I-retinopathy ye-prematurity, ebizwa nangokuthi i-ROP, isifo esithinta i-retina yeso. I-ROP ithinta imithwalo yegazi ku-retina emehlweni e-preemie, futhi ingenye yezimbangela ezibangela ubuphofu buntfwana.
Sibutsetelo
Ngesikhathi sokukhulelwa, imithwalo yegazi emanzini omntwana aqala ukuthuthukisa cishe amasonto angu-16 ukubeletha. Ngeviki lama-34 lokukhulelwa, imithwalo yegazi esweni isoselwe ngokwanele kangangokuthi i-retina inegazi elihle.
Lapho abantwana bezalwa ekuqaleni, imithwalo yegazi ku-retina ayitholakali ngokugcwele. Ngemva kokuzalwa, izitsha zingase ziqale ukukhula ngokushesha kangangokuthi ukukhula kwabo kubonakalisa i-retina. I-retinopathy ye-prematurity (i-ROP) yigama lokukhula okungalungile kwemithambo yegazi ku -retina kanye nomonakalo obangelwa ukukhula.
Ezenzweni eziningi ezithuthukisa i-ROP, ukukhula kwemithambo yegazi le-retinal kuyokwenyuka ngokwakho, futhi umbono uzokhula ngendlela evamile. Nokho, ezinye izingane ezingakabiphi isikhathi, zakha i-ROP enamandla.
Izigaba
I-retinopathy ye-prematurity ihlukaniswa ngokwezinyathelo ezahlukene. Izigaba eziphakeme ze-ROP zimbi kakhulu, futhi kungenzeka ukuthi zibangele ubumpumputhe noma izinkinga zesikhathi eside. Izigaba ezingezansi ze-ROP zinzima kakhulu; izingane eziningi ezinezigaba I no-II ROP zizophuthuka ngaphandle kokwelashwa futhi ziyoba nombono ovamile.
- Isigaba soku-1: Ukukhula okungavamile kwemikhumbi yokubuyisela. Ngokuvamile uthola kangcono ngaphandle kokwelashwa futhi akanayo imiphumela yesikhathi eside.
- Isigaba sesi-2: Ukukhula kwezitsha zokubuyisela ngokwemvelo kungavamile ngokwejwayelekile. Ngokuvamile uthola kangcono ngaphandle kokwelashwa futhi akanayo imiphumela yesikhathi eside.
- Isigaba sesi-3: Ukwanda kwezitsha zokubuyiselwa okuyisimanga kakhulu. Izinsana ezinezigaba ezintathu ze-ROP zingadinga ukwelashwa kwe-ROP futhi zibe nengozi ephezulu yezinkinga zesikhathi eside. Izinsana ezinezifo eziningi, isibonakaliso sokuthi i-ROP iyaqhubeka ngokushesha, ngokuvamile idinga ukwelashwa ngalesi sigaba.
- Isiteji sesi-4: Inqola yangasese yokubuyisela. Ngokuvamile kudinga ukwelashwa futhi kungaholela ezinkingeni zesikhathi eside zombono noma ukuphuphuthekisa.
- Isiteji sesi-5: Qedela imishini yokubuyisela. Kudinga ukwelashwa futhi kungaholela ezinkingeni zesikhathi eside zombono noma ubumpumputhe.
Ukuxilongwa
I-retinopathy ye-prematurity iyatholakala ngesikhathi sokuhlola iso. Ukulungiselela ukuhlolwa, ama-eyedrops asetshenziselwa ukuhlanza abafundi bezingane. Ngesikhathi sokuhlolwa, i-ophthalmologist izobheka ngokucophelela i-retina ukuhlola ukuthi izitsha zikhula ngokufanele futhi, uma kungenjalo, iyiphi ingxenye ye-retina ebonisa izimpawu zenkathazo.
Akuzona zonke izingane ezingaphambi kwesikhathi ezizodinga ukuhlola ukuhlola i-ROP. Izibhedlela zihluka lapho izingane zihlolwe khona nge-ROP, kodwa iningi lezingane ezizalwa ngaphambi kwamasonto angu-31 ukubeletha kuzodingeka okungenani ukuhlolwa okulodwa ukuhlolwa kwe-ROP. Uma ukuhlolwa kungenakulinganiswa noma amehlo omntwana abonisa izimpawu ze-ROP, ukuhlolwa okulandelayo kuzohlelwa ngezikhathi ezithile.
Ukwelapha
Amacala amaningi we-retinopathy of prematurity azoba ngcono futhi awadingi ukwelashwa.
