Enye yezinto ezibaluleke kakhulu ezenzeka ngesikhathi sokukhulelwa yikuthuthukiswa kwamapayipi emntwaneni. Amapayipi athuthukile ngokugcwele ngenye yezinto ezibalulekile ezidingekayo ekuphileni ngaphandle kwesisu. Eziningi zezinye izingxenye zengane zisebenza ngokushesha kakhulu ngesikhathi sokukhula komntwana , kepha emaphashini, zonke izinsuku zentuthuko zibalulekile. Ngisho nosuku olulodwa lungenza umehluko ekuthuthukiseni amaphaphu.
Kuzingane ezisengozini yokuzalwa kusenesikhathi, isibonelo, odokotela bagxila ngokuyinhloko ekuqinisekiseni ukuthi amaphaphu asathuthukile ngangokunokwenzeka ngaphambi kokuba umntwana azalwe, ngakho umntwana unethuba elihle lokusinda.
Abantu badinga amaphaphu ukuze baphefumule umoya, kunjalo? Ngakho-ke, ungasho ukuthi amaphaphu abaluleke kakhulu ekukhuleni kwengane nentuthuko. Kodwa ingabe amaphaphu athile ngokugcwele?
Indlela Amapula Amantombazane Athuthukisa ngayo
Ukuthuthukiswa kwamangqamuzana kubantu kwenzeka ngezindlela eziyisihlanu ezahlukene. Ngemuva kwesigaba sombungu , amaphaphu wengane akhula kulokho okubizwa ngokuthi yi-pseudoglandular stage. Phakathi nalesi sigaba, okuyinto esukela emavikini angu-5 kuya kwamasonto angu- 17 ukubeletha, amaphaphu wengane angafaniswa nesiqu somuthi onamagatsha avela kuso. Njengoba umntwana ekhula, "amagatsha" asebenza kakhulu futhi azinzima.
Izigaba ezilandelayo zenzeka ngezigaba, kusukela emavikini angu-26-36, futhi ekugcineni, isigaba sokugcina sokuthuthukiswa kwamaphaphu asiqali kuze kufike amasonto angu-36 .
Lesi sigaba sokugcina senzeke ngenyanga yokugcina yokukhulelwa kanti nakuba kungase kubonakale sengathi ingane "yenziwe" ngaleso sikhathi, empeleni kukhona inani elikhulu lokukhula okwenzeka kuleso sigaba sokugcina samaphaphu. Phakathi nenyanga eyedlule, amaphaphu wengane enza iningi lokuthuthuka ukuthi lidinga ukusebenza ngaphandle kwesibeletho, yingakho kubaluleke kakhulu ukwenza konke okusemandleni ukuvumela izingane ukuba zithuthukise futhi zikhethe izinsuku zabo zokubeletha, ngaphandle uma kunesidingo sokwelapha ekuqaleni .
Amapayipi empeleni enye yezinto zokugcina ukuqedela ukukhula emntwaneni, yingakho iqoqo lamaphaphu langaphambilini lingaba yingozi kakhulu kumntwana uma ezalwa maduze kakhulu. Amapayipi ayahlukile ngoba yiwo kuphela amasistimu emzimbeni ahlala ngokukhululeka kuze kube sekuzalweni. Zonke ezinye izinhlelo, ezifana nesimiso senhliziyo noma isimiso semisipha, zigcwele futhi ziyaqhubeka ngenkathi umntwana esese-utero. Kodwa umntwana esiswini uthola umoya wakhe ophuma e-placenta, ngakho amaphaphu awawutholi "ukuhlolwa kwawo" okusemthethweni kuze kufike ngesikhathi sokuzalwa.
Umntanakho wenza "ukujwayela" ukuphefumula esibelethweni, kodwa akukho ukushintshaniswa kwangempela kwamaphaya emaphashini kuze kube yilapho ingane ishiya isibeletho. Inqubo yonke yentuthuko yamaphaphu iyinkimbinkimbi kakhulu futhi ihilela imisebenzi eminingi ehlukene, ngakho-ke uma sekuyisikhathi sokuba baqale ukusebenza, kuyisikhathi esibalulekile. Ngeshwa, ngoba kuhilela izinto eziningi ezihamba kahle, kunamathuba amaningi okuthi izinto zihambe kahle.
Uma ingane izalwa futhi uma isibopho sishaywa ucingo, kufanele sishintshe "ekuphefumuleni" ngegazi le-placenta ekuphefumuleni umoya wangempela. Phakathi naleso sikhathi, amaphaphu wengane akhula emoyeni, "i-flap" enhliziyweni igwema ukuqala ukusakaza emaphashini, futhi uhlelo olusha lokuthola i-oxygen egazini elivela emoyeni lukhahlela.
