Maitiro Ekuchengetedza Vananyamukuta Muzvirwere zveTyphus
Pendauluan
Typhus (typhoid fever) chirwere chinotapukira chinokonzerwa neSalmonella typhi uye chinowanzo pararira kuburikidza nechikafu kana zvinwiwa zvakasviba. Typhus inoda kutarisirwa kwakanyanya kumadzimai ane pamuviri, vakadzi vachangobva kusununguka, uye vanaamai vanoyamwisa nekuti inogona kukuvadza mamiriro eamai, kukanganisa mamiriro ekudya, kuwedzera njodzi yekushaya mvura mumuviri uye kupererwa neropa, uye kutokanganisa kugara zvakanaka kwemwana ari mudumbu. Panyaya yekutarisirwa kwevanaamai, vananyamukuta vanoita basa rakakosha mukuona mwana ari mudumbu nekukurumidza, kuongorora kwakazara, kushanda pamwe chete nevashandi vezvehutano, dzidzo, uye kuenderera mberi nekutarisa. Chinyorwa chino chinotaura nezvenzira dzekutarisira vananyamukuta vane typhoid, chichisimbisa nzira yakachengeteka, inotarisa murwere, uye inotarisa mhuri.
Pfungwa huru dzeTyphus mumabasa ekubatsira vana vanozvara
Chirwere cheTyphoid chinowanzoonekwa nefivha inogara kwemazuva anopfuura manomwe, kushaya simba, musoro, kurwadziwa kwetsandanyama, matambudziko ekugaya chikafu (kuda kurutsa, kurutsa, kuzvimba, kana manyoka), kudzikira kwechido chekudya, uye dzimwe nguva kuoneka kwemavara matsvuku (mavara erose). Muvakadzi vane pamuviri, zviratidzo zvinogona kuva zvakanyanya nekuda kwekuchinja kwemuviri wepamuviri, kusanganisira kuwedzera kwezvinodiwa zvemvura uye zvinovaka muviri uye shanduko mukudzivirira kwemuviri. Kana ikasarapwa, typhoid inogona kutungamira kumatambudziko akadai sekubuda ropa mudumbu, kubooka kwemudumbu, sepsis, uye kusagadzikana kwepfungwa. Saka, kutarisirwa kwevana vanozvara kunofanirwa kusimbisa kuziva zviratidzo zvengozi uye kutumira varwere panguva yakakodzera.
Kuongororwa kweKubereka
Nzira yekutanga yekutarisira vananyamukuta muzvirwere zvetyphus ndeyekuongorora kwakazara kuburikidza ne anamnesis, kuongororwa kwemuviri, uye kuongororwa kunotsigira zvichienderana nemvumo nekubatsirana.
1. Anamnesis Yakatungamirirwa
Nyamukuta achaunganidza nhoroondo yenyaya huru yaakanyunyuta: nguva yefivha, fivha (inowedzera zvishoma nezvishoma kana kuti inoramba iripo), kushandisa mishonga kare, uye chero zviratidzo zvinotevera zvakaita sekusvotwa, kurutsa, kurwadziwa mudumbu, manyoka/kuzvimba, kukosora, uye kushaya simba. Nhoroondo yekudya chikafu kunze, tsika yekugeza maoko, mvura yekunwa, uye kana paine nhengo dzemhuri dzakamborwara nezvirwere zvakafanana zvakakoshawo.
Kune vakadzi vane pamuviri, vananyamukuta vanofanira kubvunza nezvezera repamuviri, kufamba kwemwana ari mudumbu, kurwadziwa kwepamuviri, kubuda ropa, kana kuputika kweganda. Kune vakadzi vachangobva kusununguka, mibvunzo inofanira kubvunzwa nezve lochia, kurwadziwa mudumbu, zviratidzo zvehutachiona hwemaronda, uye kufambira mberi kwekuyamwisa.
2. Kuongororwa Kwemuviri
Zviratidzo zvinokosha zvinokosheswa: tembiricha, kurova kwemoyo, BP, mwero wekufema, uye zviratidzo zvekupererwa nemvura (ganda richibuda, kuoma kwemukati memucosa, uye kubuda kweweti). Nyamukuta anoongororawo mamiriro emurwere, ruzivo rwake, uye kuvapo kweanemia. Kuongororwa kwedumbu kunogona kuona kana paine kurwadza, kuzvimba, kana chiropa kana chiropa chakakura, kana chiripo.
Vakadzi vane pamuviri vanoongororwa nezvekusununguka: kureba kwechibereko, kurova kwemoyo wemwana asati aberekwa (FHR), uye kugara zvakanaka kwemwana asati aberekwa zvichienderana nemakore ekuzvitakura. Kana zvichibvira, kuongororwa kweDoppler kana kutumirwa kunoongororwa neultrasound kunogona kufungwa kana paine fungidziro yekuti mwana anenge aine dambudziko.
