I-apnea yobudala bokuqala

I-apnea ithetha "ngaphandle komoya" kwaye ibhekisa ekuphefumleni okucothisa okanye kuyeke nakweyiphi na isizathu. I-apnea yobudala bokuqala ibhekisa ekuphefumleni kwiintsana ezizalwe ngaphambi kweeveki ezingama-37 zokukhulelwa (ukuzalwa kwangaphambi kwexesha).

Uninzi lweentsana ezizelwe ngaphambi kwexesha zinendawo ethile yokuphefumla ngenxa yokuba indawo yengqondo elawula ukuphefumla isakhula.

Kukho izizathu ezininzi zokuba abantwana abasanda kuzalwa, ngakumbi abo bazalwe kwangoko, banokuba ne-apnea, kubandakanya:

• Iindawo zobuchopho kunye neendlela zemithambo-luvo ezilawula ukuphefumla zisaphuhliswa.
• Izihlunu ezigcina umoya uvulekile zincinci kwaye azomelelanga njengokuba ziya kuba mva ebomini.

Olunye uxinzelelo kumntwana ogulayo okanye ongaphambi kwexesha lusenokuba mandundu i-apnea, kubandakanya:

• Ukunqongophala kwegazi
• Iingxaki zokondla
• Iingxaki zentliziyo okanye zemiphunga
• Usulelo
• Amanqanaba eoksijini asezantsi
• Iingxaki zobushushu

Indlela yokuphefumla yabantwana abasandul 'ukuzalwa ayisoloko ihleli rhoqo kwaye inokubizwa ngokuba "kukuphefumla ngamathuba athile." Le patheni inokwenzeka ngakumbi kwiintsana ezisanda kuzalwa ezizalwe kwangoko (iintshaba). Iqukethe iziqendu ezimfutshane (malunga nemizuzwana emi-3) yokuphefumla nzulu okanye eyeke ukuphefumla (i-apnea). Ezi ziqendu zilandelwa ngamaxesha okuphefumla rhoqo ahlala kwimizuzwana eli-10 ukuya kweli-18.

Ukuphefumla ngokungaqhelekanga kunokulindeleka kwiintsana ezingakhuli ngokwaneleyo. Kodwa indlela yokuphefumla kunye nobudala bomntwana zibalulekile xa usenza isigqibo sokuba umntwana ugula kangakanani.

Iziqendu ze-apnea okanye "izehlo" ezihlala ngaphezulu kwemizuzwana engama-20 zithathwa njengezinzulu. Umntwana unokufumana:

• Yehla kwinqanaba lentliziyo. Oku kwehla kwentliziyo kubizwa ngokuba yi-bradycardia (ekwabizwa ngokuba yi "brady").
• Yehla kwinqanaba leoksijini (ukwanda kweoksijini). Oku kubizwa ngokuba kukungabinasimo (kukwabizwa ngokuba yi "desat").

Zonke iintsana ezingaphambi kwexesha ezingaphantsi kweeveki ezingama-35 zokumitha ziyangeniswa kwiiyunithi zokhathalelo olusandul 'ukuzalwa, okanye kwiindawo ezizodwa zononophelo, ezinabagadi abakhethekileyo kuba basemngciphekweni omkhulu wokuphefumla. Iintsana ezindala ezifunyenwe zine-epnea episodes nazo ziya kubekwa esweni esibhedlele. Olunye uvavanyo luya kwenziwa ukuba usana alunaphambi kwexesha kwaye lubonakala lungaphilanga.

• Iimonitha zigcina umkhondo wenqanaba lokuphefumla, ukubetha kwentliziyo, kunye nenqanaba leoksijini.
• Ukuhla kwenqanaba lokuphefumla, ukubetha kwentliziyo, okanye inqanaba leoksijini kunokuseta ii-alamu kwezi monitors.
• Iimonitor zabantwana ezithengiselwe ukusetyenziswa kwekhaya azifani nezo zisetyenziswa esibhedlele.

