I-Necrotizing enterocolitis

I-Necrotizing enterocolitis (NEC) kukufa kwezicubu emathunjini. Oku kwenzeka rhoqo kwiintsana ezingaphambi kwexesha okanye ezigulayo.

I-NEC yenzeka xa ulungelelwaniso lodonga lwamathumbu lusifa. Le ngxaki phantse ihlala ikhula kwimveku egulayo okanye ngaphambi kwexesha. Kungenzeka ukuba yenzeke ngelixa umntwana esesibhedlele.

Oyena nobangela wale ngxaki akaziwa. Ukwehla kokuhamba kwegazi ukuya emathunjini kungonakalisa izicwili. Iibhaktheriya emathunjini nazo zingongeza kwingxaki. Kwakhona, iintsana ezingaphambi kwexesha zinempendulo yomzimba engaphuhliswanga kwizinto ezinjengebhaktheriya okanye ukuhamba kwegazi okuphantsi. Ukungalingani kummiselo we-immune kubonakala ngathi kuyabandakanyeka kwi-NEC.

Iintsana ezisemngciphekweni omkhulu wale meko zibandakanya:

• Iintsana ngaphambi kwexesha
• Iintsana ezondliwa ubisi olungumgubo kunokuba lubisi lomntu (Ubisi lomntu luqukethe izinto ezikhulayo, ii-antibodies kunye neeseli zomzimba ezinokunceda ukuthintela ingxaki.)
• Iintsana kwindawo yokugcina abantwana apho kuqhambuke khona
• Iintsana eziye zatofelwa igazi okanye zagula kakhulu

Iimpawu zinokuza kancinci okanye ngequbuliso, kwaye zinokubandakanya:

• Ukudumba kwesisu
• Igazi esitulweni
• Urhudo
• Iingxaki zokondla
• Ukungabikho kwamandla
• Ubushushu bomzimba obungazinzanga
• Ukuphefumla okungazinzanga, ukubetha kwentliziyo, okanye uxinzelelo lwegazi
• Ukuhlanza

Uvavanyo lunokubandakanya:

• X-ray esiswini
• Isitulo sovavanyo lwegazi lobugqi (guaiac)
• I-CBC (inani elipheleleyo legazi)
• Amanqanaba e-Electrolyte, iigesi zegazi kunye nezinye iimvavanyo zegazi

Unyango losana olunokuba ne-NEC rhoqo kubandakanya:

• Ukumisa ukutya ngaphakathi (iphecana le-GI)
• Ukuphelisa irhasi emathunjini ngokufaka ityhubhu esiswini
• Ukunika ulwelo IV kunye nesondlo
• Ukunika ii-antibiotics ze-IV
• Ukubeka iliso kwimeko nge-x-ray esiswini, iimvavanyo zegazi kunye nokulinganiswa kweegesi zegazi

Usana luya kufuna utyando ukuba kukho umngxunya emathunjini okanye ukudumba kodonga lwesisu (peritonitis).

Kolu tyando, ugqirha uya:

• Susa izicwili ezifayo
• Yenza icolostomy okanye ileostomy

Amathumbu anokuphinda aqhagamshelwe emva kweeveki okanye iinyanga ezininzi xa usulelo luye lwaphola.

I-Necrotizing enterocolitis sisifo esibi. Ukuya kuthi ga kwiipesenti ezingama-40 zeentsana ezine-NEC ziyafa kuyo. Kwangoko, unyango olunoburharha lunokunceda ukuphucula iziphumo.

Iingxaki zinokubandakanya:

• I-Peritonitis
• Sepsis
• Ukugqobhoza emathunjini
• Ukuqiniswa kwamathumbu
• Iingxaki zesibindi ngenxa yokungakwazi ukunyamezelana nokunyamezeleka kokutya kunye nemfuno yesondlo se-parenteral (IV)
• Isifo esifutshane samathumbu ukuba kulahleka isixa esikhulu samathumbu

Fumana ukhathalelo lonyango olungxamisekileyo ukuba ngaba kukho naziphi na iimpawu ze-necrotizing enterocolitis ezikhulayo. Iintsana ezibhedlele ngenxa yokugula okanye ukukhula komzimba zisengozini ephezulu ye-NEC. Bajongwe ngeliso elibukhali kule ngxaki ngaphambi kokuba bagoduswe.

• Amathumbu eentsana

ICaplan M. Neonatal necrotizing enterocolitis. Ku: UMartin RJ, uFanaroff AA, uWalsh MC, ii-eds. UFanaroff kunye noMartin's Neonatal-Perinatal Medicine. Ngomhla we-10. IPhiladelphia, PA: Elsevier Saunders; 2015: isahluko 94.

IGreenberg JM, uHaberman B, uNarendran V, uNatan AT, uSchibler K.Izifo ezibangelwa kukuzalwa komntwana ngaphambi kokuzalwa. Ku: Resnik R, Lockwood CJ, Moore TR, Greene MF, Copel JA, Isilivere RM, ii-eds. I-Creasy kunye neResnik's Maternal-Fetal Medicine: Imigaqo kunye nokuziqhelanisa. Ngomhla we-8. IPhiladelphia, PA: Elsevier; I-2019: isahluko 73.

Imbewu PC. I-microbiome kunye nempilo yabantwana. Ku: Kliegman RM, St Geme JW, Blum NJ, Shah SS, Tasker RC, Wilson KM, ii-eds. Incwadi kaNelson yeNcwadi yePediatrics. Umhla wama-21. IPhiladelphia, PA: Elsevier; 2020: isahluko 196.