3. Kutsigira Bvunzo (Kushanda Pamwe Chete)
Kuongororwa kwetyphus kunoitwa nevashandi vezvehutano kuburikidza nekuongororwa kwakadai sekuongororwa kweropa (leukocytes, maplatelet), bvunzo yeWidal, Tubex, kana blood cultures (dzakanyatsojeka). Basa revananyamukuta nderekuona kuti varwere vanosvika munzvimbo dzekuongororwa, kutarisa mhedzisiro, uye kududzira ruzivo zvakajeka. Mimwe miedzo, yakaita se electrolytes, bvunzo dzekushanda kwechiropa, kana bvunzo dzeweti, inogona kudiwa kana paine kushaya mvura mumuviri kana matambudziko.
Kuongororwa kweUmbungu uye Kuziva Matambudziko
Mukutarisira vananyamukuta, vananyamukuta vanoona matambudziko chaiwo neanogona kuvapo, semuenzaniso:
– Hyperthermia inobatanidzwa nehutachiona.
– Njodzi yekushaya mvura mumuviri inokonzerwa nefivha yakanyanya, kusanwa mvura yakakwana, kuda kurutsa/kurutsa/manyoka.
– Matambudziko ekudya akaderera pane zvinodiwa nemuviri.
– Njodzi yekurwara kwemwana ari mudumbu (panguva yekuzvitakura) nekuda kwefivha yakareba uye kusadya zvakanaka.
- Kushaya simba/kudzikira kwesimba rekuita mabasa ezuva nezuva.
– Kushaya ruzivo rwemhuri nezvekutapurirana kwetyphoid uye kudzivirira.
Kuzivikanwa kwezviratidzo zvengozi kunofanira kujeka: fivha yakanyanya, kurutsa nguva dzose, manyoka akanyanya, kurwadziwa mudumbu, tsvina nhema kana ine ropa, kusaziva zvakanaka, pfari, kufema zvishoma, uye kuvakadzi vane pamuviri, kusafamba zvakanaka kwemwana ari mudumbu, kubuda ropa, kana kusununguka nguva isati yakwana.
Kuronga Kutarisira
Kuronga kunoitwa zvichienderana nemamiriro emurwere uye mamiriro ake ekusununguka, kusanganisira mabasa ekuzvimirira, kushanda pamwe chete, dzidzo, uye kutumira varwere kana zvichidikanwa.
1. Chiito Chekuzvimirira Chevananyamukuta
– Kudzora fivha: mishonga inodziya, mazano ekuzorora zvakakwana, kutarisa tembiricha nguva dzose, uye kudzidziswa nezvekushandisa mishonga inorwisa pyretics sezvakakurudzirwa nachiremba.
– Kunwa mvura: kurudzira kunwa mvura shoma nguva nenguva, munyu wekudzorera mvura mumuviri kana paine manyoka, tarisa ruvara uye kuwanda kweweti.
– Kuzadzikisa zvinovaka muviri: kudya zvinyoro nyoro zvine macalorie akawanda nemapuroteni, kudya zvishoma asi kazhinji, uchidzivisa kudya zvine spice/acid zvinokonzeresa kutsamwa kwemudumbu.
– Dzidziso yehutsanana: kugeza maoko nesipo, kushandisa mvura yakachena, chikafu chakabikwa, uye kuchenesa midziyo yekudyira.
– Kudzivirira kutapurirana kwehutachiona kumba: musagovane midziyo yekudyira, musachenesa zvimbuzi, uye iva nechokwadi chekuti nhengo dzemhuri dzinochengetedza kuchena.
2. Kushandira pamwe kweVarapi
Kurapa typhoid kunoda mishonga inorwisa utachiona inonyorerwa nachiremba. Vananyamukuta vanovimbisa kutevedzera mishonga, vanoongorora migumisiro yakaipa (semuenzaniso, kuda kurutsa, allergic reactions), uye vanosimbisa kukosha kwekupedza mishonga yese inorwisa utachiona. Kana murwere aine pamuviri, kusarudza mishonga inorwisa utachiona kunofanira kunge kwakachengeteka pakubata pamuviri, zvichiita kuti kushanda pamwe chete kuve kwakakosha. Uyezve, kana kushaya mvura mumuviri kwakanyanya, murwere anogona kuda kurapwa nemvura inopinzwa mutsinga panzvimbo yekutumira varwere.
