunzima . Lokhu kuhlukaniswa kunganquma ukuthi uhlelo lwezinzwa lomntwana luzothinteka kanjani.

Kodwa khumbula, noma ngabe i-HIE incane, iyisimo esiphuthumayo sezokwelapha . Ngoba ukwelashwa okusheshayo kubalulekile ukuvimbela izinkinga ezisongela impilo. Udokotela uzokwazi ukukunikeza incazelo engcono kakhulu ngesimo sengane yakho. Ngemuva kwalokho ungenza isinqumo bese uqhubeka phambili.

Sivame kangakanani lesi simo?

Ngokwezibalo, i-HIE ithinta phakathi kwengane eyodwa neyisithupha kweziyi-1,000 ezizalwayo . Ngisho nasezweni elifana ne-United States, cishe izinsana ezisanda kuzalwa ezingu-9,000 kuya kweziyi-12,000 zibhekana nalesi simo minyaka yonke. Nakuba kunzima ukuthola izibalo eziqondile eSri Lanka, lesi akusona isimo esinganakwa.

Ziyini izimpawu ze-HIE? Kuthiwani ngengane esanda kuzalwa?

Uma umntwana osanda kuzalwa ene-HIE encane noma ephakathi, angase abe nezimpawu ezifana nalezi:

• Umzimba ubuthakathaka futhi awunampilo (`hypotonia`) noma uqinile futhi uqinile (`hypertonia`) .
• Ubunzima bokuphuza ubisi.
• Uhlala ebonisa isimo sengqondo sokukhathala.
• Ukukhala njalo ngaphandle kwesizathu, ukungahlaliseki.
• Ukukhala ngokubuthakathaka.
• Umbala okhanyayo, oluhlaza okwesibhakabhaka, noma ompunga (`i-cyanosis`) esikhumbeni, ezinyaweni zeminwe, nasezindebeni.

Uma i-HIE inzima kakhulu, izimpawu ziba zimbi kakhulu:

• Cishe akukho mpendulo ngisho noma uyithinta noma wenza umsindo.
• Ukusabela okubuthakathaka kakhulu.
• Izindlela zokuphefumula ezingavamile (isb., ukuphefumula okusheshayo, ukuphelelwa umoya).
• Ukushaya kwenhliziyo okungajwayelekile noma okuhamba kancane kakhulu.
• Ukuquleka .
• Ukulahlekelwa ukwazi.

Okubalulekile: Uma ingane yakho ikhombisa noma yiziphi zalezi zimpawu, yiyise esibhedlela esiseduze noma ushayele u-911 ngokushesha . Ngisho noma i-HIE ibonakala incane, kuyisimo esiphuthumayo. Ukwelashwa okusheshayo kuyinto ebaluleke kakhulu.

Yiziphi izimbangela ze-HIE?

Imbangela eyinhloko ye-HIE ukuntuleka komoya-mpilo kanye nokuhlinzekwa kwegazi ebuchosheni. Kunezindlela eziningana lokhu okungenzeka ngazo.

I-HIE ingenzeka ngesikhathi sokuthuthukiswa kwengane esibelethweni ngenxa yalokhu okulandelayo:

• Ukukhula noma ukusebenza okungavamile kwenhliziyo noma amaphaphu engane engaphansi komntwana.
• Umama unesifo (njenge-toxoplasmosis noma i-CMV).
• Ukwanda noma ukwehla ngokweqile komfutho wegazi kumama okhulelwe.
• Ukwehla kwamazinga omoya-mpilo egazini likamama okhulelwe.

Uma kukhona izinkinga ngesikhathi sokukhulelwa noma sokubeletha, umntwana usengozini enkulu yokuthola i-HIE. Isibonelo:

• Intambo yomlomo, ephuma esithweni sangasese sowesifazane ngaphambi kokuba umntwana azalwe (`intambo yomlomo`).
• Ukucindezelwa kwentambo yesisu noma ukuyeka ukugeleza kwegazi kuyo.
• Ukuphazamiseka kwe-placenta.
• Ukuqhekeka kwesibeletho.
• I-Placenta previa (emboza umlomo wesibeletho).

