Amachiza anamhlanje angakwazi ukugcina abantwana bephila ngokukhawuleza kwaye baxhasa ukuphuhliswa kwabo ukuze bahluke kwiintsana ezizalwayo. Nangona kunjalo iqondo lokulungelelaniswa lixhomekeke kwixesha apho umntwana azalwa khona. Ngamanye amaxesha kunokwenzeka ukuba ugweme imiphumo emibi, kwaye ngamanye amaxesha iimpawu zophuhliso zihlala ebomini. Ngaloo miphumo yokuzalwa kwangaphambi kokuzalwa komntwana ingaba kwaye iya kuxutyushwa ngezantsi.
Ubude obuqhelekileyo bokukhulelwa kwabasetyhini buvela kwiiveki ezingama-38 ukuya kuma-42. Abantwana abazalwa emva kweeveki ezingama-37 zokukhulelwa, kungakhathaliseki ukukhula kwabo, kuthiwa yiintsana ezisandul 'ukuzalwa. Abantwana abazalelwa ngaphambi kweveki yama-37 babizwa ngokuba bazalwa ngaphambi kokuba bazalwe okanye bangabantwana abasanda kuzalwa. Okwangoku, amayeza anamhlanje angagcina iintsana ezizalwe ngaphambi kwe-27 nangaphambi kweveki yama-25 yokukhulelwa. Ezi zintsana zilinganisela ngaphantsi kunokuba abantwana bafanele baqikelele ekuzalweni-kwenzeka ukuba bayalinganisa ngaphaya kwe-500 g. Naphezu kokungabikho kokuvuthwa okukhulu kunye neengozi ezininzi ezizilindeleyo, abantwana abanjalo bahlala bekhula ngokuqhelekileyo. Ewe, le nyaniso ye-prematurity ayikwazi ukudlulela ngokupheleleyo ngaphandle kokulandelwa. Ngokuqhelekileyo, abantwana banengxaki yezitho zangaphakathi kunye nengqondo. Okokuthi, abantwana bahlehla emva kwengqondo, nangona oku akuyimfuneko kwaye kuxhomekeka kwiimeko ezininzi.
Ukuhlala ewadi ngenxa yokuzalwa kwangaphambili, njengomthetho, ixesha elide. Oku kungathatha inyanga eziliqela, de kube umntwana ezuze ubunzima obuqhelekileyo bakhe ubudala kunye nezitho zakhe aziyi kusebenza ngokuzimela. Kwixesha elizayo, ukunakekelwa kwengane enjalo kudlula ngaphaya kokutyelela okukhuselekileyo kunye nokugonywa kweintsana kwaye kaninzi kufuna ukuqeqeshwa ngokufanelekileyo kunye nenkxaso yophuhliso. Kukho neendlela zokufumanisa ukufumanisa kwangaphambili iimpazamo, ezifana nokuva kunye nombono. Ukuxilongwa kwangaphambili kukuvumela ukuba unike uncedo olufanelekileyo ngexesha elifanelekileyo kunye nexabiso elifanelekileyo.
Izixhobo eziyimfuneko
Ukuze usindise ubomi bomntwana ozalelwe kwangaphambili, izixhobo zanamhlanje ziyadingeka. Esinye isisombululo sisisitishi esenza ngokutsha isisu. Kukho umntwana usemimiselo elisondeleyo kunokwenzeka kulabo abantwana abaphuhlisayo phambi komhla wokugqibela. Kufuneka kugcinwe ukushisa okufanelekileyo kunye nomswakama. Ngelishwa, kude kube ngoku ingxaki enkulu yezobuchwepheshe - into enjalo ifowuni inkulu kakhulu emsebenzini. Ngomntwana, oku akukhathazekiyo, kwaye abo basebenza ngecala, banikezela ubunzima obuninzi.
Ngeemiphumo zokubeletha kwangaphambi kokuzalwa, kudla ngokufuneka ukuxhuma umntwana kwikhamera, leyo leyo eyona yindawo yokuphefumula. Kwakhona, uqhagamshelwe kwisixhobo sokulawula izitho ezibalulekileyo. Le fowuni ibonisa ubukhulu beentliziyo, ukuphefumla, i-oxygenation yegazi, uxinzelelo lwegazi. Umsebenzi wayo kukukhusela i-cardiac and breathing arrhythmia kwaye uyeke ukuphefumla.
