I-Asphyxia yezingane ezisanda kuzalwa iyinkimbinkimbi eqala esikhathini sokuqala sokuhamba kwesikhathi. Lesi sifo sihambisana nokuphulwa kwenqubo yokuphefumula kanye nomsebenzi wesimiso senhliziyo emntwaneni. Cabanga ngalesi simo ngokuningiliziwe, thola izimbangela zayo, izinhlobo, sizozithola: yini ehlukanisa i-hypoxia ye-fetus ne-asphyxia yengane esanda kuzalwa.
Iyini "i-asphyxia" enganeni esanda kuzalwa?
I-Asphyxia yezingane ezisanda kuzalwa iyimvelo yenyama encane lapho kuphulwa ukuphefumula. Kulesi simo, kukhona umehluko phakathi kwalesi sifo kanye nencazelo "ye-hypoxia yengane esanda kuzalwa." Indlala yocingo (i- hypoxia ) iqala ngesikhathi sokukhulelwa noma ukubeletha (ukukhipha imfucumfucu, ukucindezela umthamo we-umbilical), futhi ihambisana nokudla okunganele oksijini. Inqubo yokuphefumula ayiphuli. I-Asphyxia (ukuhlushwa) ibonakala ngokuphelelwa yisikhathi kokuphefumula futhi kudinga ukuvuselelwa.
Izimbangela Zokufaza Kwezingane ezisanda kuzalwa
I-Asphyxia yengane ngesikhathi sokubeletha ingacasulwa yizici eziningi. Kulokhu, izimbangela ezibangela ukugula, zingahlobene ngqo nenqubo yokulethwa kanye nezici zokuthuthukiswa kwe-intrauterine ye-fetus. Phakathi kwezici eziyinhloko zempilo ezibangelwa i-asphyxia, odokotela bahlukanisa:
- Cijela, ukungasebenzi ngokungazelelwe emgodleni wegazi nangaphakathi kwentambo yomzimba - iphoyinti lentamo yomntwana , ukwakheka kwe-node emthonjeni we-umbilical, i-constriction.
- Ukuphazanyiswa kwenqubo yokushintshaniswa kwegesi ohlelweni lwe-utero-placental - isethulo esingalungile sendawo yengane, inqola engakapheli nengxenye .
- Ukwehluleka kwenqubo yokusakaza ku-placenta, ebangelwa ukucindezeleka kwegazi kumama.
- Ukunciphisa izinga le-oxygen egazini lomama ekubelethweni - i- anemia , izifo zenhliziyo, izifo zokuphefumula.
- Ukubunzima kokuphefumula emntwaneni kungumonakalo wokuthuthukiswa kwamaphaphu, izinqubo ezingapheli ezithathelwanayo, umphumela wemithi ethathwe.
Lezi zimbangela zivusa ukuphefumula okuyisisekelo kwezinsana ezisanda kuzalwa, eziqala ekulethwa kwezidingo. Kodwa-ke, i-asphyxia ingabuye ibe yinkinga yesibili uma isifo sikwenzeka ngokushesha ngemuva kokuzalwa komntwana. Phakathi kwezizathu ze-secondary asphyxiation yilokhu:
- isifiso sokuphefumula - uketshezi ukungena kumaphaphu;
- ukwephulwa kwenqubo yokujikeleza kwengqondo;
- ukungahlali emaphashini - umzimba awukwazi ukwenza ukunyakaza kokuphefumula;
- ukukhubazeka kokuzalwa kwengqondo, inhliziyo, amaphaphu.
Ama-degree of asphyxia of the newborns
Kuye ngesithombe somtholampilo nokuqina kwesifo, odokotela bahlukanisa izigaba eziningana zokukhubazeka. Ukuhlolwa kwenziwa ngemuva kokuzalwa komntwana eminithini yokuqala. Ukuhlukaniswa kwe-asphyxia kwezinsana kulandela lokhu:
- i-degree degree;
- isilinganiso;
- inzima;
- ukufa komtholampilo.
