Kafushane uxazulule umcimbi ongachazwanga - BRUE

Umcimbi oxazululwe kafushane ongachazwanga (i-BRUE) kulapho usana olungaphansi konyaka owodwa luyeka ukuphefumula, luguquka ithoni yemisipha, luphenduke lube mhlophe noma luhlaza okwesibhakabhaka ngombala, noma lungaphenduli. Lo mcimbi wenzeka ngokuzumayo, uthatha imizuzwana engaphansi kwengama-30 kuye kwangama-60, futhi uyethusa umuntu onakekela usana.

I-BRUE ikhona kuphela uma ingekho incazelo ngomcimbi ngemuva komlando ophelele nokuhlolwa. Igama elidala elisetshenziselwa lezi zinhlobo zemicimbi umcimbi obonakala usongela impilo (i-ALTE).

Akucaci ukuthi lezi zehlakalo zenzeka kangaki.

I-BRUE ayifani nesifo sokufa kwezinsana ngokuzumayo (SIDS). Akufani futhi namagama amadala anjengelithi "eduze-miss SIDS" noma "abort crib death," angasasetshenziswa.

Imicimbi ebandakanya ushintsho ekuphefumuleni kwengane, umbala, ithoni yemisipha, noma indlela yokuziphatha ingabangelwa inkinga yezokwelapha engaphansi. Kepha le micimbi NGEKE ithathwe njenge-BRUE. Ezinye zezimbangela zemicimbi engeyona i-BRUE zifaka:

• Reflux ngemuva kokudla
• Izifo ezinzima (njenge-bronchiolitis, ukukhwehlela)
• Ukukhubazeka kokuzalwa okubandakanya ubuso, umphimbo, noma intamo
• Ukukhubazeka kokuzalwa kwenhliziyo noma amaphaphu
• Ukusabela okweqile
• Ukuphazamiseka kwengqondo, imizwa, noma imisipha
• Ukuhlukunyezwa kwezingane
• Izinkinga ezithile ezingavamile zofuzo

Imbangela ethile yomcimbi itholakala cishe isigamu sesikhathi. Ezinganeni ezinempilo ezinomcimbi owodwa kuphela, imbangela ayitholakali.

Izici eziyingozi kakhulu ze-BRUE yilezi:

• Isiqephu sangaphambilini lapho ingane iyeke ukuphefumula, yaphenduka iphaphatheka, noma yaba nombala oluhlaza okwesibhakabhaka
• Izinkinga zokondla
• Amakhanda asanda kubanda noma i-bronchitis
• Ubudala obungaphansi kwamasonto ayishumi

Isisindo sokuzalwa esiphansi, ukuzalwa kusenesikhathi, noma ukuvezwa kwentuthu kagwayi nakho kungaba yingozi.

Le micimbi kungenzeka yenzeke ezinyangeni ezimbili zokuqala zokuphila naphakathi kuka-8 ekuseni no-8 ntambama.

I-BRUE ifaka okukodwa noma ngaphezulu kokulandelayo:

• Izinguquko zokuphefumula - noma ngabe awukho umzamo wokuphefumula, ukuphefumula kanzima kakhulu, noma ukwehla kokuphefumula
• Ukuguqulwa kombala - imvamisa kuluhlaza okwesibhakabhaka noma okukhanyayo (izingane eziningi ziba bomvu, lapho zikhala ngokwesibonelo, ngakho-ke lokhu akubonisi i-BRUE)
• Shintsha kwithoni yemisipha - imvamisa ziyaxhuga, kepha zingaba lukhuni
• Shintsha ezingeni lokuphendula

Ukuchofoza noma ukuvala umlomo kusho ukuthi kungenzeka umcimbi ubungeyona i-BRUE. Lezi zimpawu kungenzeka zibangelwe yi-reflux.

