I-Asphyxia yintsana iyinkxalabo ephuhliswayo kwithuba lokugqibela emva kokubeleka. Le ntsholongwane ihambelana nokuphulwa komsebenzi wokuphefumula kunye nomsebenzi wesistim se-cardiovascular in the baby. Cinga ngale ngcaciso ngokubanzi, cwangcisa iibangela zayo, iintlobo, siya kufumanisa: yintoni eyahlula u-hypoxia we-fetus kunye ne-asphyxia yintsana.
Yintoni "i-asphyxia" kwintsana esanda kuzalwa?
I-Asphyxia yintsana iyimeko yendalo encinci apho kukho ukuphulwa komphefumlo. Kule meko, kukho umehluko phakathi kwesi sifo kunye nencazelo "ye-hypoxia yintsana." Indlala ye-oksijini (i- hypoxia ) ikhula ngexesha lokukhulelwa okanye ukubeletha (ukukhutshwa kwe-placental, ukuchukumisa intambo yomthambo), kwaye ihamba kunye nokutya okwaneleyo oksijini. Inkqubo yokuphefumula ayiphuli. I-Asphyxia (ukuhluthwa ngokuxhatshazwayo) ibonakaliswa ukuphefumula okwethutyana kwaye idinga ukuvuselelwa.
Iingxaki zokusasazeka kweNtsana
U-Asphyxia kumntwana ngexesha lokubeletha unokucatshulwa yizinto ezininzi. Kule meko, izimbangela ezibangela ukukhubazeka, zinokuthi zihambelane ngqo nenkqubo yokunikezelwa kunye neendlela zokuphuhliswa kwe-intrauterine ye-fetus. Phakathi kweziganeko eziphambili ezibangelwa i-asphyxia, oogqirha bahlula:
- Ukukhawuleza, ukungasebenzi ngokukhawuleza kwigazi kunye nentambo yomthi - intonga yentamo yomntwana , ukubunjwa kwesodi kwintambo yomthamo, isithintelo.
- Ukuphazamiseka kwenkqubo yokutshintshwa kwegesi kwinkqubo ye-utero-placental - inkcazo engafanelekanga kwendawo yomntwana, i- detachment engasemva .
- Ukungaphumeleli kwinkqubo yokujikeleza kwi-placenta, ebangelwa uxinzelelo lwegazi oluphezulu kumama.
- Ukunciphisa izinga le-oksijini egazini lomama ekuzalweni - i- anemia , izifo ze-cardiovascular, izifo zokuphefumula.
- Ubunzima bokuphefumla ebusweni buyi-anomalies yophuhliso lwemiphunga, iinkqubo ezingapheliyo ezithintekayo, umphumo wezonyango ezithathiweyo.
Oku kubangelwa ukukhupha i-asphyxia ephambili yabantwana abasanda kuzalwa, eqhubekayo kwinkqubo yokuhanjiswa. Nangona kunjalo, i-asphyxia ingaba yinto yesibini xa isifo sifana ngqo emva kokuzalwa komntwana. Phakathi kwezizathu zesibini zokukhupha i-asphyxiation:
- Inqweno yesiphene sokuphefumula - ukungena kwamanzi kwimiphunga;
- ukuphulwa kwenkqubo yokujikeleza kwengqondo;
- ukungakhangeli kwemiphunga - umzimba awukwazi ukwenza ukunyakaza kokuphefumula;
- ukungasebenzi komntwana wengqondo, intliziyo, imiphunga.
Iziganga ze-asphyxia zintsana
Ngokuxhomekeke kwimifanekiso yeklinikhi kunye nokunyaniseka kwesi sifo, oogqirha bahlula amanqanaba amathambo. Ukuvavanya kwenziwa ngokukhawuleza emva kokuzalwa komntwana kwiminithi yokuqala. Ukwahlulelwa kwe-asphyxia yeentsana ziza kulandela:
- iqondo lokukhanya;
- umyinge;
- bunzima;
- ukufa klinikhi.
I-Asphyxia ye-neonatal imnene
I-Asphyxia yezinga eliphantsi libonakaliswa ngokungabikho kokumemeza, nangona kunjalo ukusabela komntwana ekuthinteni kukhoyo. Ukuphefumula komntwana oza kusana kuzinzimeleyo, kodwa kuthoba kwaye kuyangqinelani. Imilenze nezandla zinomthunzi we-cyanotic, umsebenzi wenhliziyo awuphuli. Emva kokucoca umgangatho ophezulu wokuphefumula kwi-mucus kunye nobuthakathaka, ukwenza ukukhuthazwa okuchukumisayo (ukuxubha umva, ukukhangela izithende) kunye ne-oksijeni yonyango kwi-mask, imeko yesandul 'ukuzalwa iqhelekile.
Umntwana ozelwe kwimeko ye-asphyxia ephakathi, akanakho iingxaki zokuphefumla. Kule meko, iingxaki ezincinci ze-neurological zinokwenzeka, ngendlela:
- ukwanda kwetoni yomsila;
- ukuthuthumela kweengxaki, imilenze, umhlathi ophantsi.