I-Asphyxia ye-neonatal imnene
I-Asphyxia yezinga eliphansi ibonakala ngokungabikho kokuklabalasa, kepha ukusabela kwengane ukuthinta kuyatholakala. Ukuphefumula komntwana osanda kuzalwa kuyimfihlo, kodwa kuyashesha futhi kungavamile. Imilenze nezandla zinomthunzi we-cyanotic, umsebenzi wenhliziyo awuphukile. Emva kokuhlanza iphethini lokuphefumula okuvela emcimbini kanye nobandlululo, ukwenza ukugqugquzela okuthinta inhliziyo (ukushaya emuva, ukugaya izithende) kanye nokwelashwa kwe-oksijeni ngokusebenzisa imaski, isimo sesanda kuzalwa sijwayelekile.
Ingane ezalwe yisimo se-asphyxia esilinganiselwe, engenazo izinkinga zokuphefumula. Kulokhu, izinkinga ezincane ze-neurological zingenzeka, ngendlela:
- ukwanda komsindo we-muscle;
- ukuthuthumela kwezimbambo, imilenze, umhlathi ophansi.
I-Asphyxia yobunzima obulinganiselayo osanda kuzalwa
Lelizinga lokukhubazeka libhekene nokungabikho kokuklabalaza ngesikhathi sokuzalwa. Kulesi simo, ukusabela ekuthinteni okuthinta ukuxhumana akuthinti. Isici sesici salolu hlobo luyishintsho embala wesikhumba, ngakho ngokuvamile kubhekiselwa njenge-blue asphyxia yabantwana abasha. Izinyathelo zokuphefumula zinohlobo olulodwa, noma kunjalo, umsebenzi wenhliziyo awuphephile.
I-asphyxia ejwayelekile yomsana idinga umoya. Ukuze wenze lokhu, kaningi usebenzise isikhwama esikhethekile, ngezikhathi ezithile umaski we-oxygen. Ifomu elidlulisiwe le-pathology liye lashiya uphawu emndenini wezingane, okwenza izinguquko ze-neurologic:
- ukukhuphuka okukhulu - ukukhala okungenangqondo, ukuzamazama kwesikhathi eside nemilenze;
- ukucindezeleka - ukuphuza isifuba esiphuthumayo, umsebenzi ophansi wezimoto (ukunyakaza ngezingalo nemilenze akukwenzi okwenziwa).
I-Asphyxia yezinga elibi ezinganeni ezisanda kuzalwa
Izinga eliphakeme lokukhubazeka lihambisana nokuphefumula okuphelele ngesikhathi sokuzalwa. Isikhumba ngenxa yokuntuleka kwegazi sishaya. Ngenxa yalokhu, leli fomu le-pathology libhekwa njenge-white asphyxia yengane esanda kuzalwa. Uma wenza uvivinyo oluyinkimbinkimbi, ingane ayifuni ukusithinta. Kukhona ukwephulwa kwenqubo yesifo senhliziyo - uma ukulalela imisindo yenhliziyo iminyene kakhulu noma ayikho ngokuphelele. I-bradycardia eqinile iqala.
Le-asphyxia yezingane ezisanda kuzalwa idinga ukuvuselelwa okuphuthumayo. Izenzo zodokotela zihlose ukubuyisela umsebenzi wokuphefumula nomoya wengane. Ingane ixhunywe kuphefumula. Ngesikhathi esifanayo, intambo yomzimba ilawulwa ngemithi ekhuthaza umsebenzi wenhliziyo. Izingane ezinjalo isikhathi eside ziphefumula nge-hardware, futhi zizobe zakha ukukhathazeka okukhulu kwezinzwa, kungenzeka ukuba ziphuze ukuthuthukiswa kwe-neuropsychic.
