Kuchulukanso kwa chizoloŵezi choyamba, chomwe chimatchedwanso ROP, ndi matenda omwe amakhudza retina wa diso. ROP imakhudza mitsempha ya magazi pa retina mu maso a preemie, ndipo ndi chimodzi mwa zifukwa zomwe zimayambitsa ubongo waunyamata.
Mwachidule
Pakati pa mimba, mitsempha ya magazi m'maso mwa mwana imayamba kukula pafupifupi masabata khumi ndi awiri. Pafupifupi sabata la 34 la mimba, mitsempha ya m'maso ili bwino kwambiri moti retina ali ndi magazi abwino.
Pamene makanda amabadwa mofulumira, mitsempha ya m'mitsempha ya retina sinakwaniridwe bwino. Pambuyo kubadwa, ziwiya zimayamba kukula mofulumira kwambiri kuti kukula kwawo kuwononge retina. Kuchokera m'mbuyo kwa chithunzithunzi (ROP) ndi dzina la kukula kosavuta kwa mitsempha ya magazi pa retina komanso kuwonongeka kumeneku.
Pa adani ambiri omwe amapanga ROP, kukula kwa mitsempha ya m'mitsempha imachepetsanso, ndipo masomphenya adzayamba bwino. Komabe ana ena asanabadwe, amakhala ndi ROP yaikulu.
Miyendo
Kuchokera m'mbuyo kwa chizoloŵezi choyambirira kumayikidwa malinga ndi magawo osiyanasiyana. Maphunziro apamwamba a ROP ndi ovuta kwambiri, ndipo amachititsa khungu kapena mavuto a masomphenya a nthawi yaitali. Gawo laling'ono la ROP ndi lochepa kwambiri; ana ambiri omwe ali ndi pulaneti I ndi II ROP adzasintha popanda chithandizo ndipo adzakhala ndi masomphenya abwino.
- Gawo 1: Kukula kwachibadwa kosavuta kwa zotengera za retinal. Kawirikawiri amayamba bwino popanda chithandizo chilichonse ndipo alibe zotsatira za nthawi yaitali.
- Gawo 2: Kukula kwa zotengera za retina ndizosazolowereka. Kawirikawiri amayamba bwino popanda chithandizo chilichonse ndipo alibe zotsatira za nthawi yaitali.
- Gawo lachitatu: Kukula kwa zotengera za retina kumakhala kovuta. Ana omwe ali ndi siteji 3 ROP angafunike chithandizo kwa ROP ndipo ali ndi chiopsezo chachikulu cha mavuto a masomphenya a nthawi yaitali. Ana omwe ali ndi matenda ambiri, chizindikiro chakuti ROP ikufulumira, kawirikawiri amafuna chithandizo pa siteji iyi.
- Gawo lachinayi: Katundu wothandizira. Kawirikawiri amafunikira chithandizo ndipo zingayambitse mavuto aakulu a masomphenya kapena akhungu.
- Gawo lachisanu: Kuthamanga kwathunthu kwa retina. Amafuna chithandizo ndipo zingayambitse mavuto aakulu a masomphenya kapena akhungu.
Kudziwa
Kubwereranso kwa chithunzithunzi choyambira kumayambanso kupezeka muyeso la kuyang'ana. Pofuna kukonzekera, mayendedwe amagwiritsidwa ntchito kuti awononge ophunzira a mwanayo. Pakati pa kafukufukuyu, katswiri wamagetsi adzayang'anitsitsa pa retina kuti aone ngati ziwiyazo zikukula bwino ndipo ngati ayi, mbali ina ya retina ikuwonetsa zizindikiro za vuto.
Sikuti anyamata onse asanakwane adzafunika kuyesedwa kuti ayese ROP. Mzipatala zimasiyanasiyana zomwe ana akuyang'aniridwa ndi ROP, koma ana ambiri omwe amabadwa asanakwane masabata 31 asanakwatire amakhala ndi mayeso limodzi kuti ayese ROP. Ngati kafukufukuyo sali ovomerezeka kapena maso a mwanayo amasonyeza zizindikiro za ROP, ndiye kuti mayesero otsogolera adzakonzedwa nthawi ndi nthawi.
Chithandizo
Nthawi zambiri matenda obwera chifukwa cha kutaya thupi amayamba kukhala abwino paokha ndipo samafuna chithandizo.