Ngethuba lokunyamekela umntwana ozelwe ngaphambi kokuzalwa, idivaysi yokubonelela ngesondlo sayo, eyokuqala ngokulawulwa kwimizimba yabantwana, i-intravenously, isetyenziswa kwakhona. Ngoko emzimbeni womntwana i-proteins, amafutha kunye nama-carbohydrates ukuqinisekisa ukuphuhliso olufanelekileyo. Inkqubo ekhethekileyo isetyenziselwa le njongo kusetyenziswa imilambo yegazi (umgca ogciniweyo omgca awunamelana nokukhululeka okuninzi) kunye nepom ehambisa izondlo zondlo ngeemeko ezingenakuthenjwa.
Iinkcukacha zemiphumo yokuhanjiswa kwangaphambili kwintuthuko yabantwana
Iingxaki ngokuphefumla
Iintsana ezizalwe kungekudala ziphantse zineengxaki zokuphefumula, ngenxa yokuba imiphunga yabo ayiphumeli kakuhle. Basenomxholo omncinci wabafakezi-mafutha, ngaloo ndlela bancitshiswe ukungqinelana kombane we-alveoli, ebenza ukuba bangabambisani kunye nokuphuma. Emiphakeni yomntwana onempilo, konke oku kuveliswa kwiimeko zobugcisa malunga neveki ezingama-35 zokukhulelwa. Abantwana abazalwa ngokukhawuleza (ngaphambi kweveki yama-35 yokukhulelwa) banqatshelwe ithuba lokuphefumula ngokuqhelekileyo. Izinto ezisebenzayo ezisetyenziswayo zilawulwa yi-inhalation ngokusebenzisa i-tube ye-intubation ngqo kwindawo yokuphefumula, ngaloo ndlela unceda abantwana abaneengxaki zokuphefumula. Oku kunqanda ubunzima obuninzi bokungapheli (umz., Ubuchopho kunye nokusuleleka). Ukuveliswa kwezinto ezinobungozi obusebusweni obunjani ngendlela yemichiza yindlela yokuguqulwa ekuhlanguleni iintsana ezingekafiki. Ngelishwa, ezinye iintsana ezingaphambi kwexesha, ngokukodwa ezincinci zivuthiwe, zifuna ukuphuphuma umoya kwinyanga.
Ngamanye amaxesha aba bantwana bahlakulela izifo ezingapheliyo zamaphaphu, ezinxulumene nokungaqali kwamathambo emiphunga. Kwiimeko ezinjalo, ukusetyenziswa kwezidakamizwa ezongezelelweyo ezisetyenziselwa ukukhuthaza ukukhula kwamathambo emiphunga. Bakhululeke kakhulu kwimiphumo ebhubhisa i-oxygen kwaye bajojowe phantsi kwengcinezelo yokugcina ubomi.
Kwixesha elizayo, abantwana. Wazalelwa ngaphambi kokudala, ngokuqhelekileyo abe zizigulane ezineemfuno ezizodwa. Isiphumo sesifo esingapheliyo sesiphunga singabangela ukuba kubekho i-bronchitis eyingozi, i-dyspnea ngexesha lokusuleleka, okanye ingozi enkulu yokwenza isifo se-asthma.
Iimpawu zesisu
Kwiintsana ezingaphambi kwexesha, ingqondo isengumntwana. Kukho amacandelwana amahle kwaye ambi kule nto. Iziganeko ezimbi zibukhulu besisifo samathambo angamahloni esonakalisa umonakalo kunye nokuntuleka kokomoya okwaneleyo. Into entle, nangona kunjalo, ukuba ingqondo engapheliyo iphositiki enkulu kwaye iiscupu zinokuthi zithatyathelwe ngolu hlobo yizo ndawo zonakaliswe ziselula. Nangona kunjalo, umonakalo wezicubu ezinomdla zichaphazela kakhulu ukusebenza okuqhubekayo kwinkqubo yesantya yomntwana.
Abantwana abazalelwa ngaphambi kwexesha bahlala bexhomekeka kwiintsholongwane. Ziye zanyamekela iimvakalelo, zisebenza ngakumbi, zidinga indlela ekhethekileyo. Ngaloo ndlela abantwana abahlala belula ukujamelana nabo, bahlala bekhala, badla kakubi, balala kancinci. Iimpawu ezinjalo ezimbi zigqityiwe, kodwa i-sediment isala ubomi.
