Imibuzo ephathelene ne-Bronchopulmonary Dysplasia kwiintsana ezandulela
I-bronchopulmonary dysplasia, okanye i-BPD, uhlobo lwesifo se-lungum esichaphazela iintsana zangaphambi kwexesha ezidinga inkxaso yokuphefumula emva kokuzalwa. I-BPD yindlela yesifo esingapheliyo samaphaphu, okanye i-CLD.
Sibanzi
I-BPD yinkqubela yexesha elide lokungcoliswa kwangaphambili elibangela ukuvuvukala kunye nokukhawulwa kwemiphunga yengane. Ezi zinguquko zempuphu zenza kube nzima kwiintsana ezine-BPD ukuphefumula kakuhle ngaphandle kwenkxaso yokuphefumula.
Ukuba unomntwana ongasemva kweNICU oneminyaka engama-ubudala okanye ngaphezulu kwaye usadinga inkxaso yokuphefumula (i-canal cannula, i-CPAP, okanye i-ventilation yamashishini), umntwana wakho unokuba ne-BPD.
Iimpawu
Ukuqhubeka nokuphefumula ukuphefumula kukubonakalisa uphawu oluphambili lwe-BPD. Iintsana ezine-BPD zingadinga i-oksijeni eyongezelelweyo ukuze igcine i- oksijeni ye-oxygen . Ukuphefumula ngokukhawuleza, ukutshitshiswa kwendoda, kunye nokutshintshwa kwesifuba kuyafana.
Nangona i-BPD ichaphazela kakhulu imiphunga, ingabangela iimpawu kuwo wonke umzimba. Iintsana kunye ne-BPD kufuneka zisebenze nzima kunabanye abantwana ukuba baphefumule, kwaye ukuncelisa okanye ukunyusa ibhodlela kwenza ukuba basebenze nzima ngokukodwa. Batshisa ezininzi iikhalori zokuphefumla, kwaye banokudla ixesha elinzima. Ngenxa yoko, bahlala benengxaki ezinomsoco ezifana nokufumana ubunzima obubi kunye nokuba noveliso lomlomo.
Intliziyo nemiphunga zixhunyiwe, kwaye iingxaki kwimiphunga zihlala zichaphazela intliziyo. Iingxaki ze-cardiac ezifana nokuhluleka kwentliziyo ye-congestive kunye ne- cor pulmonale ingafumaneka kwiintsana ezine-BPD.
Ukuxilongwa
Ngaphambi kokuba ufumanise umntwana wakho nge-BPD, oogqirha baya kujonga kwizinto eziliqela. Ingane yakho inokuthi ifumaneke nge-bronchopulmonary dysplasia ukuba unayo:
- Imbali yenkxaso yokuphefumula: Iziphumo ze-BPD ukusuka kwingozi yemiphunga eyenzekayo xa umoya uphoqelelwa kwimiphunga, ngokuqhelekileyo ngeventilisi okanye kwi-ventilation entle (PPV). Ulwaphulo lwe-oksijeni lungonakalisa izicubu zomphunga.
- Ukunyamezela ukuphefumula ukuphefumula: Iintsana ezine-BPD zidla ngokuphefumula okuphefumulayo okuhlala ixesha elide kuneentsuku zokuqala ezingama-28 okanye emva kokuba umntwana efikelele kwiiveki ezingama-36. Ezi zintsana zingaphumelela ngokukhawuleza, zineenkomo zomzimba, zinenkathazo yokugcina i-oksijeni egciniweyo, okanye ibonakala ngathi isebenza nzima nzima ukuphefumula.
- Ii-Ray-ray ezibonisa i-BPD: I- X-ray ingasetyenziselwa ukuqinisekisa ukuxilongwa kwe-BPD. Kwi-ray-ray, imiphunga yengane ene-BPD ibukeka ikhutshwe kwaye i-tishu yamaphaphu iyona mkhulu kunesiqhelo. Imiphunga ibukeka "ingabonakaliyo" kwaye iziphumo azizuzi kangangoko kwixesha.
Unyango
I-BPD yimeko engapheliyo, kwaye ixesha liphela yonyango. Njengoko umntwana wakho ekhula, uya kukhula ngokutsha, amathisiphi emiphunga enempilo kwaye iimpawu ziya kuphucula. Ezinye iintsana ezine-BPD ziphuma zonke iimpawu zesifo ngexesha lokuya esikolweni, kanti ezinye ziza kuba neengxaki zomphefumlo wangasese ezifana nesifo se-asthma okanye izifo zentsholongwane rhoqo.
Nangona umntwana wakho usemncinci, injongo yonyango kukunciphisa iimpawu xa iimpompo zikhula kwaye zikhula. Uphuhliso oluqhelekileyo lwe-BPD lubandakanya:
- Inkxaso yokuphefumula: Iintsana kunye ne-BPD zingadinga ukuba zibe ne-oksijeni eyongezelelweyo ngeenyanga. Ezi ntsana zingaphinde zikhutshwe kwi-NICU efuna i-oksijini ekhaya. Iintsana ezininzi ezine-BPD zidinga i-canal ye-nasal ukuze zinike i-oksijini emva kokuya ekhaya; abanye bafuna i-tracheostomy kunye ne-air ventical full okanye ngexesha lexeshana.
- I-Nebulizers: I-nebulizer ngumatshini ojika amayeza enomphefumlo onokuphefumula kwimiphunga. Izigulane ngeBPD zingasebenzisa i- bronchodilators ekhuselweyo ukuvula imiphunga yabo, okanye i- steroids yokukhupha ukunciphisa ukuvuvukala.
