Chikamu cheApgar chinoshandiswa nevanogadzirisa maitiro kuti vaongorore hutano hwemucheche. Iyo nzira inoitwa muimba yekurera mumaminitsi ekutanga mushure mokuberekwa kwechecheche. Ngatimbokurukurai zvakadzama nezvegorongwa hwekuenzanisa, tichawana: maonero akaverengwa pachikamu cheApgar, uye zvavanoreva.
"Akayera Apgar" - chii ichocho?
Mushure mekunge amai vaziviswa nezvekuongororwa kwakaenzana, mubvunzo weiyo Apgar yechidiki inorevei kune izvo zvinoshandiswa zviri mupfungwa dzeyo achangobva mum. Iyi nzira inosanganisira kuongorora zviratidzo zvinoshanda zvinoratidza huri hwemucheche mumaminitsi ekutanga ehupenyu hwake. Mhedzisiro inoguma inobatsira kutarisisa huwandu hwemamiriro ezvimedu.
Chikamu cheApgar, chinoshandiswa pakuberekwa, chinoratidza kushanda kwakarurama kwezvikamu zvinokosha uye zvirongwa. Kubva pane zvakawanikwa, vanachiremba vanopa humwe hunofanotaura nezvehupenyu hwomwana, chido chekudzorerwa zvakare. Kuongororwa kwenyika paApgar chikamu kunobatsira vanachiremba vekuwana kuwana ruzivo pamusoro pechecheche mumaminitsi ekutanga mushure mekuberekwa.
Apgar chikamu - nhoroondo yechitarisiko
Mamiriro ekuzvarwa patsva pachikwata cheApgar chakatanga kuongororwa nechiremba weAmerican anesthesiologist. Pakarepo zita rake rainzi iyo nzira pachayo. Chiyero chekuongorora chakabvumirwa nepamutemo pakati pezana remakore rechi20, pane anesthesia congress. Pachiitiko ichi, Virginia Apgar akazvipira kuti aongorore nyika yemwana achangoberekwa kwete chete kuburikidza nekushanda kwesangano rake, asiwo kufunga nezvehutano hwekuvandudza dambudziko rehutano muhutumbi. Pakarepo mushure memusangano, chikwata cheApgar chakanga chichishandiswa zvakasimba mumatambudziko.
Chii chinoongororwa pachikamu cheApgar?
Kuongorora kwechecheche pachikwata cheApgar chinoratidza kuitisa muchidimbu kuongororwa kwezvidzidzo zvishanu panguva imwe chete. Chimwe nechimwe chezviratidzo izvi chinofungidzirwa pamatanho matatu (0-2 points). Zvigumisiro zvinoratidza kuongororwa kwepamusoro kubva kune 0 kusvika ku10. Zvinofanira kuonekwa kuti chirevo ichi, pamwe nekurema nekukwirira, zviratidzo zvakakosha zvinoratidzwa kune vatsva mumumhuri. Chiongorori chekutanga pachikamu cheApgar chinoitwa muminiti yekutanga yehupenyu.
Nokuda kwepamusoro pakuyeuchidza kwezviratidzo izvo zvinoongororwa zvinoitwa, chiremba wevana Josef Butterfield akashandisa kushandisa zita rokuti APGAR sechirevo:
- A-kuonekwa-ruvara rweganda;
- P-kupisa - nhamba yekubata moyo;
- G - grimace - reflexes;
- A - basa - musinga tone;
- R - kupumha - nhamba yekufema.
Ndeipi mamiriro emucheche?
Kuongororwa kwenyika yemucheche pachikwata cheApgar hakurevi kuvapo kwezvinhu zvakakosha uye zvigadzirwa. Mune nzira iyi, mwana anobudiswa pachena pakarepo 2 mavara: shure kwekuberekwa nemaminitsi mashanu ehupenyu. Muchiitiko ichi, tsika dzekutanga dzinoratidzwa munhamba, nhengo dzechipiri mune dhinominator. Kuongororwa kwenyika yechechecheche inosanganisira yakawanda yezviratidzo zvose zvishanu:
- Ganda - tine pink tinge, kubva pane yakajeka kusvika kune yakajeka. Nokuti izvi kupa 2 pfungwa. Ne cyanotic mapeni nemakumbo - 1 nhovo, yunifomu yemavara emucheka weganda - 0.
- Mutengo wemwoyo - wepakati pesarudzo yevana vatsva ndeye 130-140 kurohwa paminiti. Zvisinei, pakuongorora neonatologists zvinotevera zvinoshandiswa: zvinopfuura 100 kurohwa - 2 nhope, pasi pe 100 kurohwa - 1 pfungwa, kusavapo kwemhepo - 0 (kudzorerwa kunotarisirwa).
