Necrotizing enterocolitis

ʻO Necrotizing enterocolitis (NEC) ka make o nā mea i loko o ka ʻōpū. Kū pinepine ia i nā pēpē ma mua a i ʻole nā ​​maʻi.

Hana ʻo NEC ke make ka uhi o ka paia ʻōpū. Aneane ulu mau kēia pilikia i loko o kahi pēpē i maʻi a wanaʻao paha. E hana ʻia ana paha ia i ka wā e waiho ana ka pēpē i ka haukapila.

ʻAʻole ʻike ʻia ke kumu kūpono o kēia maʻi. Hiki i kahi kulu i ke kahe o ke koko i ka ʻōpū ke hoʻopōʻino i kaʻiʻo. Pākuʻi paha ka bacteria i ka ʻōpū i ka pilikia. Eia kekahi, loaʻa i nā pēpē premature kahi pane pale ʻole i hoʻomohala ʻia i nā mea e like me ka bacteria a i ʻole ke kahe o ke koko haʻahaʻa. Pili ke kaulike ʻole ʻia o ka hoʻoponopono pale pale i ka NEC.

ʻO nā pēpē i ʻoi aku ka makaʻu no ka maʻi me:

• Nā pēpē mua
• ʻO nā pēpē i hānai ʻia i ka haʻihaʻi ma mua o ka waiū kanaka. (Loaʻa ka waiū kanaka i nā mea ulu, nā ʻūpā a me nā hunaola i pale ʻia e pale i ka pilikia.)
• ʻO nā pēpē i kahi kula hānai kahi i ulu ai ka maʻi
• ʻO nā pēpē i loaʻa i nā pānaʻi hoʻololi koko a i ʻole nā ​​maʻi ʻino

E hele lohi a hōʻeha paha nā ʻōuli, a komo pū paha:

• ʻŌpū ʻōpū
• Koko i loko o ka pahu
• Pohā
• Nā pilikia hānai
• Ka nele o ka ikehu
• Ka mahana wela o ke kino
• Ka hanu paʻa ʻole, ka helu o ka puʻuwai, a i ʻole ke kaomi koko
• ʻO ka luaʻi

E komo pū paha nā hoʻāʻo:

• Hihi x ʻōpū
• Kahi no ka hoʻāʻo ʻana i ke koko hoʻokalakupua (guaiac)
• CBC (helu piha koko)
• Nā pae uila, nā kinoea koko a me nā hoʻokolohua koko ʻē aʻe

ʻO ka mālama ʻana no kahi pēpē e loaʻa pinepine paha iā NEC:

• Hānai i nā hānai komo (GI tract)
• Hoʻomaha i ke kinoea i loko o ka ʻōpū ma ka hoʻokomo ʻana i kahi paipu i loko o ka ʻōpū
• Ke hāʻawi nei i nā wai IV a me ka meaʻai
• Ke hāʻawi nei i nā antibiotic IV
• Ke nānā nei i ke ʻano me nā kukuna x o ka ʻōpū, nā hoʻāʻo ʻana o ke koko, a me ke ana ʻana i nā kinoea koko

Pono ke keiki pēpē inā loaʻa kahi puka i loko o nā ʻōpū a i ʻole mumū o ka paia o ka ʻōpū (peritonitis).

I kēia ʻoki kino, e kauka ke:

• Wehe i ke kino ʻōpū make
• Hana i kahi colostomy a i ʻole ileostomy

Hoʻohui hou ʻia ka ʻōpū ma hope o kekahi mau pule a i ʻole mau mahina i ka wā i ola ai ka maʻi.

ʻO Necrotizing enterocolitis kahi maʻi koʻikoʻi. Hiki i 40% o nā pēpē me NEC e make iā ia. Hiki i ka hoʻomaʻamaʻa kakahiaka nui ke kōkua i ka hoʻomaikaʻi ʻana i ka hopena.

Komo pū nā pilikia:

• Peritonitis
• Sepsis
• Perforation ʻōpū
• Hoʻopaʻa ʻōpū
• Nā pilikia o ka akepaʻa mai ka hiki ʻole ke hoʻolōʻihi i nā hānai komo a me ka pono no ka meaʻai makua (IV)
• Pīpī puʻupuʻu inā e nalowale kahi nui o ka ʻōpū

E kiʻi i ka mālama olakino olakino inā ulu kekahi mau ʻōuli o ka necrotizing enterocolitis. ʻO nā keiki pēpē i hōʻeha ʻia no ka maʻi a i ʻole prematurity ma mua o ka nui o ka makaʻu o ka NEC. Nānā pono ʻia lākou no kēia pilikia ma mua o ka hoʻouna ʻia ʻana i ka home.

• ʻŌpū pēpē

ʻO Caplan M. Neonatal necrotizing enterocolitis. I: Martin RJ, Fanaroff AA, Walsh MC, hua. ʻO Fanaroff lāua ʻo Martin's Neonatal-Perinatal Medicine. 10 o ka lā. Piladelapia, PA: Elsevier Saunders; 2015: chap 94.

Greenberg JM, Haberman B, Narendran V, Nathan AT, Schibler K. Neonatal morbidities o ka hānau mua. I: Resnik R, Lockwood CJ, Moore TR, Greene MF, Copel JA, Silver RM, eds. ʻO Medicine a Maternal-Fetal a Creasy a me Resnik: Nā Manaʻo a me ka Hoʻomeheu. 8th ed. Piladelapia, PA: Elsevier; 2019: chap 73.

PC hua. ʻO ke olakino microbiome a me pediatric. I: Kliegman RM, St. Geme JW, Blum NJ, Shah SS, Tasker RC, Wilson KM, eds. ʻO Puka Textbook of Pediatrics ʻo Nelson. 21st ed. Piladelapia, PA: Elsevier; 2020: chap 196.