Isilinganiso se-Apgar sisetshenziselwa izidakamizwa ukuhlola isimo somsebenzi wengane esanda kuzalwa. Inqubo yenziwa e-nursery ngemizuzu yokuqala emva kokuzalwa kwengane. Ake sicabangele ngokuningiliziwe i-algorithm yokulinganisa, sizoyithola: ukuthi amaphuzu abalwa kanjani esikalini se-Apgar, nokuthi asho ukuthini.
"U-Apgar we-Scale" - kuyini?
Ngemuva kokuba umama ekwaziswa ngokuhlolwa okubalwa, umbuzo walokho okushiwo u-Apgar ukuthi yikuphi okusetshenziselwayo engqondweni yomusha omusha. Le nqubo ihilela ukucacisa izimpawu ezisemqoka ezibonisa isimo somntwana osanda kuzalwa emaminithini okuqala okuphila kwakhe. Isiqephu esiphelele sisiza ukuhlola isimo jikelele semvuthu.
Isilinganiso se-Apgar, esisetshenziselwa ukuzalwa, sibonisa ukusebenza kahle kwezitho ezibalulekile nezinhlelo. Ngokusekelwe ekutholeni, odokotela banikeza izibikezelo ezengeziwe mayelana nokusebenza kwengane, isidingo sokuvuselelwa. Ukuhlolwa kombuso esikalini sase-Apgar kusiza izingane zakudala ukuthola ulwazi mayelana nosana oluthatha imizuzu yokuqala emva kokubeletha.
Isilinganiso se-Apgar - umlando wokubukeka
Isimo somntwana osanda kuzalwa esikalini sase-Apgar saqale sihlolwe ngumhlengikazi we-American anesthesiologist. Igama lakhe ngokuqondile libizwa ngokuthi indlela ngokwayo. Isilinganiso sokuhlola samukelwa ngokusemthethweni phakathi nekhulu lama-20, enhlanganweni ye-anesthesia. Kulo mcimbi, uVirginia Apgar uzinikezele ukuhlola isimo somntwana osanda kuzalwa hhayi ngesisekelo sokusebenza kwezitho zakhe, kodwa futhi ucabangela amathuba okuthuthukisa izinkinga zezinzwa ekamelweni lokulethwa. Ngokushesha ngemva kwenkomfa, izinga le-Apgar lalisetshenziselwa ukusebenzisana ngamandla.
Yini ehlolwe esikalini se-Apgar?
Ukuhlolwa kwezingane ezisanda kuzalwa esikhulwini se-Apgar kuphakamisa ukuhlaziywa okufingqiwe kwezinkomba eziyisihlanu ngesikhathi esisodwa. Ngalunye lwalezi zikhombisi-ndlela kulinganiswa ngesilinganiso samaphuzu amathathu (amaphuzu angu-0-2). Imiphumela ibonisa ukulinganisa ebangeni kusukela ku-0 kuya ku-10 Kumele kuqashelwe ukuthi le migomo, kanye nesisindo nokuphakama, izinkomba ezibalulekile ezibikwa kumuntu omusha. Ukuhlolwa kokuqala esikalini se-Apgar kwenziwa eminithi yokuqala yokuphila.
Ukuze ngekhanda elingcono lezinkomba lapho kutholakala khona ukuhlola, udokotela wezingane uJoseph Butterfield uphakamise ukusebenzisa igama elithi APGAR njengesifingqo:
- A - ukubukeka - umbala wesikhumba;
- I-P - i-pulse - inombolo yezinhliziyo;
- I-G - grimace - reflexes;
- A - umsebenzi - i-tone muscle;
- R - ukuphefumula - inani lokunyakaza kokuphefumula.
Isimo somntwana osanda kuzalwa kanjani?
Ukuhlola isimo somntwana osanda kuzalwa esikalini se-Apgar akudingi ukuba khona kwezinsimbi ezikhethekile nezinsimbi. Kule nqubo, umntwana ubonakala ngokushesha 2 amamaki: emva kokuzalwa kanye nemizuzu emihlanu yokuphila. Kulesi simo, izindinganiso zokuqala zikhonjisiwe kumanani wokubala, amanani wesibili kuleyo ndawo. Ukuhlola isimo somntwana osanda kuzalwa kunesibalo sazo zonke izinkomba ezingu-5:
- Isikhumba - sibe ne-pink tinge, kusukela ekukhanyeni kuya ekukhanyeni. Ngalokhu unike amaphuzu amabili. Ngezicabha nemilenze ye-cyanotic - iphuzu eli-1, umthunzi wesikhumba obomvu ofanayo - 0.
- Isilinganiso senhliziyo - ipharamitha ejwayelekile yabantwana abasanda kuzalwa ngu-130-140 ukushaya ngomzuzu. Kodwa-ke, ekuhloliseni i-neonatologists lezi zindlela ezilandelayo ziyasetshenziswa: izinsimbi ezingaphezu kwezingu-100 - amaphuzu amabili, amaphuzu angaphansi kuka-100 - iphuzu eli-1, ukungabi khona kwe-pulse - 0 (ukuvuselelwa kuyadingeka).
