Ukukhupha iinkcukacha
I-anemia ichazwe ngokuchanekileyo njengemeko apho umzimba ungenayo okwaneleyo iiseli zegazi ezibomvu okanye ukuncipha kwinani lama-RBC). IiRBC, ezibizwa nangokuthi i-erythrocyte zifakwe njenge-disent encinci, zidibanisa iidiski kwaye ziqulethe iprotheni ene-hemoglobin enesityebi. Igazi lifumana umbala obomvu obomvu xa i-hemoglobin ithatha i-oksijini kwimiphunga.
Njengoko igazi lihamba emzimbeni, i-hemoglobin ikhupha i-oxygen kumaseli omzimba kunye nezicubu. I-anemia yilahleko kwinani lala maRBC.
Kodwa oko kuthetha ukuthini ngempela? Inemia ithintela njani umntwana osengumntwana kwaye yintoni enokuyenza ukuze uncede ukulungisa ingxaki?
I-anemia yinto eqhelekileyo kwaye iyakwenzeka ngezizathu ezahlukahlukeneyo. Ngaphambi kokuzalwa, igazi legazi lithwala amangqamuzana egazi abomvu ukwenzela ukukunceda uthabathe i-oksijini egazini likaMama kwi-placenta. Xa usana luzalwa, kwaye i-oksijeni engaphezulu ikhona, ayifuni le nxalenye yegazi elibomvu ngenxa yokuba iqala ukuphefumula ngokwabo. Kule nkqubo yenguqu, umzimba uyayeka ukuvelisa iiseli ezibomvu zegazi ngenxa yokuba kunokugqithiseleyo emzimbeni. Inani le-RBCs kumlambo wegazi liya kuhla ngcembe.
Xa izinga liphantsi kakhulu, umzimba uphendula ngokuqala ukuveliswa kweeseli ezintsha zegazi ezibomvu.
Le yinkqubo eqhelekileyo yeentsuku ezipheleleyo kunye neentsana eziza kusengaphambili. Kubantu abadala kunye neentsana, iiseli zegazi ezintsha zenziwa rhoqo njengoko abadala bephela kwaye badilizwe emzimbeni. Le nqubo ivela kwiimjikelezo. Kwiintsana ezingaphambi kwexesha, lo mjikelezo wegazi elibomvu ukuchithwa kwegazi kudla ngokukhawuleza kwaye kubomvu ukuveliswa kweeseli zegazi ngokuqhelekileyo, ngoko ke umntwana osanda kuzalwa uya kuba yinto elula.
Iintshaba zinokuthi zibe yindalo yokulahleka kwegazi ngaphambi okanye ngexesha lokunikezelwa, ukungafani kakuhle neentsholongwane zegazi kunye nonina, isidingo sokuthatha iisampula zegazi rhoqo ukuba kwenziwe iimvavanyo zelabhoratri eziyimfuneko okanye ukungakwazi ukwenza amangqamuzana egazi abomvu ukugcina i-preemie yokukhula ngokukhawuleza komntwana .
Umntwana kwi-NICU ujongwa ngokukhawuleza kunye novavanyo lwegazi olubizwa ngeHematocrit kunye ne-hemoglobin. (Yaziwa nangokuthi i-H & H) Amanyathelo e-hematocrit ipesenteji yegazi elisegazini elenziwe ngamaseli obomvu emzimbeni. Uhlobo oluqhelekileyo lwe-hematocrit luphakathi kwama-35-65 ekhulwini. Uvavanyo lwe-hemoglobin lucwangcisa ubuninzi be-hemoglobin, i-oksijini ethwele isakhi seeseli ezibomvu zegazi zikhona egazini. Uhlobo oluqhelekileyo lwe-hemoglobin luphakathi kwe-10-17. (Ii-Milligrams nge-deciliter) Amanani ahluka kakhulu kuxhomekeke kwiminyaka kunye nempilo yengane. Iintsana ezinokuqala ziya kuba nokuhlolwa kwegazi okwenziwa rhoqo ngokuba yi-reticulocyte count. (Kwaziwa nangokuthi i-retic) I-Reticulocyte entsha, iiseli zegazi ezimnyama. Ubukho be-reticulocytes kumlambo wegazi lubonisa ukuba umzimba uqala ukuvelisa iiseli zegazi ezibomvu.
Umzimba udinga insimbi ukwenza i-hemoglobin. Ukuba akukho nsimbi esaneleyo, i-hemoglobin production is limited, eguquguqukayo ichaphazela ukuveliswa kweeseli ezibomvu zegazi.
Iintsana ezandulelayo zizalwe ngeendawo ezincinci zentsimbi emzimbeni yazo kunezizukulwana ezizalwayo. Njengoko iintshaba ziqala ukukhula kwaye ziqala ukuvelisa iiseli ezibomvu zegazi kwakhona, zikhawuleza ziphuma kwintsimbi egcinwe ngumzimba wayo. Ukuthintela okanye ukunceda i-anemia elula, i-preemie inokunikwa insimbi yenkxaso yansuku zonke, edla ngokuba yindlela yamaconsi amanzi.
