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KWELI NQAKU
- Iimbangela zeMeconium Aspiration Syndrome (MAS)
- Iimpawu kunye neempawu zeMAS
- Iingxaki zeMeconium Aspiration Syndrome
- Ukuxilongwa kweMAS kwiintsana
- Unyango lwe-MAS
- Ukuxilongwa kweMAS kwiintsana
- UThintelo lweMAS
I-Meconium aspiration syndrome (MAS) yenzeka xa umntwana ongekazalwa okanye osanda kuzalwa ephefumlela umxube we-amniotic fluid kunye ne-meconium emiphungeni yabo ngelixa ingaphakathi kwisibeleko sikamama okanye ngexesha lokubeleka.
I-Meconium sisitulo sokuqala somntwana, esiluhlaza bumnyama, isitulo esityebileyo esenziwe ngeeseli, i-mucus, kunye nokukhutshwa kwamathumbu. Ngokuqhelekileyo, abantwana badlula isitulo sabo sokuqala kwiiyure ezimbalwa zokuqala okanye iintsuku emva kokuzalwa. Nangona kunjalo, inokwenzeka ngaphakathi esibelekweni kwezinye iimeko ngexesha s'follow noopener noreferrer kade'>1 ) ( Mbini ).
I-MAS inokubangela uxinzelelo lokuphefumula kwaye ikhokelele ekuguleni okanye kwezinye iingxaki. Funda le post ukuze wazi ngakumbi nge-MAS, kubandakanywa izizathu zayo, ukuxilongwa, iingxaki ezinxulumene, kunye nonyango.
ujonge ntoni umntu we virgo emfazini
Iimbangela zeMeconium Aspiration Syndrome (MAS)
Umntwana usenokuyikhupha i meconium ngoxa esesesibelekweni ngenxa yokuncipha kweoksijini kunye nonikezelo lwegazi (Nye) (3) . Isenokwenzeka kwakhona ngenxa yoxinzelelo lomntwana olubangelwa ziingxaki zeplacenta okanye intambo yombilical (4) .
Ngezantsi kukho ezinye izinto ezinobungozi ezinokubangela uxinzelelo lomntwana kunye nokukhululwa kwangaphambili kwe-meconium (Nye) (3) .
Indlela yokususa amabala amanzi anzima kwiglasi yokusela
- Ukuhanjiswa okunzima kunye nokusebenza ixesha elide
- Ukuguga kwe-placenta kwiimeko zokukhulelwa emva kwexesha
- Iimeko zoomama, ezifana nesifo seswekile, uxinzelelo lwegazi oluphezulu, isifo sentliziyo, okanye iingxaki ezingapheliyo zokuphefumla
- Ukusetyenziswa kweziyobisi komama, njengokutshaya ngexesha lokukhulelwa
- Iingxaki ezinxulumene nentambo ye-umbilical
- Ukukhula kakubi komntwana ngenxa yeengxaki ezisisiseko okanye usulelo
Iintsana zihlala zineengxaki zokuphefumla okwexeshana xa ziphefumla i-meconium. Ngokumalunga ne-5-10% yeentsana eziphefumla i-meconium zihlakulela i-meconium aspiration syndrome.
Iimpawu kunye neempawu zeMAS
Iimpawu kunye neempawu zinokuvela ngexesha le-feetal s'follow noopener noreferrer'>(1) (5) .
- Amabala anombala oluhlaza okanye imivimbo kwi-amniotic fluid
- Ukubonakala okuluhlaza kwesikhumba somntwana
- Ukubetha kwentliziyo ephantsi ngaphambi kokuzalwa
- Ukuqhwalela kusana ekuzalweni
- Amanqaku eApgar asezantsi (asetyenziselwa ukuvavanya umbala wolusu wosana olusanda kuzalwa, izinga lokubetha kwentliziyo, ingqondo, ithoni yemisipha, kunye nezinga lokuphefumla)
- Iingxaki zokuphefumla ezinokubandakanya ukuphefumla ngokukhawuleza (i-tachypnea), ukuphefumla ngokusebenzayo (dyspnea), okanye ukunqunyanyiswa kokuphefumla (i-apnea)
- Isandi sokuncwina ngelixa uphefumla
- Ukurhoxiswa (ukutsalwa) kodonga lwesifuba
- Izikhonkwane ezityheli okanye ulusu ngenxa yokuvezwa ixesha elide kwi-meconium
Iingxaki zeMeconium Aspiration Syndrome
Iintsana ezine-meconium aspiration syndrome ngokuqhelekileyo azifumani iingxaki zempilo zexesha elide. Nangona kunjalo, iintsana ezine-MAS ezinzima zinokuba nezi ngxaki zilandelayo (Nye) .
