I-bronchopulmonary dysplasia

I-Bronchopulmonary dysplasia (BPD) yisimo samaphaphu sesikhathi eside (esingapheli) esithinta izingane ezisanda kuzalwa ezazibekwa emshinini wokuphefumula ngemuva kokuzalwa noma zazalwa kusenesikhathi (ngaphambi kwesikhathi).

I-BPD ivela ezinganeni ezigula kakhulu ezathola amazinga aphezulu oksijini isikhathi eside. I-BPD ingenzeka futhi nasezinsaneni ezazisemshinini wokuphefumula (i-ventilator).

I-BPD ivame kakhulu ezinganeni ezizalwe kusenesikhathi (ngaphambi kwesikhathi), amaphaphu azo angakakhuli ngokuphelele lapho ezalwa.

Izici zobungozi zifaka:

• Isifo senhliziyo esizelwe (inkinga ngesakhiwo senhliziyo nomsebenzi okhona lapho kuzalwa)
• Ukukhulelwa ngaphambi kwesikhathi, imvamisa ezinganeni ezizalwe ngaphambi kokukhulelwa kwamasonto angama-32
• Ukutheleleka okukhulu kokuphefumula noma kwamaphaphu

Ingozi ye-BPD enamandla yehlile eminyakeni yamuva.

Izimpawu zingafaka noma yikuphi okulandelayo:

• Umbala wesikhumba o-Bluish (cyanosis)
• Khwehlela
• Ukuphefumula ngokushesha
• Ukuphelelwa umoya

Ukuhlolwa okungenziwa ukusiza ukuxilonga i-BPD kufaka:

• Igazi legazi lomzimba
• Isikena se-CT esifubeni
• I-x-ray yesifuba
• Pulse oximetry

ESIBHEDLELA

Izinsana ezinezinkinga zokuphefumula zivame ukufakwa kumshini wokuphefumula. Lona ngumshini wokuphefumula othumela ingcindezi emaphashini engane ukuze ihlale igcwele futhi ihambise umoya-mpilo omningi. Njengoba amaphaphu engane ekhula, ingcindezi ne-oxygen ziyancipha kancane. Umntwana ulunyulwa emshinini wokuphefumula. Ingane ingaqhubeka nokuthola i-oxygen ngesifonyo noma ishubhu lamakhala ngamasonto ambalwa noma izinyanga.

Izinsana ezine-BPD zivame ukondliwa ngamashubhu afakwa esiswini (i-NG tube). Lezi zingane zidinga amakhalori angeziwe ngenxa yomzamo wokuphefumula. Ukugcina amaphaphu abo angagcwalisi uketshezi, ukuphuza kwabo uketshezi kungadinga ukuthi kulinganiselwe. Bangaphinde banikezwe nemithi (isisu) esusa amanzi emzimbeni. Eminye imithi ingafaka i-corticosteroids, i-bronchodilators, ne-surfactant. I-Surfactant yinto eshelelayo, efana nensipho emaphashini esiza amaphaphu ukuthi agcwale umoya futhi agcine amasaka omoya angahluzi.

Abazali balezi zingane badinga ukusekelwa ngokomzwelo. Lokhu kungenxa yokuthi iBPD ithatha isikhathi ukuba ngcono futhi usana lungadinga ukuhlala esibhedlela isikhathi eside.

EKHAYA

Izinsana ezine-BPD zingadinga ukwelashwa komoya-mpilo amasonto kuya ezinyangeni ngemuva kokuphuma esibhedlela. Landela imiyalo yomhlinzeki wakho wezokunakekelwa kwempilo ukuqinisekisa ukuthi ingane yakho ithola umsoco owanele ngesikhathi sokululama. Ingane yakho ingadinga ukufakwa kwamashubhu noma amafomula akhethekile.

Kubaluleke kakhulu ukuvikela ingane yakho ekutholeni imikhuhlane nezinye izifo, njengegciwane lokuphefumula le-syncytial virus (RSV). I-RSV ingadala ukutheleleka okukhulu kwamaphaphu, ikakhulukazi enganeni ene-BPD.