Izimbangela ze-HIE (ubunzima bokuphefumula) ezinganeni ezindala nakubantu abadala:

• Ukuphazamiseka kwesigqi senhliziyo (`Arrhythmia`).
• Ukuminza (isib. ukuminza, ukuklinywa - `ukuminza`).
• Ukweqisa izidakamizwa noma imithi.
• Ubuthi (isib. ubuthi be-mercury).
• Ukuqala ukushaqeka.

Ubani osengozini enkulu ye-HIE?

Usana olusanda kuzalwa lungase lube sengozini enkulu ye-HIE uma:

• Ukuzalwa unesisindo esincane .
• Ukungcoliswa koketshezi lwesitho sangasese sowesifazane.
• Ukukhula kwengane okulibazisekile (ikakhulukazi ukukhula okungaphelele kwezinye izitho zomzimba, njengamaphaphu).

Umama okhulelwe usengozini enkulu yezinkinga ngesikhathi sokubeletha, enezimo ezifana nalezi:

• Umfutho wegazi ophezulu ngesikhathi sokukhulelwa (`Preeclampsia`).
• Isifo sikashukela sokukhulelwa.
• Ukubeletha isikhathi eside.
• Ukusetshenziswa kwezidakamizwa.

Yiziphi izinkinga ezingaba khona ze-HIE? Ingabe lezi ziyingozi?

I-HIE yisimo esibi kakhulu, mhlawumbe esibulalayo. Ngaphezu kwalokho, ukulimala okungapheli kobuchopho kungaholela ezinkingeni ezahlukahlukene zesikhathi eside. Ezinye zazo yilezi:

• Ukulibaziseka kokukhula : Ukulibaziseka ezintweni ezifana nokukhuluma nokuhamba.
• Izinkinga zokukhula.
• Ukukhubazeka kokuzwa noma ukubona.
• Izinkinga zokusebenza kwengqondo, ukukhubazeka kwengqondo .
• Ubunzima bokugxilisa ingqondo.
• Isifo sokuwa .
• Ukukhubazeka kobuchopho .
• Ukutheleleka okuvamile.

Eziningi zalezi zinkinga azibonakali ngokushesha. Zingase zivele kuphela lapho ingane yakho iqala isikole. Uma ingane yakho ingahlangabezani nemigomo yokukhula ehambisana nobudala bayo, noma inenkinga yokufunda ekilasini, bona udokotela ngokushesha.

Odokotela bayixilonga kanjani ngokunembile i-HIE?

Ngenxa yokuthi i-HIE iyisimo esiphuthumayo sezokwelapha, odokotela bayaqaphela kakhulu izimpawu zalesi simo ngaphambi nangemva kokuzalwa komntwana. Lokhu kwenzelwa ukuqinisekisa ukuthi ubuchopho bomntwana buthola umoya-mpilo negazi elanele. Uma kukhona ubunzima ngesikhathi sokubeletha, odokotela bakulungele ukwelapha lesi simo ngaphambi kokuba umntwana axilongwe ngokusemthethweni.

Ukuze kuhlolwe i-HIE, udokotela uzokwenza ukuhlolwa okuphelele ngokomzimba. Bazobheka izimpawu bese beyala ukuhlolwa okuningana ukuqinisekisa ukuxilongwa.

Ku-HIE ezinganeni ezisanda kuzalwa, lezi zivivinyo zingenziwa ngaphambi nangemva kokuzalwa komntwana:

• Ukuqapha inhliziyo yengane esanda kuzalwa.
• Ukuhlolwa kwegazi le-placenta.
• Ukuhlolwa kwenhlalakahle yengane esanda kuzalwa ( `Apgar score` ).
• Ukuhlola amazinga egazi negesi entanyeni.
• Ukuhlolwa kwezithombe okufana ne-'Ultrasound' noma i-'MRI' (i-Magnetic Resonance Imaging) .
• Ukuhlolwa kwe-EEG (i-Electroencephalogram) (ukukala umsebenzi kagesi wobuchopho).

