Asphyxia yevachechecheche inobatanidza kukura mumangwanani ekupedzisira pashure penguva. Izvi zvirwere zvinopesana nekuputsa kwekufema uye basa remwoyo yematambudziko mumwana. Chimbofunga izvi munyaya yakawanda, sarudza zvinokonzera, mhando, tichawana: chii chinosiyanisa hypoxia ye fetus uye asphyxia yemwana achangoberekwa.
Chii chinonzi "asphyxia" muchechecheche?
Asphyxia yevana vachangoberekwa ndiyo mamiriro ehupenyu hushoma umo kune kutyora kupema. Muchiitiko ichi, kune musiyano pakati pehutano huno uye tsanangudzo ye "hypoxia yemwana achangoberekwa." Oxygen nenzara ( hypoxia ) inowedzera panguva yekuzvitakura kana kuberekwa (placental exfoliation, kufungidzira umbilical cord), uye inofambiswa nekudya kwakakwana kwe okisijeni. Kufema kunopesana. Asphyxia (kusuruvara) inoratidzirwa nekurega kupera kwepanguva uye kunoda kuderedzwa.
Zvinokonzera Kufuridzirwa Kwevana Vacheche
Asphyxia mumwana panguva yekuberekwa kunogona kutsamwiswa nezvinhu zvakawanda. Muchiitiko ichi, zvikonzero zvinokonzera chirwere, zvinogona kuwirirana zvakananga nehutano hwekusununguka uye nehutano hwekuita intrauterine ye fetus. Pakati pezvinhu zvikuru zvinokonzerwa nehutachiona hunokonzera asphyxia, vanachiremba vanosiyanisa:
- Kurwisana, kushungurudzika kwechimbichimbi muropa uye mumutsara wembilical - ruzivo rwemutsipa wemwana , kuumbwa kwekodhi pamutsara wembilical, chisimba.
- Kuvhiringidzwa kwekugadzirisa kushandiswa kwemagetsi muhutachi-nzvimbo yepamusoro - mharidzo isina kufanira yezvimbo yemwana, kusati kwasvika uye kusarura.
- Kukundikana mukushandiswa kwekupararira mu placenta, inokonzerwa nehuwandu hwemhepo muamai.
- Kugadziriswa kwemuviri we okisijeni muropa raamai pakuberekwa - hosha yeropa, zvirwere zvepfungwa, zvirwere zvekuporesa zvirwere.
- Kuoma kwekupema mukati memuchetura kunokanganisa kushandiswa kwemapapu, zvirwere zvisingaperi zvehupembenene, zvinogadzirwa nemishonga inotorwa.
Izvi zvinokonzera kukwidzika kwekuita sepasphyxia yezvitsva, izvo zvinowedzera mukugadzirwa kwekuberekwa. Zvisinei, asphyxia inogonawo kuva yechipiri muhutano kana chirwere chinowanikwa pakarepo mushure mokuzvarwa kwomwana. Pakati pezvikonzero zvechipiri asphyxiation ndezvekuti:
- chido chemuviri wekupemha - mvura inopinda mumapapu;
- kukanganisa kwekufamba kwehuropi;
- kusakwana kwemapapu - muviri haukwanisi kuita mafambiro ekufema;
- kuberekwa kusagadzikana kwehuropi, mwoyo, mapapu.
Degrees of asphyxia of the newborns
Zvichienderana nekliniki yemifananidzo uye kuoma kwechirwere, vanachiremba vanosiyanisa zvidimbu zvakasiyana zvezvirwere. Kuongorora kunoitwa pakarepo mushure mekuberekwa kwecheche muminiti yekutanga. Kuenzanisa kweAphisxia yevana vanozvarwa kunotevera:
- chiedza chechiedza;
- average;
- nzara;
- kuchipatara kufa.
Asphyxia ye neonatal mild
Asphyxia yemwero munyoro inoratidzirwa nekusavapo kwekuchema, zvisinei nemhinduro yemwana yekubata iripo. Kufema kwechechecheche kunofanirwa, asi kunonoka uye kusina kujeka. Makumbo nemaoko ane mumvuri we-cyanotic, basa remoyo harina kuputsika. Mushure mokuchenesa nzvimbo yepamusoro yokufema kubva mumucheka uye mumvura, zvichiita kugadziriswa kwemavara (kusvetuka kumashure, kusungira zvitsitsinho) uye kurapa kweokisijeni kuburikidza nemasikisi, mamiriro evanhu vachangobva kuberekwa anowirirwa.
Mwana akaberekwa ari munharaunda yekufungidzika seanphyxia, akazove asina matambudziko nekufema. Muchiitiko ichi, dambudziko rehutano hwemagetsi hunogoneka, nenzira ye:
- kuwedzera kwemutema tone;
- kudengenyeka kwezvibatanidza, makumbo, tsvina yakaderera.
