Ukungena kwe-entocolitis okungenayo ihlanganisa ukungenwa kwamathumbu
I-enterocolitis engenayo i-neocrotizing, ngokuvamile ebizwa nge-NEC, yisimo lapho amathumbu asulele khona futhi angaqala ukufa. Isifo ngokuvamile sithinta izingane ezingakabiphi, nakuba abantwana bezingane bangathola ne-NEC. I-enterocolitis engenayo isimo esibi esingase sidinge ukuhlinzwa, futhi sinesilinganiso esiphakeme sokufa nokufa.
Sibutsetelo
Ukwakhiwa kwangaphakathi kwamathumbu kuqukethe izigidi zamabhaktheriya.
Ngokuvamile, lawa ma-bacteria (abizwa ngokuthi i-flora evamile) ayinabungozi futhi ayengxenye yenqubo yokugaya ukudla. E-NEC, noma kunjalo, amabhaktheriya aqala ukuhlasela udonga lwamathumbu. Uma lesi sifo singelashwa ngokushesha, udonga lwamathumbu luyobuthakathaka futhi luzofa. Ekugcineni, imbobo ingaba ngodonga lwamathumbu (i-perforation), ichithe okuqukethwe kwayo emgodini wesisu. I-perforation ye-bowel yisidingo esiphuthumayo sezokwelapha esidinga ukuhlinzeka ngokushesha futhi sinesilinganiso esiphakeme sokufa.
Izimbangela
Ukuqeda isimo sokuqala kuyinto engozini enkulu ekuthuthukiseni i-NEC, ngoba izitha zizalwa ngamathumbu angaphili. Ngaphandle kwalokho, odokotela abaqiniseki kahle ukuthi iziphi izimbangela ze-NEC. Bayazi ukuthi iningi lezinsana ezithola i-NEC ziqale ukondla ubisi, kodwa futhi ziyazi ukuthi ukubambezeleka kokuphakelayo akunciphisi imvamisa yalesi sifo. Ukunciphisa kwegazi ukugeleza emathunjini kungase kudlale nesici ekuthuthukiseni i-enterocolitis ene-necrotizing, kanti izingane ezinesimo senhliziyo ezifana ne- patent ductus arteriosis (PDA) zisengozini enkulu yokuthuthukisa i-NEC.
Izimpawu
Ezikhathini zokuqala ze-NEC, ukutheleleka kubangela ukuhamba kokudla kanye nomoya emathunjini ukuphumula noma ukuyeka. Lokhu kubangela ukuthi isisu somntwana sibonakale sigxiliwe noma sichithwa. Ngemuva kokunakekelwa, ukudla kuzoshiywa esiswini somntwana njengoba kusale isisu. Ekugcineni, ukudla okwanele kanye nomoya kubanjwe emathunjini ama-loops amathumbu azobonakala ebiswini lomntwana.
Isibeletho sizoba nobuhlungu futhi sivezwe, futhi umntwana angase aqale ukuhlanza i-bile noma abe nezinsalela ezinamanzi. Igazi lingase libe khona esitokisini somntwana, futhi umntwana angase aqale ukuvinjelwa yonke futhi abe nomkhiqizo omncane we-urine. Ingane ingase ibe nesikhathi esinzima ukulawula ukushisa kwayo futhi ingase iqale ukuba ne- apnea noma i- bradycardia . Ekugcineni, lesi sifo sizoqhekeka, sibangele ukutheleleka okusakazekile nokucindezeleka okuphefumula.
Ukwelapha
Esikhathini sokuqala, ukwelashwa kwe-NEC kuhlanganisa ukuyeka ukondla ubisi ukuvumela ukuphumula kwesilonda, ukunikeza ama-antibiotics ukuphatha ukutheleleka, nokususa umoya esiswini. Ingane izothola ama-x-ray amaningi ukubuka inqubekela phambili yesifo.
Uma ukwelashwa kungasebenzi noma uma isilonda sishaya, kudingeka ukuhlinzwa. Udokotela ohlinzayo uzosusa noma yikuphi izingxenye ezifile zesibindi kanye nezinye izinto ezifakwe yi-HIV. Isifuba sizobe sisetshenziswe kabusha noma sizokwehliselwa esiswini nge- stoma . Imithi yokwelashwa izoqhubeka kuze kube yilapho isifo siguquliwe.
Isibikezelo
I-NEC yisifo esibucayi, futhi cishe ama-25% wezinsana eziphuluke kwi-NEC zizodinga ukwelashwa kwezinkinga zesikhathi eside. Izinsana ezithinteka nge-NEC zingase zibe nokulibaziseka kokukhula, ukukhathazeka okunomsoco wokudla, nezinkathazo nge-liver kanye nezinyosi zezinyosi.
I-NEC yandisa futhi ingozi yokulibaziseka kwentuthuko.
Izinsana eziye zahlinzwa nge-NEC nazo zibonisa imiphumela yesikhathi eside esivela kulesi sifo. Ngaphandle kwemiphumela ye-NEC yezokwelapha, iziguli zokuhlinzwa zingase zibe nezinkinga ezinkulu zokumamatheka ezifana nesifo samathumbu esifushane futhi zibe nengozi eyingozi yokuphefumula kwesifo se- cerebral kanye nezinkinga zobuchopho neso.
Ukuvimbela
Ukuvimbela ukuzalwa ngaphambi kwesikhathi kuyindlela engcono kakhulu yokuvimbela i-enterocolitis ye-necrotizing. Uma usengozini yokuzalwa ngaphambi kokubeletha, khuluma nodokotela wakho ngalokho ongakwenza ukuze unciphise ingozi yakho.
Uma ukuzalwa kwangaphambi kokubeletha kwenzeka, ukudla kuphela ubisi lwebele kungancipha kakhulu ingozi ye-NEC.
Ubisi lwebele luqukethe izinto ezivikelayo ezikhuthaza ukuthuthukiswa kwamathumbu emathunjini futhi zinganciphisa inani lamabhaktheriya eliyingozi emathunjini. Kwesinye isifundo, izinsana ezazinakekelwayo okungenani okungenani ama-50% ubisi lwebele zahlehliswa ngokuphindwe kasithupha kwizigameko ze-NEC.
Ngaphezu kokuvimbela ukuzalwa kwangaphambi kokubeletha nokuncelisa ubisi lwebele, ukunikeza umama isifo sokubeletha lapho kulindeleke ukubeletha kungakabikho kunganciphisa ingozi ye-NEC. Futhi, ukwengeza ubisi lwebele kanye nefomula ngezinto ezahlukene ezifana nama-probiotics noma ama-immunoglobulins angasiza, nakuba kudingeke ucwaningo olungaphezulu.
Imithombo:
Bradshaw, MSN RN NNP-BC, CCRN Wanda Todd. "I-Nocrotizing Enterocolitis: Etiology, Presentation, Management, kanye Nemiphumela." Journal of Nursing Perinatal & Neonatal January / March 2009, 23: 87-94.
U-Schurr, u-P no-Perkins, i-EM. "Ubudlelwane Phakathi Kokudla Ne-Necrotizing Enterocolitis Ezinganeni Eziphansi Zesisindo Esincane." I- Neonatal Network Nov.-Dec. 2007, 27: 397-407.
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.