I-Asphyxia yoxinzelelo olulinganisekileyo kwintsana
Eli nqanaba lokukhubazeka likwabonakala ngokungabikho kwesikhala ngexesha lokuzalwa. Kule meko, ukuphendulela kwisicatshulwa esicacileyo somnxeba akugcinwa. Isici salo hlobo lushintsho kumbala wesikhumba, ngoko kudla ngokuba kubizwa njenge-blue asphyxia yeintsana. Ukunyakaza okuphefumulayo kufana nesimo esifanayo, nangona kunjalo, umsebenzi wenhliziyo awunakonakala.
Umyinge we-asphyxia wengane usana ufuna ukungena umoya. Ukwenza oku, ngokuqhelekileyo usebenzise isikhwama esikhethekileyo, ngesinye isikhathi i-mask oksijini. Ifom ye-pathology idluliselweyo ishiya onke amanqaku empilo yintsana, iququzelela iinguqu ze-neurologic:
- ukwanda okukhulu - ukukhala okungenangqondo, ukugubha kwexesha elide kunye neemilenze;
- ukuxinezeleka - ukunyamezela isifuba esilulayo, umsebenzi wezithuthi eziphantsi (ukuhamba ngeengalo kunye nemilenze akukwenziwanga).
I-Asphyxia yezinga eliphezulu kwiintsana
Isigulana esinzima sokukhubazeka siyahambisana nokuphefumula okupheleleyo ngexesha lokuzalwa. Ikhumba ngenxa yokungahambi kwegazi liya kuba libala. Ngenxa yoko, le fom ye-pathology ibhekiswa njenge-white asphyxia yintsana. Xa uqhuba uvavanyo oluchukumisayo, umntwana akathanga ukuthintela. Kukho ukuphulwa kwenkqubo ye-cardiovascular system - xa ukuphulaphula izandi zentliziyo ziqine kakhulu okanye zingekho ngokupheleleyo. I bradycardia eqinileyo ikhula.
Le-asphyxia yeintsana ifuna ukuvuselelwa ngokukhawuleza. Izenzo zoogqirha zijolise ekubuyiseleni umsebenzi wokuphefumula kunye nomoya wengane. Umntwana uqhagamshelwe kwisiphene. Ngexesha elifanayo, intambo yomzimba ilawulwa ngamachiza avuselela umsebenzi wenhliziyo. Ezi zintsana ixesha elide ziphefumlelweyo ze-hardware, kwaye emva koko zihlakulele ukuphazamiseka okukhulu kweengxaki zegazi, kunokwenzeka ukulibazisa ukuphuhlisa i-neuropsychic.
Ukufa kliniki yintsana
Ukufa klinikhi yintsana kwenzeka xa oogqirha bekulungisa ukungabikho kweempawu zobomi. Kule meko, emva kokuzalwa, umntwana akasenzi nantoni na ukuzithoba, akukho nto eyenziwa yintliziyo, ukuphendulela kwi-stimuli. Ukuqaliswa ngokufanelekileyo kunye nokufika ngexesha elifanelekileyo ngexesha lokuvuselela kunika ithemba kwisiphumo esihle. Kule meko, ubunzima beempembelelo zempilo yengane kuxhomekeke kwithuba elingakanani ukuphefumula. Kwiimeko ezinje, ubuchopho buwonakele kakhulu.
I-Asphyxia yintsana - iimpawu
Ukuhlola ubunzima beli gciwane, oogqirha basebenzisa u-Apgar. Le ndlela isekelwe ekuphononongweni kweenqakraza eziliqela kwangoko:
- ukukhupha;
- ukuphefumla;
- msebenzi we ntliziyo;
- ithoni yomzimba;
- umbala wesikhumba.
Kwiparameter nganye, amanqaku ayongeziweyo, achazwe kwaye amanqaku amanqaku ayiphumo. Iziphumo zibukeka ngathi:
- iqondo elilula - 6-7 amanqaku;
- umyinge - 4-5;
- enzima - ithole lifumana amanqaku amathathu;
- Ukufa kweklinikhi - amanqaku angu-0.
Xa kuboniswa i-degree of asphyxia, ababelethisi bavavanya iimpawu zangoku zesifo. I-pulphy e-asphyxia kwiintsana iyancitshiswa kwaye iphantsi kwe-100 beats ngomzuzu. Ukuze i-degree elula ye-asphyxia iphawu:
- Ukuphefumula kokuqala kwenzeka kwimizuzu engama-1;
- ithoni ye-muscle yehla kancane;
- unxantathu obuthathu obumbala obomvu;
- Ukuphefumula kubuthathaka.
Ngomlinganiselo osezantsi we-asphyxia, oogqirha balungisa:
- ukuphefumula
- Imilenze kunye neengalo zibuhlaza;
- inani leentliziyo zinciphisa;
- ithoni yehlunu iyancipha;
- Ukugqithiswa kwetambo yomtya kubonwa.
