I-preeme encane yintsana ebelethwe enesisindo esingaphansi kwamakhilogremu angu-12, ama-ounces angu-12 (800 amagremu) noma ngaphambi kwamasonto angu-26 ukubeletha. Njengoba lezi zinhlobo zezingane zizalwa izinyanga ngaphambi kwezinsuku ezifanele, izitha ze-micro zibhekana nokuhlala isikhathi eside ku-unit neonatal yokunakekelwa okukhulu (NICU). Nakuba izingane eziningi ezingakaze zandulele zikhulele ngaphandle kwemiphumela yesikhathi eside yokungabi nesikhathi sokuqala, abanye babhekene nezinkinga zempilo ezimbi kulo lonke ukuphila.
Yini Eyakha Umntwana Okhulile?
Ukukunika umongo othile, noma yimuphi umntwana ozelwe ngaphambi kwamasonto angu-37 ukutholwa kubhekwa njengengaphambi kwesikhathi (owaziwa nangokuthi ungaphambi kwesikhathi). Izitha ze-Micro ziyizingane ezingakafiki ngaphambi kwazo zonke. Izinsana ezizalwa phakathi kwamasonto angu-27 namasonto angu-30 ukubeletha kuthiwa "kusengakapheli isikhathi eside," izinsana ezizalwa phakathi kwamasonto angu-31 no-34 ukubeletha zibizwa ngokuthi "ngokulinganisela ngaphambi kwesikhathi," kanti labo abazalwa phakathi kwamasonto angu-34 no-37 ukubeletha kuthiwa "sekuphelile preterm. "
Isilinganiso Sokusinda Sama-Micro Preemies?
Izitha zezincane ezincane zibuthakathaka kakhulu, futhi zonke izinsuku umama ochitha ukukhulelwa ukwandisa ithuba lomntanakhe lokusinda.
| Iviki lokuzalwa | Isilinganiso Isilinganiso sokusinda |
|---|---|
| Amaviki angu-22 | Abantwana abangaba ngu-10% basinda |
| Amaviki angu-23 | Amaphesenti angu-50 kuya kwangu-66% asinda |
| Amaviki angu-24 | Amaphesenti angama-66 kuya kwangu-80% asinda |
| Amaviki angu-25 | Amaphesenti angama-75 kuya ku-85% asinda |
| Amaviki angu-26 | Amaphesenti angaphezu kuka-90% asinda |
Ngabe i-Micro Preemie ibukeka kanjani?
Abantu abaningi bayamangala ukuthi ama-pre pre micro amancane kangakanani.
Isikhumba sabo sincane, sinemivimbo ebonakalayo, futhi ingase ibonakale ifaka noma i-gelatinous. Uma uvakashela i-preemie encane ku-NICU, ungalindela ukubona okulandelayo:
- Ukusekelwa ngokuphefumula : I-preeme encane ngokuvamile inombhobho ephuma emlonyeni wayo, ehlangene nomoya ophefumulela umntwana. Ezinye izandulela ezincane zingakwazi ukuphefumula zodwa futhi zizobe zisezingeni eliqhubekayo lokucindezela umoya (CPAP) esikhundleni. Lezi zingane zizoba namaski we-CPAP aqineke phezu kwezinyosi zazo.
- Imigqa ye-IV: Izandulela ezincane zinezinhlelo zokugaya izifo ezincane futhi zinikezwa ukudla okunomsoco (IV) kokuqala. Abaningi bazoba nemigqa engu-IV emigqumeni yabo (ebizwa ngokuthi imigqa ye-umbilical ) ngesonto lokuqala noma emibili yokuphila, kanye nomzila we- PICC noma i- périphher IV kamuva.
- Imishini yokuqapha: Zonke iziguli ze-NICU zibhekwa ngokucophelela. I-preemie encane ingaba nezintambo ezinamathele esifubeni sayo, izinyawo, izikhali, izingalo nemilenze. Lokhu kuqhathanisa izinhliziyo zomntwana kanye nezinga lokuphefumula negazi lakhe lokugcwala kwe-oxygen. Ukuqapha okuhambisana nomthambo we-artery IV kungaphazamisa ukucindezeleka kwegazi.