Ngezinye izikhathi, leyo nqubo ingathatha isikhashana futhi, ikakhulu uma ingane izalwa ngaphambi kwesikhathi, kungaba nezinkinga ukuthola umoya okwanele emzimbeni.
Ukuthuthukiswa Kwamathambo Ekuzalweni
Ingxenye ebaluleke kakhulu yentuthuko yengane yamantombazane okuthiwa yi-surfactant emaphashini. I-Surfactant iyinhlanganisela yama-fatty acid components, ama-carbohydrate, nama-protein a "gqoka" amaphaphu futhi avumele ukuthi basebenze kahle. Kuyasiza ukugcina i-alveoli, okuyizikhwama zomoya lapho kuzokwenzeka khona ukushintshaniswa kwe-oxygen, evulekile futhi egcwele.
Umshini wokusebenza osebenzayo yilokhu okuqhubekayo okugcina, futhi angeke abe khona ngokugcwele uma umntwana ezalwa ngokushesha kakhulu.
Uma kungenjalo okwanele ukushisa emaphashini, umntwana akakwazi ukuphefumula kahle. Ngokuvamile, amazinga aphansi okuthiwa yi-surfactant aholela esimweni esibizwa ngokuthi ukuphefumula kwesifo (RDS) ezinganeni, ikakhulukazi izinsana zangaphambi kwesikhathi. Umntwana uzama kanzima ukuphefumula, kepha amaphaphu akakwazi ukusebenza kahle ukuze athole ukushintshaniswa kwemoya. Ezinganeni ezingakafiki, i-RDS yimbangela eyodwa yokufa.
Ngabe Amapula Amantombazane Athuthukiswa Ngokugcwele?
Ukubuyekezwa Kwonyaka Wonyaka wephephandaba i- Physiology kuchaza iqiniso elithakazelisayo: Amapayipi ezinsana, nakuba esebenzayo ngokugcwele, empeleni asengacabangi "ngokugcwele" ekuthuthukiseni isikhathi esigcwele. Khumbula lezo zigaba ezinhlanu zokuthuthukiswa kwamaphaphu? Ungase umangale ukuzwa ukuthi isigaba sokugcina sokuthuthukiswa kwamaphaphu siyaqhubeka kusukela emasontweni angama-36 ukubeletha yonke indlela eminyakeni yokuqala yokuphila kwengane. Phakathi neminyaka emithathu yokuqala yokuphila kwengane, amaphaphu aqhubeka ethuthuka futhi avuthiwe esakhiweni somuntu omdala wamaphaphu. Ngokuqondile, ama-alveoli (ama-sac "amancane" atshintsha umoya emaphashini) aqhubeka nokwenza phezu kwaleyo minyaka yokuqala yokuphila emithathu, okwandisa inani lemvelo emaphashini. Ama-alveoli amaningi = ngaphezulu kwe-air exchange.
Ayikho indlela esemthethweni yokwazi ukuthi amaphaphu akhiwa ngaphambi kokuba umntwana azalwe ngaphandle kokwenza ukuhlolwa okungavamile. Kwezinye izimo, njengokungathi kunenkinga yokukhulelwa nodokotela kudingeka badlulisele umntwana ekuqaleni, noma uma umama esengozini enkulu yokuhlinzeka kwangaphambi kwesikhathi , bangase bahlele ukuhlolwa ukuze banqume umsebenzi wamaphaphu. Izikhathi eziningi, udokotela uzolinganisa isidingo sokuhlolwa ngengozi yokuba umntwana azalwe kusenesikhathi noma ubunzima bezinkinga. Uma ingane ingaphansi kwamasonto angama-32, kungenzeka ukuthi ukuhlolwa ngeke kube usizo, ngoba amaphaphu angeke akhiwe ngokwanele ukuze kuvivinywe ukuhlolwa. Ukuhlolwa kuhilela ukuhlola i-amniotic fluid esibelethweni ukukala amazinga we-surfactant. Odokotela bayakwazi ukubona ukuthi amapulazi avuthiwe kangakanani ukuthi bangakanani abantu abafake ama-surfactant abangayithola kulolukhuni.
Uma kutholakala ukuthi amaphaphu wengane awakhuliswa ngokugcwele, udokotela angase azame ukusiza amaphaphu ngokuhamba ngokuyala i- steroids engena kumama ngenkathi esakhulelwe. Lezi zidakamizwa zingasiza "ukusheshisa" inqubo yentuthuko yamaphaphu.