Uninzi lwabantwana luba ne-anemic ngexesha elithile ngexesha leNICU lihlala. Ezinye iintsana zinokunyamezela amanqanaba aphantsi we-hemoglobin ngaphandle kokubonisa nayiphi na impawu kunye neempawu. Iintshaba ezizalwe kwiiveki ezingama-28 okanye ubuncinane ubunzima phantsi kwe-1000 grams, ezilwa nosulelo, okanye ezifesini zingenakubekezelela amanqanaba aphantsi eeseli zegazi ezibomvu kwaye zifuna ukudluliselwa kwegazi.
Ukumpontshelwa igazi kungaboniswa ukuba umntwana ubonisa iimpawu zokukhula kwegazi. Iimpawu kunye neempawu zingabandakanya umbala wesikhumba obalahlekileyo, ukuncipha kumsebenzi okanye ukulala, ukhathala ngokutya, ukunyusa ukuphefumla (tachypnea), okanye ubunzima bokuphefumula xa uphumla, uhamba kancane kunokuba uzuze ubunzima obuqhelekileyo. Ingane inokuthi ibe neqondo lokuphumla eliphezulu lentliziyo (tachycardia) okanye inokuba neentsholongwane ezingaphezulu kwe-apnea kunye ne-désaturation.
Ukutshintshiswa ngokuqhelekileyo kwenziwa ngeemveliso zegazi ezibizwa ngokuba ngama-red red cells cells. Iipilisi zegazi ezibomvu zifakiwe ziqulethe inani eliphezulu lamaRBC kunye negazi eliphantsi. Igazi lokumpontshelwa igazi lihambelana ngokufanelekileyo ukuze kugwemeke ukungahambelani kweqela phakathi kwegazi nomntwana. Iintsingiselo, igazi legazi liya kutsalwa kwaye lihambelane kunye nomniki-mali. Kwezinye izibhedlele, kunokwenzeka ukuba abazali babantwana abangaphambi kwintsana benze umnikelo othe ngqo kwiintsana zabo. Umzali kunye nosana kufuneka babe neentlobo zegazi ezihambelanayo, kwaye igazi lomzali kufuneka livavanywe, kwaye likhululeke isifo. Emva kokuba igazi liqokelelwe kuthatha iiyure ezingama-72 ukukulungiselela ukutshatyalaliswa.
Enye yezokwelapha zakutshanje ze-anemia, ezingasetyenziswa ngokubanzi, kusetyenziswa i-erythropoietin. I-Erythropoietin yi-hormone eyenziwa ngokwemvelo emzimbeni okhuthaza ukuveliswa kweeseli ezintsha zegazi ezibomvu. Ukwelashwa kwe-Erythropoietin kubandakanya izihlunu, kathathu ngeveki, kwaye zinikezwa nge-iron iron supplements. I-Erythropoietin ayisetyenziswanga ngokuqhelekileyo ukwenzela unyango lwe-anemia kwintsana yokuqala.
Kubalulekile ukukhumbula ukuba i-anemia yimbangela yenkqubo eqhelekileyo kubo bonke abatsha, kodwa yimeko eqhelekileyo yintsana engekafiki. Ukuphazamiseka kwe-anemia kuyaphathwa ngokukhawuleza kwaye yinto enye yeendlela ezininzi zokuba umntwana ozelwe ngokukhawuleza uza kuhlangabezana nohambo lwe-NICU.
> Imithombo:
> Ububanzi JA. I-Pathophysiology ye-anemia ngexesha lexesha lokuzalwa, kuquka ne-anemia ye-prematurity. NeoReviews. 2008; 9: 31-e5
> Bell EF, Strauss RG, Ubukhulu JA, Mahoney LT, i-Mock DM, uSeward VJ, et al. Iilingo ezinokuthi zenzeke ngokungahambisani neenqununu zokubanjelwa kwegazi kwi-infant preterm. Pediatrics. 2005; 115: 1685-1691
> Ceriani Cernadas JM. Ukuqala kokuqhathaniswa nokunciphisa intambo yokubambisa kwiintsana zangaphambi kweentsana: Inkcazo ye-RHL (yokugqibela ihlaziywe: 7 Matshi 2006). ILayibrari yezeMpilo yoLwazi lwe-WHO ; I-Geneva: Umbutho WezeMpilo Wehlabathi
> Von Kohorn, I. Matshi-Ehrenkranz, R. Matshi 2009. I-anemia kwintsana yokuqala: I-Erythropoietin ngokubhekiselele ekumpontsheni kwe-erythrocyte - Akuyinto elula. I-Perinatology yeCliniki. 36 (1): 111-123.