- I-NG / OG tube : Ngoba i-preemie encane ayifuni kakhulu ukudla emabhodleleni noma ebelethini, ithubhu iyophuma emlonyeni wayo (tube OG) noma ekhaleni (NG tube) ngaphakathi esiswini.
Ngokushesha, Impilo Yesikhathi Esifishane Impilo Yokukhathazeka Ngezimbangi Ezincane
Ngokushesha ngemva kokuzalwa futhi ngesikhathi sokuhlala kwe-NICU encane ye-preeme, odokotela nabahlengikazi baqaphelisisa izimo zezokwelapha eziningana, ezifana nalezi, ngezansi.
- I-Respiratory Depression Syndrome (RDS) : Iningi lezilwane ezincane (cishe ngo-85%) zinenkinga yokuphefumula emva kokuzalwa. I-RDS iphathwa ngokusekelwa kokuphefumula kanye nemithi.
- I-patent ductus arteriosus (i-PDA): Ngaphezu kwengxenye yesigamu sezingqimba ezincane ezine PDA. I-PDA yixhumano oluphikisanayo phakathi kwemikhumbi enkulu yegazi eduze nenhliziyo. Ukuxhumeka kuvamile kumntwana kodwa kufanele uvale lapho umntwana ezalwa futhi uqala ukuphefumula. I-PDA iphathwa ngemithi noma ukuhlinzwa.
- I-Sepsis: Izinsana ezingaphambi kwesikhathi zivame ukwelashwa ngezizathu eziningana. Izandulela ze-micro zinamasosha omzimba omzimba futhi zibhekene nezinqubo eziningi ezingavamile ku-NICU, ngayinye yazo engavumela amagciwane ukuba angene emzimbeni. Cishe ama-40% wezandulela ezincane zidinga ama-antibiotics ukuze aphathe izifo ze-bacteria.
- I-hemorrhage yangaphakathi (IVH): I- IV iphuma ezinxenyeni zobuchopho. Izitha ze-micro zinezitsha zegazi ezibuthakathaka ebuchosheni babo, futhi lezi zitsha zingakwazi ukuhlukana kalula. Cishe ingxenye yesine yama-micro pre pre-IVH. Amacala amaningi e-IVH ayedwa, kepha ezinye izingane zingase zidinge ukuhlinzeka ukusiza ukukhipha uketshezi oluthe xaxa.
- I-Retinopathy ye-Prematurity (ROP): Izindwangu zegazi ezinhlokweni ze-micro preemie azihlanganiswa ngokugcwele ngesikhathi sokuzalwa. Lapho izitsha zikhula, zingase zikhule ngokushesha kangangokuba zilimaze i-retina. Ngaphansi kuka-15% wezingqungquthela ezincane ezakha i-ROP, okuvame ukuxazululwa yedwa. Ukuhlinzwa kungadingeka ezimweni ezinzima.
- I-Necrotizing Enterocolitis (NEC): Njengoba izandulela ezincane zinezinhlelo zokugaya umzimba ezincane, amathumbu abo angakwazi ukutheleleka. E-NEC, izingxube zamathumbu zithole igciwane futhi ziqala ukufa. Amaphesenti angama-7% wezandulela ezincane zakha i-NEC, engaba yingozi kakhulu. I-NEC iphathwa nge-IV fluids kanye nemithi. Ukuhlinzwa kungadingeka.
Izinkinga Zempilo Yesikhathi Eside Zengculazi Zezinyathelo Ezincane
Ama-micro-prever amaningi awakubonisi imiphumela yesikhathi eside yesikhathi sokuqala. Eqinisweni, uma uneminyaka eyi-8, cishe ama-60% anama-IQ avamile. Noma kunjalo, ezinye izitha zempi ezincane zingase zibe nezinkinga zempilo yonke, kuhlanganise nalabo abalwe ngezansi.