3. Mareferensi
Kutumirwa nekukurumidza kunodiwa kana paine matambudziko, zviratidzo zvengozi, kana kana chirwere chikaramba chiripo. Kune vakadzi vane pamuviri, kutumira kunofanirwa kupihwa pekutanga kana kurova kwemoyo kwemwana mudumbu (FHR) kukaonekwa, kufamba kwemwana mudumbu kwadzikira, kana paine njodzi yekusununguka nguva isati yakwana. Vananyamukuta vanoita basa rekutanga rekudzivirira: kuona kuti mweya uri kufamba zvakanaka, kuongorora mvura, kutarisa tembiricha, uye kugadzirira magwaro ekutumira.
Kuitwa Kwekutarisira (Kuitwa)
Kuitwa kwechirongwa ichi kunosanganisira matanho akarongwa kare. Vananyamukuta vanoongorora zviratidzo zvinokosha kanenge kaviri kusvika katatu pazuva mumamiriro ezvinhu ari pakati nepakati kusvika akaipisisa kana zvichienderana nemutemo webasa. Varwere vanobatsirwa kuchengetedza kudya kwemvura, kudya chikafu chinokurudzirwa, uye kutevedzera mishonga. Kune vakadzi vane pamuviri, kutarisa kurova kwemoyo wemwana ari mudumbu (FHR) uye kuvadzidzisa nezvekuverenga mafambiro emwana ari mudumbu kwakakosha.
Vananyamukuta vanodzidzisawo mhuri nzira yekutarisira varwere vavo: kugadzirira chikafu chine hutsanana, kuchengetedza mubhedha wakachena, uye kutarisa zviratidzo zvengozi. Kana murwere achinzwa kushaya simba kwakanyanya, vananyamukuta vanokurudzira kuwedzera zvishoma nezvishoma mabasa ekudzivirira kudonha.
Kuongorora uye Kutevera
Kuongorora kunoitwa nekuongorora:
- Kuderedzwa kwefivha uye kuvandudzwa kwezvinetso zvekiriniki.
– Kunwa mvura yakakwana (weti yakakwana, pasina zviratidzo zvekupererwa nemvura mumuviri).
- Kuwedzera kwekuda kudya uye kusashivirira kudya.
- Kutevedzera mitemo yemishonga inorwisa mabhakitiriya uye kusavapo kwemigumisiro yakaipa.
– Mumadzimai ane pamuviri: DJJ yakajairika, kufamba kwakakwana kwemwana ari mudumbu, pasina zviratidzo zvekusununguka nguva isati yakwana.
Kana pasina kuvandudzika mukati memaawa 48-72 kana zviratidzo zvematambudziko zvikaonekwa, nyamukuta anofanira kukurudzira kuongororwazve uye kutumira kune mumwe munhu. Kutevera kunofanirawo kusanganisira dzidziso pamusoro pekudzivirira kudzoka kwechirwere: hutsanana, mvura yekunwa yakachena, uye kudya kwakachena.
Basa reDzidzo yehutano neKusimudzira
Kudzivirira typhus kunonyanya kuenderana nemararamiro akachena uye ane hutano. Vananyamukuta vanogona kupa dzidziso pamusoro pe:
– Tsika yekugeza maoko usati wadya uye mushure mekuenda kuchimbuzi.
– Bika chikafu zvakanaka uye usatenge zvekudya zvisina tsarukano.
– Kushandisa mvura yekunwa yakabikwa kana kuti yakavimbiswa.
- Kuchena kwezvakatipoteredza uye kutonga marara.
– Kukosha kwekuongororwa nguva dzose kwemadzimai ane pamuviri kuitira kuti zvirwere zvikwanise kuonekwa nekukasika.
Mhedziso
Maitiro ekuchengetedza murwere ane chirwere chetyphoid anoda kuongororwa kwakazara, kutarisisa zviratidzo zvehupenyu hwake, rubatsiro rwakakwana rwemvura uye rwekudya, dzidzo yekudzivirira hutachiona, uye kushanda pamwe chete kwechiremba kuti pave nekurapwa kwakakodzera kwemishonga inorwisa mabhakitiriya. Vakadzi vane pamuviri vanoda kutariswa zvakanyanya nekuti typhoid inogona kukanganisa amai nemwana ari mudumbu, zvichiita kuti kutumira varwere panguva yakakodzera kuve chinhu chakakosha pakuchengetedza. Nekushandisa nzira yakarongeka yekurapa murwere ane chirwere chetyphoid—kubva pakuongorora nekuongorora kusvika pakuronga nekushandisa kusvika pakuongorora—vananyamukuta vanogona kubatsira kukurumidzisa kupora kwemurwere uku vachideredza njodzi yematambudziko.
Kana muchida, ndinogona kugadzirisa chinyorwa ichi kuita mazwi chiuru (pari zvino chave pedyo, asi hachina kuverengerwa kuti chive chakarurama), kana kushandura fomati yacho kuita fomati yakazara yeSOAP/Varney 7-step nemienzaniso yemienzaniso.