Pa stage 3 ROP ndi apamwamba, chithandizo chingayesedwe kuti asiye kukula kosalekeza kwa mitsempha ya magazi pa retina kapena kukonzanso retinal maselo. Mitundu ya mankhwala imaphatikizapo cryotherapy, laser therapy, ndi opaleshoni ya retinal.
- Cryotherapy : Cryotherapy amagwiritsa ntchito kutentha kwa madzi ozizira kuti awononge ziwalo za retina zomwe zimakhudzidwa ndi ROP, zomwe zimasiya mitsempha yambiri yosawononga thupi m'maso.
- Mankhwala othandiza laser: Monga cryotherapy, laser therapy imagwiritsidwa ntchito kuletsa zowonjezera zombo zopanda thanzi pa retina. Laser imagwiritsidwa ntchito kupsereza pang'ono pa ziwalo za retina zomwe zakhudzidwa ndi ROP. Mankhwalawa amakhala ndi zotsatira zabwino kuposa cryotherapy ndipo amagwiritsidwa ntchito nthawi zambiri, koma cryotherapy ingagwiritsidwe ntchito nthawi zina. Pofuna kusunga masomphenya apakati, masomphenya ena amatha kutayika ndi cryotherapy ndi mankhwala a laser.
- Opaleshoni ya m'mitsempha: Pachiyambi cha 4 ndi 5 kutayika kwapang'onong'ono koyambitsa matenda, retina yayamba kutsekedwa kapena yosasunthika kumaso. Katundu wothandizira pang'onopang'ono ukhoza kukhala wabwino kapena wokha opaleshoni. Retina yosungidwa kwathunthu pafupifupi nthawi zonse imafuna opaleshoni.
Zotsatira za Nthawi Yakale
Ana okwana 90% obadwa masabata 31 asanayambe mtundu wina wa ROP. Nthawi zambiri ma CROP ndi ofatsa ndipo alibe zotsatira za nthawi yaitali. Ana omwe amavutika ndi ROP monga makanda angakhale oyang'anitsitsa, kapena akhoza kukhala ndi strabismus kapena amblyopia.
Panthawi ya ROP yaikulu, kutayika kwa masomphenya kumachitika. Mzipatala zimapindula kwambiri pofufuza ndi kuchiza ROP musanayambe kuchititsa khungu, koma milandu yoopsa ya ROP ikhoza kuyambitsa masomphenya.
Oxygen Ntchito ndi ROP
Mpweya wambiri umagwiritsidwa ntchito pothandizira kupuma kuti ateteze magazi a mwana m'magazi abwino. Akuluakulu ndi makanda aang'ono amayenera kusunga ma oxygen m'mapamwamba a 90 kuti akhalebe athanzi, koma ana asanakwane amasiyana.
Pamene kusamalidwa kwa mwana msinkhu koyamba kunali kotheka kwambiri, madokotala ndi anamwino anagwira ntchito mwakhama kuti asunge okosijeni kuti azikhala ndi thanzi labwino. Pambuyo pophunzira zambiri, anapeza kuti makanda omwe ali ndi mpweya wokhala ndi mpweya wabwino amakhala ndi chiopsezo chachikulu chokhazikitsa ROP. Madokotala ndi anamwino angathe kuteteza mpweya wokwanira kuti asunge okosijeni osachepera 83% mwa adani, kuthandiza kuteteza ROP.
Zotsatira:
Capone, Antonio ndi Quiram, Polly. "Kumvetsetsa Kwambiri ndi Kulamulira Kwatsopano kwa Retinopathy ya Prematurity." Malingaliro Amakono mu Ophthalmology 2007; 18, 228-234.
Coe, Kristi et al. "Mafuta Oyambirira Oxygen Targeting (SPOT): Pulogalamu Yowonongeka Kuchita Khungu kwa Makanda ndi Retinopathy wa Prematurity." Journal of Care Nursing Quality November 2005; 21, 230-235.
National Eye Institute. Zoona Zokhudza Retinopathy za Prematurity (ROP) http://www.nei.nih.gov/health/rop/
Sears MD, William, Sears MD, Robert, Sears MD, James, Sears RN, Martha. Buku Loyamba la Ana: Zonse Zomwe Muyenera Kudziwa Zokhudza Mwana Wanu Wamasiye Kuyambira Kubadwa mpaka M'badwo Wina . Little, Brown ndi Co., New York, 2004.