- Umngcipheko omkhulu wokuphuhlisa isifo semiphunga esingapheliyo kunye ne-bronchopulmonary dysplasia
- Imiba yophuhliso, kubandakanywa iingxaki ze-neurological
- Umphunga owileyo
- I-aspiration pneumonia
- Uxinzelelo lwegazi oluqhubekayo lwepulmonary (ukonyuka koxinzelelo lwegazi ngaphakathi kwemiphunga)
Ukuxilongwa kweMAS kwiintsana
Ukuxilongwa kwe-meconium aspiration syndrome kuxhomekeke kubukho be-meconium kwi-amniotic fluid. Inkqubo yokuxilonga inokubandakanya (Mbini) (3) :
- Ukujonga umntwana ongekazalwa ngesantya esisezantsi sentliziyo
- Ukukhangela izandi ezingaqhelekanga zokuphefumla komntwana (izandi ezirhabaxa okanye ezirhabaxa) usebenzisa i-stethoscope
- Ukuhlola amabala okanye iindawo ezinemivumbo emiphungeni kusetyenziswa iX-reyi yesifuba
- Ukufumanisa i-asidi yegazi, amanqanaba aphantsi oksijini, kunye namanqanaba aphezulu e-carbon dioxide kunye nohlalutyo lwegesi yegazi
Unyango lwe-MAS
Unyango lwe-MAS luxhomekeke kwizinto ezininzi, ezifana nenani le-meconium inhaled, ubude be-exposure, kunye nempilo yonke yomntwana osanda kuzalwa.
Usana olusandul’ ukuzalwa olusebenzayo, olukhalayo, nokuphefumla ngokuqhelekileyo ekuzalweni alufuni naluphi na unyango nangona kukho i meconium kwi-amniotic fluid. Usana luya kugcinwa phantsi kweliso njengoko iimpawu ze-MAS zinokuvela nanini na kwiiyure ze-24.
Ukuba umntwana osanda kuzalwa ubonisa iimpawu ze-MAS, ezifana nokuphefumula kokuphefumula, izinga eliphantsi lentliziyo, kunye nethoni ye-muscle engafanelekanga, umboneleli wezempilo unokuqwalasela oku kulandelayo kungenelelo. (Nye) (5) .
- I-Amnioinfusion ibonakaliswe iluncedo kwiintsana ezisengozini enkulu ngenxa yokunqongophala kweendawo zokubeka iliso. Uphando olongezelelweyo kwiimpembelelo kwabasetyhini luyafuneka kwaye alwenziwa rhoqo. Kwi-amnioinfusion, ulwelo olungenazintsholongwane lugalelwa kwi-amniotic fluid ngombhobho omncinci. Kuya kunceda ukunyibilikisa i-meconium kunye nokunciphisa inani elifakwe ngumntwana.
- Umlomo wosana kunye neendlela zomoya eziphezulu zifunxwa ngokukhawuleza emva kokuzalwa ngokufaka ityhubhu kwimigudu yomoya ngempumlo okanye emlonyeni. Nangona kunjalo, ngokwezikhokelo ze-NRP zakutsha nje, i-laryngoscopy ethe ngqo kunye ne-endotracheal suction ayiyomfuneko ngokwesiqhelo kwiintsana ezizalwe nge-MSAF.
Uninzi lweentsana lubonisa ukuphucuka ngokusebenzisa iinkqubo ezikhankanywe ngasentla. Usana lunokubekwa phantsi kweliso ukuze kuthintelwe ukuphinda kweempawu.
