Chikonzero nei Izvi Zviitiko Zvose zveVavengi Zvinogona Kutyisa Vabereki
Muvana vasati vasvika, apnea uye bradycardia vanowanzoitika pamwe chete, pamwe chete nehana yakanyanya yemajini oxygen. Kutanga, apnea inoitika uye mwana acharega kupema. Nemhaka yokuti mwana haapo kufema, ropa re oxygen rinowira. Moyo unononoka kupindura mukuderera kwemaodzanyemba kwe-oksijeni mazinga. Pamwe chete, apnea uye bradycardia vanowanzozonzi "As and B" kana kuti "spell" uye neropa rezasi rey oxyjeni rinowanzoreva kushatiswa kana kuti "kudiwa."
Oxygen saturation inoyera huwandu hwe oksijeni-kutakura hemoglobin muropa.
Ropa rezwi izwi mwana, rakafanana neyomwana kana munhu mukuru, rinofanira kuva 95 kusvika ku100% rakazara neoksijeni. Ropa remwana asati awana oxygen yakawedzerwa rinowanzochengetedzwa pakati pe 88 ne 95% kuwanisa, kwete yakakwirira, kudzivirira retinopathy ye prematurity , yakatarisa meso.
Muchipatara, kuputika oximetry kunoshandiswa kuyera kuwanda kwe okisijeni muropa.
Apo ropa risina oxygen yakakwana, rinonzi kushatiswa. Desaturations inogona kukonzera ruvara rwemiromo kana ganda uye kukonzera mwana kurasikirwa nezwi kana kuva "floppy."
Chii Chinonzi Apnea?
Apnea inoreva nguva iyo kufema kunomira. Muvana vasati vachangopera, apnea inenge ichinonoka kufema inopedza makore makumi maviri, zvichiita kuti bradycardia, kana kuti kudonha muropa reyerojijini yevana. Vana vasati vatanga vane zvirwere zvekutya zvisingatauri uye vanowanzova nezvikamu zvepnea.
Dzimwe nguva, apnea inokonzera mwoyo wemwana kuti urove zvishoma nezvishoma, anonzi bradycardia.
MuNICU, vavengi vanoputika kuti vaone kuti mavhamusi anonzwika apo kufema kwavo kunogara kwenguva refu.
Kazhinji, runyoro rwemashure kumusana ndiro izvo zvinoda kukurudzira mwana kufemazve, asi dzimwe nguva vana vanoda rubatsiro rwekupemesa kana kuti kuwedzera oxygen pavanenge vari apneic.
Vazhinji vana vasati vazvarwa vasati vasvika pamusana pekunge vakagadzirira kudzokera kumusha, asi vamwe vana vacharamba vaine dzimwe nguva zvinyorwa zvepepnea. Kana izvozvo zvikaitika, vabereki vanotora mwana wavo kumba nechekuchengetedzwa kwepnea, iyo ichaenda kana mwana akarega kufema.
Chii chinonzi Bradycardia?
Bradycardia inoreva zvishoma nezvishoma kupfuura zvepfungwa dzemwoyo. Muzvitsva, chirwere chemwoyo chinonzi bradycardia kana ichiwira pasi pemakore zana neminomwe paminiti mumwana pasi pe1250 g (2 lb 12 oz) kana kuti kudarika makumi masere nemapfumbamwe paminiti mumwana mukuru. Apo vana vari muNICU, mwoyo yavo inotariswa, uye zvikamu zvebradycardia zvinorapwa nekukurudzira. Kana bradycardia ichienderera mberi, mishonga yakadai se caffeine inogona kushandiswa kurapa mamiriro acho.
Zvinokonzera
Apnea uye bradycardia vane zvikonzero zvakawanda muvana vasati vasvika. Utachiona, anemia , uye zvinetso muuropi zvinogona kukonzera As na B. Chikonzero chinonyanya kukanganisa chepnea uye bradycardia pakati pevatungamiri muNICU, kunyange zvakadaro, chiitiko chinonzi apnea ye prematurity.
Apnea of prematurity inokonzerwa nehutano hwemhepo uye hutsika. Apnea yekufananidza kunowanzoitika nguva dzose muvatungamiri vaduku; sezvo ucheche hunopera huchiderera, apnea yekutanga kwekuwedzera inowedzera. Vane 7% chete vevana vakaberekerwa pamasvondo makumi matatu nemakumi matatu nemakumi matatu nemashanu (35) kusvika kwemavhiki makumi matatu nemakumi matatu (35) kusvika kwevhiki makumi matatu nemakumi maviri nematatu vanotambura nemamiriro ezvinhu.
Apnea inogona kuitika nokuti inenge iri muuropi iyo inoudza mwana kufema kunokundikana, uye mwana anorega kufema kufema (central apnea) kana kuti mwana anenge asina kumira musimba haana kusimba zvakakwana kuita kuti mhepo isati yavhurika uye kubuda kwemhepo kunodzivirirwa ( kuvhiringidza apnea ). Mixed central and obstructive apnea also occurs.