Asphyxia yekunyanyisa muchecheche
Iyi dhigirizhonga inoratidzwawo nekusavapo kwekuchema panguva yekuzvarwa. Muchiitiko ichi, zvinopindirana nekutaura kwemashoko ekubata hazvioni. Chimiro chechimiro chemufananidzo uyu chinoshanduka muvara rweganda, saka rinowanzoreva sebhuruu asphyxia yemwana achangoberekwa. Kufuridzirwa kwekufuridzira kune imwechete, kunyange zvakadaro, basa remoyo haritsi.
Vavhareji asphyxia yechechecheche inoda ventilation. Kuti uite izvi, kakawanda unoshandisa bhandi rinokosha, pane imwe nguva masikisi eokisijeni. Chirwere chechirwere chinoshandiswa nguva dzose chinosiya chiratidzo pane utano hwecheche, zvichikonzera kuchinja kweuropiki:
- kuwedzerwa kwekuwedzera - kusinganzwisisiki kuchema, kudengenyeka kwenguva refu kwezvibata nemakumbo;
- kuora mwoyo -kunyorova mazamu anonwisa, kupisa motokari (kushamba nemaoko nemakumbo zvisingatauri).
Asphyxia yezvakawanda mumatangwe
Chirwere chakakomba chechirwere chinoperekedzwa nekushaya kwakakwana kwekupemha panguva yekuzvarwa. Ganda rinokonzerwa nekushayikwa kweropa rinoputika. Nemhaka yeizvi, chimiro chechirwere ichi chinonzi chichena asphyxia chechecheche. Paanoita muedzo wakaoma, mwana haaiti kana akabata. Pane kukanganisa kwepfungwa dzemwoyo - kana kuteerera inzwi remwoyo zvakanyatsoputika kana kusipo zvachose. Bhardycardia yakasimba inokura.
Izvi zvinopesana nevana vanozvarwa zvinoda kukurumidza kudzorerwa. Zviito zvechiremba zvinotarisirwa kudzorera basa rekupumha uye remwoyo wechechecheche. Mwana wacho akabatanidzwa kumhepo yokufema. Panguva imwecheteyo, mutsara unoshandiswa nemishonga inokurudzira basa romwoyo. Vana vakadaro kwenguva yakareba vari pahufumi hwekufema, uye vanozopedzisira vava nehutano hwehutano hwehutano, zvinokonzerwa kunonoka kukura neuropsychic.
Kuchivirira kufa kwechechecheche
Kufa kwechirwere checheche kunoitika apo vanachiremba vanogadzirisa kusakwana kwezviratidzo zvehupenyu. Muchiitiko ichi, mushure mokuberekwa, mwana haaiti chero kuzvidzora, hapana chemuitiro wepfungwa, zvinoparidzirwa kuti zviitike zvakare. Kururamisa uye kutanga panguva yakakodzera yekudzorera matanho kunopa tariro yezvakanaka. Muchiitiko ichi, kuoma kwemigumisiro yehutano hwehutano hwemwana kunofanirwa kuti yakareba kwenguva yakareba sei kushaya kufema. Mumamiriro ezvinhu akadaro, uropi hukuvadzwa zvikuru.
Asphyxia yemucheche - zviratidzo
Kuti uone kuoma kwehutano huno, vanachiremba vanoshandisa chikamu cheApgar. Nzira yacho inobva pakuongororwa kwezvikwangwani zvakawanda panguva imwe chete:
- reflex excitability;
- kufema;
- moyo;
- muscle tone;
- ruvara rweganda.
Pamusoro pepiramu imwe neimwe, pfungwa dzinowedzerwa, dzinopfupikiswa uye chikamu chakazara chinowanikwa. Migumisiro inoita seyiyi:
- Zviri nyore - 6-7 points;
- muvhareji - 4-5;
- rinorema - mwana ari kuwana 1-3 points;
- kuchipatara kufa - 0 points.
Apo pavanoratidza chidimbu cheanphyphyia, vananyamukuta vanoongorora zviratidzo zvezvino zvechirwere. Iyo inopisa muAsphyxia muzvitsva inopera uye iri pasi pe100 kurohwa paminiti. Nokuda kwechidimbu chakaoma cheAphyphysia chimiro:
- kutanga kufema kunoitika pa1 miniti;
- mushuturi terera yakaderera zvishoma;
- nasolabial triangle yebhuruu ruvara;
- kufema kunowedzera simba.
Nevheji yepamusoro yeAsphyxia, vanachiremba vanogadzirisa:
- kuora mwoyo kufema
- Makumbo nemaoko anoshandura bhuruu;
- kuwanda kwepfungwa kunoderera;
- mutsipa tone wakaderera;
- kuputika kwemutilical kunowanikwa.
