Ukukhipha imininingwane
I-anemia ichazwa ngokwemithi njengesimo lapho umzimba ongenawo amangqamuzana egazi obomvu okwanele noma ukwehla kwamanani amangqamuzana egazi (RBCs). I-RBC, ebizwa nangokuthi i-erythrocytes ifakwe njengama-disks aphikisiwe, futhi ane-protein ye-hemoglobin enezinsimbi ezicebile. Igazi lithola umbala obomvu lapho i-hemoglobin ithatha oksijini emaphashini.
Njengoba igazi lihamba emzimbeni, i-hemoglobin ikhulula umoya-mpilo kumaseli omzimba kanye nezicubu. I-anemia ukuntuleka kwenani lala ma-RBC.
Kodwa lokhu kusho ukuthini ngempela? I-anemia ithinta kanjani ingane ngaphambi kwesikhathi futhi yini engenziwa ukusiza ukulungisa inkinga?
I-anemia yinto evamile futhi ingenzeka ngezizathu ezihlukahlukene. Ngaphambi kokubeletha, ukunikezwa kwegazi kwegazi kuthwala amangqamuzana egazi abomvu okwedlulele ukuze kusize ukuthatha i-oksijeni egazini likaMama nge-placenta. Uma sekuzalwa umntwana, futhi kune-oksijini engaphezulu, ayasadingeki lawa maseli egazi abomvu ngoba aqala ukuphefumula eyedwa. Ngalolu hlelo lokuguqula, umzimba uyeka okwesikhashana ukukhiqiza amangqamuzana egazi abomvu ngoba kukhona okungaphezu komzimba. Inombolo ye-RBCs ekusakazweni kwegazi izokwehla kancane kancane.
Lapho izinga liphansi kakhulu, umzimba uphendula ngokuqala ukwenziwa kwamaseli amasha wegazi elibomvu.
Lena inqubo evamile kokubili izinyanga ezigcwele nezinsuku ezingakapheli. Kubantu abadala nabantwana, amangqamuzana amasha wegazi ayenziwa njalo njengalabo asebekhulile bese bephukile emzimbeni. Le nqubo ivela kumjikelezo. Ezinganeni zangaphambi kwesikhathi, lo mjikelezo wegazi elibomvu ukuchithwa kwegazi ngokuvamile kuvamise ukukhiqizwa kwamaseli egazi ngokushesha futhi okubomvu ngokuvamile kuhamba kancane, ngakho-ke umntwana osanda kuzalwa uzoba yi-anemic kalula.
Izithasiselo zingase zibe yi-anemic ekulahlekelweni kwegazi ngaphambi noma ngesikhathi sokubeletha, ukungahambisani nezinhlobo zegazi kanye nomama wegazi, isidingo sokuthatha amasampula egazi njalo ukuze kwenziwe izivivinyo ezidingekayo ze-laboratory, noma ukungakwazi ukwenza amangqamuzana egazi abomvu okwanele ukuhambisana ukukhula okusheshayo kwezingane ngaphambi kwesikhathi.
Ingane e-NICU ihlolwe eduze ngokuhlolwa kwegazi okuthiwa i-Hematocrit ne-hemoglobin. (Eyaziwa nangokuthi i-H & H) Izinyathelo ze-hematocrit iphesenti yegazi elimanzi elenziwe amangqamuzana egazi abomvu emzimbeni. Uhlobo olujwayelekile lwe-hematocrit luphakathi kwama-35-65 wamaphesenti. Ukuhlolwa kwe-hemoglobin kulinganisa ukuthi i-hemoglobin engakanani, ingxenye ye-oxygen ethwala amangqamuzana egazi abomvu ekhona egazini. Uhlobo oluvamile lwe-hemoglobin luphakathi kuka-10-17. (Izigidi nge-deciliter ngayinye) Izinombolo ziyahluka kakhulu kuye ngokuthi uneminyaka nobani besana. Izinsana zangaphambi kwesikhathi zizohlolwa ukuhlolwa kwegazi okwenziwa njalo ngokuthi yi-count reticulocyte. (Eyaziwa nangokuthi ubuciko) Ama-reticulocytes amasha, amangqamuzana egazi abomvu. Ukuba khona kwama-reticulocytes ekusakazeni kwegazi kuyisibonakaliso sokuthi umzimba uqala ukukhiqiza amangqamuzana awo obomvu egazi.
Umzimba udinga insimbi ukwenza i-hemoglobin. Uma kungenayo i-iron eyanele etholakalayo, ukukhiqizwa kwe-hemoglobin kunomkhawulo, okuphendulela kuyo kuthinta ukukhiqizwa kwamaseli abomvu egazi.
