Isiqhelo se-Apgar sisetyenziswe ngabagqithisi ukuba bavavanye imeko esebenzayo yintsana. Inkqubo eyenziwa kwii-nursery kwimizuzu yokuqala emva kokuzalwa komntwana. Makhe siqwalasele ngokungakumbi iinkcukacha ze-algorithm yoqikelelo, siya kufumanisa: njani ukuba amanqaku abalwa kwinqanaba le-Apgar, kwaye bathetha ukuthini.
"Scar Apgar" - yintoni na?
Emva kokuba umama ekwaziswa ngokuvandlakanywa okubalwe, umbuzo wendlela i-Apgar isingiselo yintoni ekusetyenziselwayo engqondweni yomtsha esandula. Le nqubo ibandakanya ukucacisa iimpawu ezisemgangathweni ezisemgangathweni ezibonisa ukuba usana olusandul 'ukuzalwa olusemva kwemizuzu yokuqala yobomi bakhe. Amanqaku aphumelelayo anceda ukuvavanya imeko yonke yeemvuthu.
Isiqhelo se-Apgar, esetyenziselwe ekuzalweni, sibonisa ukusebenza kakuhle kwezixhobo ezibalulekileyo kunye neenkqubo. Ngokusekelwe kwiziphumo, oogqirha banika izibikezelo ezingaphezulu malunga nokusebenza komntwana, isidingo sokuvuselelwa. Uvavanyo lombuso kwisikhululo se-Apgar lunceda ootitshala bezingane ukuba bafumane ulwazi malunga nosana olutsha emva kwemizuzu yokuqala emva kokubeletha.
Isixa se-Apgar - imbali yokubonakala
Umbuso wengane esekelwe kwisiqhelo se-Apgar saqale sahlolwa ngumgqirha wase-American anesthesiologist. Igama lakhe ngokuthe ngqo lalibizwa ngokuba yindlela ngokwayo. Isilinganiso sokuhlola savunywa ngokusemthethweni ngekhulu lama-20, kwintlanganiso ye-anesthesia. Kulo mcimbi, uVirginia Apgar wanikela ukuvavanya imeko yesantwa esisandul 'ukuzalwa kungekhona kuphela ngokusetyenzisweni kwezitho zakhe, kodwa nangokuqwalasela amathuba okuphuhliswa kweengxaki zeengxaki kwiindawo zokuhambisa. Ngokukhawuleza emva kwendibano, isixa sama-Apgar sisetyenziswe ngokusetyenziswa kwizibilini.
Yintoni ehlolwayo kwinqanaba le-Apgar?
Ukuvavanywa komntwana osanda kuzalwa kwi-Akhasi ye-Apgar kukhombisa ukuhlalutya isishwankathelo seempendulo ezi-5 ngexesha elilodwa. Ngalunye lwalezi zikhombisi ziqikelelwa kwisikali sesithathu (amanqaku angama-0-2). Iziphumo zibonisa uqikelelo kwibanga ukusuka ku-0 ukuya ku-10. Kufuneka kuqatshelwe ukuba le mqathango, kunye nobukhulu kunye nokuphakama, izibonakaliso ezibalulekileyo ezichazwe kumtsha nje. Uvavanyo lokuqala kwisikali se-Apgar senziwa kwiminithi yokuqala yobomi.
Ukukhunjulwa ngcono kwezibonakaliso apho uhlolisiso lwenziwe khona, udokotela wezingane uJoseph Butterfield wacebisa ukuba usebenzisa igama elithi APGAR njengesigqibo:
- A-ukubukeka - umbala wesikhumba;
- I-P-pulse - inombolo yeentliziyo;
- G - grimace - reflexes;
- A - umsebenzi - ithoni yeethambo;
- R - ukuphefumula - inani leentshukumo zokuphefumula.
Njani imeko yintsana?
Uvavanyo lombuso olusandul 'ukuzalwa kwi-Apgar level alufunanga ubukho bezixhobo ezikhethekileyo kunye nezixhobo. Kule nkqubo, umntwana ubonakala ngokukhawuleza 2 amanqaku: emva kokuzalwa kunye nemizuzu emihlanu yobomi. Kule meko, iimpawu zokuqala ziboniswe kumanani, ixabiso lesibini kwi-denominator. Uvavanyo lombuso wengane olutsha luquka isixa-mali sazo zonke izikhombisi-5:
- Isikhumba - sibe ne-pink tinge, ukusuka kwibala uze ukhanyise. Oku kunikeza amanqaku amabini. Iipenitiki kunye nemilenze ye-cyanotic - i-1 iphuzu, umthunzi oluhlaza okwesibhakabhaka wesikhumba - 0.
- Intlawulo yenhliziyo - ipharamitha ephakathi kwintsana i-130-140 ibhokhwe ngomzuzu. Nangona kunjalo, ekuvavanyeni i-neonatologists ezi zilandelayo zilandelwa: iingubo ezingaphezulu kwe-100 - amanqaku a-2, ngaphantsi kwe-100 beats - iphuzu eli-1, ukungabikho kwe-pulse-0 (ukuphinda kuhlaziywe kuyadingeka).
