Kuchengeta zvinyorwa
Anemia inorondedzerwa sechirwere semamiriro ezvinhu umo muviri hauna masero masero matsvuku eropa kana kuderera kwema (RBCs) masero matsvuku eropa. MaRBC, anonziwo erythrocytes akaumbwa sediki asingagadziri, akaputika disks uye ane iron yakawanda yeprotein hemoglobin. Ropa rinowana ruvara rutsvuku apo hemoglobin inotora oksijeni mumapapu.
Sezvo ropa richifamba nemuviri, hemoglobin inobudisa okisijeni kumasero emitumbi uye maviri. Anemia inoshaya muhuwandu hweRBCs.
Asi izvi zvinorevei? Inemia inobata sei mwana asati asvika uye chii chinogona kuitwa kubatsira kugadzirisa chinetso?
Anemia inowanzoitika uye inogona kuitika nekuda kwezvikonzero zvakasiyana-siyana. Asati aberekwa, ropa revana rinotakura masero matsvuku eropa kuitira kuti tibatsire kutora okisijeni kubva muropa raamai kuburikidza neparcenta. Kana imwe nguva mwana akaberekwa, uye akawanda oksijeni iripo, havasisinazve mamwe masero matsvuku eropa nokuti anotanga kufema oga. Nenzira iyi yekushandura, muviri unorega kubudisa masero matsvuku eropa nokuti kune kuwedzera mukati memuviri. Nhamba yeRBCs iri muropa inowedzera zvishoma nezvishoma.
Apo nhamba yacho inowedzereka kwazvo, muviri unopindura nokutanga kubudiswa kwemasero matsvuku eropa.
Iyi ndiyo nzira yakasarudzika yevana vose vakagara kwenguva refu uye vasati vasvika. Muvanhu vakuru uye vacheche, masero matsva eropa anogara achiitwa sekukwegura kwekare uye kuputsika mumuviri. Izvi zvinowanzoitika mumitambo. Muvana vasati vachangopera, izvi zvinenge zvisingabatsiri masero ekuparara kweropa zvinowanzowedzera uye zvakasvibirira kushandiswa kwemasero eropa zvinowanzopfupika, saka mwana asati azvarwa anobva aita chirwere chendaneti nyore nyore.
Vavengi vanogonawo kuva chirwere chemararamiro kubva kurasikirwa kweropa kare kana panguva yekuberekwa, kusanganisa kwevana vemadzimai uye marudzi eropa, chido chekutora sampu dzeropa nguva dzose kuti vaite zvirongwa zvebhishopi zvinodiwa, kana kusakwanisa kuita masero matsvuku eropa kuti varambe vaine preemie baby's rapid growth rate.
Mwana muNICU anoongororwa zvakanyanya neropa reHematocrit uye hemoglobin. (Inowanziwo seH & H) Maitiro e hematocrit asi muzana wemvura yeropa iyo inoitwa masero matsvuku eropa mumuviri. Kazhinji hematocrit range iri pakati pe 35-65 muzana. Hemoglobin test inotarisa kuti hemoglobin yakawanda sei, oxygen inotakura chikamu chemasero matsvuku eropa chiri muropa. Inowanikwa hemoglobin inowanikwa pakati pe10-17. (Milligrams per deciliter) Nhamba dzinoshandiswa zvakasiyana-siyana zvichienderana nezera uye utano hwechecheche. Vana vacheche vangave vaine kuongorora ropa kunowanzoitwa reticulocyte count. (Uyewo anozivikanwa seshoko retictic) Reticulocytes mutsva, masero matsvuku eropa. Kuvapo kwereticulocytes muropa rinoratidza kuti muviri unotanga kubudisa masero ayo matsvuku eropa.
Muviri unoda iron kuti uite hemoglobin. Kana pasina iron yakawanda inowanikwa, chibereko cheHemoglobine hachina kukwana, iyo inotenderera inobata kugadzirwa kwemasero matsvuku eropa.
Vana vakaberekwa vasati vaberekwa vanoberekwa vane zvinyorwa zvepasi zvesimbi mumitumbi yavo kupfuura nguva yakazara yevana vanozvarwa. Sezvo vavengi vanotanga kukura uye vanotanga kubereka masero matsvuku eropa zvakare, vanokurumidzira kuputika pane simbi iyo muviri wavo wakaachengeta. Kuchengetedza kana kubatsira rubatsiro rwemaperembudzi, preemie inogona kupiwa iron yekubatsira zuva rega rega, iyo inowanzove yakafanana nemadonhwe emvura.
