Kana mwana aberekwa nguva isati yamboitika , vanowanzove vachinetseka kufema pachavo voga uye vanoda rumwe rudzi rwekubatsira. Rudzi rwekubatsira kupemha mwana wako ruchadikanwa runobva pane kuti mwana wako akaberekwa sei pakutanga. Iwe unogona kunge wakamboudzwa kuti mwana wako ane chimwe chinhu chinonzi RDS. RDS kana kuporesa Distress Syndrome ndechimwe chezvinetso zvinowanzosangana nevana vachaberekwa pavanoberekwa vasati vasvika.
Mucheche asati aberekwa, mapapu anowira uye oxygen inopiwa kune mwana kuburikidza neparcenta. Iyo placenta inobvumira kubuda kwe oksijeni nemirivo kubva muropa raamai kuenda kumwana weropa kuburikidza nemutsara wembilical. Mushure mokunge mwana aberekwa izvi zvose zvinoshanduka. Apo mutsara unobviswa, mutsara wehupenyu weakisijeni unowedzera kupisa ropa rinoparadzaniswa. Nzara inotanga uye mwana achangobva kuberekwa anotanga kuputira mhepo. Nezvo izvi zvinoputika, mapapu anowedzera kwekutanga uye anotendeuka kubva pakudonha, simba rakasimba kune zvikwereti zvakaderera mumhepo.
Maitiro Akaita Sei?
Mapapu emakura anoumbwa nemapupa, elastic tishu inotambanudza uye inoita sezvamunofema. Kune mamiriyoni ediki maduku, mapuranga akazara anonzi alveoli anowedzera apo mweya inopinda mukati. Muchikamu chealveoli, inenge yakateteka yewaini inonzi surfactant. Munhu asina kusimba isiri yakadai semasipu iyo inowanzopfeka mukati memapapu akakura uye inodzivirira aya mabhuru maduku (alveoli) kuti arege kuputsika.
Munhu asina kusimba anonyanya kukosha pakugoverana uku kwe okisijeni uye carbon dioxide pakati pemapapu neropa. Kugadzirwa kwemafrefactant mukati memasero emapapupu anotanga pakati pemasvondo makumi maviri nemasere kusvika kumakumi maviri nemashanu, uye kuwedzera kwekugadzira kusvikira mwana achisarudzwa.
Apo mwana anozvarwa nokukurumidza zvikuru, vane immature mapapu uye kazhinji haawanikwi zvakakwana.
Mipapu haigone kuzarura zvakanaka zvakakwana kuti isunge okisijeni kuti iite zvakanaka muropa uye igoverwe kune nhengo dzemuviri dzinokosha. Mapapu epakutanga anewo zvishomanana zvinonzi alveoli zvinoshandisa kukwanisa kuchinjana okisijeni uye carbon dioxide. Mapapu anoenderera mberi achiita alveoli kusvika pakuzvarwa. Izvo zvinotangira mwana, zvishoma zvishoma ivo vachave nazvo. Aya alveoli ane maduku uye ane nzvimbo yakanyorova. Mvura yakadzika inonamatira pamwe chete, ichikonzera kubhururuka kwepasi. Iyo isina kusimba inoita kuti kuderedzwa uku kunobvumira nzvimbo dzomumapapu kuti dziwedzere, zvichibvumira kushandiswa kwemhepo.
Mhepo yatinofema inoumbwa nemagetsi akasiyana-siyana, okisijeni, kuva akakosha zvikuru nokuti masero anoda iyo simba uye kukura. Pasina oxygen, masero emuviri aizotanga kufa. Carbon dioxide ndiro gaseous tsvina inogadzirwa yakagadzirwa nemetabolism sechikamu chekuita simba kwemuviri. Mapapu anobvumira oksijeni mumhepo kuti iendwe mumuviri, uye ichigonesa muviri kuti ubvise carbon dioxide mumhepo ichifema.
Munhu asina kusimba anonyanya kukosha pakugoverana uku kwe okisijeni uye carbon dioxide pakati pemapapu neropa. Kugadzirwa kwemafrefactant mukati memasero emapapupu anotanga pakati pemasvondo makumi maviri nemasere kusvika kumakumi maviri nemashanu, uye kuwedzera kwekugadzira kusvikira mwana achisarudzwa.
Apo mwana anozvarwa nokukurumidza zvikuru, vane immature mapapu uye kazhinji haawanikwi zvakakwana. Mipapu haigone kuzarura zvakanaka zvakakwana kuti isunge okisijeni kuti iite zvakanaka muropa uye igoverwe kune nhengo dzemuviri dzinokosha. Mapapu epakutanga anewo zvishomanana zvinonzi alveoli zvinoshandisa kukwanisa kuchinjana okisijeni uye carbon dioxide. Mapapu anoenderera mberi achiita alveoli kusvika pakuzvarwa. Izvo zvinotangira mwana anenge ane shaveoli vashomanana vangave nayo.
Matambudziko ekutanga uye ekuputira
Muzhinji, yekutanga mwana anoberekwa, mukana mukuru wekudzidzira kuporesa kunetseka. Kana kusununguka nguva isati yasvika kunogona kuchinjwa zuva rimwe chete kana maviri, amai vanogona kupiwa majekiseni maviri, maawa makumi maviri nemasere, e-steroids, zvakadai se betamethasone vasati vaberekwa.
Betamethasone inoshandiswa kubatsira rubatsiro mukukura kwemapapu kana kuberekwa kusati kwatarisira kunotarisirwa.