Iintsana ezineempawu ezinzima ze-MAS zinokuhamba ezi nkqubo zilandelayo zokuphucula ngakumbi (Mbini) (3) .
ungaxuba ntoni nge rum chata
- Ioksijini eyongezelelweyo inikezelwa ngomatshini wokuphefumla okanye ii-ventilators ezikhethekileyo
- Amayeza okubulala iintsholongwane emithanjeni ukuthintela usulelo lwemiphunga
- Ukusetyenziswa kobushushu obukhanyayo ukugcina ubushushu bomzimba womntwana kwelona luhlu lufanelekileyo
- Unyango lwesifuba somzimba apho isifuba somntwana sicofwa ngamaxesha athile ukuze kukhululwe i-meconium efakwe kwi-alveoli (iingxowa zomoya)
- Iimeko ezinzima zinokufuna ukulawulwa kwee-surfactants ukuphucula ukusebenza kwemiphunga kunye neegesi ezikhethekileyo, ezifana ne-nitric oxide, ukuphucula utshintshiselwano lwe-oxygen.
Umntwana uya kunikwa isondlo se-intravenous kwi-NICU de imeko yabo iphucule.
Ukuxilongwa kweMAS kwiintsana
Uninzi lweentsana zingadinga iintsuku ezimbini ukuya kwezine zonyango, kwaye i-syndrome ixazulula kwiiveki ezimbalwa. Iintsana ezine-MAS ezinzima zingabonakalisa ukuphefumla ngokukhawuleza kwiintsuku ezimbalwa emva kokuba ezinye iimpawu zisonjululwe. Ngokuqhelekileyo akukho ziphumo zexesha elide okanye umonakalo wemiphunga, nakwiintsana ezineempawu ezinzima.
iindlela ezilungileyo zokucela intombazana ukuba igoduke
Kwiimeko ezinqabileyo, usana lunokuba noxinzelelo lwegazi oluqhubekayo lwepulmonary (ixesha elide loxinzelelo lwegazi oluphezulu kwimiphunga), ukucutha ngokusisigxina kweendlela zomoya, kunye nokulimala kwengqondo ngenxa yokunganeli kweoksijini yengqondo. Uninzi lweentsana azifane zibonise iingxaki ezimandundu kuba zinemiphunga ekhulayo, ethi ivelise i-alveoli entsha ukuze kube lula ukuphefumla. (Nye) .
UThintelo lweMAS
Ukuhlolwa rhoqo kunye ne-ultrasonography kunokunceda ekubhaqweni kwangaphambili kweengxaki zokuphefumla komntwana obonisa i-MAS. Usenokuthatha la manyathelo okhuseleko alandelayo ukunqanda umngcipheko weMAS (Nye) (3) .
- Landela i-ultrasonography yakho (i-ultrasound checks) ishedyuli ngenkuthalo. Inokunceda ekufumaneni kwangethuba izinto ezinobungozi ezikhokelela ekukhutshweni kwangaphambili kwe-meconium, njengeengxaki kwi-placenta okanye intambo yombilical.
- Ukulawulwa ngokufanelekileyo kweemeko zempilo ngexesha lokukhulelwa, njengesifo sikashukela, kunokuncedisa ukunciphisa umngcipheko we-MAS.
- Yiphephe imikhwa engafanelekanga, enjengokutshaya, ngexesha lokukhulelwa.
- Qhagamshelana nogqirha wakho ukuba ubona ulwelo oluluhlaza ngexesha lekhefu lamanzi ngexesha lokukhulelwa.
I-Meconium aspiration syndrome idla ngokuba yimeko engaqhelekanga, kwaye iintsana ezihlangabezana nazo azifane zibe neziphumo ezibi. Nangona kunjalo, iimeko ezinzima zinokukhokelela kwiingxaki zexesha elide, kubandakanywa nokusebenza kakubi kwemiphunga.
Mbini. I-Meconium aspiration syndrome : Johns Hopkins Medicine
3. I-Meconium aspiration syndrome : IThala leeNcwadi leSizwe laMayeza laseU.S
Isine. I-Meconium Aspiration ; Isibhedlele sabantwana sasePhiladelphia
5. I-Meconium aspiration syndrome : Isibhedlele sabantwana saseBenioff
