Chifukwa Chiyani Zochitika Zowwirizi za Adani Zimakhala Zochititsa Makolo
M'mwana wakhanda msanga, apnea ndi bradycardia nthawi zambiri zimachitika palimodzi, kuphatikizapo magazi ochepa okosijeni. Choyamba, apnea imapezeka ndipo mwanayo amasiya kupuma. Chifukwa chakuti mwanayo sapuma, mpweya wa okosijeni udzagwa. Mtima umachepetsanso poyang'ana mpweya wochepa wa magazi. Pamodzi, apnea ndi bradycardia nthawi zambiri zimatchedwa "As ndi B" kapena "spells" ndi mlingo wa m'munsi wa oxygen nthawi zambiri amatchedwa kutayidwa kapena "kufuna."
Kutentha kwa okosijeni kumatengera hemoglobini yokanyamula oksijeni m'magazi.
Magazi a mawu akuti mwana, monga a mwana kapena wamkulu, ayenera kukhala 95 mpaka 100% odzaza ndi mpweya. Magazi a mwana wakhanda asanakwanitse kulandira mpweya wochuluka nthawi zambiri amakhala pakati pa 88 ndi 95% okwanira, osati apamwamba, kuteteza kutembenuka mtima kwa chithunzithunzi choyambirira , chowoneka bwino.
Mu chipatala, kutentha kwa oximetry kumagwiritsidwa ntchito kuyeza kuchuluka kwa mpweya mu magazi.
Pamene magazi alibe oxygen yokwanira, amatchedwa kutayika. Mafotokozedwe amatha kupanga ubweya wa milomo kapena khungu ndipo amachititsa mwana kutayika kapena kukhala "floppy."
Kodi Apnea Ndi Chiyani?
Apnea imatanthauza nthawi imene mpweya umasiya. M'mwana wakhanda asanakwane, apnea ndi kupumula kulikonse komwe kumatenga nthawi yaitali kuposa masekondi makumi awiri, kuchititsa bradycardia, kapena kuchepa kwa msinkhu wa magazi wa mwana. Makanda osamalidwa amakhala ndi machitidwe amanjenje osakanikirana ndipo amatha kukhala ndi ziwalo za apnea.
Nthawi zina, apnea imayambitsa mtima wa mwana kugunda pang'onopang'ono, wotchedwa bradycardia.
Mu NICU, adani omwe amawotchera amayang'aniridwa kuti ayang'ane kuti malamulo omveka ngati kupuma kwawo kuli ndi nthawi yayitali.
Kawirikawiri, kumathandiza kuti mwana apume mpweya wabwino, koma nthawi zina ana amafunikira kupuma kapena okosijeni akamapuma.
Ambiri amayamba msinkhu wawo akamangopita kunyumba, koma ana ena adzalinso ndi mpweya wochepa wa apnea. Ngati izi zitachitika, makolo atenga mwana wawo kunyumba ndi mawonekedwe a apnea, omwe amatha ngati mwanayo ayima kupuma.
Kodi Bradycardia N'chiyani?
Bradycardia amatanthawuza pang'onopang'ono kuposa mtima wachibadwa. Ana omwe amabadwa, mtima umatchedwa bradycardia ngati umagwera pansi pa 100 beats pamphindi kwa mwana osachepera 1250 g (2 lb 12 oz) kapena kuposera 80 pamphindi pa mwana wamkulu. Pamene makanda ali mu NICU, mitima yawo imayang'aniridwa, ndipo ma episodes of bradycardia amachiritsidwa. Ngati bradycardia ikupitirira, mankhwala monga caffeine angagwiritsidwe ntchito pochiza matendawa.
Zimayambitsa
Apnea ndi bradycardia ali ndi zifukwa zambiri m'mimba ya msanga. Matenda, kuchepa magazi m'thupi , ndi mavuto mu ubongo zingathe kuchititsa As ndi B. Chifukwa chofala kwambiri cha apnea ndi bradycardia pakati pa adani ku NICU, komabe, ndi chikhalidwe chotchedwa apnea of prematurity.
Apnea wa prematurity ndi chikhalidwe chimene chimayambitsa machitidwe amanjenje ndi minofu. Apnea of prematurity amapezeka kawirikawiri mwa adani; pamene msinkhu wamakono umachepa, apnea wa prematurity imakula. Ana 7% okha amene amabadwa pamasabata 34 mpaka 35 aliwonse amakhala ndi vuto la kupweteka, koma oposa theka la ana obadwa masabata 30 mpaka 31 akudwala.
Apnea ikhoza kuchitika chifukwa chakuti ubongo umauza mwana kupuma, ndipo mwanayo amasiya kupuma (apnea pakati) kapena chifukwa mwana wosabadwa thupi sali wamphamvu mokwanira kuti mpweya uyatsegule ndi kutuluka kwa mphepo kutsekedwa ( kubisala apnea ). Zosakanikirana komanso zolepheretsa kutukuka zimapezanso.
