Wake wakhathazeka kancane noma wakhathazeka ngokuphefumula kwengane yakho encane ngemva kokuzalwa kwayo? Ngezinye izikhathi, izingane ezisanda kuzalwa zingaba nezinkinga ezinkulu zokuphefumula. Namuhla sizokhuluma ngesinye isimo esibi kangaka, kodwa kubalulekile ukuqaphela. Lokhu ngokwezokwelapha kubizwa ngokuthi i-Persistent Pulmonary Hypertension of the Newborn, noma i-PPHN ngamafuphi.
Kalula nje, iyini i-PPHN?
Ukuze siqonde lokhu, sidinga kuqala ukuqonda umehluko endleleni umntwana aphefumula ngayo ngesikhathi esesiswini sikanina nangemva kokuzalwa.
Cabanga ngakho, uma ingane yakho isesiswini sakho, ithola umoya-mpilo ewudingayo kuwe ngentambo yesisu. Ngaleso sikhathi, amaphaphu engane awasebenzi. Ngakho-ke, imithambo yegazi eya emaphashini (esiwabiza ngokuthi imithambo yamaphaphu) ivame ukuqina futhi ivalekile. Igazi livame ukudlula amaphaphu ukuze liye kuwo wonke umzimba.
Kodwa ushintsho olukhulu kufanele lwenzeke ngokushesha nje lapho umntwana ezalwa futhi ephefumula okokuqala . Njengoba amaphaphu engane egcwele umoya, leyo mithambo yegazi eyayicindezelwe ngaphambilini kufanele ivuleke. Kungaleso sikhathi kuphela lapho igazi lingaya khona emaphashini, lithathe umoya-mpilo, bese lithwala lelo gazi eligcwele umoya-mpilo liye kuwo wonke umzimba, ikakhulukazi ubuchopho, inhliziyo, nezinso.
Esimweni esibizwa ngokuthi i-PPHN, akwenzeki lokho. Ngisho nangemva kokuzalwa komntwana, imithambo yegazi emaphashini akhe ayivuli kahle. Ihlala iqinile. Ngemuva kwalokho, ngenxa yokuthi igazi elanele aliyi emaphashini, izitho zomntwana azitholi umoya-mpilo eziwudingayo.
I-PPHN iyisimo esiphuthumayo sezokwelapha esingathi sína kakhulu, esisongela ukuphila esingase senzeke enganeni esanda kuzalwa. Ngokuvamile senzeka ngokushesha ngemva kokuzalwa.
Sivame kangakanani lesi simo?
Lesi akusona isimo esivamile kakhulu. Cishe izingane ezimbili (2) kweziyi-1,000 ezizalwa ziphila zisengozini yokuthola i-PPHN. Sivame kakhulu ezinganeni ezizalwa ngesikhathi sokubeletha (phakathi kwamasonto angu-37 no-42) kanye nasezinsaneni ezizalwa ngemva kwamasonto angu-42. Kodwa-ke, asivamile ukwenzeka ezinganeni ezizalwa ngaphambi kwesikhathi.
Ziyini izimpawu ze-PPHN?
Kubaluleke kakhulu ukuqaphela lezi zimpawu, ngoba uma uzibona, kufanele ufune iseluleko sezokwelapha ngokushesha.
| Isibonakaliso | Incazelo elula |
|---|---|
| Ubunzima bokuphefumula | Izinto ezifana nokuphefumula okusheshayo noma okuhamba kancane, umsindo wokuphefumula lapho uphefumula, kanye nokudonsa isifuba. |
| Ukwanda kwesilinganiso senhliziyo | Ukushaya kwenhliziyo okuphezulu ngendlela engavamile enganeni. |
| Ukushintsha kombala wesikhumba okuluhlaza okwesibhakabhaka/okumpunga (i-Cyanosis) | Uma kungekho umoya-mpilo owanele egazini, isikhumba somntwana, ikakhulukazi izindebe, ulimi, kanye neminwe, singaba luhlaza okwesibhakabhaka noma sibe mpunga. |
| Umfutho wegazi ophansi (i-Hypotension) | Umfutho wegazi wengane uphansi ngendlela engavamile. |
| Ukwehla kwamazinga omoya-mpilo egazini | Izinga lomoya-mpilo egazini lomntwana liphansi kakhulu uma lilinganiswa ngemishini yezokwelapha. |
| Imisindo yenhliziyo engavamile (i-Heart Murmur) | Ukuzwa umsindo ongavamile noma ongavamile ovela enhliziyweni lapho udokotela ewuhlola nge-stethoscope. |
Yiziphi izimbangela kanye nezici eziyingozi ze-PPHN?
