Lapho ingane izalwa ngaphambi kwesikhathi , bayovame ukuphefumula ngokwabo futhi badinga uhlobo oluthile losizo. Uhlobo losizo lokuphefumula ingane yakho oluzoyidinga luyoxhomeka ekutheni ingane yakho izalwa kanjani ekuqaleni. Kungenzeka ukuthi utshelwe ukuthi ingane yakho inento okuthiwa i-RDS. I-RDS noma i- Respiratory Distress Syndrome ingenye yezinkinga ezivamile ingane ezohlangana lapho izalwa ngaphambi kwesikhathi.
Ngaphambi kokuba umntwana azalwe, amaphaphu awela futhi i-oksijeni inikezwa ingane ngeplascenta. I-placenta ivumela ukuhamba kwe-oksijeni nezakhi ezivela egazini likaMama egazini lomntwana ngekhanda lomzimba. Ngemuva kokuthi ingane izalwe zonke lezi zinguquko. Lapho insimu ye-umbilical igawulwa, umzila wokuphefumula we-oksijini ocebile igazi eliyi-placental lihlukanisiwe. Ukulamba kwendlala kuqala futhi umntwana osanda kuzalwa uzoqala ukungena emoyeni. Ngalokhu kuqhuma, amaphaphu akhulisa okokuqala futhi aguqulwe kusukela ekuhlungeni, emzimbeni oqinile kuya esikhwameni esithambile emoyeni ogcwele.
Indlela ama-Lungs asebenza ngayo
Amaphaphu avuthiwe akhiwe ngamapulangwe, izicubu ezinwebekayo ezithinta futhi zinyakazela njengoba uphefumula. Kunezigidi zamapokhethi amancane, azungezile okuthiwa i-alveoli eyandisa lapho umoya ungena khona. Ngaphakathi kwe-alveoli, ungqimba oluncane lwe-liquid okuthiwa i-surfactant. I-Surfactant yinto efana ne-sipopu ejwayele ukugqoka ngaphakathi kwamaphaphu avuthiwe futhi ivimbele la mabhaloni amancane (alveoli) ekuwa.
I-surfactant ibalulekile kulokhu kushintshaniswa kwe-oxygen ne-carbon dioxide phakathi kwamaphaphu kanye negazi. Ukukhiqizwa kwe-surfactant ngaphakathi kwamaseli wamapayipi kuqala phakathi kwamasonto angu-24 kuya kwangu-28 ukubeletha, ngokukhiqizwa okwandisiwe kuze kube yilapho ingane isondla isikhathi.
Lapho umntwana ezalwa kusenesikhathi kakhulu, banamaphaphu amancane futhi kaningi akakwazi ukungena esibhedlela.
Amapayipi awakwazi ukuvula kahle ngokwanele ukugibela umoya-mpilo ukuze ubanjwe kahle egazini bese usatshalaliswa ezithombeni ezibalulekile. Amapayipi angaphambi kwesikhashana nawo anama-alveoli amancane amancane asithinta ikhono lokushintshanisa i-oxygen ne-carbon dioxide. Amapayipi aqhubeka enza i-alveoli kuze kube yilapho ukulethwa. Ngaphambi kokubeletha ingane, i-alveoli encane iyoba nayo. Lezi zingu-alveoli zincane kakhulu futhi zinezinhlabathi ezinomanzi. Izakhiwo ezimanzi zinamathele ndawonye, kubangele ukungezwani komzimba. I-surfactant iyanciphisa lokhu kuphazamiseka okuvumela ukuba izindawo ezimanzi zamaphaphu zande, okuvumela ukushintshaniswa kwe-air.
Umoya esiphefumulayo wenziwa ngegesi eziningana, oksijini, okubaluleke kakhulu ngoba amangqamuzana adinga wona amandla nokukhula. Ngaphandle kwe-oxygen, amangqamuzana omzimba ayezoqala ukufa. I-carbon dioxide yilapho imfucuza evuthayo eyenziwe yi-metabolism njengengxenye yenqubo yokwenza amandla emzimbeni. Amapayipi avumela umoya omoya emoyeni ukuba uthathwe emzimbeni, kanti futhi uvumela umzimba ukuba ususe i-carbon dioxide emoyeni uphefumulelwe.