Zotsatira za Nthawi Yakale
Madokotala sakudziwa kuti zotsatira za nthawi yaitali za apnea ndi bradycardia ndi zotani. Amadziŵa kuti bradycardia imapangitsa kuchepa kwa kanthawi m'magazi a magazi ndi mpweya. Amadziwanso kuti ana omwe ali ndi nthawi yambiri asanakwane, omwe anali ndi masiku ambiri omwe ali ndi zizindikiro zolembera za apnea amakhala ndi zaka zochepa pa zaka zitatu zomwe zimayesedwa zomwe zimayendera zotsatira zowonjezera komanso zokhudzana ndi ubongo, koma sangathe kunena kuti apnea ndi bradycardia zimayambitsa zochepa.
Chinthu chimodzi chomwe madokotala amadziwa ndicho chakuti apnea ndi bradycardia sichimayambitsa matenda a mwana wakhanda mwadzidzidzi, kapena SIDS. Ngakhale kuti ana asanakwane, ambiri, amakhala ndi chiopsezo chachikulu cha SIDS kusiyana ndi ana a nthawi zonse, apnea wa prematurity sikumayambitsa matenda a SIDS.
Chithandizo
Pamene makanda a NICU ali ndi kachilombo ka apnea kapena bradycardia, oyang'anitsitsa omwe amalembetsa mpweya wawo ndi kupuma kumayamba kulamu. Nthawi zina, phokoso la alamu ndilokwanira kuti mwana apume kachiwiri, ndipo mwanayo akupuma bwino asanamwalire ngakhale nthawi yoti ayankhe. Nthawi zina, alamu sikokwanira. Kulimbikitsidwa, pogwiritsa ntchito kupaka kapena kubisa mwana, kumagwiritsidwa ntchito. Ngati mwanayo sakuchira, ndiye kuti mwanayo apatsidwa mpweya ndi thumba.
Ana amene nthawi zambiri amatha kupuma, amatha kuika mpweya wabwino (CPAP) kuti awathandize kupuma kapena atha kupuma mpweya. Mankhwala angathe kugwiritsidwanso ntchito kuti athetse matenda obwera m'mimba. Caffeine ndi mankhwala atsopano a apnea omwe ali ndi zotsatira zochepa ndipo akhala opambana kwambiri.
Kupewa Zowonjezera Zina
Kudziwa chomwe chimayambitsa zizindikiro za apnea ndi bradycardia kungathandize anamwino ndi makolo kuchepetsera chiwerengero cha mazonje omwe ana omwe asanabadwe ali nawo. Apnea ndi bradycardia amayamba kupezeka pamene akugona tulo tofa nato, choncho nkofunika kulola ana kuti agone tulo tofa nato. Konzani maulendo anu ku NICU ndi nthawi yopatsa ndi kuyesa, ndipo gwiritsani ntchito mau achisoni ngati mukuchezera pamene mwana wanu akugona. Kusintha kwa madzi osungunuka kutentha kumachititsanso kuti As ndi B, choncho yesetsani kusungira kutentha kotentha m'kati mwa makina opangira mavitamini mwa kusunga zitseko zotsekemera zitsekedwa mwatcheru.
Kudyetsa nkhuku ndi chinthu china chofala cha apnea ndi bradycardia. Pamene mukudyetsa mwana asanakwane pa bere kapena botolo, kuyendayenda kumakhala kofunikira makamaka makamaka kumayambiriro kwa chakudya. Ngati mwana wanu akuwoneka akuyamwa mosalekeza kupuma, pitirizani kudyetsa nthawi ndi nthawi ndikuchotsa msomali pakamwa pake.
Kodi Zidzatha Liti?
M'mwana ambiri, apnea ayamba kuthetsa nthawi yoyenera kubadwa, komanso nthawi yoyamba kudya zakudya zokwanira kuti azilemera kwambiri komanso kusungunuka kutentha kunja kwa kachipangizo. Komabe, ana ena adzapitirizabe kukhala ndi matenda a apnea ndi bradycardia ngakhale atakhala okonzeka kuchoka ku NICU mwanjira ina iliyonse. Zipatala zambiri zimafuna kuti ana akhale ndi masiku angapo popanda apnea kapena bradycardia asanamasulidwe kuti atsimikizidwe kuti ali ndi apnea wamba wa prematurity kwathunthu.
Ana amene ali ndi ziwalo za apnea kapena bradycardia ngakhale atakhala okonzeka kupita kunyumba m'njira zina akhoza kuchotsedwa kuchipatala ndi mawonekedwe apnea apakhomo. Owunika awa akutsutsana chifukwa sakuwonekeranso bwino zachipatala ndipo ndi zovuta kuti makolo azikhala nawo, koma akugwiritsidwabe ntchito kwambiri kwa ana omwe ali ndi apnea opitirirabe.
Zotsatira:
Stokowski, RN, MS, Laura. "Malangizo a Makolo Othandizira Kumvetsetsa Apnea." Kupita Patsogolo Pothandiza Ana Amayi June 2005. 5; 175-176
Stokowski, RN, MS, Laura. "Choyamba pa Apnea ya Prematurity." Kupita Patsogolo pa Kusamalira Ana Amayi June 2005. 5; 155-170
University of Virginia Health System. "Apnea of Prematurity." Http://www.healthsystem.virginia.edu/uvahealth/peds_respire/apneapre.cfm