Infant BRUE (Ikintu Cabaye Kidasobanuwe Gitorera umuti Mu Bugufi): Guhindura Ibara Bukwi na Bukwi, Gucumbagira canke Guhumeka¶

Kubona umwana atarashika ku mwaka umwe ahagarika guhema bukwi na bukwi, agahinduka ubururu canke akagira ibara ry’umuhondo, akagenda aracumbagira nk’igipupe c’impuzu canke akagenda akora umugongo, hanyuma agakira mu masegonda makeyi ni kimwe mu bintu biteye ubwoba cane umuvyeyi canke uwumurera ashobora kubona. Mu buvuzi bw’abana bw’ibihe vyihutirwa, iyo uruyoya ruri munsi y’amezi 12 rushikiwe n’ikintu gitunguranye kimara umunota umwe kirimwo ububabare bw’umubiri canke ububabare bw’umubiri, guhema ataco canke kudasanzwe, uguhinduka gukomeye kw’ijwi ry’imitsi, canke uguhinduka kw’inyishu bishobora gutorera umuti burundu gusubira ku ntango ata n’ikibazo kigaragara, Ivyabaye bitasobanuwe (BRUE)**. Naho umwana wawe yoba asa n’uwuri maso 100 kw’ijana, afise ibara ry’agahama, kandi anezerewe igihe ufata telefone, ikintu cose kitasobanuwe ku mwana w’uruyoya ruri munsi y’umwaka umwe bisaba ko ahita asuzumwa n’abaganga mu guhamagara aho uba . inomero z'ivyihutirwa (911 muri Leta Zunze Ubumwe za Amerika no muri Kanada, 112 mu bihugu vyose vy’Ubumwe bw’Uburayi, 999 mu Bwongereza) canke ukaja guca mu kigo c’abana gifasha abana. Ivyo bisa n’uguhagarika amasegonda 20 ata co bimaze birashobora kuba ikimenyetso ca mbere co kugabisha umuntu afise indwara y’ibicurane (apnée pertussis), umugera w’indwara y’ibicurane (RSV), indwara y’umutima nk’iyitwa Long QT Syndrome, indwara y’ibihimba vy’umubiri ivukana, canke indwara y’umutima, kandi utegerezwa kandi kumenya ingene wobikora . CPR y'abana n'inzoya no kunyiganyiga gukiza no gutandukanya uruyoya BRUE kuva ku mwana muto guhagarika impwemu n'uguhagarika impwemu kw'uruyoya canke umuriro mwinshi w'uruyoya n'ugufatwa n'umuriro.

