Matenda a sycytial ( RSV ) ndi omwe amachititsa kuti anthu adziwe matenda. Ngakhale kuti nthawi zambiri zimangochititsa zizindikiro zofanana ndi chimfine cha ana akuluakulu komanso akuluakulu, makanda ndi ana ang'onoang'ono, zimayambitsa matenda a bronchiolitis , matenda oopsa kwambiri, okhudzana ndi kutupa m'mapapo, kupuma komanso kupuma mosavuta.
RSV ingayambitsenso kuyambitsa matenda , khutu la khutu , ndi chibayo.
Sukulu ya RSV
Matenda a RSV ndi nyengo, ndipo ku United States, matenda akuluakulu amayamba mu November kapena December ndipo amapitilira mpaka March mpaka May. Choncho, nyengo ya RSV imakhala kuyambira November mpaka May.
Matenda a RSV ndi ofala kwambiri moti pafupifupi magawo awiri pa atatu alionse ali ndi kachirombo ka HIV m'chaka chawo choyamba cha moyo ndipo pafupifupi ana onse ali ndi matenda a RSV pamene ali ndi zaka ziwiri. Ambiri mwawa ndi matenda ochepa, koma RSV imatsogolera kuchipatala cha chaka cha 125,000 cha ana ndipo 1-2% mwa ana omwe akuchipatala amafa.
Nthawi zambiri ana amayamba kukhala ndi zizindikiro masiku 2-8 atalandira munthu wina yemwe ali ndi kachilombo ka RSV (nthawi yosakaniza). Zizindikirozi zimaphatikizapo mphuno, koma ngati kachilomboka kakufalikira, zizindikiro zikhoza kuwonjezereka ndipo zikhoza kuphatikiza kukhwima, kusanza, kutentha thupi (zomwe zingakhale zochokera pansi mpaka kufika pamtunda), kupuma mofulumira ndi kubwezeretsa ndi kutuluka, kuthamanga, ndi kudya moperewera.
Pazovuta kwambiri, ana akhoza kukhala ndi apnea ndi kulephera kupuma.
Kuchiza Matenda a RSV
Mofanana ndi matenda ambiri a mavairasi, chithandizo cha RSV chimakhala chachizindikiro. Kwa ana omwe ali ndi magudumu ndi kupuma kovuta, mankhwala a nebulized ndi albuterol nthawi zina ankaganiza kuti ndi othandiza koma tsopano sakuvomerezedwa.
Mankhwala ena angaphatikizepo mpweya wambiri wothandizira komanso madzi omwe amapezeka m'magazi ngati mwana wanu sangathe kudya ndi kumwa bwino. Chithandizo cha bronchiolitis ndi steroids ndizovuta ndipo nthawi zambiri sichikuganiza kuti n'chothandiza. Popeza ndi kachilomboka, mankhwala ochiza ma antibayotiki samathandizanso, pokhapokha mwana wanu atakula kachilombo koyambitsa matenda a bakiteriya.
Ngakhale ana ambiri omwe ali ndi matenda a RSV amatha kuchiritsidwa kunyumba, pafupifupi 1% ya ana, makamaka ana ang'onoang'ono kapena omwe ali ndi matenda aakulu, amafunikira kuchipatala ndikuyang'anitsitsa. Nthaŵi zina, ana omwe amavutika kwambiri kupuma ndi / kapena apnea ayenera kuikidwa pa mpweya woti awathandize kupuma. RSV ikhozanso kupha ana ena.
Kuteteza Matenda a RSV
Ana omwe ali pachiopsezo chachikulu chifukwa cha matendawa a RSV ndi ana omwe ali asanakwane kumene ali ndi matenda opanda matenda akuluakulu a m'mapapo ndi ana omwe ali ndi matenda aakulu a mapapu. Mwamwayi, mankhwala amapezeka kupeŵa matenda a RSV mwa odwala omwe ali oopsa kwambiri.
RespiGam (RSV-IVIG) idapatsidwa chilolezo mu 1996 pofuna kupewa matenda a RSV omwe ali oopsa kwambiri. Zimapezeka ngati kulowetsedwa kwa mwezi ndi mwezi ndipo zimapereka ana okhala ndi ma antibodies motsutsana ndi RSV ndi zina zomwe zimapuma kuteteza kuti asatenge kachilomboka.
Synagis (palivizumab), anti-monoclonal anti-RSV, inapezeka patapita zaka zingapo, mu 1998.
Ngakhale kuti imaperekedwe mwezi uliwonse, Synagis imapezeka ngati jekeseni ya m'mimba. Ndipo mosiyana ndi RespiGam, Synagis si mankhwala a magazi ndipo sangasokoneze katemera wa ana anu (ana sangalandire katemera wa MMR kapena katemera wa nkhuku kufikira patapita miyezi 9 pomaliza mapeto awo a RespiGam).