Ukufa emtholampilo kwengane esanda kuzalwa
Ukufa komntwana okwenzeka emtholampilo kwenzeka lapho odokotela behlela ukungabikho okuphelele kwezimpawu zokuphila. Kulesi simo, ngemuva kokubeletha, umntwana akenzi lutho lokuzivocavoca, akakho umsebenzi wezinhliziyo, ukusabela okubangelwa yi-stimuli naye. Ukuqaliswa okulungile nokufika ngesikhathi sokubuyisela kabusha kunika ithemba lokuthola umphumela omuhle. Kulokhu, ukuqina kwemiphumela yengqondo yengane yomntwana kuncike ekutheni ukungabi nokuphefumula kwaze kube nini. Ezimweni ezinjalo, ubuchopho bulimaza kakhulu.
I-Asphyxia yezingane ezisanda kuzalwa - izimpawu
Ukuhlola ubunzima be-pathology, odokotela basebenzise izinga le-Apgar. Le ndlela isekelwe ekuhlolweni kwezinkomba eziningana ngesikhathi esisodwa:
- i-excitability ye-reflex;
- ukuphefumula;
- umsebenzi wenhliziyo;
- i-muscle ithoni;
- umbala wesikhumba.
Kupharamitha ngayinye, amaphuzu ayengeziwe, afakwa futhi afakwe amaphuzu amaningi. Imiphumela ibonakala kanje:
- degree elula - 6-7 amaphuzu;
- isilinganiso - 4-5;
- enzima - le kid ithola amaphuzu angu-1-3;
- ukufa komtholampilo - amaphuzu angu-0.
Lapho ebonisa ukuphefumula kwe-degree, ababelethisi bahlola izimpawu zamanje zesifo. I-pulp in asphyxia ezinsana iyancipha futhi ingaphansi kwezingu-100 ngomzuzu ngamunye. Ngokuba i-degree elula ye-asphyxia yizici:
- ukuphefumula kokuqala kwenzeka eminithi elingu-1;
- imisindo ye-muscle yehle kancane;
- unxantathu we-nasolabial wombala okwesibhakabhaka;
- ukuphefumula kubuthakathaka.
Ngesilinganiso esijwayelekile se-asphyxia, odokotela balungise:
- ukuphefumula buthakathaka
- Imilenze nezingalo ziphenduka okwesibhakabhaka;
- inani lezinhliziyo linciphisa;
- imisindo ye-muscle yehle;
- I-pulsation ye-cord umbilical ibonakala.
Isilinganiso esinzima salesi sifo sibonakala yizimpawu ezilandelayo:
- ukuphefumula akusekho;
- i-bradycardia enamandla;
- i-muscle atony;
- isikhala sesikhumba;
- ukuthuthukiswa kokuntuleka okunamandla;
- i-pulsation eqinile yemithanjeni yentambo ye-umbilical.
I-Asphyxia yezingane ezisanda kuzalwa - imiphumela
Ekhuluma ngokuthi i-asphyxia eyingozi ezinsaneni ezisanda kuzalwa, odokotela bayabhala ukuthi ngokuphulwa okungathí sina, ukufa komntwana kungenzeka. Kwenzeka emahoreni wokuqala okuphila. Ngezinga eliphansi futhi eliphansi, ukubikezela kulungile. Umphumela uxhomeke esikhathini sokuvuselelwa, ukutholakala kwezifo ezihambisanayo. Imiphumela ye-pathology eyakhula ngesikhathi sokuzalwa ingavela, kokubili emahoreni wokuqala okuphila, nangesikhathi esidala.