- I-Diuretics: I-edema ye-pulmonary, uphawu lwe-BPD, luhlobo lokuvuvukala emiphakeni eyenzeka xa uketshezi kwakha emathangeni amaphaphu. Ukuphuma kwamanzi kwimiphunga kungenza kube nzima ukuphefumula kwaye kungenza i-BPD ibe nzima. Ukunika i-diuretics (ngamanye amaxesha kuthiwa "iipilisi zamanzi") kunokuncedisa ukunciphisa umkhuhlane kumaphaphu kwaye kwenze kube lula ukuphefumula.
- Ukutya okuphezulu kweekhalori: Ngenxa yokuba ukutya kunzima kwiintsana ezine-BPD, abahlali bakwazi ukuthabatha iikhalori ezaneleyo. Oogqirha banokwenza i-formula ye-preemie ekhethekileyo kunye neekhalori ezingaphezulu kwendlela yokuzalwa yentsana okanye nokuba noomama bayomeleze ubisi lwabo lwebele kunye neekhalori ezongezelelweyo ukwenzela kube lula kwiintsana kunye ne-BPD ukuba zenze ubunzima.
Iziphumo zexesha elide
Uninzi olunabantwana kunye ne-BPD kunye nokuphuma kweempawu zabo kwaye luya kubakho ubomi obude, obuphilileyo. Ngeli-2 ubudala, i-bronchopulmonary dysplasia isoloko isisombululo yaye aba bafana banomsebenzi wesiqhelo somphunga.
Ezinye iintsana, ngakumbi abo banezinye iingxaki zempilo ezinxulumene nokuphelelwa kwintsholongwane, banokuba neengxaki zexesha elide lomphunga. Iintsana kunye ne-BPD nazo zingasengozini ephezulu kwimiphumo emide yexesha elidlulileyo lokungabikho kwempilo engathintanga nemiphunga. Iingxaki ze-neurological ezifana nokukhubazeka kokufunda, ukukhubazeka kwe- cerebral , kunye nokulibaziseka kokuphuhliswa kwazo zonke ziqhelekileyo kwiintsana ezine-BPD.
Unonophelo lweKhaya lweNyanga
Ukuba umntwana wakho unempilo yeBPD, injongo yakho ephambili emva kokukhutshwa kwesibhedlele kukumnceda ukuba ahlale enempilo. Ngokuqinisekisa ukuba umntwana wakho ufumana ukutya okunomsoco kwaye uhlala usulelekileyo, uza kunceda umphunga wengane yakho ukuba ikhule.
Usulelo luyisongelo esikhulu kwintsana eneBPD. Nangona kubanda kakhulu kungabangela ukusuleleka kwintsholongwane emangalisa, ke qiniseka ukuba wonke umntu odibana nomntwana wakho uhlamba izandla. Buza ugqirha wakho ukuba umntwana wakho ufanelekile ukufumana i-Synagis ukukhusela i- RSV , kwaye uhlale ngaphandle kweendawo zokunakekelwa kwabantwana kwimizuzu yonke.
Ukugcina ukutya okunempilo kubaluleke kakhulu kubantwana bakho. Ukuba unamncelisayo, yigcine ixesha elide unako. Ingaba ukondla kwebele okanye ibhotile, qiniseka ukuba umntwana wakho ufumana ukutya okunokutya okuphezulu ngendlela enokwenzeka.
Funa ukungenelela kwangaphambili kwimpawu zokuqala zokulibaziseka okanye iingxaki zeengxaki. Ukungenelela kwangethuba kunokunceda ukugcina iimpawu ezinqamlekileyo ukuba umntwana wakho akanako ukushaya amanqaku emzimbeni okanye ngengqondo ngexesha, kwaye unokunceda umntwana wakho ukuba afumane oontanga.
Thintelo
Kwixesha elidlulileyo, ezininzi iintshaba zineBPD esibhedlele. Ngombulelo kwimpumelelo ngendlela odokotela abanakekela ngayo iintsana ezingekafiki, intsingiselo ye-BPD iye yehla kakhulu kule minyaka engama-20 edluleyo. Oogqirha banceda ukukhusela i-BPD ngokusebenzisa ukunyanzeliswa kwe-ventilator ephantsi, ngokusebenzisa i-CPAP esikhundleni se-ventilators xa kunokwenzeka, kwaye usebenzisa amanqanaba angaphantsi oksijini. Ukunakekelwa kweNonatal ukuqhubeka nokuqhubela phambili, kwaye sinethemba lokuba isantya esi siphumo esibi, esize sithuba esizeleleko sokuzalwa kwangaphambi kokuzalwa siya kuqhubeka nokuhla.
Imithombo:
> Gracey, K., Talbot, D., uLankford, R., noDodge, P. "Ibhokisi leeNcwadi zoBomi: Yintoni iBronchopulmonary Dysplasia?" Ukuphucula ukuNakekelwa kweNonatal. NgoDisemba 2002. 2: 339-340.
U-Romanko, E. "Ukunyamekela Abantwana abane-Bronchopulmonary Dysplasia kwi-Home Setting." Umhlengikazi wezeMpilo ekhaya. NgoFebruwari 2005. 23: 95-103.
I-Tropea., K. no-Christou, H. "Iindlela ezikhoyo ze-Pharmocologic zokuLungisa nokuPhathwa kweBronchopulmonary Dysplasia." I-International Journal ye-Pediatrics . NgoNovemba 4, 2011. 2012: amakhasi 9.