Vakawanda vacheche vanova neronda pane dzimwe nguva panguva yeNICU. Vamwe vana vanogona kubvumira hutsika hweHemoglobin pasina zviratidzo nezviratidzo. Vavengi vanozvarwa pamasvondo makumi maviri nemasere kana kuti vashoma vanorema pasi pe1000 gmm, vari kurwisana nehutachiona, kana vari muvhariyuta vangarega kubvumira mashoma masero emasero matsvuku uye zvingada kuwedzerwa ropa.
Kuwedzerwa ropa kunogona kuratidzwa kana mwana ari kuratidza zviratidzo zvekushaya ropa. Zviratidzo nezviratidzo zvinogona kusanganisira maruva paganda, kupera kwebasa kana kurara, kuneta nekudya, kuwedzera mukufema (tachypnea), kana kuoma mukufema kana pazororo, zvishoma nezvishoma kupfuura kuwanzana kwekuwedzera. Mwana wacho anogonawo kuva nepamusoro yepamusoro yepamwoyo yepamusoro (tachycardia) kana kuti angave ane mamwe mapepa eepnea uye deaturation.
Kufuridzirwa kunowanzoitwa neropa rinobudiswa nemasero matsvuku eropa. Pakavharwa masero matsvuku eropa ane nhamba yakakura yeRBCs ine ropa rezasi. Ropa rekuwedzerwa ropa rinopindirana kuitira kuti isabatanidzwa neboka reropa risina kuwirirana pakati pemupi uye mwana. Zvinoreva, ropa rechecheche richaswededzwa uye rinoenzaniswa neiro remupiro. Mune zvimwe zvipatara, zvinogona kuitika kuti vabereki vevana vasati vasvika vape zvipo zvakananga kumucheche wavo. Mubereki nemucheche vanofanira kunge vane maitiro akafanana eropa, uye ropa remubereki rinofanira kuongororwa, uye risina hutachiona. Mushure mekunge ropa rinounganidzwa zvinotora maawa makumi manomwe nemaviri kuti zvigadzirire kuisa ropa.
Chimwe chezviongorori zvekare zvekushaya ropa, izvo zvisingawanzoshandiswa zvikuru, iko kushandiswa kwe erythropoietin. Erythropoietin inonzi hormone inowanzoitika mumuviri inokurudzira kugadzirwa kwemasero matsvuku eropa. Erythropoietin kurapwa kunosanganisira shots, katatu pavhiki, uye inopiwa nemuromo wesimbi kuwedzera. Erythropoietin haisati yakashandiswa zvikuru nguva dzose pakurapa kweanemia mukutanga kwechecheche.
Zvakakosha kuyeuka kuti chirwere chekushaya ropa chinokonzerwa netsika yakasununguka kune vose vakaberekerwa, asi ndiyo inonyanya kuwirirana nechechechecheche. Anemia inobatwa nyore nyore uye inongova imwe yemigwagwa yakawanda iyo mwana akaberekerwa nguva isati yasvika achafanira kutarisana panguva yendo rwavo rweNICU.
> Sources:
> Kuwedzera JA. Pathophysiology yeanemia munguva yevaonatal nguva, kusanganisira anemia ye prematurity. NeoReviews. 2008; 9: 31-e5
> Bell EF, Strauss RG, Kuwedzera JA, Mahoney LT, Mock DM, Seward VJ, et al. Randomized muedzo wehurukuro nekuregeredza zvinorayira zvemasero matsvuku ekuisira ropa mumwana asati azvarwa. Pediatrics. 2005: 115: 1685-1691
> Ceriani Cernadas JM. Pakutanga nekukanganiswa kwembilical cord kupindira mukutanga kwevana: RHL rondedzero (yakagadziridzwa yakagadziriswa: 7 March 2006). IWR Reproductive Health Library ; Geneva: World Health Organization
> Von Kohorn, I. & Ehrenkranz, R. Chivabvu 2009. Anemia mudangwe rekutanga: Erythropoietin uye kuwedzerwa kweyerythrocyte - Hazvisi nyore. Clinical Perinatology. 36 (1): 111-123.