Isiganga esinzima sale ntsholongwane sibonakaliswe ziimpawu ezilandelayo:
- ukuphefumula akukho;
- bradycardia
- i-muscular atony;
- ukugqithisa kwesikhumba;
- ukuphuhliswa kobunzima bokungena;
- ukutsaliswa okunamandla kweemvini zentambo.
I-Asphyxia yeintsana-iziphumo
Ukuthetha malunga nokuba yingozi kangakanani i-asphyxia kwiintsana ezisanda kuzalwa, oogqirha baqaphele ukuba ngokuchithwa okukhulu, ukufa kwintsana kunokwenzeka. Kwenzeka kwiiyure zokuqala zobomi. Ngomlinganiselo osemgangathweni kunye nobumnene, ukuhlutha kwesibhambathiso kulungile. Isiphumo sincike kwixesha lokuvuselela, ubukho beengxaki zokudibanisa. Imiphumo yentsholongwane ephuhlisiwe ngexesha lokuzalwa olutsha lingavela, kokubili kwiiyure zokuqala zokuphila, kunye nokudala.
I-Asphyxia kwintsana emva kokubeletha - iziphumo
I-asphyxia ekhuselekileyo yabantwana abasanda kuzalwa, imiphumo yayo kuxhomekeke ekuchanekeni kunye nokukhawuleza kwonyango eqalisiwe, ayidluli ngaphandle komkhondo womzimba. Iingxaki zinokuthi zenzeke, zombini kwizigaba zakuqala zokuphuhliswa komntwana kwangasemva kokudala, kunye nokudala. Ukuzalisa i-brain inrophy emva kokuba i-asphyxia kwiintsana ivele yinto encinane. Phakathi kweengxaki eziqhelekileyo zokuphucula kwangaphambili:
- encephalopathy;
- i-hydrocephalus;
- isifo soxinzelelo;
- ulwalamano okanye u-hyperexcitability.
I-Asphyxia yeintsana-iziphumo ekudala
I-Asphyxia kunye ne-hypoxia yeintsana zizalana nezo ngxaki zokukhulelwa ezichaphazela impilo yengane emva kokuzalwa kwakhe. Iingxaki zinokubonakala ezinyangeni ezimbalwa, ngamanye amaxesha neminyaka. Phakathi kweengxaki zokugqibela:
- i-meningitis;
- pneumonia;
- sepsis.
Unyango lwe-asphyxia kwiintsana
Xa uvavanya amanqaku a-Apgar angama-4 okanye ngaphantsi, eqhutywe kwiminithi yokuqala, kufuneka kuvuselelwe kwakhona. Ukuvuselelwa kwintsana e-asphyxia kwenziwa ngamanqanaba amane:
- Ukukhululwa kwendlela yokuphefumula, ukuqinisekisa ubungqina babo. Kuqhutyelwa ngoncedo lwentambo kunye nepompo yamandla. Ukuba i-asphyxia iyenzeka kwi-utero, ukuphathwa ngokucoca kwenziwa ngokukhawuleza emva kokubonakala kwentloko.
- Ukugcina inkqubo yokuphefumla. I-vententi eyincedisayo iqhutyelwa ngoncedo lwesikhwama sokuphefumula, kwaye ukuba ingenakusebenza, intubation yenziwa kwaye ifowuni yokufakelwa umoya ixhunyiwe.
- Ukubuyiselwa kwenkqubo yokujikeleza. Ngenxa yale njongo, i-body massage evaliweyo iyenziwe, kwanezocutshulwa (kunye ne-bradycardia ye-60-70 beats ngomzuzu). Kuqhutyelwa ngokunyanzela kwi-sternum enezithupha ezimbini, ngokuphindaphindiweyo kwama-100-120 ngamazuzu ngomzuzu. Xa umsebenzi wenhliziyo ungabuyiselwa ngaphakathi kwimizuzu, qhubeka kwinqanaba elilandelayo.
- Ulawulo lweeyeza. Kule nqanaba lonyango, oogqirha basebenzisa ezi zi yobisi ukunyanga i-neonatal asphyxia:
- Atropine 0.1% - 0.05-0.1 ml;
- I-Adrenaline 0.1% - 0.02-0.03 ml;
- I-bicarbonate ye-sodium - 1-2 ml.
Ukuthintela i-asphyxia yeintsana
Ukuze ukhusele ingxaki enzima - i-fetal kunye ne-asphyxia esandulweyo, kufuneka kuthathwe amanyathelo okukhusela kokubili kwisigaba sokucwangcisa ukukhulelwa, kwaye xa umntwana ezalwa. Phakathi kweendlela eziphambili:
- Unyango olusesikhatsini lwezilwanyana ezingapheliyo kubasetyhini abakhulelweyo.
- Ulawulo lwenkqubo yokubambisa ingqalelo kwiingxaki zobungozi.
- Ukuqhutyelwa kweengxelo ze-intrauterine zeemeko ze-fetal ne-placenta (i-dopplerography, ultrasound).
- Ukuthintela i-hypoxia ngexesha lokubambisa, ukukhutshwa ngexesha elifanelekileyo lokuphefumula.