Vavengi ne RDS vanowanzowana maitiro ezvokuita zvekushanda, achipiwa pasi pfupa yekufema; zvakananga kumapapu umo inopfeka mabhodhi emhepo achibvumira kushandiswa kwemhepo kwakanaka. Mwana ane RDS angatowedzera kuwedzera mumazuva mashomanana ekuberekwa asi acharatidza zviratidzo zvekuvandudza apo mapapu anotanga kubudisa avo vanoita zvisizvo, kazhinji mukati memavhiki mashoma.
Vacheche vane RDS vachawanzodiwa neimwe nzira yekuwedzera oxygen. Imwe nzira yekuvandudza mwana weiyakisi yakagadziriswa ndeyokuwedzera kukanganiswa kweokisijeni mumhepo mwana ari kugamuchira. Kazhinji nzvimbo yemhepo inenge 21 muzana oksijeni. Vacheche vanoda kuwedzera oksijeni inogona kuwana kusvika ku100 muzana oksijeni, mumamiriro ezvinhu akaoma, kana zvichidiwa. Maitiro eokisijeni uye mazinga anoongororwa zvakanyanya sezvakakosha kuwana hutano hwakanaka. Zviduku zvishoma zvinogona kukonzera kukanganisa kwenheyo yenheyo uye zvakawanda zvinogona kukanganisa mapapu pachavo, pamwe nemaziso.
Oxygen saturation chekucherechedza, (inowanzozivikanwa semafuta emapurisa kana kuti purogiramu yakagara) inoiswa kune imwe netsoka kana pfupa remucheche-izvi zvinoderedza mazinga eokisijeni muropa recheche. Nhamba ye okisijeni inonyorwa sezana. Iyi yezana ndiyo yakawanda yeokisijeni mamolekemu ye hemoglobin muropa iri kutakura.
Ropa romuviri rinonzi ropa gasi ndedzimwe nzira yekuyera kuti kushandurana uku kuri kuitika sei mumwana wemwana. Uyu muedzo unopa ruzivo rwakawanda kupfuura kuwedzera kwekuona uye rinowanzoshandiswa kana mwana ari pamazinga akakwirira ekutsigirwa kuporesa. Chinangwa chacho ndechokuti uve nehuwandu hwekutsigirwa kuchengetedza mwana wemhepo yakakosha mumatambudziko aunoda. (Iyi yakarongeka yakavakirwa pamazera ekutenda.)
Kune mazita akasiyana-siyana akasiyana-siyana ekutsigira mwana ane RDS. Sezvo mapapu ari kukura, chiyero chekufuridzirwa kunopera muitiro unonzi kusvimha. Iyi yekugadzirisa inonyanya kudikanwa kumucheche uye ichagadziriswa nekuoma kwakaitwa mwana kufema, oksijeni yakagadziriswa, uye mazimbe emhepo, uye hutano hwemwana.
Heano zvimwe zvezvikamu zvakanyanya kufanana zvemishoni zvinoshandiswa pakufema, izvo zvinowanzotsanangurwa:
- Ventilator - Mapumpu air uye oxygen mumapapu kuburikidza ne endotracheal tube. (Izvo zvinonzi ET tube kana kufema bhutu.) Mhepo inofema ichafema kumwana uye inogadzirirwa kupa mweya imwe nguva nenguva.
- Oscillator - rudzi rwemhepo inoputika inoshanda nekudengenyeka kweokisijeni mune uye carbon dioxide kunze kwemazana emagetsi mashoma anopfutira paminiti.
- Kuenderera mberi Zvakanaka Airway Pressure - Inowanzonzi CPAP. CPAP haisi kupfurikidza nemhepo kune mwana, asi inoputira kubuda kwemhepo mumapapu emucheche pamusana pekudzivirira kuchengetedza mapapu zvishoma nezvishoma. CPAP inowanikwa kuburikidza nemapapu emucheka.
- (Bubble) CPAP - inoshanda nekuratidza kusingirirwa kusingaperi kumhepo yechecheche. (Via nasal prongs) yakafanana neCPAP asi ine dutu rinopfurikidza rinowanikwa pasi pemvura, uye bubbles-izvo zvinokonzera kushungurudzika uye zvinopa nguva dzose oscillation mukati memapapu emapapu.
- Nasal Cannula - Oxygen iyo inopihwa zvakananga kumwana kuburikidza nepurasitiki ine zvidhinha zviduku zvinowanikwa mumhino dzomwana.
RDS yakajairika chaizvo mumwana asati azvarwa nekuti mapapu haazviri ivo pachawo. Kubva pamaitiro ekutanga mwana wako akazvarwa achaona kuti vachafambira sei kuburikidza nemamiriro aya. Zvinotyisa kukuona mudiki wenyu kurwisana nezvinhu zvisiri nyore isu isu vakuru tisingatorereki kwechipiri chezuva rega rega. Tariro, ruzivo urwu rwakakubatsira kuti unzwisise kuti chii nei uye chii cheRSS uye ichikubatsira iwe, iwe pachako kufema zvishoma zvishoma, pamwe chete nemwana wako.
Sources:
Mvura, Vacheche uye Biology: Nhau ye Surfactant. (nd). Kudzorerwa kubva ku http://www.fasebj.org/content/18/13/1624e.full
Chokwadi pamusoro peRetinopathy ye Prematurity (ROP) | National Eye Institute. (nd). Yakadzorerwa kubva ku https://www.nei.nih.gov/health/rop/rop
The Immature Lung - AboutKidsHealth. (nd). Kudzorerwa kubva ku http://www.aboutkidshealth.ca/en/resourcecentres/prematurebabies/aboutprematurebabies/breathing/pages/the-immature-lung.aspx
Zvinorayirwa neonatal surfactant therapy. (nd). Kudzorerwa kubva ku http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2722820/