Necrotizing enterocolitis
Necrotizing enterocolitis (NEC) waa dhimashada unug ka mid ah xiidmaha. Waxay badanaa ku dhacdaa carruurta dhicis ah ama jiran.
NEC waxay dhacdaa marka dahaadhka derbiga xiidmaha uu dhinto. Dhibaatadani waxay had iyo jeer ku dhacdaa dhallaanka jirada ama dhiciska ah. Waxay u badan tahay inay dhacdo inta ilmuhu weli ku jiro cisbitaalka.
Sababta dhabta ah ee cilladan lama garanayo. Dhibicda socodka dhiigga ee mindhicirka ayaa dhaawici karta unugyada. Bakteeriyada ku jirta xiidmaha ayaa waliba dhibaatada ku sii dari karta. Sidoo kale, dhallaanka dhiciska ah waxay leeyihiin jawaab celin aan difaac lahayn oo ku saabsan arrimo ay ka mid yihiin bakteeriyada ama socodka dhiigga oo hooseeya. Isku dheelitir la'aanta qawaaniinta difaaca ayaa u muuqata inay ku lug leedahay NEC.
Ilmaha khatarta ugu jira xaaladan waxaa ka mid ah:
- Dhallaan dhicis ah
- Dhallaanka la siiyo caano-boodhka halkii laga siin lahaa caanaha dadka. (Caanaha dadku waxay ka kooban yihiin cunsurro koritaan, unugyada difaaca jirka iyo unugyada difaaca kuwaas oo gacan ka geysan kara kahortagga dhibaatada.)
- Dhallaanka ku jira xanaanada carruurta halkaas oo uu cudur ka dillaacay
- Dhallaanka laga helay dhiig ku shubista dhiigga ama aad u jiran
Astaamuhu waxay u imaan karaan si tartiib ah ama lama filaan ah, waxaana ka mid noqon kara:
- Calool xanuun
- Saxarada oo dhiig ka yimaado
- Shuban
- Dhibaatooyinka quudinta
- Tamar la’aan
- Heerkulka jirka oo aan degganayn
- Neefsasho aan degganeyn, garaaca wadnaha, ama cadaadiska dhiigga
- Matagid
Tijaabooyinka waxaa ka mid noqon kara:
- Raajo caloosha ku jirta
- Saxaro baaritaanka dhiigga sixirka (guaiac)
- CBC (tirinta dhiigga oo dhameystiran)
- Heerarka korantada, gaasaska dhiigga iyo baaritaannada kale ee dhiigga
Daaweynta ilmaha laga yaabo inuu yeesho NEC badiyaa waxaa ka mid ah:
- Joojinta quudinta (GI tract)
- Ka joojinta gaaska caloosha adoo tuubo gelinaya caloosha
- Siinta dareeraha IV iyo nafaqada
- Siinta antibiyootigyada IV
- La socoshada xaaladda raajada caloosha, baaritaanka dhiigga, iyo cabirka gaasaska dhiigga
Ilmuhu wuxuu u baahan doonaa qalliin haddii god ku yaal mindhicirrada ama caabuqa derbiga caloosha (peritonitis).
Qalliinkan, dhakhtarku wuxuu:
- Ka qaad unugyada caloosha dhintay
- Samee colostomy ama ileostomy
Mindhicirka ayaa dib la isugu xiri karaa dhowr toddobaad ama bilo kadib markii infekshanku bogsaday.
Necrotizing enterocolitis waa cudur halis ah. Ilaa 40% dhallaanka qaba NEC ayaa u dhinta. Goor hore, daaweynta gardarrada ah waxay gacan ka geysan kartaa hagaajinta natiijada.
Dhibaatooyinka waxaa ka mid noqon kara:
- Xiiq-dheerta
- Cudurka Sepsis
- Daloolista mindhicirka
- Cadaadiska xiidmaha
- Dhibaatooyinka beerka ee ka yimaada awood la'aanta muddada dheer u dulqaadaneysa quudinta dareenka iyo baahida loo qabo nafaqada waalidnimada (IV)
- Cudurka mindhicirka oo gaagaaban haddii qadar aad u badan oo mindhicirku lumo
Hel daryeel caafimaad oo deg-deg ah haddii ay soo ifbaxaan astaamo kasta oo necrotizing enterocolitis ah. Dhallaanka loo jiifiyo isbitaalka xanuun ama dhicis waxay halis sare ugu jiraan NEC. Si dhow ayaa loola socdaa dhibaatadan kahor intaan loo dirin guryahooda.
- Xiidmaha dhallaanka
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Greenberg JM, Haberman B, Narendran V, Nathan AT, Schibler K. Cudurada neonatal ee asalka dhalmada ka hor. Gudaha: Resnik R, Lockwood CJ, Moore TR, Greene MF, Copel JA, Silver RM, eds. Creasy iyo Daawada Hooyada-Uur-qaadista ee Resnik: Mabaadi'da iyo Tababarka. 8aad ed. Philadelphia, PA: Elsevier; 2019: cutubka 73.
Abuurka PC. Microbiome-ka iyo caafimaadka carruurta. Gudaha: Kliegman RM, St. Geme JW, Blum NJ, Shah SS, Tasker RC, Wilson KM, eds. Nelson Buugga Buugga Caafimaadka Caruurta. 21aad ed. Philadelphia, PA: Elsevier; 2020: cutubka 196.