Xa usana luzalwa ngaphambi kwesikhathi , baya kudla ukuphefumula ngokwabo baze bafune uhlobo oluncedo. Uhlobo lwencedo lokuphefumula lwakho umntwana oluya kulufuna luya kuxhomekeka kwindlela umntwana wakho azalwa ngayo ngokukhawuleza. Unokuxelelwa ukuba umntwana wakho unokuthiwa yi-RDS. I-RDS okanye i- Distressary Distress Syndrome yenye yeengxaki eziqhelekileyo umntwana uza kuhlangana xa ezalwe ngaphambi kwesikhathi.
Ngaphambi kokuba umntwana azalwe, imiphunga iyawa kwaye i-oksijeni inikwa umntwana nge-placenta. I-placenta ivumela ukuhamba kwe-oksijini kunye nezondlo kwigazi lomama kwigazi lomntwana ngokusebenzisa intambo yomlomo. Emva kokuba umntwana azalwe konke oku kutshintsha. Xa intambo yomnxeba unqunywe, umgca wokuphila we-oksijini ophucula igazi le-placental lihlulwe. Ulambile womoya uqala kwaye umntwana osandul 'ukuzalwa uza kuqala ukuphazamisa umoya. Ngaloo nto, imiphunga iyakwandisa okokuqala kwaye iguqulwe kwi-mass collapsed, eqinile kwiingxowa ezigciniweyo zomoya.
Ukusebenza kwamaLung
Amapopu aqolileyo ayenziwe ngamapulane, ama-tissue elastic (elastic stretch) alula kwaye anxibe njengoko uphefumula. Kukho izigidi zamatokhe amancinci, ajikeleziweyo abizwa ngokuthi i-alveoli enyukayo xa umoya uhamba ngaphakathi. Ngaphakathi kwe-alveoli, uluhlu oluncinci lwe-liquid ebizwa ngokuba yi-surfactant. I-Surfactant yinto efana ne-sophi edla ngokwemvelo ngaphakathi kwimiphunga evuthiweyo kwaye ivimbela le mabhaluni amancinci (alveoli) ukuwa.
I-Surfactant ibalulekile kulo tshintsho lwe-oxygen kunye ne-carbon dioxide emiphakeni kunye negazi. Ukuveliswa komsebenzi osebenzayo ngaphakathi kwiseli yemiphunga iqala phakathi kweeveki ezingama-24 ukuya kuma-28, kunye nokuveliswa kwemveliso kuze kube yintsana.
Xa usana luzalwa ngokukhawuleza, banemiphunga encinci kwaye kaninzi banqongophala ngokwaneleyo.
Imiphunga ayikwazi ukuvula kakuhle ngokwaneleyo ukumbamba i-oksijeni ukuba ifakwe kakuhle kwigazi kwaye ihanjiswe kumalungu omzimba obalulekileyo. Iipomphu zamandulo ziba ne-alveoli encinane echaphazela ukukwazi ukutshintshisa i-oxygen ne-carbon dioxide. Imiphunga iyaqhubeka yenza i-alveoli ide ifikelelwe. Ngaphambi kokuqala umntwana, i-alveoli encinci baya kuba nayo. Ezi alveoli zincinci kwaye zinomhlaba omanzi. Imihlaba emanzi ibambelele ndawonye, kubangele ukungabikho komhlaba. I-Surfactant iyanciphisa lo mbandezelo ovumela ukuba imihlaba emanzi yamaphaphu ikhule, ivumela ukutshintshwa komoya.
Umoya esiwuphefumlayo wenziwe ngamagesi ahlukeneyo, i-oksijeni, eyona nto ibaluleke kakhulu kuba iiseli ziyidinga amandla kunye nokukhula. Ngaphandle kwe-oxygen, iiseli zomzimba ziya kuqala ukufa. I-carbon dioxide iyinkunkuma engcolileyo eyenziweyo eyenziwe yi-metabolism njengenxalenye yenkqubo yokwenza amandla emzimbeni. Imiphunga ivumela i-oksijini emoyeni ukuba ithathelwe emzimbeni, ngelixa ivumela umzimba ukuba uphephe i-carbon dioxide emoyeni ephefumlayo.
