I-entocolitis ye-Necrotizing iquka ukungena kwamathumbu
I-entocolitis ene-Necrotizing, ngokuqhelekileyo ibizwa ngokuba yi-NEC, yimeko apho amathumbu athatshulwa aze aqale ukufa. Esi sifo sidla ngokuchaphazela iintsana ezingekafiki, nangona iintsana zokuhlala zifumana i-NEC. I-entocolitis ene-Necrotizing yimeko embi engadinga ukuhlinzwa, kwaye inokulingana okuphezulu nokufa kwabantu.
Sibanzi
Ingxube yangaphakathi yamathumbu iqulethe izigidi zebhaktheriya.
Ngokuqhelekileyo, ezi bhaktriya (ezibizwa ngokuba yi-flora eziqhelekileyo) aziyingozi kwaye ziyinxalenye yenkqubo yokugaya. Kwi-NEC, nangona kunjalo, iibhaktheriya ziqala ukuhlasela udonga lwamathumbu. Ukuba isifo asizange siphathwe ngokukhawuleza, udonga lwamathumbu luya kuncipha kwaye luze lufe. Ekugqibeleni, umngxuma ungabumba ngodonga lwebilini (i-perforation), uchithe iziqulatho zalo kwisisu esiswini. Ukuxakeka kwezilwanyana kwimeko engxamisekileyo yonyango efuna ukuhlinzwa ngokukhawuleza kwaye inokufa kwezinga eliphezulu.
Izizathu
Ukuqhaqhaqhaqhaqhaqhaqha yinkalo enkulu yokuphuhlisa i-NEC, kuba iintshaba zizalwe ngamathumbu angaphanga. Ngaphandle koko, oogqirha abaqinisekanga ngokuqinisekileyo oko kubangelwa i-NEC. Bayazi ukuba ininzi yeintsana ezifumana i-NEC ziqalisile ukunyusa ubisi, kodwa ziyazi nokuba ukulibazisa ukuxiliswa akunciphisi ubude besifo. Ukunyuka kwegazi kumathumbu kungaphinda kubambe iqela ekuphuhliseni i-enterocolitis engenanto, kunye neentsana ezineemeko zentliziyo ezifana ne- patent ductus arteriosis (PDA) zisengozini enkulu yokuphuhlisa i-NEC.
Iimpawu
Kwimigangatho yokuqala ye-NEC, ukusuleleka kukubangela ukunyuka kokutya kunye nomoya emathunjini ukuphucula okanye ukuyeka. Oku kubangela ukuba isisu somntwana sibonakale sigqityiwe okanye sichithwe. Emva kokutya, ukutya kuya kushiyelwa kwisisu somntwana njengoko isantya sesisu. Ekugqibeleni, ukutya okwaneleyo kunye nomoya kuya kubanjelwa emathunjini amathumbu angama-loops aya kubonakala kwisisu somntwana.
Isisu siya kuba buhlungu kwaye sichaze, kwaye umntwana usenokuqala ukuhlanza i-bile okanye ukuhlaselwa. Igazi lingaba khona kwizitshixo zomntwana, kwaye umntwana angase aqale ukutshatyalaliswa yonke indawo kwaye abe nemveliso emncinci. Ingane inokuba nako kunzima ukulawula ubushushu bayo kwaye ingaqala ukuba ne- apnea okanye i- bradycardia . Ekugqibeleni, isilonda siya kuphuka, kubangele isifo esasasazekayo kunye nokuphefumula okuphefumulayo.
Unyango
Kwimigangatho yokuqala, unyango lwe-NEC lubandakanya ukunqanda ubisi ukuvumela ukuphumla kwesibilini, ukunika i-antibiotics ukunyanga isifo, nokususa umoya kwisisu. Ingane iya kufumana i-x-ray rhoqo ukujonga inkqubela yesi sifo.
Ukuba unyango lwangonyango alusebenzi okanye ukuba isilonda siphucula, kufuneka utyando. Udokotela ogqirha uya kususa nawaphi na amacandelo efile ebilwini kunye nezinye izinto ezikhuselweyo. Ubilwelwane luya kuphinda luphindwe kwakhona okanye luya kuphambukiswa kwisisu ngokusebenzisa i- stoma . Unyango luya kuqhubeka kuze kube yilapho eso sifo sigqibo.
Prognosis
I-NEC sisifo esibi, kwaye malunga ne-25% yabantwana abasuka kwi-NEC baya kufuna unyango lweengxaki zexesha elide. Iintsana ezonyango eziphathekayo kwi-NEC zinokulibaziseka kokukhula, inkathazo yokuxhamla izondlo, kunye neengxaki kunye neengqungquthela zabo kunye neentsimbi zentsimbi.
I-NEC inokwandisa umngcipheko wokulibaziseka kokuphuhliswa.
Iintsana eziye zahlinzwa ngokubhekiselele kwi-NEC zibonise iziphumo ezide ezivela kwisifo. Ukongeza kwimiphumo ye-NEC yezokwelapha, izigulane ezigulana zinokuba neengxaki ezinzima zokuxhamla ezifana nesifo sengqondo esifutshane kunye neengozi ezongezelelekileyo zokukhubazeka kwe- cerebral kunye neengqondo kunye neengxaki zeso.
Thintelo
Ukuthintela ukuzalwa ngaphambi kokuzalwa kuyindlela efanelekileyo yokukhusela i-enterocolitis. Ukuba usengozini yokuzalwa ngaphambi kokuzalwa, xela nodokotela wakho malunga nokwenza ntoni ukunciphisa umngcipheko wakho.
Ukuba ukuzalwa kwangaphambi kokuzalwa, ukutya kuphela ubisi lwebele kunokunciphisa kakhulu umngcipheko we-NEC.
Ubisi lwebele lubandakanya izinto ezikhuselekileyo ezikhuthaza ukuphucula intlungu kwaye zinganciphisa inani leebhaktheriya ezinobungozi emathunjini. Kwisifundo esithile, iintsana ezazisondeza ubisi ezingama-50% zobisi lwebele zazincipha ezintandathu kwiziganeko ze-NEC.
Ukongezelela ukuthintela ukuzalwa kwangaphambi kokubeleka kunye nokuncelisa ubisi lwebele, ukunika i-steroid kumama xa kuzalwa kulindeleke kunganciphisa umngcipheko we-NEC. Kwakhona, ukuncedisa ubisi lwebele kunye nefomula ngezinto ezahlukeneyo ezifana neprobiotics okanye i-immunoglobulins kunokunceda, nangona uphando olungakumbi luyimfuneko.
Imithombo:
Bradshaw, MSN RN NNP-BC, CCRN Wanda Todd. "Inocolitis Necrotizing: Etiology, Presentation, Management, kunye neziPhumo." I-Journal ye-Nursing ne-Neonatal Nursing uJanuwari / Matshi 2009, 23: 87-94.
Schurr, P noPerkins, EM. "Ubudlelwane Phakathi Kokutya kunye ne-Necrotizing Enterocolitis Kwiintsana Eziphantsi Kakhulu Zokuzalwa." Inethiwekhi ye-Neonatal Network Nov.-Dec. 2007, 27: 397-407.
Ii-Sears MD, uWilliam, i-Sears MD, uRobert, i-Sears MD, uJames, i-Sears RN, uMarta. Incwadi Yomntwana Yengaphambi Kwangaphambili: Yonke Into Okufuneka Uyazi Ngomntwana Wakho Okhulileyo Kusukela Ekuzalweni Kuya Kudala . Little, Brown kunye neCo, eNew York, 2004.