- Ukuziphendulela kuphakathi kwezizindla ezingenakunqunywa ezikhona kuzo zonke izinsana: ukuphefumula kokuqala, ukukhala, ukugwinya nokuncelisa. Ukuba khona kwabo kulinganiselwa kumaphuzu amabili, ukungabikho okuyingxenye - 1, egcwele - 0.
- I-tone ye-muscle - ngemva kokubeletha, ikhanda lomntwana likhonjiswe esifubeni, izibambo ziboshwe emahlangothini, izandla ziyafakwa enqabeni. Imilenze ifakwe emlonyeni wezinyosi kanye namadolo. Ukulungiswa kokunyakaza akuphelelanga - izingane zivule izingalo nemilenze yazo, futhi kulokhu i-neonatologists inika amaphuzu amabili. Ngokubambisana okuncane, iphuzu eli-1 lihlelwe, ithoni eluthakathaka le-muscle kulinganiselwa kumaphoyinti angu-0.
- Ukunyakaza kokuphefumula - isilinganiso sama-40-45 ngomzuzu. Lokhu kuvamile kuvamile futhi amaphuzu amabili akhokhisiwe. Ngesikhathi esifanayo, ukukhala kokuqala kwengane kuhlolwa, okumele kube nokuzwakala okukhulu. Ngokuphefumula okunomsoco nokukhamuluka njengokububula - iphuzu eli-1 liboniswa, ukungabikho kokuphefumula noma ukukhala - 0.
Isilinganiso se-Apgar - ukucacisa
Amaphuzu ku-Apgar avumela odokotela ukuba bahlole isimo somntwana osanda kuzalwa, benze isibikezelo. Ngakho, ingane enempilo esikalini se-Apgar iqoqa inani lama-7-10 amaphuzu. Ngesikhathi esifanayo, amaphesenti amancane ezinsana athola amaphuzu aphezulu. Ukuhlolwa okuvamile ku-7/8 no-8/9. Isilinganiso sesibili, usethe emaminithini angu-5 ngemuva kokuzalwa komntwana, 1-2 ulinganisela ngaphezulu. Indima ebalulekile kulokhu idlala ngendlela yokulethwa. Ngokwenza njalo, izinsana ezizalwe yisigaba se-cearean zithola amaphuzu ambalwa kunezo ezizalwa ngokwemvelo.
Ama-Apgar scores asho ukuthini?
Ukusebenzisa indlela efana nesilinganiso se-Apgar, ukumiswa kwamaphuzu atholakele usana kwenziwa ngokuqondile odokotela. Kulesi simo, odokotela bale nkomba bangakwazi ukuhlola ngokushesha isimo somntwana, bakhombise ukwephula. Ngakho-ke, uma kulinganisa ama-5-6 ngesikhathi sokuzalwa, i-neonatologists ikhombisa izinga elilula le- hypoxia . Uma ingane ithola amaphuzu angu-3-4 - i-degree ejwayelekile ye-oksijeni yindlala iyatholakala, i-0-2 - ibonisa izinga lokuhlukumezeka okukhulu - ukuqubuzana okudinga ukunakekelwa okuphuthumayo.
I-apgar isikali - ithebula
Ukuhlolwa kwengane esikalini se-Apgar kwenziwa ngokusebenzisa itafula. Ihlunga yonke imingcele ekhona kanye nokuphambuka kwabo. Odokotela bahlola isimo sangempela somntwana ngenkathi bebukela ukuthi yimiphi imigomo okufanele ibe yinto evamile. I-neonatologists abanokuhlangenwe nakho bangenakho izindlela ezingalungile, izibonelelo zihlola isimo somntwana bese zibeka amaphuzu ajwayelekile. Imiphumela ifakwe irekhodi lezokwelapha.
Ama-Apgar amanqaku aphansi
I-Apgar score ephansi ingabonisa umehluko ekungajwayelekile nokukhubazeka kwengane esanda kuzalwa. Phakathi kwezici ezivame ukuvusa isimo esinjalo somntwana:
- u-hypoxia we-fetus ngesikhathi sokubeletha kwengane nokubeletha;
- ukuvuthwa kwemvelo - kubonakaliswa ukuzethemba, ukungahambi kahle, ukuntuleka kokunyakaza, ukucabanga okungaguquguquki. Ingane ilala isikhathi eside, ithatha ukudla okuncane.
Uma ingane ithola isilinganiso esiphansi esikalini se-Apgar kumzuzu wokuqala, kubalulekile ukwandisa le parameter ngamaphuzu angu-1-2 kumaminithi angu-5. Izinguquko ezinjalo zikhombisa amandla enamandla. Noma kunjalo, ingane enjalo idinga ukuqapha okuqhubekayo, ukunakwa okukhethekile kwabasebenzi bezokwelapha. Uma isimo somntwana sidabukisa, ukuvuselelwa kungase kudingeke.