I-pneumonia ebantwaneni-ekuhlaleni okufunyenweyo

I-pneumonia sisifo semiphunga esibangelwa ziibhaktheriya, iintsholongwane, okanye ifungi.

Eli nqaku ligubungela inyumoniya efunyenwe eluntwini (CAP) ebantwaneni. Olu hlobo lwenyumoniya lwenzeka kubantwana abasempilweni abangakhange babesesibhedlele okanye kwelinye iziko lokhathalelo lwempilo.

Inyumoniya echaphazela abantu abakumaziko onyango, njengezibhedlele, idla ngokubangelwa ziintsholongwane ekunzima ukuzinyanga.

Iintsholongwane zezona zinto zixhaphakileyo kwinyumoniya kwiintsana nasebantwaneni.

Iindlela umntwana wakho anokufumana ngazo i-CAP zibandakanya:

• Iibhaktheriya kunye neentsholongwane ezihlala empumlweni, iisono, okanye umlomo zingasasazeka kwimiphunga.
• Umntwana wakho unokuphefumla ezinye zezi ntsholongwane ngqo emiphungeni.
• Umntwana wakho uphefumlela ukutya, ulwelo, okanye ukugabha okuphuma emlonyeni uye kwimiphunga yakhe.

Izinto ezinobungozi ezonyusa ithuba lomntwana lokufumana i-CAP zibandakanya:

• Ukuba mncinci kuneenyanga ezi-6 ubudala
• Ukuzalwa ngaphambi kwexesha
• Iziphene zokuzalwa, ezinje ngenkalakahla ecandekileyo
• Iingxaki zenkqubo yovalo, ezinje ngokuxhuzula okanye ukukhubazeka kobuchopho
• Isifo sentliziyo okanye semiphunga sikhona xa sizalwa
• Amajoni omzimba abuthathaka (oku kunokwenzeka ngenxa yonyango lomhlaza okanye isifo esifana ne-HIV / AIDS)
• Utyando lwamva nje okanye umothuko

Iimpawu eziqhelekileyo zenyumoniya kubantwana zibandakanya:

• Ukuxinwa okanye ukuphuma empumlweni, iintloko
• Ukukhwehlela okukhulu
• Umkhuhlane, onokuba mnene okanye ophakamileyo, kunye nokubanda kunye nokubila
• Ukuphefumla ngokukhawuleza, ngeempumlo ezivuthayo kunye nokuxinwa kwezihlunu phakathi kweembambo
• Ukukhawuleza
• Ukuqaqamba okanye ukuhlaba iintlungu zesifuba esiba mandundu xa uphefumla ngokunzulu okanye ukhohlela
• Amandla aphantsi kunye ne-malaise (engaziva kakuhle)
• Ukugabha okanye ukulahla ukutya

Iimpawu eziqhelekileyo kubantwana abanesifo esibi kakhulu zibandakanya:

• Imilebe eblue kunye neenzipho ngenxa yeoksijini encinci egazini
• Ukudideka okanye kunzima kakhulu ukuvusa

Umboneleli wezempilo uya kumamela esifubeni somntwana wakho nge-stethoscope. Umboneleli uya kumamela ngokuqhekeka okanye ukuphefumla okungaqhelekanga. Ukuthinta udonga lwesifuba (ukubetha) kunceda umboneleli aphulaphule kwaye azive izandi ezingaqhelekanga.

Ukuba ikrokrela inyumoniya, umboneleli unokuyalela i-x-ray yesifuba.

Olunye uvavanyo lunokubandakanya:

• Iiartery zegazi ezijikelezayo ukubona ukuba ioksijini eyaneleyo ingena kwigazi lomntwana wakho kwimiphunga
• Inkcubeko yegazi kunye nenkcubeko yesikhohlela ukukhangela intsholongwane enokubangela inyumoniya
• CBC ukujonga ubalo lweeseli ezimhlophe
• I-X-ray yesifuba okanye i-CT yesifuba esifubeni
• I-Bronchoscopy - ityhubhu eguqukayo enekhamera ekhanyisiweyo ekugqibeleni edluliselwe emiphungeni (kwiimeko ezinqabileyo)
• Ukususa umbane kwisithuba phakathi komda wangaphandle wemiphunga kunye nodonga lwesifuba (kwiimeko ezinqabileyo)

Umboneleli kufuneka kuqala athathe isigqibo sokuba ngaba umntwana wakho ufuna ukuba esibhedlele.

Ukuba uphathwe esibhedlele, umntwana wakho uya kufumana:

• Ulwelo, iielectrolyte, kunye nezibulala ntsholongwane ngemithambo okanye emlonyeni
• Unyango lweoksijini
• Unyango lokuphefumla ukunceda ukuvula i-airways

Umntwana wakho kunokwenzeka ukuba angeniswe esibhedlele ukuba:

• Unenye ingxaki yezonyango, kubandakanya nemicimbi yezempilo yexesha elide (engapheliyo) enje ngecystic fibrosis okanye isifo seswekile
• Yiba neempawu ezinzima
• Abakwazi ukutya okanye ukusela
• Ngaphantsi kweenyanga ezi-3 ukuya kwezi-6 ubudala
• Yiba nenyumoniya ngenxa yentsholongwane eyingozi
• Ndithathe i-antibiotics ekhaya, kodwa ayibi ngcono

Ukuba umntwana wakho une-CAP ebangelwa ziintsholongwane, ziya kunikwa ii-antibiotics. Amayeza okubulala iintsholongwane akanikwa inyumoniya ebangelwa yintsholongwane. Kungenxa yokuba amayeza okubulala iintsholongwane awazibulali iintsholongwane. Amanye amayeza, anjengee-antivirals, anokunikwa ukuba umntwana wakho unomkhuhlane.

