I-Necrotizing enterocolitis

I-Necrotizing enterocolitis (NEC) ukufa kwezicubu emathunjini. Kwenzeka kaningi ezinganeni ezizalwe ngaphambi kwesikhathi noma ezigulayo.

I-NEC yenzeka lapho ulwelwesi lodonga lwamathumbu lufa. Le nkinga icishe ivele enganeni egulayo noma engakashayi isikhathi. Kungenzeka kwenzeke ngenkathi usana lusesibhedlela.

Imbangela ngqo yalesi sifo ayaziwa. Ukwehla kwegazi kuye emathunjini kungalimaza izicubu. Amagciwane emathunjini nawo angangeza enkingeni. Futhi, izinsana ezingakashayi isikhathi zinempendulo engakakhuli yomzimba kuzinto ezinjengebhaktheriya noma ukugeleza kwegazi okuphansi. Ukungalingani emithethweni yokuzivikela komzimba kubonakala sengathi kuyabandakanyeka ku-NEC.

Izingane ezisengozini enkulu yalesi simo zifaka:

• Izinsana ngaphambi kwesikhathi
• Izinsana eziphakelwa ubisi lwebhodlela kunobisi lomuntu. (Ubisi lomuntu luqukethe izinto ezikhulayo, amasosha omzimba namaseli omzimba okungasiza ekuvikeleni inkinga.)
• Izinsana enkulisa lapho kuqubuke khona ukugqashuka
• Izinsana eziye zampontshelwa igazi noma zagula kakhulu

Izimpawu zingavela kancane noma ngokuzumayo, futhi zingafaka:

• Ukuqunjelwa kwesisu
• Igazi esitokisini
• Uhudo
• Izinkinga zokondla
• Ukungabi namandla
• Izinga lokushisa lomzimba elingazinzile
• Ukuphefumula okungazinzile, ukushaya kwenhliziyo, noma umfutho wegazi
• Ukuhlanza

Ukuhlolwa kungafaka:

• I-x-ray yesisu
• Indle yokuhlolwa kwegazi lokusebenzelana nemimoya (guaiac)
• I-CBC (ukubalwa kwegazi okuphelele)
• Amazinga e-Electrolyte, amagesi egazi nokunye ukuhlolwa kwegazi

Ukwelashwa kwengane engaba ne-NEC kaningi kufaka:

• Ukuphakelwa kokuphakanyiswa kwe-enteral (GI tract)
• Ukhulula igesi emathunjini ngokufaka ishubhu esiswini
• Ukunikeza uketshezi lwe-IV nokondleka
• Ukunikeza ama-antibiotic e-IV
• Ukuqapha isimo ngama-x-ray esiswini, ukuhlolwa kwegazi, nokukalwa kwamagesi egazi

Usana luzodinga ukuhlinzwa uma kunembobo emathunjini noma ukuvuvukala kodonga lwesisu (peritonitis).

Kulokhu kuhlinzwa, udokotela uzo:

• Susa izicubu zamathumbu ezifile
• Yenza i-colostomy noma i-ileostomy

Amathumbu angaxhunywa kabusha ngemuva kwamasonto ambalwa noma izinyanga lapho ukutheleleka seluphilile.

I-Necrotizing enterocolitis yisifo esibi. Kufika ezinganeni ezingama-40% ezine-NEC ezifa ngayo. Ukwelashwa kwasekuqaleni okunolaka kungasiza ekuthuthukiseni umphumela.

Izinkinga zingafaka:

• I-Peritonitis
• I-Sepsis
• Ukubhoboza amathumbu
• Ukuqina kwamathumbu
• Izinkinga zesibindi ngenxa yokwehluleka isikhathi eside ukubekezelela ukuphakelwa kokungena kanye nesidingo sokondliwa kwabazali (IV)
• Isifo samathumbu esifushane uma kulahleka inani elikhulu lamathumbu

Thola ukunakekelwa kwezimo eziphuthumayo uma kuvela noma yiziphi izimpawu ze-necrotizing enterocolitis. Izinsana ezibhedlela ngenxa yokugula noma ngaphambi kokuvuthwa zisengozini enkulu ye-NEC. Babhekelwa kakhulu le nkinga ngaphambi kokuba bathunyelwe ekhaya.

• Amathumbu ezingane

ICaplan M. Neonatal necrotizing enterocolitis. Ku: Martin RJ, Fanaroff AA, Walsh MC, ama-eds. UFanaroff kanye neMithi kaMartin's Neonatal-Perinatal Medicine. Umhlaka 10. IPhiladelphia, PA: Elsevier Saunders; 2015: isahluko 94.

UGreenberg JM, uHaberman B, uNarendran V, uNathan AT, uSchibler K. Izifo ezibangelwa imvelaphi ngaphambi kokubeletha. Ku: Resnik R, Lockwood CJ, Moore TR, Greene MF, Copel JA, Silver RM, abahleli. ICreasy neResnik's Maternal-Fetal Medicine: Izimiso kanye Nokuzijwayeza. Umhlaka 8. IPhiladelphia, PA: Elsevier; 2019: isahluko 73.

Imbewu PC. I-microbiome kanye nempilo yezingane. Ku: Kliegman RM, St Geme JW, Blum NJ, Shah SS, Tasker RC, Wilson KM, eds. Incwadi kaNelson Yezingane. Umhlaka 21. IPhiladelphia, PA: Elsevier; 2020: isahluko 196.