Umhlinzeki wezokunakekelwa kwempilo uzokucela ukuthi uchaze ukuthi kwenzekeni ngesikhathi somcimbi. Umhlinzeki uzobuza futhi mayelana:

• Eminye imicimbi efana nalena esikhathini esedlule
• Ezinye izinkinga zezokwelapha ezaziwayo
• Imithi, amakhambi, noma amavithamini angeziwe okungenzeka ukuthi ingane iyaphuza
• Eminye imithi ekhaya ingane ibingayiphuza
• Izinkinga ngesikhathi sokukhulelwa nokubeletha, noma lapho kuzalwa, noma ukuzalwa kusenesikhathi
• Izelamani noma izingane zasendlini nazo ebezinalolu hlobo lomcimbi
• Izidakamizwa ezingekho emthethweni noma ukusetshenziswa kotshwala obunzima endlini
• Imibiko yangaphambilini yokuhlukunyezwa

Lapho unquma ukuthi ingabe kudingeka ukuhlolwa okwengeziwe, umhlinzeki uzobheka lokhu:

• Uhlobo lomcimbi owenzekile
• Bezinzima kangakanani izimpawu
• Yini ebiqhubeka ngaphambi komcimbi
• Ezinye izinkinga zempilo ezikhona noma ezitholakala ekuhlolweni komzimba

Ukuhlolwa okuphelele komzimba kuzokwenziwa, ukuhlola:

• Izimpawu zokutheleleka, ukuhlukumezeka, noma ukuhlukunyezwa
• Izinga le-oxygen ephansi
• Inhliziyo engajwayelekile izwakala
• Izimpawu zokukhubazeka kokuzalwa okubandakanya ubuso, umphimbo, noma intamo okungadala izinkinga zokuphefumula
• Izimpawu zokusebenza okungavamile kobuchopho

Uma kungekho okutholakele okuphakamisa ubungozi obukhulu be-BRUE, ukuhlolwa kwelebhu nokuhlolwa kwe-imaging ngokuvamile akudingeki. Uma ukuklinyeka noma ukukhefuzela kwenzeka ngesikhathi sokuncelisa futhi usana lwalulama ngokushesha, ukuvame ukuhlolwa okuningi ngeke kudingeke.

Izici eziphakamisa ubungozi obuphakeme bokuphindeka noma ukuba khona kwembangela enkulu kufaka:

• Izinsana ezingaphansi kwezinyanga ezimbili ubudala
• Ukuzalwa emasontweni angama-32 noma ngaphambili
• Ngaphezu komcimbi ongu-1
• Iziqephu zihlala isikhathi eside kuneminithi elingu-1
• I-CPR ngumhlinzeki oqeqeshiwe yayidingeka
• Izimpawu zokuhlukunyezwa kwezingane

Uma izinto ezinobungozi zikhona, ukuhlolwa okungenziwa kubandakanya:

• Ukubalwa kwegazi okuphelele (CBC) ukubheka izimpawu zokutheleleka noma i-anemia.
• Iphrofayili ye-metabolic yokubheka izinkinga ngokuthi izinso nesibindi zisebenza kanjani. Amazinga angajwayelekile we-calcium, amaprotheni, ushukela wegazi, i-magnesium, i-sodium ne-potassium nawo angatholakala.
• Umchamo noma isikrini segazi ukubheka izidakamizwa noma ubuthi.
• I-x-ray yesifuba.
• Ukuqapha kweHolter noma i-echocardiogram yezinkinga zenhliziyo.
• I-CT noma i-MRI yobuchopho.
• I-Laryngoscopy noma i-bronchoscopy.
• Uvivinyo lokuhlola inhliziyo.
• Hlola i-pertussis.
• Isifundo sokulala.
• Ama-X-ray amathambo afuna ukuhlukumezeka kwangaphambilini.
• Ukuhlolwa kwezinkinga ezahlukahlukene zofuzo.

Uma umcimbi ubumfishane, ungafakwanga nezimpawu zokuphefumula noma izinkinga zenhliziyo, futhi walungiswa wedwa, ingane yakho kungenzeka ingadingi ukuhlala esibhedlela.