Ivyo ubikore ubu¶

1. Shira uruyoya ku ruhande rwiwe ku kintu gikomeye maze usuzume inzira y’impwemu n’uguhema ubwo nyene. Ntufate uruyoya rucumbagira canke rudashobora kwishura rumuhagaze ku rutugu rwawe, kuko guhagarara ahagaze bikura amaraso kure y’umubiri w’ubwonko kandi bituma umutwe w’uruyoya ushobora gutera imbere kuva ku kibuno gushika ku gikiriza. Rambika umwana ku ruhande rwiwe (aho umwana akira) ku matela ikomeye, hasi, canke ku meza yo guhindurirako kugira ngo amata yose canke umunyu wose wo mu kanwa uve mu kanwa aho kuja mu mahaha.
2. Shirako ubuhinga bukomeye bwo gukora ku mubiri mu masegonda 5 gushika ku 10 (ntiwigere uzunguza umwana). Ukoreshe umwana umugongo canke ibere ryiwe (sternum), bagatera canke bagakora ku birenge vyabo ata co bambaye, hanyuma bagafuha umuyaga utose ku matama yabo kugira ngo bivyure ubushobozi bwo guhema bw’ibihimba bitatu. Ntukigere uzunguza uruyoya rwo mu mutwe kugira ngo rumuvyure, kuko guzunguruka amarira bituma imitsi y’imbere mu gihanga igira ububabare kandi bigatuma ubwonko buva amaraso yica.
3. Tangira CPR y’uruyoya canke gukiza uruyoya rwo kunyiganyiga ubwo nyene iyo uruyoya ruhumeka canke ngo rusubize mu masegonda 10. Shira telefone yawe ku nkuru kugira ngo uhamagare inomero y’ivyihutirwa yo mu karere kawe (911 muri Amerika na Canada, 112 mu Bumwe bw’Uburayi bwose, 999 mu Bwongereza). Nimba umwana acereje kandi adashobora guhema ubwo nyene amaze kugaburira canke guhagarika umutima ku mazi manini, n’utere ibipfunsi 5 vy’uruyoya mu mugongo (ugushigikira urwaya n’igikiriza ku ruhande rw’ukuboko kwawe kw’imbere umutwe uri munsi y’igifu) hanyuma ibipfunsi 5 vy’intoke zibiri mu gikiriza; iyo umwana ataco yishuye ata guhema gusanzwe kandi ata n’ikintu kigaragara co guhagarika umutima, tangura Gufata ubuzima bw’uruyoya ku 30 mu gikiriza kugeza ku 2 gufuha kw’umuyaga (canke 15:2 iyo hari abarokozi babiri bamenyerejwe), ukanda amasentimetero 4 (1,5 inches) uburebure mu gikiriza gusa ku murongo wa ra1. 120 z’ugufatanya ku munota.
4. Raba isaha yawe canke isaha ya telefone yawe maze ushire mu rutonde rw’igihe nyaco n’ibintu bine vy’ubuvuzi. Abaganga bo mu cumba c’ubuvuzi vyihutirwa bizigira ivyo wiboneye kugira ngo bashire umwana mu rwego rw’abafise ingorane ntoyi canke abafise ingorane nyinshi BRUE. Mu bwenge, nushiremwo canke wandike: (a) amasegonda angahe ico kintu cabaye, (b) ibara nyaryo ry’iminwa, ururimi n’isura (ubururu/umutuku, umweru/umweru nk’uw’ibinyoma, canke umutuku ukeye), © nimba umubiri w’uwo mwana waciye ugira ububabare bwose (hypotonia) canke ikomeye kandi ipfutse (hypertonia), na (d) ivyo umwana yariko arakora mu minota 5 imbere y’uko ico kintu kiba (kuryama hasi, kwicara mu ntebe y’imodoka, kugaburira, guca amacandwe canke kurira).
5. Genda mu bitaro vyihutirwa ubwo nyene naho umwana yoba asa n’uwusanzwe 100 kw’ijana ubu. Ntusubire gushiramwo umwana ngo asinzire i muhira ngo urindire umuganga w’abana mu gitondo. Mu bana bato bari munsi y’amezi 12 (na cane cane abana bato bari munsi y’imisi 60 canke bavutse bataragera ku myaka 32 y’ubuvyeyi), uguhagarika guhema kw’amasegonda 30 gutorera umuti ni kenshi ikintu gikomeye kiba imbere y’amasaha ya kabiri, maremare, ashobora gutuma umuntu apfa.
6. Fota ifoto y’aho umwana asinziriye canke agaburirwa maze uzane amavuta y’umwana, imiti, n’urutonde rw’abamwitaho mu bitaro. Imbere yo kugenda canke mu gihe uwundi muntu akuze ariko arapakira, fata ifoto yihuse kuri telefone ngendanwa y’aho umwana yari aryamye (igitanda c’umwana, igitanda c’abana, igitanda co gusinziramwo, intebe y’ibifungurwa y’imodoka, canke b herbal teething gels, canke imiti yo mu nzu y’ubukonje kugira ngo abaganga b’ibihe vyihutirwa bashobore gukora igenzura ryuzuye ry’ugusinzira neza n’ubumara.

Igiti c’ingingo: Ibara ry’uruyoya rihinduka bukwi na bukwi, guhagarika guhema canke gucumbagira¶

