Amasu Okusiza Ukuphefumula Kwezingane Ezisanda Kuzalwa
Izinsana ziyiqembu labantu elidinga ukunakwa okukhethekile, ikakhulukazi uma kukhulunywa ngokuphefumula. Inqubo yokuzalwa iyinto ejulile enganeni, futhi kwezinye izimo, ingane esanda kuzalwa ingadinga usizo lokuqala kabusha noma ukuqhubeka nokuphefumula ngemva kokuzalwa. Kulesi sihloko, sizohlola amasu okuphefumula asanda kuzalwa abalulekile kochwepheshe bezempilo ukuqinisekisa ukuphepha nenhlalakahle yengane.
Kungani Usizo Lokuphefumula Ludingeka?
Akuzona zonke izingane ezishintsha kalula zisuka esibelethweni ziye ekuphileni kwangaphandle kwesibeletho. Cishe u-10% wazo zonke izingane angadinga uhlobo oluthile losizo lapho ezalwa ukuze aqale ukuphefumula ngempumelelo. Izici ezingabangela izinkinga zokuphefumula ezinganeni ezisanda kuzalwa zifaka phakathi ukukhulelwa ngaphambi kwesikhathi, ukutheleleka, ukufutha umoya, noma izinkinga zesakhiwo endleleni yokuphefumula.
Uma ingane ingaphefumuli ngokwanele ngokushesha ngemva kokuzalwa, ukuqaliswa okusheshayo kwezinqubo zokuphefumula zokusindisa kubalulekile ukuvimbela ukulimala kobuchopho noma ukufa. Usizo olufanele nolufika ngesikhathi lungenza umehluko phakathi kokuphila nokufa.
Ukuhlolwa Kokuqala
Isinyathelo sokuqala sokuhlola isidingo somntwana sokusekelwa kokuphefumula ukwenza ukuhlolwa okusheshayo ngokushesha ngemva kokuzalwa. Izici eziyinhloko okufanele uzihlole yilezi:
1. Umbala Wesikhumba: Izingane eziphethwe yi-aspiration ngokuvamile zizobonakala ziphaphathekile noma ziluhlaza okwesibhakabhaka.
2. Ukuqina Kwemisipha: Izingane ezinempilo zivame ukuba nomuzwa omuhle wemisipha kanye nokunyakaza okuzenzakalelayo.
3. Ukuzalwa Nokusabela: Hlola indlela ingane esabela ngayo ezintweni ezishukumisayo njengokuthinta noma ukushukumisa umsindo.
4. Ukuphefumula Nokushaya Kwenhliziyo: Hlola ukuthi ingane iphefumula ngokuzenzakalelayo yini nokuthi izinga lokushaya kwenhliziyo lingaphezu kwama-beats ayi-100 ngomzuzu.
Uma ingane ingabonakali izimpawu zokuphefumula okuzenzakalelayo noma ukushaya kwenhliziyo okwanele, kudingeka ukungenelela okusheshayo.
Ukukhuthaza Ukuthinta
Isinyathelo sokuqala sokusiza ingane engaphefumuli ukunikeza ugqozi lokuthinta. Lokhu kungenziwa ngokuhlikihla umhlane wengane kancane noma ngokuhlikihla amathe ezinyawo zayo. Umgomo uwukukhuthaza ukuphefumula okuzenzekelayo. Uma ingane ingabonisi zimpawu zokuphila naphezu kogqozi, qhubekela kwezinye izindlela zokuphefumula zokusindisa.
Ukususwa Kwendlela Yomoya
Ngaphambi kokusiza ingane ukuthi iphefumule, kubalulekile ukuqinisekisa ukuthi indlela yokuphefumula yomntwana ayinawo amafinyila noma ezinye izithiyo. Lokhu kungenziwa kusetshenziswa isibani sokufunxa noma i-catheter ekhipha amanzi. Khumbula ukuthi ukufunxa ngokweqile kungalimaza izicubu ezithambile zomgudu wokuphefumula womntwana, ngakho-ke kumelwe kwenziwe ngokucophelela.
Umoya Ophansi Ocindezelayo
Uma ingane ingasabeli kahle noma ingaphefumuli kahle ngemva kokushukunyiswa kanye nokususwa komoya, kufanele kuqalwe ukuphefumula ngengcindezi enhle (PPV). I-PPV yenziwa kusetshenziswa imaski yesikhwama noma idivayisi yokuphefumula yemishini. Izinyathelo eziyisisekelo zokunikeza umoya omuhle ngengcindezi yilezi:
1. Ukulungiselela Imishini: Qinisekisa ukuthi imaski yesikhwama kanye neminye imishini edingekayo ihlanjululwe futhi isebenza kahle.
2. Indawo Yekhanda: Beka ikhanda lengane ukuze indlela yokuphefumula ihlale ivulekile. Lokhu kuvame ukufezwa ngokutshekisa ikhanda emuva kancane.