Izizathu zokuthi ingane yakho ingeniswe ngobusuku obubodwa zifaka:

• Umcimbi ubufaka nezimpawu ezikhombisa imbangela ebucayi.
• Ukuhlukumezeka okusolwayo noma ukunganakwa.
• Ubuthi obusolisayo.
• Ingane ibonakala ingaphilile noma ingakhuli kahle.
• Udinga ukuqapha noma ukugcina ngenkathi udla.
• Ukukhathazeka ngokwazi kwabazali ukunakekela ingane.

Uma ivunywa, izinga lokushaya kwenhliziyo yengane yakho nokuphefumula kwakho kuzobhekwa.

Umhlinzeki angancoma ukuthi wena nabanye abanakekeli:

• Beka usana lwakho emhlane wakhe lapho ulele noma ulele. Ubuso bakhe kufanele bukhululeke.
• Gwema izinto zokulala ezithambile. Izinsana kufanele zibekwe kumatilasi oqinile, oqinile wokulala ngaphandle kombhede oxegayo. Sebenzisa ishidi elikhanyayo ukumboza ingane. Ungasebenzisi imicamelo, ama-comforters, noma ama-quilts.
• Gwema ukuvezwa intuthu kagwayi.
• Cabanga ngamaconsi ekhaleni likasawoti noma usebenzise isibani samakhala uma ikhala liminyene.
• Funda izindlela ezifanele zokuphendula kunoma imiphi imicimbi yesikhathi esizayo. Lokhu kufaka UKUNGASINIKIZISI usana. Umhlinzeki wakho angakufundisa.
• Gwema ukondla ngokweqile, yenza ukubhoboza njalo ngesikhathi sokuphakelwa, bese ubamba usana luqonde ngemuva kokuncelisa.
• Khuluma nomhlinzeki wakho ngaphambi kokuqinisa ukondliwa kwengane yakho noma ukusebenzisa imithi eyehlisa i-asidi ne-reflux.

Noma kungajwayelekile, kunganconywa amadivayisi wokuqapha ekhaya.

Imvamisa, le micimbi ayinabungozi futhi ayilona uphawu lwezinkinga ezinkulu zempilo noma ukufa.

I-BRUE mancane amathuba okuthi ibe yingozi yesifo sokufa kwezinsana ngokuzumayo (SIDS). Iningi lezisulu ze-SIDS azinazo izinhlobo zemicimbi ngaphambili.

Ingane enezinto ezinobungozi ze-BRUE ingaba nengozi enkulu yokuphindeka noma yokuba khona kwembangela enkulu.

Shayela umhlinzeki ngokushesha uma kusolwa ukuhlukunyezwa kwengane. Izimpawu ezingaba khona zokuhlukunyezwa zifaka:

• Ubuthi noma ukulimala ekhanda okungabangelwa ingozi
• Ukulimaza noma ezinye izimpawu zokulimala kwangaphambili
• Lapho izehlakalo zenzeka kuphela lapho kukhona umnakekeli oyedwa lapho kungekho zinkinga zempilo ezitholakala njengezimbangela zale micimbi

Umcimbi obonakala usongela impilo; ALTE

UMarcdante KJ, uKliegman RM. Ukulawula ukuphefumula. Ku: UMarcdante KJ, uKliegman RM, ama-eds. UNelson Essentials Pediatrics. Umhlaka 8. IPhiladelphia, PA: Elsevier; 2019: isahluko 134.

UTieder JS, uBonkowsky JL, u-Etzel RA, et al; Subcommittee on Apparent Life Songela Imicimbi. Kafushane kuxazululwe imicimbi engachazeki (imicimbi ebisengcupheni yokuphila ngaphambilini) nokuhlolwa kwezinsana ezinengcuphe ephansi. Izifo zezingane. 2016; 137 (5). I-PMID: 27244835 pubmed.ncbi.nlm.nih.gov/27244835/.