I-surfactant ibalulekile kulokhu kushintshaniswa kwe-oxygen ne-carbon dioxide phakathi kwamaphaphu kanye negazi. Ukukhiqizwa kwe-surfactant ngaphakathi kwamaseli wamapayipi kuqala phakathi kwamasonto angu-24 kuya kwangu-28 ukubeletha, ngokukhiqizwa okwandisiwe kuze kube yilapho ingane isondla isikhathi.
Lapho umntwana ezalwa kusenesikhathi kakhulu, banamaphaphu amancane futhi kaningi akakwazi ukungena esibhedlela. Amapayipi awakwazi ukuvula kahle ngokwanele ukugibela umoya-mpilo ukuze ubanjwe kahle egazini bese usatshalaliswa ezithombeni ezibalulekile. Amapayipi angaphambi kwesikhashana nawo anama-alveoli amancane amancane asithinta ikhono lokushintshanisa i-oxygen ne-carbon dioxide. Amapayipi aqhubeka enza i-alveoli kuze kube yilapho ukulethwa. Ngaphambi kwesikhathi umntwana uzoba ne-alveoli encane abazoba nayo.
Izinkinga Zokulethwa Ngaphambi Kokuqala Nezinkinga Zokuphefumula
Ngokuvamile, ingane izalwa ekuqaleni, ingozi enkulu yokuthuthukisa ukucindezeleka kokuphefumula. Uma ukubeletha kusenesikhathi kungahlelelwe usuku noma ezimbili, umama anganikezwa ama-injection angu-2, amahora angu-24 ngaphandle, we-steroids, njenge-betamethasone ngaphambi kokubeletha.
I-Betamethasone isetshenziselwa ukusiza usizo ekuthuthukiseni kwe-lung fetal uma kulindeleke ukubeletha ngaphambi kwesikhathi.
Izithasiselo nge RDS zivame ukutholwa amanani okufakelwa okufakelwa yi- surfactant , enikezwa ithubhu lokuphefumula; ngqo emaphashini lapho egqoka amabhasi emoyeni avumela ukushintshaniswa komoya okungcono. Ingane ene RDS ingaba yimbi kakhulu ezinsukwini zokuqala ezimbalwa zokuzalwa kodwa izobonisa izimpawu zokuphuthuma lapho amaphaphu eqala ukukhiqiza abaqashi bawo, ngokuvamile phakathi kwamasonto ambalwa.
Amantombazane ane RDS azovame ukudinga uhlobo oluthile lokuphefumula oksijini. Enye indlela yokuthuthukisa ukungenwa kwe-oksijeni yengane ukukhulisa umoya omoya emoyeni usana olutholayo. Ikamelo elijwayelekile lomoya liyingxenye engamaphesenti angu-21 oksijini. Izingane ezidinga uketshezi oluthe xaxa zingathola amaphesenti angama-100 oksijeni, ezimweni ezimbi kakhulu, uma kudingeka. Izilungiselelo ze-oksijini namanqanaba ahlolwe kakhulu njengoba kubalulekile ukuthola ukuhlushwa okulungile. Okuncane kakhulu kungabangela umonakalo ohlelweni lwezinzwa futhi okuningi kungabangela umonakalo emaphashini ngokwawo, kanye namehlo.
Ama-saturation ababheki be-oksijeni, (ngokuvamile abizwa ngokuthi i-pulse oxula noma i-probe ehleliwe) abekwa noma unyawo noma isilonda somntwana-lokhu kwenza amazinga e-oxygen egazini legazi. Inani le-oxygen lirekhodiwe njengephesenti. Leli phesenti liyi-oksijeni i-molecule ye-hemoglobin esegazini.