Abacwaningi abakayitholi imbangela ethile yalokhu okwamanje , kodwa kukholakala ukuthi lesi simo singase sibangelwe yimithambo yegazi emaphashini engane engakhuli kahle, noma ukungakwazi komntwana ukuzivumelanisa (nokuvuleka) nomhlaba wangaphandle ngemva kokuzalwa.
Nakuba imbangela eqondile ingaziwa, izici ezithile zingase zandise ingozi yokuthola i-PPHN.
| Isici sengozi | Kwenzekani ngalokhu? |
|---|---|
| Ukuphefumulela kweMeconium | Indle ejiyile, eluhlaza okwesibhakabhaka (i-meconium), okuyindle yokuqala yomntwana, ingangena emaphashini omntwana. Lokhu kungalimaza amaphaphu futhi kubangele i-PPHN. |
| Izifo | Izifo ezingathi sína ezifana nezifo zamaphaphu njenge-pneumonia noma ubuthi egazini. |
| Isifo Sokucindezeleka Kokuphefumula (RDS) | Ubunzima bokuphefumula buvame ukwenzeka ezinganeni ezizalwa ngaphambi kwesikhathi ngoba amaphaphu azo awakakhuli ngokugcwele. |
| Ukuphelelwa Yithemba Kokuzalwa | Ukuntuleka komoya-mpilo ebuchosheni nasemzimbeni ngaphambi noma ngesikhathi sokuzalwa. |
| I-Hernia ye-Diaphragmatic | Imbobo ku-diaphragm (umsipha ohlukanisa isifuba nesisu) ivumela izitho ezisesiswini ukuba ziphume ziye esifubeni. Lokhu kuphazamisa ukukhula kwamaphaphu. |
| Ezinye izinkinga zokuzalwa | Ezinye izinkinga ezifana namaphaphu amancane azalwa nawo noma ivalvu yenhliziyo evalekile. |
| Eminye imithi ethathwa ngesikhathi sokukhulelwa | Eminye imithi yokwelapha izinhlungu (ama-NSAID) kanye neminye imithi yokucindezeleka (ama-SSRI) ethathwa phakathi nengxenye yokugcina yokukhulelwa ingathinta lokhu. |
Ingabe i-PPHN ingabangela imiphumela yesikhathi eside?
Yebo. Lesi yisimo esibi kakhulu, njengoba singabangela imiphumela yesikhathi eside ngenxa yokuntuleka komoya-mpilo ebuchosheni nakwezinye izitho zomzimba. Cishe ingane eyodwa kwezine (25%) ezisinda ku-PPHN zizoba nohlobo oluthile lokukhubazeka.
Kunjalo:
- Ukulibaziseka kokukhula
- Ukukhubazeka kokuzwa noma ukungezwa
- Ubunzima bokufunda
- Ukwehla kwamandla okwenza imisebenzi yomzimba
Itholakala kanjani i-PPHN?
Uma odokotela besola ukuthi ingane inalesi simo, bazokwenza izivivinyo eziningana ukuqinisekisa ukuthi itholakele.
| Ukuhlolwa | Ubonani kulokhu? |
|---|---|
| Inani Eliphelele Legazi (i-CBC) | Ukulinganisa inani lamaseli amhlophe egazi, amaseli abomvu egazi, nama-platelet egazini. Lokhu kungasiza ekunqumeni ukuthi kukhona yini ukutheleleka. |
| I-Pulse Oximetry (I-Pulse Ox) | Idivayisi encane ixhunywe emunweni noma emlenzeni wengane futhi ikala njalo izinga lomoya-mpilo egazini. |
| Igesi Yegazi Emithanjeni (ABG) | Thatha isampula yegazi bese ulinganisa ngokunembile amazinga alo e-oxygen kanye ne-carbon dioxide. |
| I-X-ray yesifuba | Ukuhlola ukuthi inhliziyo ikhulisiwe noma kukhona yini ezinye izinkinga zamaphaphu. |
| I-Echocardiogram (i-Echo) | Lokhu ukuskena kwenhliziyo. Kubalulekile ukuhlola ukugeleza kwegazi enhliziyweni nasemaphashini nokuqinisekisa isimo se-PPHN. |
| I-Head Ultrasound (ukuskena kwekhanda) | Ukuhlola ukuthi kukhona yini ukopha ebuchosheni ngenxa yokuntuleka komoya-mpilo ebuchosheni. |
Iphathwa kanjani i-PPHN?