- I-Reflexes ziphakathi kweengcamango ezingenakunqununu ezikhoyo kuzo zonke iintsana: ukuphefumula kokuqala, ukukhala, ukugwinya nokunywa. Ubukho babo buqikelelwa kwiingongoma ezi-2, ukungabikho kwamanye amazwe - 1, epheleleyo-0.
- I-tone ye-muscle - emva kokuzalwa, intloko yesana iboniswa kwisifuba, izibambo zinyamekile kwiintambo, izandla zifakwa kwisibindi. Imilenze ifakwe kwi-hip kunye namadolo. Ulungelelaniso lwezinto ezihamba phambili alukugqibekanga - abantwana bavusa iingalo kunye nemilenze yabo, kwaye kule ngxaki i-neonatologists inika amanqaku amabini. Ngokulungelelaniswa ngokukhawuleza, i-point 1 icwangcisiwe, ithowiti ye-muscle ebuthakathaka iqikelelwa kuma-0 amanqaku.
- Ukunyakaza okuphefumulayo - umyinge wama-40-45 ngomzuzu. Eli qhelo liqhelekile kwaye amanqaku amabini ahlawulwe. Ngexesha elifanayo, ukukhala kokuqala komntwana kuhlolwa, okumele kuvuke ngokukrakra. Ngokuphefumula okukrakrayo nokumemeza njengento yokububula - iphuzu eli-1 liboniswa, ukungabikho kokuphefumula okanye ukukhala - 0.
Isilinganiselo sama-Apgar - ukucacisa
Iingxelo zeApgar zivumela oogqirha ukuba bahlole imeko yentsana, baxelele. Ngoko, umntwana ophilileyo kwi-Akhasi ye-Apgar uqokelela kwinani lama-7-10. Ngelo xesha, ipesenti ezincinci zentsana zifumana amanqaku aphezulu. Uvavanyo oluqhelekileyo lu-7/8 kunye ne-8/9. Isilinganiselo sesibini, isetyenziswe emizuzu emi-5 emva kokuzalwa komntwana, 1-2 ixabiso eliphezulu. Inendima ebalulekileyo kule nto idlalwe yindlela yokuhambisa. Ngokwenza oko, iintsana ezizalwe ngecandelo lamanzi zifumana amanqaku ambalwa kunezo zizalwa ngokwemvelo.
Ziyintoni na iiAggar izikolo?
Ukusebenzisa indlela efana negalelo le-Apgar, ukuchithwa kwamaphuzu athathwe ngumntwana kuqhutyelwa ngqo oogqirha. Kule meko, oogqirha beli khombisa banokuvavanya ngokukhawuleza imeko yomntwana, bathethe ukuphulwa. Ngoko ke, xa uqikelela u-5-6 ngexesha lokuzalwa, i-neonatologists ibonisa iqondo elincinane le- hypoxia . Ukuba umntwana ufumana amanqaku ama-3-4 - iqondo eliqhelekileyo le-oksijini yindlala ifunyenwe, i-0-2 - ibonisa ukuphulwa komthetho obunzima - ukuxhalabisa okudinga ukunakekelwa ngongxamiseko.
Itafile ze-Apgar
Ukuvavanywa komntwana kwinqanaba le-Apgar lwenziwa ngokusebenzisa itafile. Iluhlu zonke iiparitha ezikhoyo kunye nokuphambuka kwabo. Oogqirha bavavanya imeko yangempela yentsana ngelixa bebukele ukuba yiyiphi imimiselo kufuneka ibe yinto eqhelekileyo. I-neonatologists abanolwazi abanakho ngaphandle kweendlela eziphuculweyo, izibonelelo zivavanya imeko yomntwana kwaye zivelise amanqaku afanayo. Iziphumo zifakwe kwingxelo yonyango.
Amanqaku aphantsi a-Apgar
Umgangatho ophantsi we-Apgar ungabonisa umahluko phakathi kokungaqhelekanga kunye nokukhubazeka kwintsana. Phakathi kwezinto ezivakalayo ezibangele imeko enjalo yengane:
- i-hypoxia yobusana ngexesha lokuthwala umntwana kunye nokuzala;
- ukungafumani komzimba - kubonakaliswe ngetekisi, ukungahambi, ukungahambi kakuhle kweemeko, iimpawu ezixhasayo. Umntwana ulala ixesha elide, uthatha ukutya okungaphantsi.
Ukuba umntwana ufumana isilinganiselo esiphantsi kwinqanaba le-Apgar kwiminithi yokuqala, kubalulekile ukwandisa le pharamitha ngamanqaku angama-1-2 ngemizuzu emi-5. Utshintsho olunjalo lubonakalisa iinguqu ezinamandla. Nangona kunjalo, loo mntwana ufuna ukubeka iliso rhoqo, ingqalelo ekhethekileyo evela kubasebenzi bezonyango. Ukuba imeko yengane iyaba nzima, ukuhlaziywa kungafuneka.