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Kungani ukukhetha izikhala zokufaka amandla okugcina kwezintwana kudinga ukuthembeka kwezinsizakalo nezinkimbinkimbi zokuphatha kwezinsizakalo
Uma kuziwa ezinganeni, imizimba yazo ihluke ngokwanele kubantu abadala kangangokuthi sidinga izinaliti ezikhethekile ukuze sisebenzise ama-anesthesia. Cabanga ngezingane ezizalwa ngaphambi kwesikhathi, imithambo yazo ngokuvamile engaphansi kuka-1 mm ububanzi, cishe isisindo esifanayo nesenwele. Lokho kushiya indawo encane kakhulu yamaphutha. Izinaliti ezinkulu zingabangela izinkinga zokudumba cishe ezinganeni ezine kwezingu-10 ezisanda kuzalwa, kodwa uma zincane kakhulu zenza izinto zithathe isikhathi eside futhi zandisa ingozi yokuba namazinga aphansi e-oxygen lapho isikhathi sibaluleke kakhulu. Umgogodla ngokwawo uyashintsha lapho izingane zikhula, uqala cishe ku-L3 ezinganeni futhi ukhuphukela ku-L1 cishe lapho zineminyaka emibili. Lokhu kusho ukuthi odokotela kumelwe bakhethe ubude benaliti kuze kube sezingeni eliyi-millimeter. Ukwenza lokhu ngendlela efanele akuyona nje indaba yendlela, empeleni kuthinta indlela ukwelashwa okusebenza ngayo. Ucwaningo lubonisa ukuthi izinsana ezingakazalwa zingena kaningi ngenaliti evamile engu-25G uma iqhathaniswa naleyo emincane engu-30G, okuchaza ukuthi kungani iziqondiso ezifanayo zingasebenzi ekunakekelweni kwezingane. Kukhona nokungafani kokuqina kwezicubu, ukukhathazeka ngesikhathi senqubo, nezinye izinkinga zempilo njengamaphutha enhliziyo ezenza icala ngalinye lihluke. Uma ungawanaki la maqiniso, kunethuba langempela lokulimaza imithambo yegazi, ukuvuza kwemithi ezicutshini ezikuzungezile, noma ukunciphisa izinga lokuphendula okuphuthumayo, konke lokhu kubeka engozini ukuphepha kwesiguli nokusebenza kahle kokwelashwa.
Imithambo Yokubhala Ngokwesibonelo Sokugcina I-Needle Yokubhala Kwezinkimbinkimbi Zokuzalwa
Abantwana abancane kufuneka bafakwe ngemithambo yokubhala yokubhala okuyisibonelo sokuzalwa. Izinguquko zokuzalwa nezinkinga zokuzalwa ziyadinga imithambo eyodwa ukuze kunciphise izinkinga futhi kuvumeleke ukuthi kwenziwe ngokuphelele. Imboni yekhanda yekhanda yasibonela ukuthi imithambo eyodwa iyancipha izinkinga ngama-31% kwezinkimbinkimbi zokubhala kubantwana (I-Journal ya-American Academy ya Child & Adolescent Psychiatry, 2022).
Abantwana abancane (<1 isihlanu): Ukubhekisa ubucayi phambi kokushisa — 27G–30G, ½"–¾"
Imithambo emibi ngokuphelele (27G–30G) noma imithambo eminyane (½"–¾") iyidinga kakhulu kubantwana abancane abazimele kakhulu kanye nezivili ezingaphansi. Imithambo yomthambo we-30G iyancipha isibonelo sokukhona kwemithambo yezikhumba ngama-40% kulokho okukhona kumithambo emikhulu kubantwana abancane abazimele, futhi umthambo wemithambo wemihlanu uyancipha ukuthi kwenziwe izinkinga zokuzalwa kwezinye izinto ngokungafanele futhi uyavumela ukuthi kwenziwe ngokuphelele ukuthi kwenziwe ngokuphelele.
Abantwana abadlala nezinye zezinsuku (1–5 iminyaka): Ukubalansha Umkhahlelo Wokugcina nokuthanda Kwemithambo — 25G–27G, ¾"–1"
Lezi zizindaba zikufuna izihlangothi ze-25G–27G nesilinganiso se-¾"–1". Lokhu kuchaza umkhahlelo wokugcina okuhlanganisa ukuzimela kwezinto ezingaphambili ngokukhawuleza ngaphandle kokukhipha izinhlobo zemithambo kubantu ababuyelela. Izifundo zibonisa ukuthi izihlangothi ze-27G ziyafika emkhahleni wokugcina-kuphakathi kwezinhlobo zemithambo kwe-85% yezindlela ngaphandle kokuvula isikhundla somphakathi (Ukuphatha Kwabantwana Ngokwesibonelo, 2023).