flowchart TD
    A["Uruyoya ruri munsi y’amezi 12 rurahagarika guhema bukwi na bukwi, rugahinduka ubururu/ubururu, canke rugaca rucumbagira/rukomantara"] --> B{"Uryama ku ruhande + ushireko igihimba c’irondoka / ushireko ibirenge mu masegonda 5 gushika kuri 10. Mbega guhema biragaruka?"}
    B -->|"Oya: Ntaco yishuye kandi ntahema neza"| C["Hamagara 911 / 112 / 999 ku nsiguro ubwo nyene"]
    C --> D{"Mbega igice catanguye n’ugunyiganyiga cane ku mata canke ku kintu?"}
    D -->|"Ego: Inzira y'impwemu irazibiwe"| E["Gukora Ibipfunsi 5 vy’Umugongo w’Uruyoya + Ibipfunsi 5 vy’Igikiriza; gusubiramwo gushika inzira y'impwemu ivuye canke utangure CPR nimba udasubiza"]
    D -->|"Oya: Guhagarika hagati canke gucumbagira"| F["Gutangura CPR y’uruyoya: gufatanya 30 mu gikiriza (4 cm / 1.5 mu burebure, 100 gushika 120/min) + 2 guhumeka neza"]
    B -->|"Ego: Umwana arakira mu masegonda 60 agasubira ku rugero rusanzwe"| G{"Mbega uwo mwana yoba afise ikimenyetso kigaragara c’uko afise ubumuga? (Umuriro, guhema, gusubiramwo gukorora, gutera induru, gucika intege)"}
    G -->|"Ego: Si ibidasobanutse"| H["Igisata c’Ivyihutirwa gisuzuma vuba ku ndwara ikora (Indwara y’ibicurane, RSV, Indwara y’ibicurane, Indwara y’ibicurane, Indwara y’ibicurane)"]
    G -->|"Oya: Umwana asa n'uwusanzwe 100% ku ntango (Birashoboka BRUE)"| I{"Suzuma AAP-Ingorane Nkuru BRUE Ivyagezwe (Hari 1 iriho?)"}
    I -->|"Imyaka <= imisi 60 CANKE Itarashika < 32 wks (< 45 wks ikosowe) CANKE Igihe >= 1 min CANKE Gusubiramwo ibintu CANKE Bikenewe CPR"| J["HIGH-RISK BRUE: Gutwara umuntu mu bitaro vyihutirwa + Kwakirwa mu bitaro + Gukomeza gupima umwuka, Pertussis/RSV PCR, ECG y’amabara 12, Sepsis/Metabolic screen"]
    I -->|"Imyaka > imisi 60 gushika ku mezi 12 KANDI Igihe cose >= 32 wks KANDI Ivyabaye vya mbere < umunota 1 KANDI Nta CPR ikenewe KANDI ikibazo gisanzwe"| K["LOW-RISK BRUE: Isuzuma ryihutirwa ry’Igisata c’Ivyihutirwa + amasaha 1 gushika kuri 4 y’ugupima umuvuduko w’amaraso, ECG y’amabara 12, ipima ry’indwara y’ibicurane, Igenzura ry’itiro ryiza, n’ugukurikirana kw’umuganga w’abana amasaha 24"]

Ivyagezwe vy’ubuvuzi: Ni igiki gisobanura BRUE n’igituma yasubiriye ALTE¶

Mu myaka mirongo itatu imbere y’umwaka wa 2016, abaganga b’abana barakoresha ijambo ry’inyongera ry’umutaka wagutse ALTE (Ikintu kigaragara ko gitera ubwoba ubuzima) kugira ngo umuntu adondore ikintu cose giteye ubwoba cabaye mu ruyoya catumye uwumurera atinya ko uruyoya ruriko rurapfa. Ubushakashatsi bwakozwe mu vy’ubuvuzi bwaciye bugaragaza ko . ALTE yari iteye akaga: yashize hamwe abana bakiri barwaye cane mu cumba c’ubuvuzi bw’ibiza n’abana bari barakize burundu, kandi yari yizigiye urugero rw’ubwoba bw’uwubitaho aho kwizigira ibimenyetso vy’umubiri. Mu mwaka w’2016 (kandi bikomezwa n’ingingo ngenderwako mpuzamakungu zakurikiyeho zerekeye ubuvuzi bw’abana), Ishure ry’ubuvuzi bw’abana ryo muri Amerika (AAP) yasohotse mu kiruhuko c'izabukuru ALTE kandi ashinga isuzuma rikomeye kandi ritagira aho rigarukira ry’indwara ya BRUE (Ivyabaye Bitasobanuwe Mu Mugufi).

