Intsholongwane yokuphefumula i-syncytial virus ( RSV ) yimbangela eqhelekileyo yokusuleleka kubantu abaneminyaka yonke. Nangona kubakho nje kubangele iimpawu ezifana nebandayo ebantwini kubantwana abadala nakubantu abadala, kwiintsana kunye nabantwana abancinci, kunokubangela ukuba i- bronchiolitis , isifo esiphezulu kakhulu, ehambisana nokuvuvukala emiphakeni, ukuphefumula nokuphefumula.
I-RSV inokubangela i-croup, i- ear infections , kunye ne-pneumonia.
Ixesha le-RSV
Izifo ze-RSV zonyaka, kwaye e-United States, izifo ezininzi ziqala ngoNovemba okanye ngoDisemba kwaye ziyaqhubeka zize zifike ngoMatshi ukuya ngoMeyi. Ngoko, ixesha le-RSV lisukela ngoNovemba ukuya kuMeyi.
Izifo ze-RSV zixhaphake kangangokuthi malunga neyesibini kubantwana babesetyholwe ngunyaka wabo wokuqala wobomi yaye phantse bonke abantwana banesifo se-RSV xa beseneminyaka emibini ubudala. Uninzi lwezi zifo ezithobekileyo, kodwa i-RSV ikhokelela kuma-125,000 esibhedlele esibhedlele ngonyaka kwaye i-1-2% yabantwana abasesibhedlele bayafa.
Abantwana bavame ukuvelisa iimpawu malunga neentsuku ezingama-2-8 emva kokuba bevezwe kumntu onentsholongwane ka-RSV (ixesha lokunyusa). Ezi zimpawu ziquka kuphela impumlo ecacileyo, kodwa njengoko intsholongwane iyasasazeka, iimpawu zingadala kwaye zingabandakanyeka ukukhwehlela, ukuhlanza, umkhuhlane (onokuqala ukusuka kwibakala elingaphantsi ukuya phezulu), ukuphefumla ngokukhawuleza kunye nokubuyiswa komzimba kunye nokukhawuleza, ukuqhuma, kunye ukutya okubi.
Kwiimeko ezinzima, abantwana banokuba ne-apnea kunye nokungaphumeleli kokuphefumula.
Ukunyanga izifo ze-RSV
Njengokusuleleka kwiintsholongwane zentsholongwane, unyango lwe-RSV sulelo luvame ukuphazamiseka. Kubantwana abanokuphefumula nokuphefumula, ukunyanga kwama-nebulized nge-albuterol kuye kwacingelwa ukuba kuncedo kodwa ngoku akukhuthazwa.
Ezinye iindlela zonyango zingabandakanya i-oksijeni eyongezelelweyo kunye ne-fluid intravenous ukuba umntwana wakho akanako ukutya nokusela kakuhle. Unyango lwe-bronchiolitis kunye ne-steroids luphikisana kwaye kaninzi alucingelwa ukuba luncedo. Ekubeni yintsholongwane, unyango kunye neyeza-antibiotics alisoloko luncedo, ngaphandle kokuba umntwana wakho ahlasele isifo sesibini se-bacteria.
Nangona abaninzi abantwana abaneengxaki ze-RSV bangaphathwa ngendlela ephephile ekhaya, malunga ne-1% yabantwana, ingakumbi iintsana eziselula okanye abo banezifo zonyango ezingapheliyo, kufuneka babekwe esibhedlele kwaye bahlolwe ngokugqithiseleyo. Ngamanye amaxesha, abantwana abanenkinga enkulu yokuphefumula kunye / okanye i-apnea kufuneka bafakwe kwi-ventilator ukuze bancede baphefumule. I-RSV ingaphinda ibulale abanye abantwana.
Ukukhusela ii-RSV Izifo
Abantwana abasemngciphekweni weengxaki ezinzulu zentsholongwane ye-RSV zibandakanya iintsana ezingaphambi kwexesha okanye ezingenazo izifo ezingapheliyo zeemiphunga kunye neentsana ezisetyenziswayo ezinezifo ezingapheliyo. Ngethamsanqa, unyango luyafumaneka ukukhusela ii-RSV izifo kulezi zigulane.
I-RespiGam (i-RSV-IVIG) inikwe ilayisenisi ngo-1996 ukukhusela ii-RSV izifo kwizigulane ezisengozini. Itholakala njenge-infusion yenyanga ngenyanga kwaye inika abantwana abane-antibodies nge-RSV kunye nezinye izifo zentsholongwane zokukhusela ukukhuselwa.
I-Synagis (palivizumab), i-antioclonal antibody ne-RSV, yafumaneka emva kweminyaka embalwa, ngo-1998.
Nangona kunikwa kwakhona ngenyanga, i-Synagis ifumaneka njengesilenze se-intramuscular. Ngokungafani ne-RespiGam, i-Synagis ayiyiyo imveliso yegazi kwaye ayiyi kuphazamisa ukugonywa kwabantwana bakho (abantwana abanakufumana iMMR okanye i-chickenpox vaccine kuze kube emva kweenyanga ezili-9 zokugqiba i-RespiGam infusions).
