Pneumothorax uye Dzimwe Mhando dzeMhepo Mhepo
Chii chinonzi Pneumothorax?
A pneumothorax rudzi rwemapapu akaputsika apo mweya inounganidza mukati memapfupa emapfupa, pakati pemapapu uye murusvingo rwechifuva. A pneumothorax, dzimwe nguva inonzi "pneumo," inogona kuva yanyoro kana yakaoma zvichienderana nemhepo yakawanda iripo.
Pneumothorax inogona kukonzerwa nemhepo inopinda mubhokisi kubva kunze kwemuviri kana kubva kumapapu pachavo.
Mune NICU, akawanda pneumos anoitika apo mhepo inobva mumapapu inoderera. A pneumothorax inongova imwe chete yemhepo inoputika. Kana mhepo ichienda pane imwe nzvimbo kunze kwechifukidzo chechipfuva, kuputika kwemhepo kune zita rakasiyana.
Chii Chinokonzera Pneumothorax?
A pneumothorax kana imwe mhepo inoputika inotanga apo inonzi alveoli , maduku maduku emhepo mumapapupa umo oxygen uye carbon dioxide zvinoshandurwa, zvinoputika. Apo ngarava inoputika, mhepo inopukunyuka uye inokonzera mhepo ichidonha.
Vacheche vane mapapu asina simba, uye zvinhu zvakawanda zvinogona kuwedzera pangozi yevana yepneumothorax kana mamwe mafungu emhepo. Kunyange zvazvo vamwe vana vari pangozi huru kupfuura vamwe, chero mucheche angangoberekwa anogona kuvaka pneumo sezvo mapapu avo anowedzera mushure mokuberekwa. Zvinhu zvinokuvadza zvinopa mwana wako mukana mukuru wekugadzira pneumo zvinosanganisira:
- Kuberekwa kusati kwaitika : Vavengi vane mishonga yakaoma kwazvo yemapapu, uye alveoli yavo inoputika nyore nyore. Vacheche vanoyera zvishoma kudarika 1500 g (3 lb 5 oz) pakuberekwa vari pangozi huru.
- Batsira kufema pawakaberekwa: Kana vana vasingapfuuri pakarepo mushure mekuberekwa, boka rekudzorera rinoshandisa ambu bag kana imwe chigadziro kupa mweya kufema kusvikira mwana atanga kufema. Kunyange zvazvo zvichidiwa, izvi zvinobatsira kufema zvinogona kukonzera pneumo.
- Mechanical ventilation: Vana vanoda rubatsiro rwakapetwa kufema, zvichibva kumhepo kana kubva kuCPAP, vane ngozi yakanyanya yepneumo. Izvi zvinokonzerwa nokuti magetsi anopinza mweya mumapapu kuitira kuti vaite kuti vanyengedze uye vachengetedze oksijeni yemwana.
- Meconium aspiration: Vana vanofema meconium panguva yekuzvarwa vanogona kurwara zvikuru. Meconium inogona kuvhara mhepo, zvichibvumira mweya kupinda mukati asi kwete kunze kwemapapu. Iyi kuisa mweya inogona kuwedzera kukurira mukati memaarveoli uye inoita kuti vaparare.
Pneumothorax inotorwa sei?
Kana vanachiremba vachifunga kuti mwana wako ane pneumo, ivo vachaita bhokisi re-ray kuti vaone kuti vanoona sei. Kana pasina x-ray iripo, inogona kuvhenekera chiedza kuburikidza nechifukidzo chemucheche wako (transillumination) kutarisa nzvimbo dzakachena apo mweya yakaunganidza.
Kurapa kwemafunguro emhepo kunoenderana nekuipa kwezviratidzo uye kuti zvakakura sei kubuda kwemhepo. Vacheche vane zvidiki zviduku zvingave vasina zviratidzo zvachose uye vangave vasingadi kurapwa. Izvo zvinokonzera zvichaporesa pachazvo, uye muviri unodzorerazve mhepo.
Pneumo huru inogona kuita kuti mwana ave nechinetso chikuru chokufema. Kuvakwa kwemweya kunogona kusundira mwoyo, mishonga yakanyanya yeropa, uye mhepo inoputika kubva panzvimbo yakarurama uye inogona kuva mamiriro ekurapa anotambudzika. Mishonga inobva paukuru hwezviratidzo, uye inogona kusanganisira:
- Supplemental oksijeni: Mune zvimwe zviitiko, kupa mwana muzana 100% oksijeni kunogona kubatsira mutumbi kudzorera mweya kubva pneumo. Iyi nzira inoshandiswa chete mumakore ekupedzisira pamusana pengozi yeROP muvatungamiri.
- Nyorera kushuva: Neteyo yakabatanidzwa nesiriniti inogona kuiswa mukati meruzha rwechifuva uye inoshandiswa kubvisa mhepo yakaunganidza. Iyi tsono inobviswa ipapo uye ganda rinosungwa.
- Chep tube: Muine pneumothorax yakakomba kana muvana vasati vasvika pamhepo, mudziyo webhokisi inowanzoshandiswa kubvisa mhepo kusvikira mweya wakanyarara wakagadzirisa. Aipurasitiki yepurasitiki inopinza ichaiswa mubhokisi recheche uye inogadziriswa, uye iyo inobatana nekutsvaira. Kuyamwisa kuchabvisa mweya sezvo inounganidza. Bhuku rebhokisi rinozobviswa mushure mokunge mweya wose wakabviswa uye kubviswa kwacho kwapora.
Mushure mokunge pneumothorax inorapwa, vanachiremba vachadzokorora bhokisi x-ray kuti vaone kuti kuora kunoporesa uye hapana mhepo itsva yakawana.
References:
Yunivhesiti yeRochester Medical Centre Health Encyclopedia. "Pneumothorax." Inowanikwa kubva ku http://www.urmc.rochester.edu/Encyclopedia/Content.aspx?ContentTypeID=90&ContentID=P02397
Rennie, J. (2012). Rennie & Robertson's Textbook of Neonatology, 5th ed. Elsevier.
Litmanovitz, I. & Carlo, W. (Nov. 2008). "Inotarisira Kutarisira Kwepneumothorax muZvinyoro Zvisina Kukwana." Pediatric, 122 (5); e975-e979.