Dambudziko rakaoma rekudzivirira uku rinoratidzwa nezviratidzo zvinotevera:
- kufema hakusipo;
- bradycardia yakasimba;
- muscle atony;
- kureba kweganda;
- kukurudzirwa kweadrenal kusakwana;
- kuputika kwakasimba kwemaketani emutsara wembilical.
Asphyxia yevana vachangoberekwa - migumisiro
Kutaura nezvekukuvadza kwakaitwa asphyxia muzvitsva, vanachiremba vanocherechedza kuti nekudarika kukuru, kufa kwecheche kunogona. Zvinowanikwa mumaawa ekutanga ehupenyu. Nevhareji uye zvinyoro zvishoma, kufungidzira kunofadza. Mhedzisiro inobva pane nguva yekudzorerwa, kuvapo kwezvinetso zvinokonzera. Migumisiro yehutachiona yakagadziriswa munguva yechangoberekwa inogona kusimuka, zvose mumaawa ekutanga ehupenyu, uye pazera remakore.
Asphyxia mumwana achangoberekwa mushure mokubereka - migumisiro
Yakanyanya kufanana nevana vachangoberekwa, iyo migumisiro inobva kune iyo yakarurama uye nguva yekurapa yakatanga, haipfuri kunze kwemuenzaniso wemuviri. Zvinetso zvinogona kuitika, zvose pazvikamu zvekutanga zvekukura kwepininatal, uye panguva yakwegura. Uropi hutachiona hwekurota mushure mokunge asphyxia mucheche inowanika kazhinji. Pakati pezvinetso zvinowanzoitika munguva yekutanga yekudzikinura:
- kushungurudza encephalopathy;
- hydrocephalus;
- hypertensive syndrome;
- unyengeri kana kutengesa.
Asphyxia yevana vachangoberekwa - migumisiro mukukwegura
Asphyxia ne hypoxia yemwana achangoberekwa zvakabatana nematambudziko ehutachiwana hunoita hutano hwemwana mushure mokuberekwa kwake. Zvinetso zvinogona kuonekwa mumwedzi mishomanana, uye dzimwe nguva kunyange makore. Pakati pezvinetso zvakapera:
- meningitis;
- pneumonia;
- sepsis.
Kurapa kweAsphyxia muzvitsva
Kana uchitarisa maApgar chikamu 4 kana zvishoma, unoitwa muminiti yekutanga, kudzorerwa kunotarisirwa. Kudzorerwa kwechecheche muAsphyxia inoitwa mumatanho mana:
- Kusunungurwa kwepurogiramu yokufema, kuchengetedza maitiro avo. Iyo inoitwa kunze kwekubatsira katheter uye pombi yegetsi. Kana asphyxia inowanikwa muUtero, kushandiswa kwekuchenesa kunoitwa pakarepo mushure mekuonekwa kwemusoro.
- Kuramba uchifema. Mhepo yekubatsira inobatsira inoitwa nekubatsirwa nebhandi rinofema, uye kana risina maturo, intubation inoshandiswa uye chigadzirwa chekugadzirisa mafungiro chakabatanidzwa chakabatanidzwa.
- Kudzorerwa kwemhepo inotenderera. Nokuda kweizvi, muviri wakavharwa muviri unoshandiswa, kunyange nekucheka (ne bradycardia yekubata 60-70 paminiti). Inoitwa nekudzvinyirira sternum ine maviri maviri, uye inowanzoita 100-120 ka-minute. Kana basa remwoyo risati radzorerwa mukati memaminiti, ramba uchienda kune rimwe danho rinotevera.
- Kutarisira mishonga. Panguva iyi yekurapa, vanachiremba vanoshandisa zvinodhaka zvinotevera kurapa neonatal asphyxia:
- Atropine 0.1% - 0.05-0.1 ml;
- Adrenaline 0.1% - 0.02-0.03 ml;
- Sodium bicarbonate - 1-2 ml.
Kudzivirira kweAsphyxia yevana vachangoberekwa
Kuti udzivirire dambudziko rinotyisa - fetal uye mucheche asphyxia, matanho ekudzivirira anofanirwa kutorwa pamwe chete pachikwata chekudzivirira pamuviri, uye kana mwana akazvarwa. Pakati pemashoko makuru:
- Kurapa kwenguva pfupi kwezvirwere zvechirwere mumadzimai ane pamuviri.
- Kutungamirirwa kwehutano hwekuita chikwata uchifunga nezvezvikonzero zvinowonzera ngozi.
- Kuitisa intrauterine kutarisa kwema fetal and placenta (dopplerography, ultrasound).
- Kudzivirira kwe hypoxia panguva yebasa, kusununguka kwenguva yakakodzera kwepurogiramu yokufema.