I-Surfactant ibalulekile kulo tshintsho lwe-oxygen kunye ne-carbon dioxide emiphakeni kunye negazi. Ukuveliswa komsebenzi osebenzayo ngaphakathi kwiseli yemiphunga iqala phakathi kweeveki ezingama-24 ukuya kuma-28, kunye nokuveliswa kwemveliso kuze kube yintsana.
Xa usana luzalwa ngokukhawuleza, banemiphunga encinci kwaye kaninzi banqongophala ngokwaneleyo. Imiphunga ayikwazi ukuvula kakuhle ngokwaneleyo ukumbamba i-oksijeni ukuba ifakwe kakuhle kwigazi kwaye ihanjiswe kumalungu omzimba obalulekileyo. Iipomphu zamandulo ziba ne-alveoli encinane echaphazela ukukwazi ukutshintshisa i-oxygen ne-carbon dioxide. Imiphunga iyaqhubeka yenza i-alveoli ide ifikelelwe. Ngaphambi kokuba umntwana abe ne-alveoli encinci abaya kuba nayo.
Iingxaki zokuPhathwa kwexesha eliPhambi kunye neengxaki zokuphefumula
Ngokuqhelekileyo, kwangaphambili umntwana uzalwa, ingozi enkulu yokuphucula ukuphefumula. Ukuba ukuhanjiswa kwangethuba kungasetyenziselwa usuku okanye ezimbini, unina unako ukunikezelwa kwintsholongwane engama-2, iiyure ezingama-24, ngaphandle kwe-steroids, njenge-betamethasone ngaphambi kokunikezelwa.
I-Betamethasone isetyenziselwa ukukunceda ekuphuculeni umphunga wamaphaphu ukuba kuzalwe ukubeleka kwangaphambili.
Iintshaba kunye ne-RDS ziza kufumana amanani okufakelwa ngumntu osebenzayo , enikezwa yiphubhu yokuphefumula; ngqo kwimipuphu apho ihlamba iifake zomoya ezivumela ukutshintshiselana komoya. Ingane ene RDS ingaba nzima kakhulu kwiintsuku zokuqala zokuzalwa kodwa iya kubonisa iimpawu zokuphucula xa imiphunga iqala ukuvelisa i-intactantant yayo, ngokuqhelekileyo kwiiveki ezimbalwa.
Iintsana ezine-RDS ziza kufuneka zifumane uhlobo oluthile lwe-oxygen. Enye indlela yokuphucula ukutshatyalaliswa kwe-oksijini yenyana kukunyusa uxinzelelo lwe-oksijini emoyeni usana olufumanayo. Igumbi eliqhelekileyo lomoya lithetha malunga neepesenti ezingama-21 zomoya. Iintsana ezifuna i-oksijeni eyongezelelweyo ifumana i-100 ekhulwini ye-oksijeni, kwiimeko ezinzima, xa zifuneka. Izimo ze-oxygen kunye namanqanaba zijongwa ngokugqithiseleyo njengoko kubalulekile ukufumana ingcamango efanelekileyo. Into encinci ingabangela umonakalo kwinkqubo yesantya kwaye kuninzi kunokudala umonakalo kwimiphunga ngokwabo, kunye namehlo.
I-oxygen saturation surveillance, (ebizwa ngokuba yinkomo ye-pulse okanye iperereji ehleliyo) ifakwe kwinqanaba okanye kwintshontsho yengane-inokulinganisa amazinga oksijini egazini lomntwana. Isixa se-oxygen sibhalwa njengepesenti. Eli phesenti ngumlinganiselo we-oksijeni i-molemle ye-hemoglobin egazini ithwala.
I-sampuli yegazi ebizwa ngokuba yi-gazi yegazi yenye indlela yokulinganisa indlela okutshintshiselana ngayo kwenzeka kwinkqubo yomntwana. Olu vavanyo lunikeza ulwazi olungaphezulu kunowokubeka iliso kwaye liqhelekileyo lisetyenziswe xa umntwana esezantsi eziphezulu zokuxhasa ukuphefumula. Injongo kukuba nenani elincinci lenkxaso yokugcina amanqanaba e-oksijini ebuntwini kwibala elifunayo. (Olu luhlu lusekelwe kwiminyaka yobudala.)
