Vana vacheche vanoberekwa vasati vava nenguva yakaderera mazinga ezvirwere, maitiro muropa iro rinobatsira kuchengetedza kurwisana nehutachiona. Muchikamu chinotevera chepamuviri, zvirwere zvinotapukira muparcenta kubva kuna amai kusvika pamucheche. Kana mwana akaberekwa nguva isati yapera vanorasikirwa nehutachiona hwehutachiona hwekudzivirirwa kwezvirwere zvekudzivirira uye naizvozvo, mungozi yavo yekudzivirira zvirwere yakakwirira.
Vavengi vanowanzoita zvirwere nokuti zvirwere zvavo zvemasimba zvirwere hazvina simba uye naizvozvo zvakaoma kuti varwise zvirwere zvakanaka ivo pachavo. Zvirwere muhutachiona zvinogona kuchinja kukwanisa kwavo kufema, kuwedzera kuwanda, zvinogona kuwedzera kugara kwavo kuchipatara uye zvinogona kutungamirira kune mamwe matambudziko asingagumi. Zvakakosha kuziva kuti nematanho akakodzera uye ruzivo, tinokwanisa kudzivirira zvimwe zvezvirwere izvi uye zvinogona kuita kusiyana kukuru muhutano huzhinji pamwe nemigumisiro yevana vasati vasvika .
Nemhaka yekudzivirira kwezvirwere zvekudzivirirwa kwezvirwere uye kusakwana kwekudzivirira, mwana asati azvarwa anogona kuve nehutachiona munenge chero chikamu chemuviri. Yakawanda inowanikwa muropa (inonzi sepsis), mumapapu, uropi (pneumonia) uye musipinha (meningitis), ganda, kana itsvo, chivako (urinary tract infection-UTI), kana mumatumbo (NEC). Nguva pfupi mushure mekuberekwa, vana vose vanowana marudzi maviri emishonga, vamwe vane hutano, uye mamwe mabhakitiriya anokwanisa kukuvadza.
Mabhakitiriya ane hutano anobatsira kuchengetedza zvinokuvadza. Mabhakitiriya Akanaka anobatsira rubatsiro mukudya. Dzimwe nguva, kune preemie, iyi yakaoma nzira inova isina kuenzanisa iyo inogona kutungamirira kumatambudziko uye kutapukirwa. Ganda ndiyo yekutanga yekudzivirira. Mucheche asati avapo, ganda racho rakaoma uye rinogona kugara richirapa sezvakaita IV inotanga, majekiseni, uye kuongorora ropa.
Izvi zvinogona kuva chivako chezvipembenene kupinda mucheche asati asvika. Nemhaka yokuti utachiona pachahwo hunogona kuva chikonzero chekuberekwa kusati kwavapo, preemie inogona kunge yakarohwa uye inotora utachiona muUtero apo mabhakitiriya kana chirwere chinoparadzirwa kubva muropa raamai kuburikidza ne-placenta uye umbilical cord kumwana. Vanogonawo kukudziridza zvirwere kubva pakusununguka mumamiriro avo ezvinhu, shure kwemazuva kana masvondo mukati meNICU.
Zvirwere zvinokonzerwa nechimwe chemarudzi matatu emakoromondi; mabhakitiriya, mavairasi, kana fungi. Mabhakitiriya mashoma masero akawanikwa ari munharaunda, paganda, uye mu (GI) gumbo rematumbo. Mishonga inonzi antibiotics inoshandiswa kurapa zvirwere zvinokonzerwa nemaabhakitiriya. Ampicillin neGentamicin ndiwo maviri emishonga inowanzoshandiswa muNICU. Virusi zvipenyu izvo zviduku kudarika mabhakitiriya uye hazvibviri kurwisa mishonga inorwisa mabhakitiriya. Ikoko kune mishonga inowanikwa inonzi antiviraire inobatsira nemamwe maitiro eubhakitiriya anokonzera utachiona. Fungi kana zvinowanzonzi mbiriso zvinowanzowanikwa muturakiti reGI uye paganda uye inogona kuva chikonzero chehutachiona hunopisa upenyu. Mishonga inonzi intifungals inoshandiswa pakurapa zvirwere zvefungal.
Zvinogona kuva zvakaoma kutaurira kana preemie iri kukura utachiona. Zvimwe zvezviratidzo zvingave zvinosanganisira: ganda rakaputika kana rakasvibiswa, rinononoka kudarika moyo wakawanda, nguva dzepnea (inomira mukufema), uye kusakwanisa kuchengeta kutonhora kwemuviri kwakasimba; kana yakakwirira kwazvo kana yakaderera. Mwana wacho anogona kunge ane urombo hutema kana kuti ari chikwata uye angave akaoma kuramba akachenjerera kana kuti angave akaoma. Icheche inogonawo kunetseka kubvumira zvokudya zvavo.