Ngokuvamile, iningi lezingane ezizalwa emavikini angu-35 zizoba nemaphesheni asebenzayo kanye nezinsana zibhekwa njenge "full-term" ngamapayipi athuthukile ajwayelekile ngamasonto angu-37. Kodwa-ke, i-American College of Obstetricians kanye neGynecologists manje incomeka ukuthi abantwana akufanele bahanjiswe noma bahambisane ngaphambi kwamasonto angama-39 okukhulelwa ngaphandle kokuthi ukuhlolwa kuqinisekiswe ukuthi amaphaphu athuthukile ngokugcwele. Amantombazane angathuthuka ngezikhathi ezihlukene futhi phansi, amaphaphu wengane ahlala ekhula, ngakho-ke zonke izinsuku zibalelwa ngesikhathi sokukhulelwa.
Yini Ethinta Intuthuko Yengane Yabantwana?
Izinto eziningi zithinta indlela amaphaphu wengane akhula ngayo esibelethweni. Ngokwesibonelo, ukubhema kutholakale ukulimaza ubude bokubeletha ngisho nangaphambi kokuba ukhulelwe. Lokhu kusho ukuthi ukubhema kanye ne-nicotine ngokukhethekile kungabawela umgoqo we-blood-placenta.
Kunezici ezingekho umzali ongakwazi ukulawula ezingathinta ukuthuthukiswa kwamapapu, njengezocansi zesisu kanye nobuhlanga. Isibonelo, izinkinga zamaphaphu zivame kakhulu ezinsaneni zamantombazane uma kuqhathaniswa nabantwana besifazane, naphakathi kwezinsana ezimnyama nabaseNingizimu Afrika ngaphezu kwanoma yimuphi omunye umhlanga.
Izwi elivela ku-Verywell
Nakuba kuhluka, amaphaphu wengane awabhekwa njengokusebenza ngokugcwele kuze kufike amasonto angama-37 ukubeletha, okubhekwa ngokuthi "isikhathi esigcwele." Kodwa-ke, ngoba ukukhulelwa nokuthuthukiswa kungahle kwenzeke emazingeni ahlukene, lokhu akuyona inombolo enzima futhi esheshayo. Ezinye izingane ezizalwa ngaphambilini zingase zibe namaphaphu asebenza ngokugcwele, kanti ezinye izingane ezizalwe kamuva zingase zibe nezinkinga ngamaphaphu azo ngesikhathi sokuzalwa ngoba ukuthuthukiswa kwamaphaphu kungahluka kakhulu.
Ukuthuthukiswa komgogodla kungenye yezakhi ezibaluleke kakhulu ekukhuleni kwengane futhi kungenye yezizathu eziyinhloko ezibangela ukuthi odokotela bakhuthaze omama ukuba bagweme izinyathelo ezingadingekile ezingezona isizathu sezokwelapha. Uma ukulethwa kwesandulela ngculaza kungenakugwema, udokotela angase alawule imithi ekhethekile ukusiza amaphaphu wengane asebenze kangcono. Ukwelashwa kwemithi kanye nokwesekwa kungasiza ingane ngemuva kokuzalwa kwakhe, uma kunezinkinga emaphashini.
Amapayipi omntwana abhekwa njengokusebenza ngokugcwele ngesikhathi sokuzalwa okugcwele, kodwa amaphaphu wengane azoqhubeka nokuthuthukisa eminyakeni emithathu yokuqala yokuphila aze afane nesakhiwo esivuthiwe somuntu omdala.
> Imithombo
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> I-Harmanjatinder S. Sekhon ... uJon Lindstrom, u-Eliot R. Spindel (1999, Mashi 1). I-nicotine engakazalwa ngaphambi kokukhulisa i-pulmonary α7 i-nicotinic receptor inkulumo futhi ishintshe ukuthuthukiswa kwamaphaphu emfusheni ezinkomeni. I-Journal of Clin Invest. 1999; 103 (5): 637-647. i-doi: 10.1172 / JCI5232.
> Kamath-Rayne, BD, DeFranco, EA, & Marcotte, MP (2012). I-Antenatal Steroids Yokunakekelwa Kwe-Fetal Lung Immaturity Ngemuva kwamaviki angu-34 okuGestation: Ukuhlolwa kwemiphumela ye-Neonatal. I-Obstetrics and Gynecology , 119 (5), 909-916. http://doi.org/10.1097/AOG.0b013e31824ea4b2
> Kotecha, S. (2000). Ukukhula kwamangqamu: izinkinga zintsana esanda kuzalwa. I-Archives of Disease ebuntwaneni - I-Fetal ne-Neonatal Edition, 82 : F69-F74. Ibuyiselwe kusuka ku- http://fn.bmj.com/content/82/1/F69
> Lafler, DJ & Mendoza, A. (2001, July). Ukuhlola i-laboratory ukuhlola ukuvuthwa kwe-lungal fetal. Imithi yokwelapha, 7 (32). Ibuyiselwe kusuka ku-https://academic.oup.com/labmed/article-pdf/32/7/393/9720682/labmed32-0393.pdf
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