Sepsis neonatal

ʻO ka sepsis neonatal kahi maʻi maʻi koko i kū i kahi pēpē ma mua o 90 mau lā. ʻIke ʻia nā sepsis hoʻomaka mua i ka pule mua o ke ola. Hana ʻia ka sepsis hoʻomaka hope ma hope o 1 pule ma o 3 mau makahiki o ka makahiki.

Hiki ke kumu ʻia nā sepsis neonatal e nā koʻohune e like me Escherichia coli (E coli), Listeria, a me kekahi mau ʻano o ka streptococcus. ʻO ka Group B streptococcus (GBS) kahi kumu nui o ka neonatal sepsis. Eia naʻe, ua lilo kēia pilikia i mea liʻiliʻi no ka mea ua nānā ʻia nā wahine i ka wā hāpai. Hiki i ka herpes simplex virus (HSV) ke kumu i kahi maʻi nui i loko o kahi pēpē hou. Hana pinepine kēia i ka wā a ka makuahine i maʻi hou ai.

Hōʻike pinepine ʻia nā sepsis neonatal mua ma waena o 24 a 48 mau hola o ka hānau ʻana. Loaʻa i ka pēpē ka maʻi mai ka makuahine ma mua a i ʻole ka wā hānau. ʻO ka mea aʻe e hoʻonui ai i ka makaʻu o ke pēpē i ka sepsis bacteria hoʻomaka mua:

• ʻO ka noho kolone GBS i ka wā hāpai
• Ka lawe mua ʻana
• ʻO ka haki wai (haki o nā membrane) ʻoi aku ka lōʻihi ma mua o 18 mau hola ma mua o ka hānau ʻana
• ʻO ka maʻi o nā placenta a me nā wai amniotic (chorioamnionitis)

Hoʻopilikia ʻia nā pēpē me nā sepsis neonatal lohi ma hope o ka hānau ʻana. Hoʻonui ka mea aʻe i ka makaʻu o ke keiki pēpē ma hope o ka hānau ʻana:

• Loaʻa i kahi catheter i loko o kahi kīʻaha koko no ka manawa lōʻihi
• Noho i ka haukapila no kahi manawa lōʻihi

Loaʻa i nā pēpē me nā sepsis neonatal kēia mau ʻōuli:

• Hoʻololi ka mahana o ke kino
• Nā pilikia hanu
• Hōʻemi a hōʻemi paha i ka neʻe ʻana o ka ʻōpū
• Koko kōpaʻa haʻahaʻa
• Nā neʻe hoʻemi
• Hoʻoemi i ka omo ʻana
• Ka hopu ʻana i nā maʻi
• Lōʻihi a wikiwiki paha ka helu o ka naʻau
• Kahi ʻōpū pehu
• ʻO ka luaʻi
• ʻIli melemele a keʻokeʻo o nā maka (jaundice)

Hiki i nā hoʻokolohua lab ke kōkua i ke koho ʻana i nā sepsis neonatal a hoʻomaopopo i ke kumu o ka maʻi. Pili pū paha nā hoʻokolohua koko:

• Moʻomeheu Koko
• Pūmua C-reactive
• Helu piha koko (CBC)

Inā loaʻa nā ʻōuli o ka sepsis i kahi pēpē, e hana ʻia kahi lumbar puncture (spinal tap) e nānā ai i ka wai o ka iwi kuamoʻo. Hiki ke hana ʻia nā moʻomeheu o ka ʻili, ka noho, a me ka mimi no ka maʻi herpes, keu hoʻi inā he moʻolelo ka maʻi ka makuahine.

E hana ʻia kahi hihi umauma ke loaʻa ka pēpē a i ʻole nā ​​pilikia e hanu ana.

Hana ʻia nā hōʻike moʻomeheu mimi i nā pēpē i ʻoi aku ma mua o kekahi mau lā.

ʻO nā pēpē ma mua o 4 mau pule he mau fiva a i ʻole nā ​​hōʻailona ʻē aʻe o ka maʻi i hoʻomaka ʻia i nā antibiotic intravenous (IV) koke. (He 24 a 72 paha mau hola e loaʻa ai nā hopena o ke keʻena.) ʻO nā keiki hānau hou nona ka makuahine i loaʻa i ka chorioamnionitis a i ʻole e makaʻu nui paha no nā kumu ʻē aʻe e loaʻa pū kekahi iā lākou nā antibiotic IV, ʻoiai inā ʻaʻohe o lākou mau ʻōuli.

E loaʻa nā pēpili i ka pēpē a i ʻekolu mau pule inā loaʻa nā koʻohune i loko o ke koko a i ʻole ka fluid spinal. E pōkole ka hoʻomaʻamaʻa inā ʻaʻole loaʻa kahi bacteria.

E hoʻohana ʻia kahi lāʻau antiviral i kapa ʻia acyclovir no nā maʻi i loaʻa ʻia e HSV. ʻAʻole hiki ke hāʻawi ʻia nā pēpē ʻelemakule i loaʻa nā hopena lab a maʻamau a loaʻa wale ke kuni. Ma kahi o, e hiki paha i ke keiki ke haʻalele i ka haukapila a hoʻi mai no ka nānā ʻana.

ʻO nā pēpē pono i ka lāʻau lapaʻau a hoʻi i ka home ma hope o ka hānau ʻana e hoʻokomo pinepine ʻia i ka haukapila no ka nānā ʻana.

Nui nā pēpē me nā maʻi bacteria e hoʻōla piha a ʻaʻohe pilikia ʻē aʻe. Eia nō naʻe, ʻo sepsis neonatal kahi kumu nui o ka make ʻana o ke pēpē. ʻO ka wikiwiki o ka mālama ʻana o kahi pēpē, ʻoi aku ka maikaʻi o ka hopena.

Komo pū nā pilikia:

• Kīnā ʻole
• Make

E ʻimi koke i ke kōkua lapaʻau no kahi pēpē e hōʻike ana i nā ʻōuli o neonatal sepsis.

Pono paha nā wahine hāpai i nā lāʻau ʻaloʻalo pale inā loaʻa iā lākou:

• Chorioamnionitis
• ʻO ka kolone B kolonialisasi
• Hānau ʻia i ka wā ma mua i kahi pēpē me nā sepsis i hoʻokumu ʻia e ka bacteria

ʻO nā mea ʻē aʻe e hiki ke pale i ka sepsis me:

• Kāohi a mālama ʻana i nā maʻi i nā makuahine, me HSV
• Ke hāʻawi nei i kahi maʻemaʻe no ka hānau ʻana
• Ke hāʻawi nei i ka pēpē ma waena o 12 a 24 mau hola o ka wā e haki ai nā membrane (hana ʻia ʻo Cesarean i nā wahine ma waena o 4 a 6 mau hola a i ʻole e haki koke nā membrane.

Sepsis neonatorum; Septicemia neonatal; Sepsis - pēpē

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Polin R, Randis TM. Nā maʻi Perinatal a me ka chorioamnionitis. I Martin RJ, ʻo Fanaroff AA, ʻo Walsh MC, nā ʻaoʻao. ʻO Fanaroff lāua ʻo Martin's Neonatal-Perinatal Medicine. 11th hua. Piladelapia, PA: Elsevier; 2020: chap 25.

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