Iko kune zvimwe zviedzo zvinowanzoitwa muNICU apo mwana ari kuratidza zvirwere zvehutachiona. Iyi miedzo inogona kuitikawo nguva dzose kuti ibvise chero chero chinogona kuitika chinetso chinogona kuitika.
Ropa rinogona kutorwa kutarisa kuchena kwecheche yeropa yevana. Mishonga yakachena yeropa '(WBC) chinangwa chikuru pamuviri ndewokurwisa zvirwere. Ipamusoro kupfuura yakasvibirira kana yakaderera kupfuura yevoruzhinji WBC count inonetseka kuti mwana angave ari kukura kana ane utachiona. Chirongwa cheWBC chinonzi neutrophil chinobudiswa mumuviri mukupindura nekuputika uye utachiona. Neutrophils iWBCs isati yasvika uye kana utachiona huripo, muviri unokurumidze kusunungura masero aya asina kusimba kuti abatsire kurwisa zvirwere zviduku. Chimwe chekuongorora ropa chinonzi CRP kana C-reactive protein test inogona kuitwa. C-reactive protein ndiyo chinhu chinosunungurwa nemuviri mushure mekuputika. Chirongwa cheRPP chakakwirira chingaratidza kuvapo kwehutachiona. Ropa tsika ndiyo muedzo unoitwa kuedza nekukura microorganism inogona kuvapo muropa. Uyu muedzo unoitwa kuti uone chinangwa chaicho chinogona kuvapo uye chichabatsira kusarudza kuti ma antibiotic akakodzera sei kubata chirwere chacho.
Chifukidzo X-ray chiratidzo chekuongororwa kuona mapapu kuti aone kana kune hutachiona hwakadai sepineumonia. Mucherechedzo wepelinha kana kuputika kwechiremba (LP) chimwe chiedza chinogona kuitwa kuti chiongorore meningitis. Mukati reLP, chidiki chepereum spinal fluid (iyo inoshanduka inopoteredza uropi nemutsipa wesipinha) inobviswa uye yakaongororwa nokuda kwehutachiona.
Kana pane uchapupu hwehutachiona, mwana anogona kurasikirwa nemishonga inorwisa mabhakitiriya, zvirwere zve IV, oxygen, kana kunyange mhepo inokonzera mhepo zvichienderana nekuoma kwezviratidzo uye microorganism pachayo. Kunyange zvazvo dzimwe zvirwere zvinogona kunge zvakakomba zvikuru, vazhinji vanopindura zvakanaka kumishonga inorwisa mabhakitiriya.Pakutanga kacheche inotapurirwa, zviri nani mukana wekubudirira kurwisa utachiona.
Mune maitiro ezvirwere zvemuviri wemwana asati azvarwa asati apera acharamba achive asina kuchena kwemwedzi mishoma yekutanga yehupenyu uye kusashanda pamwe chete neyeiyo mwana achangobva kuberekwa uye saka anovaisa pangozi yakawanda yekutengesa zvirwere, kunyanya zvirwere. Kuchengetedza preemie yako iri muNICU uye mushure mekuyerera kunokosha zvikuru. Kushambidza maoko uye kushandiswa kwemafuta sanitizerasi zvinhu zviviri zvinokosha zvikuru zvaunogona kuita nekukurudzira vamwe vanozoshanyira kana kuti vakakomberedza preemie yako kuti uite zvakafanana. Deredzai nhamba yevashanyi uye chengetedzai avo vane zviratidzo zvekudziya, kuchena kana kutapukirwa. Zvirwere zvakajeka muvana vakwegura nevakuru zvinogona kunge zvakakomba uye kunyange zvinouraya mwana asati azvarwa.
Sources
Stoll et al. Kutanga kunotanga kusangana neonatal sepsis: mutoro weboka reB streptococcal uye E. coli chirwere chinopfuurira. Pediatrics. 2011: 127: 817-826.
Rennie JM (2005) Roberton's Textbook yeNeonatology , England, Churchill Livingstone, p1017
Kaufman D, Fairchild KD. Clinical microbiology yebhakitiriya uye sefisi yefungal mucheche-pasi-kuberekwa-ucheche vacheche. Clin Microbiol Rev. Jul 2004; 17 (3): 638-80.
Lopez Sastre, JB, Coto Cotallo, D., & Fernandez Colomer, B. (2002). Neonatal sepsis ye nosocomial inotangira: chirwere chepachivande kubva ku "Grupo de Hospitales Castrillo". J Perinat Med, 30 (2), 149-157