Abantwana besebeyisikole nabafana nabesifazane (6–18 iminyaka): Ukuguqula kuze kube ngamaprotokholi wesilwane — 22G–25G, 1"–1¼"
Njengoba ubude bomphakathi wezinhlobo zemithambo uyakhuphuka, izihlangothi ze-22G–25G nesilinganiso se-1"–1¼" ziyavumelana. Lezi zizinga ziyagcinwa kwezinhlobo zemithambo ezinkulu ngaphandle kokunqula umkhahlelo wokugcina kwezindlela eziningi. Kuyabonakala kakhulu ukuthi izihlangothi ze-24G ziyafika emphakathini wokugcina kwe-98% yezindlela zokuqala kwezinhlobo zemithambo kubantwana abaningi kune-50 pounds—kuyaqhubeka nokusebenza kwezinhlobo zemithambo zesilwane.
Ukuthumela Kwemithombo Yokuqonda Kwezinkinga Zokunqamuka Okungafanele Kwezincwadi Zokuphatha Amadoda Emaphakathi
Izinkinga Eziningi Zokunqamuka Nezinkinga Zokubhukuda Ngamashilini Owodwa Kwezincwadi Zokuphatha Amadoda Emaphakathi
Kodwa abadokotela baphatha izikhali zokufaka amandla okuphuma kwezinkomo ezincane kubantwana abazalwa ngaphambi kwezinsukwane, bafumana imiphumela emibi kakhulu. Amagqabi amancane wabo akungakwazi ukuthola isikhundla sokufaka izikhali zokufaka amandla okuphuma ezingenabizo. Izifundo zibonisa ukuthi lapho izikhali zokufaka amandla okuphuma zezigaba 25G noma zingaphezulu kufakwa, iziqukethwe ziyapha ngaphezu kwe-40% kulokho okuthi kufakwa izikhali ezincane kakhulu. Kuzoba yini? Imedisini iyathinta phansi konke endaweni engeyona eyo eyayikufanele. Lokhu kungaholela kuze kubhekwe kwezinye izindlela zokulungisa, futhi kungaholela kwezinye iziqukethwe ezinomthelela emhlabeni. Ukuguqula ukusebenzisa izikhali ezingaphansi kwezigaba 27G kuya kusuka kwe-30G kuyenza umphumela omkhulu. Lezi zikhali ezingaphansi kakhulu ziyathumela indawo yokufaka amandla okuphuma kodwa ziyasinda amagqabi amancane kusukela kwezinkinga ezingenabizo. Ukubheka lokho okuhlanganisa emva kokufakwa kuyabonisa lokhu okubhekisayo: abantwana abafunyenwe izikhali zokufaka amandla okuphuma ezingenabizo babenomabhunu angu-2/3 kancane kwebantu abafunyenwe izikhali ezingenabizo, futhi akukho kuchazwa kwemiphumela yokuqondisa kwezindawo zokufaka amandla okuphuma.
Ukuphula kwezikhathi zokufaka amandla okuphuma kwezinkomo zokufunda i-cancer nezinkomo zokufunda i-cardiac ngokwesikhundla sokufuna amandla okuphuma
Abantwana abasebenzisa ukulwa kwemihlaba noma abanemiphumela yomhlaba wokuphila kubalulekile kakhulu uma kusethelwa izikhumba zokuhlanganisa amasiko okuzimisa ngokungafanele kuzo. Iivessels zabantwana ababili lezi ziyakwenzeka zingaphansi kokusebenza kwe-chemotherapy noma iziqu zokuzalwa, okunika isibonelo sokuba izivine ziyakwenzeka zizihlalela phansi kwezikhumba zezivine zezinkampani zokuzimisa zokugcina. Izifundo zibonisa ukuthi iziphumo ezimangalisayo zokuzimisa kwezikhumba ziyakwenzeka zingaphansi kwe-53 percent phakathi kwezilimi lezi zisobala uma kusetshenziswa izikhumba ezinkulu. Ukuguqula kwezikhumba eziphansi kwe-25G kuya kubiza ku-27G kuyakwenzeka kubusa iziphumo zokuzimisa ngokuphelele ngokuphakeme kwe-ithird kuba kuzimisa inkulu yezivine ezinengqondo. Abasemtharengu bapheka ukukhula kwezinyathelo kancane kwezinyathelo futhi, kanye nokuphatha kwe-28 percent kokuhlala kwezivine zokuvavanya kwezivine (vasovagal reactions) uma abadokotela bayaqhubeka nokubhekana kwezikhumba nezivine zokuphila kwezintwana.