Umgomo oyinhloko wokwelashwa nge-PPHN ukwandisa inani lomoya-mpilo ofinyelela ezithweni zomntwana . Lokhu kungasiza ekuvimbeleni izinkinga ezinkulu. Kusetshenziswa izindlela eziningana zokwelapha kulokhu.
| Indlela yokwelapha | Kwenzekani ngalokhu? |
|---|---|
| Ukunikeza umoya-mpilo | Ukunikeza ingane umoya-mpilo ongu-100% ngepayipi elincane elixhunywe ekhaleni, imaski, noma i-oxygen hood. |
| Umoya Wokusebenza Ngomshini | Kufakwa ipayipi embhobho womoya womntwana bese kusetshenziswa umshini wokuphefumula ukuze umntwana aphefumule. |
| Imithi yokulawula umfutho wegazi | Ukunikeza imithi yokubuyisela umfutho wegazi nge-saline (IV). |
| I-Nitric Oxide | Lokhu kuyigesi. Ukunikeza le gesi ngomshini wokuphefumula kusiza ukwandisa imithambo yegazi emincane emaphashini. |
| I-ECMO (i-Extracorporeal Membrane Oxygenation) | Lokhu kuyindlela yokwelapha eyinkimbinkimbi kakhulu esetshenziswa njengesixazululo sokugcina. Uma inhliziyo namaphaphu engane ehluleka, umshini we-ECMO uthatha igazi emzimbeni, ungeze umoya-mpilo kuwo, bese ulibuyisela emzimbeni. Kufana nenhliziyo namaphaphu angaphandle. |
Kuthatha isikhathi esingakanani ukuthi umntwana alulame?
Iningi lamacala e-PPHN aphela phakathi nesonto noma amabili, kodwa ezinye izingane zingathatha izinyanga ukuze zilulame ngokugcwele. Phakathi nalesi sikhathi, kubalulekile ukuvikela ingane yakho emakhazeni, emkhuhlaneni, nakwezinye izifo ezibangelwa amagciwane.
- Geza izandla zakho kahle.
- Gwema ukuyisa ingane ezindaweni ezinabantu abaningi.
- Gcina ingane kude nabantu abagulayo.
- Wonke umuntu ekhaya kufanele athole umuthi wokugomela umkhuhlane waminyaka yonke.
Futhi, kubalulekile ukuya emitholampilo ngezinsuku ezihleliwe ukuze ubone ukuthi ukukhula nokukhula komntwana kuvamile yini.
Kufanele ngimbone nini udokotela?
Ngemva kokuba ingane yakho ibuyile esibhedlela, kudingeka uqaphele kakhulu. Uma ubona noma yiziphi izimpawu ezilandelayo, funa usizo lwezokwelapha ngokushesha. Yisa ingane yakho eMnyangweni Wezimo Eziphuthumayo (ETU) wesibhedlela esiseduze.
- Uma ingane inomkhuhlane.
- Uma ungaphuzi ubisi olwanele.
- Uma isifuba sakho sidonswa ngaphakathi uma uphefumula noma uma uphefumula uvulekile kakhulu.
- Uma uzwa umsindo wokukhala noma wokububula lapho uphefumula.
- Uma isikhumba somntwana siqala ukuphenduka sibe luhlaza okwesibhakabhaka noma sibe mpunga futhi.
Uma uthola ukuthi ingane yakho ine-PPHN, ungase uzizwe unemizwa eminingi, njengokudabuka, ukwesaba, intukuthelo, nokudideka. Lokhu kuvamile. Into engcono kakhulu ongayenza ukufunda okuningi ngangokunokwenzeka ngesimo kodokotela nabahlengikazi abaphatha ingane yakho. Lokhu kuzokusiza ukuthi uqonde isimo kangcono. Ngokuhamba kwesikhathi, uzoba uchwepheshe wakho ngesimo somntwana wakho. Uzoqiniseka ukuthi wenza konke ongakwenza ngomntwana wakho.
Umlayezo Wokuya Nawe Ekhaya
- I-PPHN iyinkinga yokuphefumula engathi sína, kodwa engelapheka ezinganeni ezisanda kuzalwa.
- Lesi yisimo esiphuthumayo sezokwelapha esidinga ukulaliswa esibhedlela kanye nokwelashwa ngokushesha.
- Hlala uqaphile izimpawu eziyisixwayiso ezifana nokuthi isikhumba sengane yakho siphenduka sibe luhlaza okwesibhakabhaka futhi siphefumula ngokushesha.
- Umgomo oyinhloko wokwelashwa ukunikeza umoya-mpilo owanele ebuchosheni bomntwana nakwezinye izitho zomzimba.
- Ngisho nangemva kokuba umntwana eseluleme, kubaluleke kakhulu ukuhlala uxhumana nodokotela njalo ukuze kuqashwe intuthuko yesikhathi eside.
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