Izinsana zangaphambi kokuzalwa zizalwa nezinqolobane ezincane zensimbi emizimbeni yazo kunezinsana ezisanda kuzalwa. Njengoba izithako ziqala ukukhula futhi ziqala ukukhiqiza amangqamuzana abomvu aphinde aphinde aphume ngensimbi egcinwe umzimba wawo. Ukuze uvimbele noma usize i-anemia emnene, i-preemie inganikezwa i-iron supplement nsuku zonke, ngokuvamile efana namaconsi amanzi.
Iningi lezingane liba nesifo sengculaza ngesikhathi esithile ngesikhathi i-NICU ihlala. Ezinye izingane zingakwazi ukubekezelela amazinga aphansi we-hemoglobin ngaphandle kokubonisa izimpawu nezimpawu. Izithaswane ezizalwa emavikini angu-28 ukubeletha noma okuncane kunesisindo esingaphansi kuka-1000 amagremu, abalwa nokutheleleka, noma esebenzisa umoya we-ventilator angeke abekezelele amazinga aphansi amangqamuzana egazi abomvu futhi angadinga ukumpontshelwa igazi.
Ukumpompela igazi kungaboniswa uma ingane ibonisa izimpawu zokukhulelwa kwegazi. Izimpawu nezimpawu zingabandakanya umbala wesikhumba obalahlekile, ukwehla emsebenzini noma ukulala kakhulu, ukukhathala ngokudla, ukwandisa ukuphefumula (tachypnea), noma ubunzima bokuphefumula lapho uhlala khona, uhamba kancane kunenzuzo evamile yesisindo. Ingane ingase ibe nokushaya kwenhliziyo ephakeme (tachycardia) noma ingase ibe nezinhlamvu eziningi ze-apnea kanye ne-deaturation.
Ukuguqulwa ngokuvamile kwenziwa ngemkhiqizo wegazi okuthiwa amangqamuzana egazi abomvu aphakanyisiwe. Amaseli abomvu aphakanyisiwe aqukethe inombolo ephezulu ye-RBC enomsindo ophansi wegazi. Igazi lokumpompela lihambisana ngokufanayo ukuze kugweme ukungafani kwegazi phakathi komnikeli nomntwana. Okusho ukuthi igazi lomntwana lizodonswa futhi lihambelane nelomnikeli. Kwezinye izibhedlela, kungenzeka ukuthi abazali bezingane ezingakafiki ngaphambi kokuba benze umnikelo oqondile kubantwana babo. Umzali nengane kufanele babe nezinhlobo ezihambisanayo zegazi, futhi igazi lomzali kumele lihlolwe, futhi likhululekile ukutheleleka. Ngemuva kokuthi igazi liqoqwe kuthatha cishe amahora angu-72 ukulilungiselela ukumpompela.
Enye yezokwelapha zakamuva ze-anemia, engasetshenziswanga kakhulu okwamanje, ukusetshenziswa kwe-erythropoietin. I-Erythropoietin i-hormone engokwemvelo emzimbeni okhuthaza ukukhiqizwa kwamaseli amasha wegazi obomvu. Ukwelashwa kwe-Erythropoietin kuhilela izibhamu, kathathu ngesonto, futhi kunikezwe nge-supplements iron. I-Erythropoietin ayisetshenziswanga kakhulu njalo ukuphathwa kwe-anemia enganeni yokuqala.
Kubalulekile ukukhumbula ukuthi i-anemia ingumphumela wenqubo evamile kuyo yonke intsha, kepha yisimo esivame kakhulu sezingane ezingakafiki. I-anemia iyaphathwa kalula futhi ingenye yezindlela eziningi ezithinta izingane ezizozalwa ngaphambi kwesikhathi lapho zizohamba khona ngesikhathi seNICU.
> Imithombo:
> Ubukhulu JA. I-Pathophysiology ye-anemia ngesikhathi sokubeletha, kuhlanganise ne-anemia ye-prematurity. I-NeoReviews. 2008; 9: 31-e5
> Bell EF, Strauss RG, Ubukhulu JA, Mahoney LT, Mock DM, uSeward VJ, et al. Ukuhlolwa okungahleliwe kwezinhlahlandlela ezivulekile ezihambisana nokuvimbela igazi elibomvu kwegazi ezinganeni zakuqala. Izingane zokwelapha. 2005; 115: 1685-1691
> Ceriani Cernadas JM. Ukuqala kokubambezeleka kokubambezeleka kwezintambo ezincane ezisencane: Ukuhlaziya kwe-RHL (okugcine ukubuyekezwa: 7 Mashi 2006). I-WHO ye-WHO yokuLawulwa kweMpilo ; I-Geneva: I-World Health Organization
> Von Kohorn, I. & Ehrenkranz, R. Mashi 2009. I-anemia enganeni yokuqala: I-Erythropoietin ngokumpontshelwa kwe-erythrocyte - Akulona lokho okulula. I-Perinatology yemitholampilo. 36 (1): 111-123.