- Kufunganya kune mamwe mafungiro asina kukwana anowanikwa mumwana wose achangobva kuberekwa: kutanga kufema, kuchema, kumedza nekuyamwisa. Kuvapo kwavo kunofungidzirwa pa 2 nharo, kusasarura kwemazana - 1, full - 0.
- Utachiona toni - mushure mekuberekwa, musoro wemwana unoratidzwa mubhokisi, zvinyorwa zvinonamatira pamakumbo, maoko anoiswa mubhokisi. Makumbo akanamatira muhudyu uye pamabvi. Kugadziriswa kwekufamba kune kure-kukwana - vana vanovhura maoko avo nemakumbo, uye munyaya ino neonatologist inotora 2 pfungwa. Nekugadzirisa kusinganzwisisiki, 1 pfungwa yakasarudzwa, inonzwika musinga tema inofungidzirwa pa 0 nhamba.
- Kufema kwepumusoro -kupera kwema40-45 paminiti. Izvi zvinowanzoitika uye 2 mapepa anokweretwa. Panguva imwecheteyo, kuchema kwekutanga kwechecheche kunoongororwa, iyo inofanira kunge yakanzwika uye yakasimba. Nekufema kusviba uye kupururudza sekugomera - 1 pfungwa inoratidzirwa, kusakwana kwakakwana kwekupema kana kuchema - 0.
Apgar chikamu - kududzira
Pfungwa paApgar zvibvumira vanachiremba kuti vaongorore mamiriro echechecheche, fungidzira. Saka, mwana ane hutano pamusana weApgar anounganidza muhuwandu hwe7-10 points. Panguva imwe chete, chikamu chiduku chevana vachangoberekwa chinogamuchira chikamu chikuru. Chimwe chezvinhu zvinowanzoitwa 7/8 uye 8/9. Nhamba yechipiri, yakagadzirirwa pamaminitsi mashanu mushure mekuberekwa kwecheche, 1-2 inofanirwa kupfuura. Basa rinokosha mune izvi rinotambidzwa nenzira yekuendesa. Mukuita, vana vanozvarwa nechikamu chekudzivirira vanowana zvishoma zvishoma kune avo vanozvarwa zvakasununguka.
Ndezvipi zviApgar zvitsanangudzo zvinorevei?
Kushandisa nzira yakadai seApgar, kuongorora kwemashoko akagamuchirwa nechecheche kunoitwa zvakananga navanachiremba. Muchiitiko ichi, vanachiremba nokuda kwechiratidzo ichi vanogona kuongorora pakarepo mamiriro emwana, vanoratidza kuputsa. Saka, kana uchitarisa 5-6 panguva yekuzvarwa, neonatologists inoratidza chidimbu che hypoxia . Kana mwana ari kuwana mapeji 3-4 - chiyero chemajini chekushaya nenyuchi chinowanikwa, 0-2 - chinoratidza chiremera chakaipisisa chekuputsa - kusagadzikana kunoda kuchengetedzwa kwekukurumidza.
Apgar chikamu - tafura
Kuongororwa kwemwana pachikamu cheApgar chiri kuitwa uchishandisa tafura. Inonyora zvose zvingaita mitemo uye kukanganisa kwavo. Vanachiremba vanoongorora mamiriro chaiwo emucheche pavanenge vachiona kuti zvipi zvingave zvakasikwa. Neonatologists ane ruzivo anogona kusina nzira dzisina kufanirwa, zvipo zvinotarisisa mamiriro echecheche uye kubudisa zvikamu zvakafanana. Zvigumisiro zvakapinda murekodhi yezvechiremba.
Low Apgar scores
A low Apgar chikwata chinogona kuratidza musiyano mukusafanana uye kurwara mumucheche. Pakati pezviitiko zvinowanzokonzera mamiriro ezvinhu akadaro emucheche:
- hypoxia we fetus panguva yekuberekwa kwomwana uye pakuberekwa;
- kusvibiswa kwepanyama - kuratidzirwa nelethargy, passivity, kushaya kwekufamba, kufungidzirwa mafungiro. Mwana wacho anorara kwenguva yakareba, anotora zvokudya zvishomanana.
Kana mwana wacho achigamuchira zvakaderera pachikamu cheApgar muminiti yokutanga, zvakakosha kuwedzera iyi parameter ne 1-2 points mumaminitsi mashanu. Kuchinja kwakadaro kunoratidza maitiro akanaka. Zvisinei, mwana akadaro anoda nguva dzose kutarisa, kunyatsotarisirwa kubva kuvarapi. Kana chirwere chemwana chikawedzera, kudzorerwa kunogona kudiwa.