Ukusebenzisa Ngokwemvelo: Ukugxila Amaphrothokholi Wezinyawo Zokufaka Isifuba Kwimisebenzi Yokuqala NeYokuphela Kwesikhathi Sokubhukuda Kwezintwana
Ukuhambisana nezindlela zokusebenzisa izikhumba zokufaka amadragu ezinye ngokwesibonelo kumaphakathi akhuluma kuzokufanele kubhekwe ngamazwi amaningi. Okokuqala, abadokotela nabafundi bafuna ukufundwa kahle ngokukhulula kwabafana, ubukhulu bezikhumba okuhle kuzo zizindawo ezithile, nokuzinikela izinkinga ezingaqondakali. Ukuphakama kwezinsuku zokufunda ngokuphelele ngezinto ezifanayo nezinye zezinye zomzimba wabafana kusiza kubuyisela lokhu kuzobudlela. Okwesibili, ukuthi kunezikhumba zokusebenza ezifanayo kusenza konke kuhle. Lezi zikhumba kufanele zibe nenkinga yazo yonke, nezikhumba zihlanganiswe ngokulinganisa ngezinsuka zokuzalwa ukuze akukho mthetho wokuchaza lapho isikhathi sibalulekile. Isibonelo, izilabeli zomthubi zingaba zihlakaniphile ukuthi izikhumba zemphakathi yezikhumba zezikhumba zomthubi (27G–30G) ziyasebenziswa kubantwana abazalwa emhlabeni. Okwesithathu, kufanele sijabule ukuthi lezi zindlela zihamba njani ngokubheka izinto ezithile njengeziquketho zokwenza ngokwesibonelo, izimo apho izidragu zihlula ngokungafanele, nokuthi abaparenti bathi ntoni ngokwesibonelo. Ukubheka lezi zinombolo ngishumi elinye kusiza ukuthintela izindlela zethu, ikakhulu kubantwana abaqhubeka ngokuthi bafunda ukuthi babonelela imiphumela yokufa, abafana nempilo eyodwa. Ngaphandle kwalokhu wonke lokusebenza ngokwesibonelo, amahospitale kufanele aqonde ukuthi abantwana bahlale balungile ngaphandle kokusebenzisa izidragu. Izinto ezincane njengokuvumela abaparenti ukuba bazamele kubantwana bazo ngokusebenza noma ukusebenzisa izicabha ukuthi bavulele ubucayi bazo, kusiza kunciphisa ubucayi kakhulu njengoba kubonakala emaphakathi amasha. Ukuchazela ukusebenzisa izindlela ezinhle ngokwesibonelo nendlela yokuncoma ubucayi kusenza amaphakathi akhuluma kuzokufanele kubhekwe ngamazwi amaningi.
Imibuzo Evame Ukubuzwa
Kungani ukukhetha izikhali kuyisisekelo esikhulu ekubeni kusetyenziswa ukugcina kwabafana?
Ukukhetha izikhali kuyisisekelo ngokwesibonelo sezinkulungwane nezinhlobo zokusebenza kwezinkulungwane, okuhambisana nabantu abadala. Ukusebenzisa izikhali ezipheleleyo zokuhambisana nendawo kuzokwenza ukuthi kungakho izinkinga futhi kuzokhula ukusebenza kwezinkulungwane.
Kuzoba kuphi uma izikhali ezingaphezulu kakhulu zisebenziswa emaqhwebhu amancane?
Izikhali ezingaphezulu kakhulu zingasiza ekuvumelweni kwezinkulungwane ezincane, okunika izinkinga zokubhisha nezinye izinkinga. Izikhali ezingaphansi kakhulu ezinconywa ngokupheleleyo kwezinkulungwane ezingaphansi kakhulu zingasiza kakhulu ekunciphiseni lezi zinkinga.
Izikhali zokusebenzisa zizokwenza kanjani ukuthi izifundo zokufunda kubhekene nezinkulungwane ezingaphansi kakhulu ziyathola umphumela wokufunda kanye?
Ukuguqula isikhali sokusebenzisa ngokwesibonelo sezinkulungwane zokufunda kuzosiza ekunciphiseni ukuphepha kwezinkulungwane ezingaphansi kakhulu, okunika izindlela ezingaphezulu kakhulu yokuthola umphumela wokufunda kanye.