Ukuzalwa kwangaphambili - umama nomntwana
Ngokukhawuleza emva kokuzalwa kwangaphambi kokuzalwa, umfazi kufuneka ancelise umntwana. Xa umntwana engakwazi ukutya ngokuzimeleyo, ujojowe ngobisi lomama ngefestile, ephoqelelwe. Kubaluleke kakhulu ukuba kwiiyure zokuqala kunye neentsuku zobomi, ubisi ngaluphi na uhlobo olungena emzimbeni womntwana. Siyabulela kule nto, intlungu yomntwana isantya ngokukhawuleza kwaye ifunda ukutya ukutya. Ubisi bomama lubonelela ngolutsha olunezilwanyana eziza kukuvumela ukuba ulwe neebhaktheriya kwaye ukhuseke ekubeni usulele.
Nangona umama engasondeli ngokusondeza umntwana ozalelwe ngaphambi kokugqibela, usafuna ukugcina lonke ubisi. Kungekudala okanye kamva, umzuzu wokuqhagamshelana ngqo nomntwana kunye nonina uya kuza. Ukuba umama wakwazi ukugcina umveliso wobisi okanye ukuvuselela kwakhona - oku kuya kuba luncedo oluhle lokulungiswa komntwana. Umntwana sele sele akwazi ukulungelelanisa ukusondeza ngokugwinya, ngoko unokuzama ukuyifaka kwisifuba sakho. I-Preterm intsana ayilahlekelwa yimvelo yokusana, ngoko bayazi ukuba bayayidinga. Ukuba ubisi lukanina lufikeleleke ngokwaneleyo, abantwana banokufumana isisindo esifanelekileyo kwaye bahlengahlengiswa. Banobunzima obuncinci kunezo zikhuliswe ngokufanelekileyo.
Inendima yokuthintela kunye nomnxeba othintekayo
Eside ngaphambi kokuqala kokutya, unina umenyiwe kwiindlela ezahlukeneyo zokuqhagamshelana nomntwana: ukuthintela, ukubetha, ukuvuma, ukudlulisa ukushisa, ukuphulaphula isandi seentliziyo. Oomama bavumela ukumbamba umntwana ngomzuzwana emva kokukhutshwa kwi-incubator, ukuyicinezela yona ngokwawo, ukubetha. Le ndlela yokunyamekela abantwana yayiluncedo kakhulu kwiintsana zangaphambi kwexesha. Oku kunikeza inzuzo kokubili ukuphuhliswa komntwana kunye nonina.
Umama kufuneka amthinte umntwana wakhe, uthethe naye, umculele. Ucelwa nje ukuba asuse iingubo, ukubeka izandla kwi-elbow kwaye uhlambe izandla ngaphambi kokuba uzibeke kwi-incubator. Ngoko umama unikela umntwana kuphela "ubulungele" ibhaktheriya kwesikhumba, ukuze lube lukhuseleke kwizilwanyana ze-nosocomial.
Unxibelelwano lweengqondo
Oomama abaninzi ababeletha ngaphambi kokuba bahlupheke. Oku kwahluke kancinane kwabanye oomama abanengxaki yokudakumba. Baziva benetyala elikhulu. Bahlala bezibuza ukuba kutheni kubakho ukubeletha kwangaphambi kokuqala kunye nokuba bakuphi na ukusola apha. Yaye nangona umfazi engathethi ngokumangalisa ngokungathandabuzekiyo, i-neonatologist iyamxhasa kwaye inika ithemba lokuba banokujamelana neengxaki ezininzi.
Ukuba khona komntwana kufuphi nomama kumvumela ukuba akholelwe ukuba unako ukwenza okuninzi kuye. Uyakwazi ukubona indlela intliziyo yomntwana itshintsha ngayo xa uyichukumisa. Uyeka ukukhala, aze abe noxolo kwaye alele. Unina ufumana ithemba lokuba unokukwazi ukujamelana neengxaki.
Ndibuya nini ekhaya?
Ngokuqhelekileyo kukho iinyanga ezintathu, ezine, kude kube yilapho umntwana ozelwe ngaphambi kokufikelela kwisisindo se-500 ukuya kwe-1800 ukuya ku-1900 amagremu. Umntwana unokukhutshwa ekhaya kuphela xa ugqirha eqinisekile ukuba unokuphefumla ngokuzimeleyo aze adle, ngokobunzima bakhe, kwaye umama uya kuhlangabezana nomntwana ekhaya. Ngethuba lokuhlala kwabo esibhedlele, abasebenzi bafunda ukunyamekela umntwana osanda kuzalwa. Kwakhona kubalulekile ukuba unxibelelwano olongezelelweyo nesibhedlele (umzekelo, ngefowuni) ukuba kukho ubunzima bokuqala.