I-American Academy ye-Pediatrics ihlaziye izikhokelo zabo apho abantwana kufuneka bafumane i-RSV prophylaxis kunye ne- Synagis ngo-2014. Nangona abantwana abasengaphambi kokuzalwa abazalwa phakathi kweeveki ezingama-32-35 kunye nabangaphantsi kweenyanga ezintathu ubudala ekuqaleni kwexesha le-RSV kunye obani ubuncinane ubunobungozi bodwa obuya kufumana i-Synagis, iziphakamiso zamuva kukuba i-Synagis inconywa ukuba:
- Iintsana ezinokuqala ezizalwe zingaphantsi kweeveki ezingama-29 kwaye zingaphantsi kweenyanga ezili-12 ubudala ekuqaleni kwexesha le-RSV (ngo-Oktobha ukuya kuMatshi).
- Ezinye iintsana ezineentsholongwane zesifo senhliziyo esingaphantsi kweenyanga ezili-12 ekuqaleni kwexesha le-RSV, ingakumbi abantwana abane-acyanotic isifo senhliziyo esifumana imithi yokulawula ukungaphumeleli kwenhliziyo kwaye iya kufuna iinkqubo zokugonywa kwenhliziyo kunye neentsana ezinomlinganiselo ochanekileyo we-pulmonary blood pressure .
- Iintsana ezinokuqala ezinokugula okungapheliyo, ezizalelwa kwiiveki ezingaphantsi kwama-32, ezineminyaka engaphantsi kweenyanga ezili-12 ekuqaleni kwexesha le-RSV, kwaye zineemfuno ze> 21% oksijini ubuncinane iintsuku ezingama-28 emva kokuzalwa.
- Abantwana abangaphantsi kweminyaka emibini abaneminyaka engama-immunocompromised ngexesha le-RSV.
- Abantwana abathile abangaphantsi kweminyaka emibili abanesifo esingapheliyo sesifo samaphaphu abaqhubeka befuna i-oksijeni eyongezelelweyo, i-corticosteroids engapheliyo, okanye unyango lwe-diuretic, njl.
- Ezinye iintsana ezinokukhubazeka kwamapulmonari okanye isifo se-neuromuscular esichaphazela amandla abo okucima izicwangciso ezivela kumgangatho wazo ophezulu ongaphantsi kweenyanga ezili-12 ubudala ekuqaleni kwexesha le-RSV.
Ekubeni i-RSV izifo ziqhelekile kwaye iimpawu zinokuba nzima kakhulu, kutheni wonke umntu angatholi i-Synagis? Esinye sezizathu kukuba abantwana abaselula kakhulu, ingakumbi ukuba bazalwa ngaphambi kokuba bazalwe, basengozini enkulu yeengxaki ezinzulu zezifo ze-RSV. Esinye isizathu siyindleko. Iigciwane ze-Synagis zibiza malunga ne-$ 900 ngenyanga kwaye zifuna injini yenyanga ngenyanga ye-RSV.
Ininzi kukuba iifundo ezininzi zifumanisa ukuba kukho "inzuzo encinci yekliniki evela kwi palivizumab prophylaxis." Sekunjalo, kungcono kunananto ize sifumane ukukhuselwa kwe-RSV yangempela.
Ukufumana i-Synagis Shots
Ufumana ii injini ze-Synagis?
Kwimimandla yethu, i-Synagis idla ngokufumaneka kwi-Pulmonologists ye-Pediatric (iingcali zengqondo), okanye kwiinkliniki ze-Synagis kwizibhedlele ezinkulu zendawo, ngakumbi abo bane-Unit enkulu yokunakekelwa kwe-Neonatal Intensive Care Unit. Ukuba une-preemie eya kukhishwa ngexesha le-RSV, ngoko oogqirha bakho baya kuthetha nawe nge-Synagis ngaphambi kokukhutshwa kwakho kwaye mhlawumbi banike umfanekiso wokuqala ngaphambi kokuba uthunyelwe ekhaya.
Abantwana bafumana iiflethi ezihlanu ukuba bahlale kwixesha le-RSV.
Ingaba umntwana wakho usemngciphekweni omkhulu wokuba neengxaki ezinokusuleleka kwi-RSV, kukho ezinye iindlela zokunciphisa amathuba omntwana wakho. Ezi ziquka:
- ukufundisa abantwana bakho kunye nababoneleli benkonzo ukuba baqhelise ukuhlamba izandla, ikakhulu emva kokusebenzisa isitya sokuhlambela (kubandakanywa utshintsho lwe-diaper) nangaphambi kokutya. Kufuneka uphinde uhlabe iimathoyizi kunye nezinye izinto abantwana bakho abakufaka emlonyeni wabo nakwezinye iindawo kunye nokulahla izicubu emva kokusula okanye ukuvuthela impumlo yomntwana.
- ukuphepha ukuthintana nabanye abantu abagulayo. Qinisekisa ukuba ulondolozo lwakho lwemini lunomgaqo oqinileyo malunga nokukhuphela abantwana abanezifo ezichaphazelayo. kwaye ungavumeli nabani na umsi womngane wakho. Ukuba utshaya, ukutshaya ngaphandle ngaphandle kwanele ngokwaneleyo ukunciphisa ingozi yomntwana weengxaki.
Xoxa nodokotela wezilwanyana ukuba ucinga ukuba umntwana wakho ufuna i-Synagis okanye ukuba ukhathazekile nge-RSV.
Imithombo:
I-American Academy ye-Pediatrics Policy Statement. Isikhokelo esihlaziyiweyo se-Palivizumab Prophylaxis Phakathi kweintsana kunye nabantwana abaselula kwiNgozi yokunyuka kwezibhedlele kwi-Syncytial Virus Infection. I-PEDIATRICS Umqulu 134, iNombolo 2, uAgasti 2014.