Esikhathini sesigaba 3 ROP nangaphezulu, kungadingeka ukwelashwa ukuvimbela ukukhula okungavamile kwemithambo yegazi ku-retina noma ukulungisa imishini yokubuyisela emuva. Izinhlobo zokwelapha zibandakanya i-cryotherapy, i-laser therapy, kanye nokuhlinzwa okubuyiselwayo.
- I-Cryotherapy : I-Cryotherapy isebenzisa amazinga okushisa okushisa ukuze iqede izingxenye ze-retina ezithintekayo yi-ROP, eyehlisa ukukhuphuka kwemithambo yegazi engafanele engozini.
- Ukwelashwa kwe-Laser: Njenge-cryotherapy, i-laser therapy isetshenziselwa ukumisa ukukhuphuka kwezikebhe ezingenampilo ku-retina. I-laser isetshenziselwa ukwenza ukushisa okuncane ezingxenyeni ze-retina ezithintekile yi-ROP. Ukwelashwa kwe-laser ngokuvamile kunemiphumela engcono kune-cryotherapy futhi isetshenziswa kaningi, kepha i-cryotherapy isengasetshenziswa ezimweni ezithile. Ukuze ulondoloze umbono ophakathi, umbono othile wendawo ungase ulahleke ngokubili ukwelashwa kwe-cryotherapy kanye nokwelashwa kwelasi.
- Ukuhlinzekwa okubuyiselwayo: Esikhathini sesigaba 4 no-5 sokuphindaphindiwe kwe-prematurity, i-retina isiqalile ukuxosha noma ikhishwa ngokuphelele emehlweni. Iqoqo elincane le-retinal lingase libe ngcono noma lingadinga ukuhlinzwa. I-retina ehlanjululwe ngokuphelele idinga njalo ukuhlinzwa.
Imiphumela Yesikhathi Eside
Kuze kube ngamaphesenti angama-90% azalwa ngaphambi kwamasonto angu-31 azokwakha uhlobo oluthile lwe-ROP. Amacala amaningi e-ROP anobumnene futhi awunayo imiphumela yesikhathi eside. Izingane eziphethwe yi-ROP njengezinsana zingase zibhekwe, noma zingase zibe ne-strabismus noma i-amblyopia.
Ezimweni ze-ROP ezinzima, ukulahleka kombono kungabonakala. Izibhedlela zingcono kakhulu ekutholeni nasekwelapha i-ROP ngaphambi kokubangela ukuphuphutheka, kodwa amacala amakhulu we-ROP angase abangele ukulahlekelwa kombono.
Ukusetshenziswa kwe-oksijeni ne-ROP
I-oxygen eyengeziwe isetshenziswa kaningi ngokusekelwa kokuphefumula ukusiza ukugcina igazi le- oxygen oxyment saturation emazingeni aphilile. Abantu abadala kanye nezinsana zesikhathi kumele zigcine ukugcwala kwe-oksijini emazingeni aphezulu angama-90 ukuze zihlale ziphilile, kodwa izingane ezingaphambi kwesikhathi zihlukile.
Lapho ukunakekelwa kwengane ngaphambi kokuqala kwaba yikhokhnoloji, odokotela nabahlengikazi basebenze kanzima ukugcina i-oxygen saturation saturation engaba yizinga eliphilile labantu abadala. Ngemuva kokutadisha okuningi, kwafunyanwa ukuthi abantwana abene-oxygen saturation bagcinwe phezulu babe nenengozi enkulu yokuthuthukisa i-ROP. Odokotela nabahlengikazi banganamathela ngokuphepha amazinga e-oksijini ukugcina ukuqhutshwa kwe-oksijeni ephansi ngokwezingu-83% ezenzweni zezitha, okusiza ukuvimbela i-ROP.
Imithombo:
UCapone, u-Antonio noQuiram, uPolly. "Ukuqonda Nokuphathwa Kwamanje Kwe-Retinopathy ye-Prematurity." Umbono wamanje ku-Ophthalmology 2007; 18, 228-234.
Coe, Kristi et al. "I-Optional Special Targeting Oxygen Targeting (SPOT): Uhlelo Lokunciphisa Ukukhubazeka Kwezinsana Ezisezintanjeni ezine-Retinopathy ye-Prematurity." I-Journal yeNgcono Yokunakekela Abahlengikazi November 2005; 21, 230-235.
I-National Eye Institute. "Amaqiniso Nge-Retinopathy of Prematurity (ROP). Http://www.nei.nih.gov/health/rop/
Sears MD, William, Sears MD, Robert, Sears MD, James, Sears RN, Martha. Incwadi Yengane Yokuqala: Yonke Into Okudingeka Uyazi Ngomntwana Wakho Okhulile Kusukela Ekuzalweni Kuya Kudala . Little, Brown and Co., New York, 2004.