Ukuhlolwa kwegazi okwengeziwe kusiza odokotela baqonde ukuthi i-HIE izithinta kanjani ezinye izitho zengane.

Yiziphi izindlela zokwelapha i-HIE? (Ukwelashwa)

Odokotela belapha i-HIE ngezindlela ezilandelayo:

• Ukupholisa umzimba wengane (i-therpeutic hypothermia) bese uyibuyisela ezingeni lokushisa elijwayelekile kungasiza ekuvimbeleni ukulimala okwengeziwe ebuchosheni.
• Ngesikhathi ingane isesibhedlela , i-EEG isetshenziselwa ukuqapha ukuquleka, futhi kunikezwa imithi yokuvimbela ukuquleka.
• Thuthukisa ukugeleza kwegazi nomoya-mpilo ebuchosheni,Ukwelashwa okusekelayo kwembangela eyinhloko (isib., ukuhlinzeka nge-oxygen eyengeziwe nge-face mask noma i-nasal cannula).

Uma kuvela izinkinga njengoba ingane ikhula, kungase kudingeke ukwesekwa okwengeziwe. Lokhu kuhlanganisa:

• Ukwelashwa ngokomzimba noma ukwelashwa ngokomsebenzi.
• Ukwelashwa ngenkulumo.
• Izinhlelo zemfundo yezingane zakuqala.
• Amadivayisi okusiza njengezibuko noma izinsiza zokuzwa.

Ingabe kungaba nemiphumela emibi ebangelwa ukwelashwa?

Imithi yokuquleka ingaba nemiphumela emibi ethile. Lokhu kuyahlukahluka kuye ngohlobo lomuthi onikezwayo. Ngaphambi kokuqala ukwelashwa, khuluma nodokotela wengane yakho ngale miphumela emibi nokuthi yiziphi izimpawu okufanele uziqaphele. ``Therapeutic hypothermia`` (ukwelashwa kokupholisa umzimba) nakho kungabangela imiphumela emibi, njenge-platelet ephansi yegazi.

Kuzothatha isikhathi esingakanani ukuthi ingane ilulame ngemva kokwelashwa?

Izingane ezinezimpawu ezincane kuphela futhi ezingenawo umonakalo wobuchopho zivame ukuphola ngokuphelele zingakapheli amasonto amabili. Kodwa-ke, uma isimo sibi kakhulu, kungaba nezinkinga zokuphila konke, ezidinga ukuphathwa isikhathi eside.

Uma ingane yami ine-HIE, yini okufanele ngiyilindele? Iyini inhloso yayo?

Ubunzima besimo se-HIE bunquma ikusasa lengane. Ucwaningo luphakamisa ukuthi phakathi kuka-20% no-50% wezingane ezine-HIE ziyafa . Futhi, phakathi kuka-25% no-60% ziba nezinkinga zemizwa zesikhathi eside noma ukukhubazeka kokufunda, njenge-cerebral palsy noma i-epilepsy .

Kodwa-ke, kwezinye izimo, i-HIE ingelapheka ngokuphelele. Uma i-HIE isheshe yelashwe futhi umonakalo wobuchopho uvinjelwa, kulapho umphumela uba ngcono khona. Kodwa-ke, kumelwe siqonde ukuthi akuzona zonke izingane ezizolulama ngokugcwele.

Uma i-HIE inzima, isikhathi sokuphila kwengane singafinyezwa. Ingane enomonakalo omkhulu wobuchopho ingafa isencane noma isencane. I-HIE encane ngokuvamile ayithinti isikhathi sokuphila. I-HIE ephakathi ingafinyeza noma ingafinyezi isikhathi sokuphila. Iningi lezingane ezine-HIE encane nephakathi zinesikhathi sokuphila esijwayelekile. Ukwelashwa okusekelayo kuyatholakala ukuze kuncishiswe imiphumela esongela ukuphila.