Kukho amanqanaba amaninzi axhasayo kumntwana nge RDS. Njengoko imiphunga ikhula, isixa sempilo yokuphefumula siya kuncitshiswa kwinkqubo ebizwa ngokuthi ukucoca. Le nkqubo yokuqhawulwa ngumntu ngokwasemntwaneni kwaye iya kugqitywa yinkqubo eyenziwa ngumntwana onzima ukuphefumla, i-oxygen saturation, kunye neqondo legesi yegazi, kunye nempilo yengane.
Nazi ezinye zezixhobo eziqhelekileyo ezisetyenziswayo zokuxhasa ukuphefumula, ngokubanzi kuchaza:
- I-Ventilator - Iipompo zomoya kunye ne-oksijini emiphakeni nge-tube endotracheal. (Ebizwa nge-ET tube okanye ityhubhu yokuphefumula.) I-ventilator iya kuphefumula umntwana kwaye isetyenziselwe ukuphefumula inani elithile lemzuzu ngomzuzu.
- I-Oscillator - uhlobo lwe-ventilator esebenza ngokushukumisa i-oksijini kunye ne-carbon dioxide ngaphandle kwekhulu lezinto ezincinane eziphefumulayo ngomzuzu.
- Ukunyamezela okuqhubekayo kwe-Airway - Eyaziwa nangokuthi yi-CPAP. I-CPAP ayifuni ukuphefumula umntwana, kodwa iqhuma umtshini womoya rhoqo kwimiphunga yengane ekunyanzelekeni okuphantsi ukugcina iimiphunga zihluthelwa ngamaxesha onke. I-CPAP ihanjiswa ngeengxowa zamanzi.
- (Ubunobumba) I-CPAP - isebenza ngokunikela uxinzelelo oluqhubekayo kwi-airway. (Ngeendlela eziphambili ze-nasal) ezifana ne-CPAP kodwa inesiphalufu esiphefumlelweyo esabekwa phantsi kwamanzi, kunye ne-bubbles-eyenza uxinzelelo kwaye inikezela ukunyuka kwexesha kummandla wamaphaphu.
- I-Canal Cannula - I-oksijini enikezelwa ngqo kumntwana ngokusebenzisa ityhubhu yeplastiki eneentambo ezincinci ezifakwe emakhaleni omntwana.
I-RDS ixhaphake kakhulu kwiintsana zokubeleka ngenxa yokuba imiphunga iyakhula. Ngokusekelwe kwindlela yokuqala umntwana wakho azalelwe ngayo iya kuqinisekisa ukuba baya kuqhuba njani le meko. Kuyikeka kakhulu ukubona umzabalazo wakho omncinci ngezinto ezilula thina abadala xa sithatha ngokulula zonke iisibini zemihla ngemihla. Ngethemba ukuba le ngcaciso inokunceda ukuba uqonde isizathu sokuba yeyiphi na i-RDS kwaye kukunceda, wena uphefumle kancane, ngokufanelekileyo kunye nomntwana wakho.
Imithombo:
Bubbles, Iintsana kunye neBiology: Ibali le-Surfactant. (nd). Ifunyenwe kwi http://www.fasebj.org/content/18/13/1624e.full
Iimfundiso malunga ne-Retinopathy ye-Prematurity (ROP) | INational Eye Institute. (nd). Kubuyiselwa kwi-https: //www.nei.nih.gov/health/rop/rop
I-Immature Lung - AboutKidsHealth. (nd). Ukufunyanwa kwi-http: //www.aboutkidshealth.ca/en/resourcecentres/prematurebabies/aboutprematurebabies/breathing/pages/the-immature-lung.aspx
Iingcebiso zonyango olusebenzayo lwe-neonatal. (nd). Ukufunyanwa kwi-http: //www.ncbi.nlm.nih.gov/pmc/articles/PMC2722820/