3. Ukubeka imaski: Beka imaski ebusweni bomntwana ukuze imboze impumulo nomlomo. Qinisekisa ukuthi ivaliwe kahle ukuze uvimbele ukuvuza komoya.
4. Ukuphefumula: Phefumula kancane, uphefumula kancane, ngokuvamile uphefumula kanye njalo ngemizuzwana eyi-1-2, ngenkathi uqapha ukuphakama kwesifuba okubonisa ukugcwala kwamaphaphu.
Ukusetshenziswa Kokulawulwa Komoya-mpilo
Kwezinye izimo, izingane zingadinga umoya-mpilo owengeziwe ngaphezu komoya-mpilo omuhle. Lokhu kuyiqiniso ikakhulukazi ezinganeni ezingaphambi kwesikhathi noma ezinezinye izinkinga eziphazamisa ukusebenza kokuphefumula. Amazinga omoya-mpilo kumele alawulwe ngokucophelela kusetshenziswa i-blender ye-oxygen ukuze kugwenywe i-hypoxemia (ukuntuleka komoya-mpilo) noma i-hyperoxemia (ukweqisa komoya-mpilo).
Ukucindezelwa Kwesifuba
Uma izinga lokushaya kwenhliziyo yengane lingaphansi kwama-beats angu-60 ngomzuzu ngemva kwemizuzwana engu-30 ye-PPV, ukucindezela isifuba kufanele kuqalwe ngesikhathi esisodwa nokuphefumula. Indlela yokucindezela isifuba enconywayo yezingane ezisanda kuzalwa iyindlela yesithupha. Ukwenza lokhu:
1. Beka zombili izithupha phakathi nesifuba somntwana, ngaphansi nje komugqa we-papilla.
2. Faka ingcindezi eyanele ukudala ukucindezela kwesifuba okungaba yingxenye eyodwa kwezintathu ukujula okuphelele kwesifuba, ngesilinganiso sokucindezela okungu-90 ngomzuzu.
3. Vumelanisa nokungenisa umoya ngesilinganiso esingu-3:1 (ukucindezela kathathu kokungenisa umoya ngakunye).
Ukuqapha Okuthuthukisiwe
Uma ingane isiqala ukuphefumula noma ukushaya kwenhliziyo yayo kukhula, ukunakekelwa akukapheli. Ukuqapha okuqhubekayo kuyadingeka ukuqinisekisa ukuthi ingane ihlala izinzile. Amapharamitha aqashwe afaka:
1. Ukuphefumula: Ukuvama kanye nekhwalithi yokuphefumula kumele kuhlolwe njalo.
2. Izinga Lokushaya Kwenhliziyo: Izinga lokushaya kwenhliziyo kufanele liqashwe ukuqinisekisa ukuthi lihlala lingaphezu kwama-beats ayi-100 ngomzuzu.
3. Umbala Wesikhumba: Ukuqapha umbala wesikhumba kunganikeza inkomba yokuthi kukhona umoya-mpilo.
Ukuqeqeshwa kanye Namakhono
Kubalulekile ukuthi bonke ochwepheshe bezempilo abahilelekile enkambisweni yokubeletha babe nokuqeqeshwa kokuvuselelwa kwezinsana. Ukuya enkambweni yokuqeqeshwa okuyisisekelo nokuthuthukisiwe koHlelo Lokuvuselelwa Kwezinsana (i-NRP) kungasiza kakhulu ekulungiseleleni ithimba lezokwelapha ukubhekana nalezi zimo eziphuthumayo. Ukuqeqeshwa okwenziwa njalo kanye nokuvuselelwa kolwazi kubalulekile ekuhlaleni ulungele ukuvimbela nokuphatha izinselele zokuphefumula ezinganeni ezisanda kuzalwa.
Isiphetho
Ukusekelwa kokuphefumula kwezinsana ezisanda kuzalwa kuyisici esibalulekile sokunakekelwa kwezinsana ezisanda kuzalwa. Ukuhlolwa okusheshayo kanye nokungenelela okufanele kungasindisa izimpilo futhi kuvimbele izinkinga zesikhathi eside. Ochwepheshe bezokunakekelwa kwempilo kumele baqeqeshwe ngokwanele futhi bahlonyiswe ngamathuluzi afanele okubhekana nalezi zimo eziphuthumayo. Ukuhlala uqaphile futhi ulungele ukwenza ukuvuselelwa kwezinsana ezisanda kuzalwa kuyisibopho esibalulekile ekunakekelweni kwezempilo ukuqinisekisa ukuphepha kanye nenhlalakahle yezinsana ezisanda kuzalwa.
Ngokusebenzisa lezi zindlela, izimpilo eziningi zingasindiswa, futhi izingane ezidinga usizo lokuphefumula ngemva kokuzalwa zingaba nethuba elihle kakhulu lokuqala impilo enempilo.