Isivusi sinokuvela ngenxa yezinye izizathu (ezinje ngokudlula kwisitulo okanye ukuhambahamba), ke umkhondo wokujonga umkhondo uphononongwa rhoqo liqela lokhathalelo lwempilo.

Indlela i-apnea ephathwa ngayo ixhomekeke:

• Unobangela
• Kwenzeka kangaphi
• Ubunzima beziqendu

Iintsana ezinempilo esempilweni kwaye ngamanye amaxesha iziqendu ezincinci zijongwa ngokulula. Kwezi meko, iziqendu ziyahamba xa iintsana zichukunyiswa kancinci okanye "zivuselelwa" ngamaxesha okuphefumla.

Iintsana eziphilileyo, kodwa ezingaphambi kwexesha kwaye / okanye ezineziqendu ezininzi zokuphefumla zinokunikwa icaffeine. Oku kuya kunceda ukwenza ipateni yabo yokuphefumla rhoqo. Ngamanye amaxesha, umongikazi uya kutshintsha indawo yomntwana, asebenzise ukutsala ukususa ulwelo okanye inwebu emlonyeni okanye empumlweni, okanye asebenzise ibhegi nemaski ukunceda ngokuphefumla.

Ukuphefumla kunokuncedwa ngu:

• Indawo efanelekileyo
• Ixesha lokondla kancinci
• Ioksijini
• Uxinzelelo oluqinisekileyo lokuhamba komoya (CPAP)
• Umatshini wokuphefumla (umshini wokuphefumla) kwiimeko ezibi kakhulu

Olunye usana oluqhubeka nokuba ne-apnea kodwa lube lukhulile kwaye lusempilweni lunokukhutshwa esibhedlele kwindawo yokujonga i-apnea ekhaya, enayo okanye engenayo i-caffeine, de iphume indlela yabo yokuphefumla engagqibelelanga.

I-apnea iqhelekile kwiintsana ezizelwe ngaphambi kwexesha. I-apnea emnene ayibonakali ineempembelelo zexesha elide. Nangona kunjalo, ukuthintela iziqendu ezininzi okanye ezinzima kulunge ngakumbi kumntwana ngaphezulu kwexesha elide.

I-apnea ye-prematurity ihlala ihamba njengoko umntwana esondela "kumhla obekiweyo." Ngamanye amaxesha, njengakwiintsana ezizalwe ngaphambi kwexesha okanye ezinezifo ezinzima zemiphunga, i-apnea inokuqhubeka iiveki ezimbalwa ubude.

I-apnea - iintsana; AOP; Njengoko kunye nee-Bs; A / B / D; Ukupela okuluhlaza okwesibhakabhaka - iintsana ezisanda kuzalwa; Ukupela kweDusky - iintsana; Pela - iintsana; I-apnea - neonatal

IAhlfeld SK. Ukuphazamiseka kwendlela yokuphefumla. Ku: Kliegman RM, St Geme JW, Blum NJ, Shah SS, Tasker RC, Wilson KW, ii-eds. Incwadi kaNelson yeNcwadi yePediatrics. Umhla wama-21. IPhiladelphia, PA: Elsevier; 2020: isahluko 122.

UMartin RJ. I-Pathophysiology ye-apnea yobudala bokuqala. Ku: Polin RA, Abman SH, Rowitch DH, Benitz WE, Fox WW, ii-eds. I-Physology yoSana kunye neNzalo. Umhla we-5. IPhiladelphia, PA: Elsevier; Ngo-2017: isahluko 157.

Patrinos ME. Ukuphefumla okungapheliyo kokubeleka kunye nesiseko solawulo lokuphefumla. Ku: UMartin RJ, uFanaroff AA, uWalsh MC, ii-eds. UFanaroff kunye noMartin's Neonatal-Perinatal Medicine. Ngomhla we-11. IPhiladelphia, PA: Elsevier; 2020: isahluko 67.