- Izinkinga zengqondo: Ukulibaziseka okuthuthukisayo , izinkinga esikoleni, nezinye izinkinga zokucatshangelwa yizinto ezivamile zokuqeda isimo sokuqala. Amaphesenti angaba ngu-20% wezandulela ezincane ezinokukhubazeka okunengqondo ezineminyaka engu-8 ubudala, kanti enye i-20% inezinkinga zengqondo ezicabangelayo ezincane.
- Ukukhubazeka kwesiberethri: Cishe ngo-10% wezandulela zempi ezincane zilinganisela ekuphefumuleni okukhulu kwe-cerebral palsy.
- Isifo samaphaphu angapheli : Cishe isigamu sezilwane ezincane zidinga oksijeni ku-NICU ukukhishwa. Izitha ze-Micro zingase zibe nesifo se-asthma noma ezinye izinkinga zokuphefumula, kuhlanganise ne-bronchopulmonary dysplasia, noma i-BPD.
- Izinkinga zokugaya : Izithasiselo ezincane zitholakala ezinkingeni zokugaya ukudla njengeGERD , ukulahlwa kokudla, noma ukudla okuncane.
- Umbono noma ukulahlekelwa kwezindlebe: Phakathi kuka-2% no-3% wezingqungquthela ezincane kunombono ohlala njalo noma izinkinga zokuzwa ngenxa yezinkinga zokungabi nesikhathi sokuqala.
Ukuthuthukisa Imiphumela Yomntwana Wakho
Nakuba izandulela ezincane zingase zibhekane nezinkinga zempilo ezinzima, kunezinto eziningi ongazenza njengomzali ukunikeza ingane yakho isiqalo esihle kakhulu.
- Thola ukunakekelwa kokuqala kokubeletha: Uma ukhulelwa, khuluma nodokotela wakho kusengaphambili ukuthi unganciphisa kanjani ingozi yokuzalwa ngaphambi kwesikhathi . Ukunakekelwa kwangaphambi kokubeletha kungasiza abomama ukugwema ukulethwa kokuqala.
- Yenza ingane yakho esibhedlela nge-NICU: Uma uyazi ukuthi ingane yakho ingakapheli isikhathi eside, ukuletha esibhedlela nge- NICU yezinga eli-3 nge-neonatology yokuhlanganisa ihora lamahora angu-24 kungamnika isiqalo esingcono kakhulu.
- Funda izibonakaliso zabasebenzi bokuqala: Uma ukhulelwe, qinisekisa ukuthi uqonda izimpawu zomsebenzi wangaphambi kokuqala , futhi ufune usizo lwezokwelapha ngokushesha uma uthuthukisa noma iyiphi yazo.
- Funa ukungenelela kwangaphambili: Izinsana ezizalwa zakuqala zingase zifanelekele izinhlelo zokungenelela zakuqala . Ukuqala lezi zinhlelo ngokushesha kungasiza ukunciphisa noma yikuphi ukucabanga okungenangqondo kokungakafiki.
Imithombo:
Hoekstra, R et al. "Ukuphunyuka nokuPhumela Kwesikhathi Eside Neurodevelopmental Imiphumela Yengane Ezingakazalwa Ngaphambi Kwezikhathi Zama-23-26 Amaviki 'Isikhathi Sokugubha Esikhungweni Esiphakeme." Izingane zokwelashwa Jan 2004; 113, c1-c7.
Qiu, X et al. "Ukuqhathaniswa kweMiphumela ye-Singleton kanye nemiphumela eminingi yokubelethwa kwezinsana ezazalwa ngaphambi noma ngemva kwamaviki angu-32 okuGestation." I-Obstetrics & Gynecology Feb 2008; 111, 365-371.
Vohr, B et al. "Imiphumela ye-Neurodevelopmental yezingane ezincane kakhulu zokuzalwa zesisindo