The American Academy of Pediatrics inasintha malangizo awo omwe ana ayenera kulandira RSV prophylaxis ndi Synagis mu 2014. Ali ndi makanda osakonzekera omwe ali obadwa pakati pa milungu 32-35 ndi osakwana miyezi itatu kumayambiriro kwa nyengo ya RSV omwe ali ndi zifukwa zosachepera zingapo zomwe angagwirizane nazo Synagis, zotsatiridwa posachedwa ndizoti Synagis ikulimbikitsidwa kuti:
- Ana omwe anali asanakwane omwe anabadwa masabata osachepera 29 ndipo omwe ali ndi zaka zosakwana khumi ndi ziwiri kumayambiriro kwa nyengo ya RSV (makamaka October mpaka March).
- Ana ena omwe ali ndi matenda a mtima omwe ali ndi zaka zosachepera khumi ndi ziwiri kumayambiriro kwa nyengo ya RSV, makamaka ana omwe ali ndi matenda a mtima acyanotic omwe akulandira mankhwala oletsa kupweteka mtima kwa mtima ndipo adzafuna njira zopaleshoni za mtima ndi makanda omwe ali ndi matenda oopsa a m'magazi .
- Ana omwe anali asanamwalire omwe ali ndi matenda akuluakulu a mapapu, omwe anabadwa masabata osachepera 32, omwe ali ndi zaka zosakwana khumi ndi ziwiri kumayambiriro kwa nyengo ya RSV, ndipo anali ndi mpweya wokwanira 21% wa oxygen kwa masiku osachepera 28 atabadwa.
- Ana osapitirira zaka ziwiri omwe sakhala osasamala kwambiri pa nthawi ya RSV.
- Ana ena omwe ali ndi zaka zoposa ziwiri omwe ali ndi matenda a mapapu osapitirirabe omwe amapitirizabe kufuna oxygen yowonjezerapo, matenda aakulu a corticosteroids, kapena mankhwala ochizira, etc.
- Ana ena omwe ali ndi matenda osokoneza bongo kapena matenda a neuromuscular omwe amachititsa kuti asamatuluke pamsewu wawo wam'mwamba omwe ali osakwana miyezi khumi ndi ziwiri kumayambiriro kwa nyengo ya RSV.
Popeza matenda a RSV ndi ofala ndipo zizindikiro zimakhala zovuta kwambiri, bwanji anthu onse samapeza Synagis? Chimodzi mwa zifukwa ndikuti ndi ana aang'ono kwambiri, makamaka ngati anabadwa msinkhu, amakhala pachiopsezo chachikulu cha matenda opatsirana ndi RSV. Chifukwa china ndizofunika. Majekeseni a Synagis amawononga ndalama zokwana madola 900 pamwezi ndipo amafuna jekeseni wamwezi pa nthawi ya RSV.
Makamaka chifukwa chakuti maphunziro ambiri amapeza kuti pali "zopindulitsa zochepa zomwe zimachokera ku palivizumab prophylaxis." Komabe, ndi bwino kuposa chilichonse mpaka titapeza katemera weniweni wa RSV.
Kupeza Zowonongeka za Synagis
Kodi mumalandira zanji za Synagis?
M'dera lathu, Synagis nthawi zambiri imapezeka kuchokera kuchipatala cha Pulmonologists (Amaphunziro a m'mapapo), kapena kuchokera ku chipatala cha Synagis kuchipatala chachikulu, makamaka omwe ali ndi Chigawo chachikulu cha Care Care. Ngati muli ndi preemie yomwe idzatulutsidwa nyengo ya RSV, ndiye madokotala anu adzakambirana nanu za Synagis musanayambe kumwa ndipo angapereke foni yoyamba musanatumize kwanu.
Nthawi zambiri ana amatenga mphini zisanu kuti azitha kupyolera mu nthawi ya RSV.
Kaya mwana wanu ali ndi chiopsezo chachikulu chokhala ndi vuto la matenda a RSV, pali njira zina zochepetsera mwayi woti mwana wanu atenge kachilomboka. Izi zikuphatikizapo:
- kuphunzitsa ana anu ndi opereka chithandizo kuti azichita masewera olimbitsa thupi, makamaka atagwiritsa ntchito bafa (kuphatikizapo kusintha kwa diaper) komanso asanadye. Muyeneranso kutsuka zidole ndi zinthu zina zomwe ana anu aziika pakamwa pawo ndi malo ena onse ndi kutaya matenda atapukutira kapena kuwomba mphuno ya mwana wanu.
- peŵani kucheza kwambiri ndi anthu ena omwe akudwala. Onetsetsani kuti chisamaliro chanu cha tsiku ndi tsiku chili ndi ndondomeko yoyenera yopezera ana omwe ali ndi matenda opatsirana. ndipo musalole aliyense kusuta kuzungulira mwana wanu. Ngati mumasuta, kusuta fodya kunja sikokwanira kuchepetsa chiopsezo cha mwana wanu wa mavuto.
Lankhulani ndi dokotala wanu wa ana ngati mukuganiza kuti mwana wanu amafunikira Synagis kapena ngati muli ndi nkhawa za RSV.
Zotsatira:
Sukulu ya American Academy of Pediatrics Policy. Ndondomeko Yowonjezeredwa ya Palivizumab Prophylaxis pakati pa ana ndi ana aang'ono pa ngozi yowonjezereka ya chipatala chifukwa cha kupweteka kwa Syncytial Virus Infection. PEDIATRICS Volume 134, Number 2, August 2014.