Uninzi lwabantwana lunokunyangwa ekhaya. Ukuba kunjalo, umntwana wakho angadinga ukuthatha amayeza afana ne-antibiotics okanye i-antivirals.

Xa unika umntwana wakho amayeza okubulala iintsholongwane:

• Qiniseka ukuba umntwana wakho akaphoswa nangayiphi na idosi.
• Qinisekisa ukuba umntwana wakho uwathatha onke amayeza njengoko kuyalelwe. Sukuyeka ukumnika iyeza, nokuba umntwana wakho uqala ukuziva engcono.

Musa ukunika umntwana wakho amayeza okukhohlela okanye amayeza abandayo ngaphandle kokuba ugqirha uthi kulungile. Ukukhohlela kunceda umzimba ukuba ukhuphe amafinyila emiphungeni.

Amanye amanyathelo okhathalelo lwasekhaya aquka:

• Ukuzisa i-mucus phezulu kwimiphunga, cofa isifuba somntwana wakho ngobunono amaxesha ambalwa ngemini. Oku kunokwenziwa xa umntwana wakho elele phantsi.
• Cela umntwana wakho aphefumle kabini okanye kathathu ngeyure. Ukuphefumla nzulu kunceda ukuvula imiphunga yomntwana wakho.
• Qinisekisa ukuba umntwana wakho usela iziselo ezininzi. Buza umboneleli wakho ukuba umntwana wakho kufuneka asele malini ngosuku.
• Yenza umntwana wakho afumane ukuphumla okuninzi, kubandakanywa ukulala yonke imini xa kufuneka.

Uninzi lwabantwana luyaphucuka kwiintsuku ezisi-7 ukuya kwezi-10 ngonyango. Abantwana abanesifo semiphunga esomeleleyo abaneengxaki banokufuna unyango iiveki ezi-2 ukuya kwezi-3. Abantwana abasemngciphekweni wenyumoniya enkulu babandakanya:

• Abantwana amajoni omzimba angasebenzi kakuhle
• Abantwana abanesifo semiphunga okanye sentliziyo

Ngamanye amaxesha, iingxaki ezinzulu zinokuvela, kubandakanya:

• Utshintsho olusongela ubomi kwimiphunga efuna umatshini wokuphefumla (i-ventilator)
• Ulwelo olujikeleze imiphunga, olunokosuleleka
• Amathumba emiphunga
• Iibhaktheriya egazini (bacteremia)

Umboneleli unokuyalela enye i-x-ray. Oku kukuqinisekisa ukuba imiphunga yomntwana wakho icacile. Kungathatha iiveki ezininzi ukuba i-x-ray icace. Umntwana wakho unokuziva ebhetele okwethutyana ngaphambi kokuba ii-x-reyi zicace.

Fowunela umnikezeli ukuba umntwana wakho unezi mpawu zilandelayo:

• Isikhohlela esibi
• Ubunzima bokuphefumla (ukuvutha, ukukrokra, ukuphefumla ngokukhawuleza)
• Ukuhlanza
• Ukuphelelwa ngumdla wokutya
• Umkhuhlane kunye nokubanda
• Ukuphefumla (iimpawu zokuphefumla) eziya zisiba mbi
• Intlungu yesifuba esiba mandundu xa ukhohlela okanye uphefumla
• Iimpawu zenyumoniya kunye nokomelela komzimba (njenge-HIV okanye ichemotherapy)
• Iimpawu eziba mandundu emva kokuqala ukuba ngcono

Fundisa abantwana abadala ukuhlamba izandla rhoqo:

• Ngaphambi kokutya ukutya
• Emva kokuvuthela iimpumlo zabo
• Emva kokuya kwindlu yangasese
• Emva kokudlala nabahlobo
• Emva kokudibana nabantu abagulayo

Izitofu zokugonya zinganceda ukuthintela ezinye iintlobo zenyumoniya. Qiniseka ukuba umntwana wakho ugonyiwe:

• Ugonyo lwepneumococcal
• Ugonyo lomkhuhlane
• Ugonyo lwePertussis kunye nokugonya kweHib

Xa abantwana bebancinci kakhulu ukuba bangagonywa, abazali okanye abanonopheli bangazigonyela inyumoniya enokuthintelwa isitofu sokugonya.

Bronchopneumonia - abantwana; Inyumoniya efunyanwa ekuhlaleni - abantwana; CAP - abantwana

• Ukukrala kwemiphunga

UBradley JS, uByington CL, u-Shah SS, et al. Isishwankathelo sesigqeba: ulawulo lwenyumoniya efunyenwe eluntwini kwiintsana nakubantwana abangaphezulu kweenyanga ezi-3 ubudala: izikhokelo zeklinikhi yokuziqhelanisa noMbutho wezifo ezosulelayo wezifo zabantwana eMelika. KwiKlinikhi yosulelo lweDis. Ngo-2011; 53 (7): 617-630. IINKCUKACHA: 21890766 pubmed.ncbi.nlm.nih.gov/21890766/.

UKelly MS, uSandora TJ. I-pneumonia efunyanwa ekuhlaleni. 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 428.

U-Shah SS, uBradley JS. Iinyumoniya ezifunyanwa eluntwini. Ku: UCherry JD, uHarrison GJ, uKaplan SL, uSteinbach WJ, uHotez PJ. Incwadi kaFeigin kunye neCherry yezifo ezosulelayo zabantwana. Ngomhla we-8. IPhiladelphia, PA: Elsevier; I-2019: isahluko 22.