I-Asphyxia entsheni emva kokubeletha - imiphumela
I-asphyxia enamandla yezingane ezisanda kuzalwa, imiphumela yayo kuxhomeke ekuqineni nasekusebenziseni ukwelashwa okuqalile, akudluli ngaphandle komkhondo womzimba. Izinkinga zingenzeka, kokubili ezinyathelweni zakuqala zokuthuthukiswa komuntu ngamunye, nasebudala. Ukuqeda i-brain atrophy ngemuva kokuba i-asphyxia ezinsaneni ivele ingavamile. Phakathi kwezimo ezinzima zesikhathi sokuqala sokuphumula:
- ukuxilongwa okuxubile;
- i-hydrocephalus;
- i-syndrome ye-hypertensive;
- hypo- noma hyperexcitability.
I-Asphyxia yezingane ezisanda kuzalwa - imiphumela ekudala
I-Asphyxia ne-hypoxia yezingane ezisanda kuzalwa zihlobene nalezi zinkinga zokukhulelwa ezithinta impilo yengane ngemuva kokuzalwa kwakhe. Izinkinga zingavela ezinyangeni ezimbalwa, futhi ngezinye izikhathi ngisho neminyaka. Phakathi kwezinkinga eziphelile:
- i-meningitis;
- i-pneumonia;
- i-sepsis.
Ukwelashwa kwe-asphyxia ezinsana ezisanda kuzalwa
Uma uhlola amaphuzu ama-4 we-Apgar noma ngaphansi, okwenziwa ngomzuzu wokuqala, ukuvuselelwa kuyadingeka. Ukuvuselelwa usana olusanda kuzalwa ku-asphyxia kwenziwa ngezinyathelo ezine:
- Ukukhululwa kwepheshana lokuphefumula, ukuqinisekisa ukufaneleka kwabo. Kuqhutshwa ngosizo lwe-catheter kanye nepompi kagesi. Uma i-asphyxia ivela ku-utero, ukuphathwa ngokuhlanzwa kwenziwa ngokushesha ngemva kokubonakala kwekhanda.
- Ukugcina inqubo yokuphefumula. I-ventilation eyisizayo yenziwa ngosizo lwekhwama lokuphefumula, futhi uma lingasebenzi, intubation yenziwa futhi idivayisi yokufakelwa umoya yokuxhuma ixhunyiwe.
- Ukubuyiselwa kwesistimu yokujikeleza. Ngalesi sizathu, kwenziwa ukusikwa komzimba okuvaliwe, ngisho nokusikeka (nge-bradycardia yezinsimbi ezingu-60-70 ngomzuzu). Kuqhutshwa ngokucindezela kwi-sternum enezithupha ezimbili, ngokuphindaphindiwe izikhathi ezingu-100-120 ngomzuzu. Uma umsebenzi wenhliziyo ungabuyiselwa ngaphakathi kwimizuzu, qhubeka esigabeni esilandelayo.
- Ukuphathwa kwemithi. Kulesi sigaba sokwelashwa, odokotela basebenzisa lezi zidakamizwa ukuze baphathe i-neonatal asphyxia:
- Atropine 0.1% - 0.05-0.1 ml;
- I-Adrenaline 0.1% - 0.02-0.03 ml;
- I-bicarbonate ye-sodium - 1-2 ml.
Ukuvimbela i-asphyxia yezingane ezisanda kuzalwa
Ukuze kuvimbele ukuhlukunyezwa okungenakuqhathaniswa - i-asphyxia yesisu nengane esanda kuzalwa, izinyathelo zokuvimbela kufanele zithathwe kokubili esigabeni sokuhlela ukukhulelwa, nalapho ingane izalwa. Phakathi kweziqondiso eziyinhloko:
- Ukwelapha okwesikhashana kwezifo ezithathelwanayo ezikhungweni zabesifazane abakhulelwe.
- Ukuphathwa kwenqubo yokubeletha kuthatha izici zobungozi.
- Ukuqhutshwa kwe-intrauterine yokuqapha isimo se-fetal ne-placenta (i-dopplerography, i-ultrasound).
- Ukuvimbela i-hypoxia ngesikhathi sokubeletha, ukuxoshwa okwesikhashana kwendlela yokuphefumula.