I-sampuli yegazi ebizwa ngokuthi igazi legazi ingenye indlela yokukala ukuthi lokhu kushintshaniswa kwenzeka kanjani ohlelweni lwezingane. Lokhu kuhlolwa kunikeza ulwazi oluthe xaxa kunomqapheli wokugcwalisa futhi kuvame ukusetshenziswa lapho ingane isemazingeni aphezulu wokusekelwa kokuphefumula. Umgomo uwukuba nesilinganiso esincane sokusekela ukugcina amazinga e-oxygen wengane ebangeni elifunayo. (Leli banga lisekelwe eminyakeni yobudala.)
Kunezigaba eziningana ezihlukene zokusekela ingane ene RDS. Njengoba amaphaphu ekhulile, inani lokusekela ukuphefumula lizoncishiswa ngenqubo ebizwa ngokuthi ukugcoba. Le nqubo yokugaya iyingqayizivele komntwana futhi izobe ikhethwe ukuthi ingane isebenza kanzima kangakanani ukuphefumula, ukugcwala kwe-oksijini, namazinga wegesi wegazi, kanye nendawo yonke yezempilo yengane.
Nazi ezinye izingcezu ezivame kakhulu zokusebenzisa ukuphefumula, ngokuchazwa kabanzi:
- I-Ventilator - Amapompo emoyeni kanye ne-oksijini emaphashini nge-tube endotracheal. (Ebizwa nangokuthi iT tube noma ithubhu lokuphefumula.) I-ventilator izophefumula umntwana futhi isethwe ukunikeza umoya isikhathi esithile ngomzuzu.
- I-Oscillator - uhlobo lweventilator olusebenza ngokudlidliza umoya-mpilo kanye ne-carbon dioxide ngekhulu lokuphefumula okuncane ngomzuzu.
- Ukucindezela Komoya Okuqhubekayo Okuqhubekayo - Eyaziwa nangokuthi i-CPAP. I-CPAP ayifuni ukuphefumulela ingane, kodwa iqhuma umoya oqhubekayo emaphashini amantombazane ngomsindo ophansi ukugcina amaphaphu aphikisiwe ngaso sonke isikhathi ngaso sonke isikhathi. I-CPAP inikezwa nge-prongs yangasese.
- (I-Bubble) i-CPAP - isebenza ngokuletha ukucindezela okuqhubekayo kwendiza yomsana. (Ngezintambo ezinama-nasal) efana ne-CPAP kodwa inomphefumulo ophefumulayo obeka ngaphansi kwamanzi, ne-bubbles-okudala ukucindezela futhi kunikeza ukuqhutshwa okuqhubekayo ngaphakathi kwamaphaphu.
- I-Nasal Cannula - I-oksijeni enikezwa ngqo kumntwana nge-tube yepulasitiki enezintambo ezincane ezifakwa emakhaleni omntwana.
I-RDS ivame kakhulu emntwaneni ongakabi yisikhathi ngoba amaphaphu ayenzi ngokwabo. Ngokusekelwe ukuthi ingane yakho izalwa kanjani kusengaphambili izokwenza ukuthi izothuthuka kanjani ngalesi simo. Kuyesaba kakhulu ukubona umzabalazo wakho omncane ngezinto ezilula thina njengabantu abadala abazithatha kalula ngazo zonke izibili zansuku zonke. Ngithemba ukuthi lolu lwazi lusize ukuba uqonde ukuthi kungani kungani futhi yi-RDS futhi kukusiza, wena ngokwakho uphefumule kancane kancane, eduze nomntanakho.
Imithombo:
Bubbles, Babies kanye Biology: Indaba of Surfactant. (nd). Ibuyiswe kusuka ku-http: //www.fasebj.org/content/18/13/1624e.full
Amaqiniso Nge-retinopathy ye-Prematurity (ROP) | I-National Eye Institute. (nd). Ibuyiselwe kusuka ku-https: //www.nei.nih.gov/health/rop/rop
I-Immature Lung - AboutKidsHealth. (nd). Ibuyiswe kusuka ku-http: //www.aboutkidshealth.ca/en/resourcecentres/prematurebabies/aboutprematurebabies/breathing/pages/the-immature-lung.aspx
Izincomo zosizo lwe-neonatal surfactant. (nd). Ibuyiselwe kusuka ku-http: //www.ncbi.nlm.nih.gov/pmc/articles/PMC2722820/