Indlela elula yokusiza ukuvikela ukutheleleka nge-RSV ukugeza izandla zakho kaningi. Landela lezi zinyathelo:

• Geza izandla zakho ngamanzi afudumele nensipho ngaphambi kokuthinta ingane yakho. Tshela abanye ukuthi bageze izandla zabo, futhi, ngaphambi kokuthinta ingane yakho.
• Cela abanye ukuthi bagweme ukuxhumana nengane yakho uma benomkhuhlane noma umkhuhlane, noma ubacele ukuthi bagqoke imaski.
• Yazi ukuthi ukuqabula ingane yakho kungasabalalisa i-RSV.
• Zama ukugcina izingane ezincane ziqhelelene nengane yakho. I-RSV ivame kakhulu ezinganeni ezincane futhi isakazeka kalula kusuka enganeni iye enganeni.
• UNGABHALI ngaphakathi kwendlu yakho, emotweni, noma kuphi eduze kwengane yakho. Ukuvezwa intuthu kagwayi kwandisa ingozi yokugula kwe-RSV.

Abazali bezingane ezine-BPD kufanele bagweme izixuku ngesikhathi sokuqubuka kwe-RSV. Ukuqubuka kuvame ukubikwa yimithombo yezindaba yendawo.

Umhlinzeki wengane yakho anganikeza umuthi palivizumab (Synagis) ukuvikela ukutheleleka kwe-RSV enganeni yakho. Landela imiyalelo yokuthi ungayinikeza kanjani ingane yakho lo muthi.

Izingane ezine-BPD ziba ngcono kancane ngokuhamba kwesikhathi. Ukwelashwa kwe-oxygen kungadingeka izinyanga eziningi. Ezinye izinsana zinomonakalo wamaphaphu wesikhathi eside futhi zidinga ukwesekwa komoya-mpilo nokuphefumula, njengokungeniswa umoya. Ezinye izingane ezinalesi sifo kungenzeka zingasindi.

Izingane ezine-BPD zisengozini enkulu yokutheleleka okuphindaphindiwe kokuphefumula, njenge-pneumonia, i-bronchiolitis, ne-RSV edinga ukuhlala esibhedlela.

Ezinye izinkinga ezingase zibe khona ezinganeni ezine-BPD yilezi:

• Izinkinga zentuthuko
• Ukukhula okubi
• Umfutho wegazi ophezulu we-pulmonary (umfutho wegazi ophakeme emithanjeni yamaphaphu)
• Izinkinga zesikhathi eside zamaphaphu nokuphefumula ezinjengezibazi noma i-bronchiectasis

Uma ingane yakho ine-BPD, bukela noma yiziphi izinkinga zokuphefumula. Shayela umhlinzeki wengane yakho uma ubona noma yiziphi izimpawu zesifo sokuphefumula.

Ukusiza ukuvimbela i-BPD:

• Vimbela ukulethwa ngaphambi kwesikhathi uma kungenzeka. Uma ukhulelwe noma ucabanga ngokukhulelwa, thola ukunakekelwa kokubeletha ukusiza ukugcina wena nengane yakho niphilile.
• Uma ingane yakho isenkingeni yokuphefumula, cela umhlinzeki ukuthi ingane yakho ingalunyulwa masinyane kanjani kumshini wokuphefumula.
• Ingane yakho ingathola i-surfactant ukusiza ukugcina amaphaphu evulekile.

I-BPD; Isifo samaphaphu esingapheli - izingane; CLD - izingane

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UMcGrath-Morrow SA, uCollaco JM. I-bronchopulmonary dysplasia. Ku: Kliegman RM, St Geme JW, Blum NJ, Shah SS, Tasker RC, Wilson KM, eds. Incwadi kaNelson Yezingane. Umhla ka-20. IPhiladelphia, PA: Elsevier; 2020: isahluko 444.

Roosevelt GE. Izimo eziphuthumayo zokuphefumula ezinganeni: izifo zamaphaphu. Ku: Walls RM, Hockberger RS, Gausche-Hill M, ama-eds. Imithi Ephuthumayo yaseRosen: Imiqondo kanye Nokuzijwayeza Komtholampilo. Umhlaka 9. IPhiladelphia, PA: Elsevier; 2018: isahluko 169.