Necrotizing enterocolitis inobatanidza hutumbu
Necrotizing enterocolitis, kazhinji inonzi NEC, ndiyo mamiriro apo maronda anotapukirwa uye anogona kutanga kufa. Chirwere ichi chinowanzokonzera vana vasati vasvika, kunyange vana vacheche vanogonawo kuwana NEC. Necrotizing enterocolitis chirwere chakakomba chingadikanwa kuvhiyiwa, uye ine uwandu hwakanyanya hwekufa nekufa.
Overview
Iyo yakagadzirirwa mukati memukati ine mamiriyoni eibhakitiriya.
Kazhinji, mabhakitiriya aya (anonzi maruva akazara) haana chakaipa uye ari chikamu chekudya kwekudya. Mune NEC, kunyange zvakadaro, mabhakitiriya anotanga kurwisa mudumbu. Kana chirwere ichi chisina kutorapwa nokukurumidza, dumbu romuviri ruchaoma uye ringafa. Pakupedzisira, hove inogona kuumbwa nemadziro emadzimai (a perforation), ichizadza zviri mukati mechipfuva. Bhowel perforation chirwere chekurapa chinoda kuvhiyiwa nekukurumidza uye ine huwandu hwekufa kwehuwandu.
Zvinokonzera
Kukura kwepakutanga ndiko kunonyanya kukonzera kukanganisa kweNEC, nokuti vavengi vanozvarwa vane matumbo asina kuchena. Kupfuura izvozvo, vanachiremba havasi kunyatsoziva kuti chii chinokonzera NEC. Vanoziva kuti ruzhinji rwevana vanowana NEC vakatanga mukaka wokudya, asi vanozivawo kuti kunonoka kudyidzana hakurevi kutengesa kwechirwere. Kuderedzwa kweropa kunopinda kumatumbo kunogonawo kutora chimwe chinhu mukuvandudzwa kwevacrotizing enterocolitis, uye vacheche vane mamiriro emwoyo akaita se patent ductus arteriosis (PDA) vari pangozi yepamusoro yekudzidzira NEC.
Zviratidzo
Muchikamu chekutanga cheN NEC, hutachiona hunokonzera kufamba kwezvokudya nemhepo kuburikidza nemukuchi kuderera kana kumira. Izvi zvinokonzera dumbu recheche kuti ritarise kana rakasanganiswa. Mushure mekudya, zvokudya zvichasiyiwa mudumbu remucheche sezvo gastric residuals. Pakupedzisira, zvokudya zvakakwana nemhepo zvinotapira mumatumbo ayo maronda ehoops ari kuonekwa pamuviri wemucheche.
Dumbu racho richava rinorwadza uye rinoratidzika, uye mwana angatanga kurutsa ivhu kana kuti kuva nemafuta. Ropa ringangodaro riri mumabhedha emwana, uye mwana angatanga kuvharwa kwose kwose uye ave nemuviri muduku. Mwana wacho anogonawo kunge akaoma nguva yekugadzirisa kutonhora kwake uye angatanga kuve nemafuta eapnea kana bradycardia . Pakupedzisira, chirwere chacho chichaputika, zvichiita kuti hutachiona hwehutachiona uye hutachiona huwedzere.
Kurapa
Muchikamu chekutanga, kurapwa kweNEC kunosanganisira kurega mukaka wekudya kuitira kuti chifukidzo chizorore, kupa mishonga inorwisa mabhakitiriya kurapa utachiona, uye kubvisa mweya kubva mudumbu. Mwana achabvuma kazhinji x-ray kuona chirwere chacho chichifambira mberi.
Kana kurapwa kwechiremba kusina kushanda kana kana chifukidzo chichikanganisika, chirwere chinoda kuitwa. Chiremba anovhiya achabvisa chero zvikamu zvakafa zvemuviri uye zvimwe zvakagadzirirwa. Chirwere chacho chinogona kushandiswa zvakare kana kuti chichaendeswa kumimba kuburikidza ne stoma . Zvirwere zvokurapa zvichaenderera mberi kusvikira chirwere chacho chagadziriswa.
Prognosis
NEC chirwere chakakomba, uye vanenge 25 muzana yevana vachipora kubva kuNEC vachada kurapwa kwezvinetso zvemazuva mazhinji. Vana vacheche vanobatwa nehutano hweNEC vanogona kuva nekukurumidza kunonoka, dambudziko rekudya mishonga, uye dambudziko nemakumbo avo uye vhudzi.
NEC inowedzerawo njodzi yekukurumidza kunonoka.
Vacheche vakave vachivhiyiwa neNEC zvakare vanoratidza zvirwere kwenguva refu kubva muchirwere. Mukuwedzera kumigumisiro yezvechiremba NEC, varwere vanovhiya vanogona kunge vane zvinetso zvakanyanya zvekudya zvakadai sechinguva chemawere epachiviri uye vane ngozi yakawanda yepereyma palsy uye nehupi neyesiso.
Kudzivirira
Kudzivirira kuberekwa nguva isati yasvika ndiyo nzira yakanakisisa yekudzivirira necrotizing enterocolitis. Kana iwe uri pangozi yekuberekwa kwekutanga, taura nachiremba wako pamusoro pezvaunogona kuita kuderedza dambudziko rako.
Kana kuberekwa kwekutanga kusati kwaitika, kugovana chete mukaka wemazamu kunogona kuderedza ngozi yeNEC.
Mukaka wepabonde une zvinhu zvinodzivirira izvo zvinokurudzira hutano hwakanaka uye hunogona kuderedza kuwanda kwemabhakitiriya anokuvadza mumatumbo. Mune rumwe ruzivo, vacheche avo vaidyara maiva ne50% mazamu emukaka aive nekuderera katanhatu mumagariro eNEC.
Mukuwedzera pakudzivirira kutanga kwekutanga nekuberekwa mukaka wemvere, kupa steroid kuna amai kana kusununguka nguva isati yasvika kunogona kuderedza dambudziko reNEC. Uyewo, kuwedzera mukaka wehadzi uye mazai nemishonga yakasiyana yakadai seprobiotics kana immunoglobulins inogona kubatsira, kunyange kutsvakurudza kwakawanda kunodiwa.
Sources:
Bradshaw, MSN RN NNP-BC, CCRN Wanda Todd. "Necrotizing Enterocolitis: Etiology, Mharidzo, Mutungamiri, uye Zvibereko." Journal of Perinatal & Neonatal Nursing January / March 2009, 23: 87-94.
Schurr, P naPerkins, EM. "Ukama Pakati Pokudya uye Necrotizing Enterocolitis Muduku Dzakawanda Kuberekwa Kwevana Vana." Neonatal Network Nov.-Dec. 2007, 27: 397-407.
Sears MD, William, Sears MD, Robert, Sears MD, James, Sears RN, Martha. The Premature Baby Book: Zvinhu Zvose Zvaunoda Kuziva Nezve Mwana Wako Usati Watanga Kubva Kuberekwa kusvika kuHera Rimwe . Little, Brown uye Co., New York, 2004.