Mhedziso Yenguva refu
Vanachiremba havazive kuti ndezvei nguva yakareba yemigumisiro yepnea uye bradycardia. Vanoziva kuti bradycardia inokonzera kuderedzwa kwechinguva muuropi yeropa uye oxygen mazinga. Vanozivawo vacheche vasati vasvika avo vane mazuva akawanda vane zvikamu zvakanyorwa zvepnea vane zvikamu zvakaderera pazera remakore matatu paongororo dzinoyera zviitiko zvekuvandudza uye neurological, asi hazvigoni kutaura zvakasimba kuti apnea uye bradycardia zvinokonzera chikamu chepasi.
Chimwe chinhu icho vanachiremba vanoziva ndechekuti apnea uye bradycardia haiti kukonzera kamwe kamwe kanzvadzi kufa syndrome, kana SIDS. Kunyange zvazvo vacheche vasati vasvika, kazhinji, vane ngozi yakanyanya yeSIDS kupfuura yenguva yakazara vacheche, apnea ye prematurity haina kukonzera SIDS mazinga.
Kurapa
Apo vana vari muNICU vane chiitiko chepnea kana bradycardia, vatariri vanonyora kukosha kwemoyo yavo uye kufema kunotanga ku-alarm. Dzimwe nguva, kutinhira kwemaawa kunokonzera mwana kufemazve, uye mwana ari kufema zvakanaka pamberi pekoti kunyange ane nguva yekupindura. Dzimwe nguva, iyo kamuti haikwani. Kukurudzirwa, kuburikidza nekubvisa kana kubvisa mwana, kuchashandiswa. Kana mwana asati achiripo, ipapo mwana achapiwa kufema nehomwe uye masikisi.
Vacheche vanogara vachiita zvepnea vanogona kuendeswa mberi kunowanikwa zvakanaka mumhepo (CPAP) kuti vabatsirwe kufema kana kuti vashandise simba. Mishonga inogonawo kushandiswa kurapa apnea yekufananidza. Caffeine inorapwa mutsva yemapnea ine zvigaro zvishoma uye yakabudirira zvikuru.
Kudzivirira Zvimwe Zvinyorwa
Kuziva chinokonzera zvikamu zvepnea uye bradycardia zvinogona kubatsira vanamukoti nevabereki kuderedza nhamba yemashiripiti vana vasati vasvika. Apnea uye bradycardia inowanzoitika panguva yekushanduka nehope huru, saka zvinokosha kubvumira vana kuti vave nenguva refu dzehope huru. Gadzirira kushanyira kwako kuNICU nekudya nguva nenguva yekuongorora, uye shandisa mazwi anyerere kana iwe uchishanyira apo mwana wako akarara. Kusiyanisa kwekudzivirira kwekushisa kunogona kukonzera As and Bs, saka edza kuchengetedza usana hwakasimba mukati memubatanidzwa nekuchengetedza makabati emagetsi akavharwa zvakanyanya sezvinobvira.
Kugadzira mbatya ndeimwe chikonzero chinowanzokonzera apnea uye bradycardia. Paunenge uchida mwana asati azvarwa pazamu kana bhodhoro, kufambira mberi kunokosha, kunyanya pakutanga kwekudya. Kana mwana wako achiita seanomwisa achingoramba asinganono kufema, fambisa kudya kwake nguva nenguva achikwevera mukoti kubva mumuromo wake.
Ichaenda Rini?
Muvana vakawanda, apnea inotanga kugadzirisa nguva yakatarwa yokuti vaifanira kuberekwa, uye panguva iyo iyo inotanga kudya zvakanaka zvakakwana kuti iwane uremu nguva dzose uye inochengetedza kutonhora kunopisa kunze kwekudzivirira. Vamwe vana, kunyange zvakadaro, vacharamba vachiine zvikamu zvepnea uye bradycardia kunyange mushure mekunge vakagadzirira kusiya NICU mune imwe neimwe nzira. Zvizhinji zvipatara zvinoda vana kuti vave nehuwandu hwemazuva vasina apnea kana bradycardia vasati vasunungurwa kuti vaone kuti vane mutezo wepanea wepakutanga wakakwana zvachose.
Vacheche vasati vane zvikamu zvepnea kana bradycardia kunyange mushure mokunge vagadzirira kuenda kumba mune imwe neimwe nzira vanogona kusunungurwa kubva kuchipatara neimba yepnea monitor. Izvozvi vataridzi vanokakavara nokuti havana kuratidza zvakajeka mazvokurapa uye zvakaoma kuti vabereki vararame, asi vachiri kushandiswa zvakanyanya kune vana vachiramba vachitsvaga apnea.
Sources:
Stokowski, RN, MS, Laura. "Mutungamiri Wevabereki Kuti Anzwisise Apnea." Kufambira Mberi Mukuchengetedzwa kwevana Neonatal June 2005. 5; 175-176
Stokowski, RN, MS, Laura. "A Primer paApnea Prematurity." Kufambira Mberi Mukugadzirira Kuberekwa Kwevabereki June 2005. 5; 155-170
University of Virginia Health System. "Apnea of Prematurity." Http://www.healthsystem.virginia.edu/uvahealth/peds_respire/apneapre.cfm