Ingabe zikhona izindlela zokuvimbela i-HIE?

Ngeshwa, i-HIE ayinakuvinjelwa njalo.

Kodwa-ke, unganciphisa ingozi yakho yokuthola i-HIE ngokuhlolwa njalo ngesikhathi sokukhulelwa . Udokotela wakho uzokunikeza iseluleko sokuthi ungahlala kanjani uphephile futhi ugcine impilo enhle. Kodwa-ke, kungakhathaliseki ukuthi uphilile kangakanani ngesikhathi sokukhulelwa, i-HIE isengenzeka.

Futhi, ukulawula ukusetshenziswa kwezidakamizwa kubaluleke kakhulu ukuvimbela izinkinga ezingathinta wena nomntwana wakho.

Ezinganeni ezindala kanye nabantu abadala, ungasiza ekuvimbeleni i-HIE ngokuthatha izinyathelo zokuphepha ngaphambi kokwenza imisebenzi engaba yingozi. Isibonelo, uma uyobhukuda, ukubhukuda lapho kukhona umqaphi wokuphila kuphela okungasiza ekuvimbeleni ukuminza.

Ngingayibona nini udokotela?

Uma ingane yakho ingahlangabezani nezigaba zokukhula ezihambisana nobudala bayo, noma uma ikhombisa izimpawu zezinkinga njengoba ikhula, bona udokotela wengane yakho. Uma ingane yakho inenkinga yokuncelisa, bona udokotela.

Kufanele uye nini e-Emergency Treatment Unit (ETU) ?

Uma wena, ingane yakho, noma othile omaziyo enalezi zimpawu ze-HIE, shayela u-911 ngokushesha bese uya egumbini lezimo eziphuthumayo eliseduze:

• Ubunzima bokuphefumula.
• Ukuquleka.
• Uma isikhumba sibonakala siphuzi, siluhlaza okwesibhakabhaka, noma simpunga.
• Ukulahlekelwa ukwazi (ukuquleka).

Yimiphi imibuzo okufanele ngiyibuze udokotela?

Ungabuza udokotela wakho imibuzo efana nale:

• I-HIE ibaluleke kangakanani?
• Ingabe ubuchopho bomntwana wami bonakalisiwe?
• Yiziphi izinkinga okufanele ngiziqaphele?
• Ingabe ikhona imiphumela emibi yokwelashwa?
• Ingane yami izokwazi nini ukuphuma esibhedlela?
• Kufanele ngilandele nini ukuzohlola impilo yengane yami?

Ekugcineni, umyalezo omncane abazali abazowuthatha baye nawo ekhaya

Ngiyaqonda ukuthi umama noma ubaba uzizwa esaba futhi ekhathazekile kangakanani lapho bezwa ukuthi umntwana osanda kuzalwa une-HIE (Hypoxic-Ischemic Encephalopathy). Ungazizwa ungenalusizo njengoba ithimba lezokwelapha lisebenza kanzima usuku lonke ukuqinisekisa ukuthi ubuchopho bomntwana buthola umoya-mpilo negazi elanele.

Phakathi nalesi sikhathi, udokotela wakho uzokugcina unolwazi ngesimo somntwana wakho . Bakhona ukuphendula noma yimiphi imibuzo ongase ube nayo. Futhi, zizungeze neqembu eliqinile lokusekela, njengomndeni wakho nabangani, ukuze likusize kulesi simo esinzima. Uma kudingeka, ukukhuluma nomeluleki wezempilo yengqondo nakho kungaba usizo olukhulu. Khumbula ukuthi awuwedwa.

I- hypoxic-ischemic encephalopathy, i-HIE, ukwehla komoya-mpilo ebuchosheni, ukwehla kokunikezwa kwegazi ebuchosheni, izinsana ezisanda kuzalwa, ukufutha kokuzalwa, ukulimala kobuchopho, ukubambezeleka kokukhula