Inkingi 4 z'ingenzi zo gupima BRUE¶

Umuganga azoshira mu rutonde igice c'uruyoya nk'BRUE iyo gusa umwana akiri munsi y’amezi 12 (umwaka 1) kandi iyo nkuru ikaba ihaza ivyo vyose bine vy’inkingi zikurikira zo gupima:

1. Mu gihe gito (Igihe kiri munsi y'amasegonda 60): Igice cose kidasanzwe camaze umunota umwe (ukuri cane BRUE ibice bimara hagati y’amasegonda 10 na 45). Iyo igice camaze umunota 1 (amasegonda 60) canke irenga, kirenze urugero rugufi maze kigaca gica mu nzira yo gupima High-Risk.
2. Ivyiyumviro (100 kw’ijana bisubira ku rwego rwo mbere): Igihe uruyoya rushika kugira ngo rusuzumwe n’abaganga, uruyoya ruzoba rwasubiye ku rwego rwo hejuru rw’amagara yarwo asanzwe. Umutima wabo utera, ukuntu bahumeka, ukuntu umwuka w’ikirere utera, ubushuhe, ukuntu urukoba rwabo rutera, ukuntu imitsi yabo itera, be n’ukuntu babona amaso bitegerezwa kuba ari ibisanzwe rwose. Iyo umwana aguma asinziriye, afise ubunebwe, afise ububabare bwo guhema (ahumeka ningoga), afise umuriro, canke afise umubabaro, ico kintu nti gitowe umuti . BRUE, ni ikibazo c’ubuvuzi gikora cane gisaba gusubira kubaho ubwo nyene no gukora ibikorwa vy’ubuvuzi bishingiye ku ntumbero.
3. Irangwa n'ihinduka ry'intumbero nibura 1 kuri 4:
4. Central cyanosis canke pallor: Ibara ry’ubururu bugaragara, ry’umuyugubwe, ry’umwiza, canke ry’umweru/ivu ry’umuzimu rihinduka ry’ibara ry’umubiri ry’iminwa, ururimi, amano, mu maso, canke umubiri wo hagati**. (Ibiganza n’ibirenge bifise ubururu bitagira akamaro iyo bikonje, bizwi nka acrocyanosis, canke gutukura kw’igihe gito gukikuje akanwa mu gihe uriko urarira canke uriko urarenga amavyi ntibishobora kuba BRUE).
5. Uguhema kutaboneka, kugabanutse canke kudasanzwe: Guhagarika vy’ukuri mu guhema (apnea), guhema mu gitutu, canke gupfukama bukwi na bukwi/guhangana n’umuyaga. (Umwana aherutse kuvuka guhema mu bihe bitandukanye, aho umwana asinziriye ahumeka kenshi vyihuta akurikirwa n’uguhagarika amasegonda 5 gushika ku 10 mu gihe aguma ari umutuku wuzuye, ni physiologie isanzwe kandi si BRUE).
6. Ihinduka rikomeye ry'ijwi ry'imitsi (hypotonia canke hypertonia): Uruyoya ruca rugenda rucumbagira rwose kandi ruca rugira Ragdoll-floppy (hypotonia) canke agakomera bukwi na bukwi afise imitwe ikomeye be n’umugongo ugoramye (hypertonia canke opisthotonos).
7. Urugero rwo kwishura rwahindutse: Uruyoya ruca ruca rudashobora kwishura ku ijwi no ku gukorako, ruca ruraba ata co rubona n’amaso y’ibirahuri, canke rurabura ubwenge.
8. Ntibisobanurwa inyuma y’amateka n’isuzuma ry’umubiri: Umuganga w’ivyihutirwa amaze gufata amateka y’umwana mu buryo burambuye, akamusuzuma kuva ku mutwe gushika ku birenge, nta mpamvu igaragara ishobora guca itera. Nk’akarorero, iyo umwana afise umuriro w’ubushuhe bwa degre 39,2 (degre 102,6) be n’ugusubira inyuma gukomeye mu gikiriza, ahagaritse guhema, iyo ndwara ni indwara y’ibihaha iterwa n’umugera canke indwara y’ibihaha iterwa n’imigera, atari indwara idasobanutse . BRUE.

Imbonerahamwe y'ukugereranya: BRUE y'akaga gatoyi n'iy'akaga kanini BRUE n'iyitagira BRUE¶

Gutahura nimba umwana wawe ashobora kugwa mu Low-Risk BRUE canke Ingorane nyinshi BRUE category ikubwira neza neza ibipimo n’ivyigwa vy’ibitaro umugwi w’abaganga bazokora. Iyo uruyoya rubuze n’umwe mu bipimo vy’Ingorane Nto, rushirwa mu rutonde rw’Ingorane Zikomeye . BRUE**.

Imvo zihishije zitera ingorane ubuzima zasuzumwe muri BRUE y'akaga gakomeye¶

Ni kuki abaganga b’ibihe vyihutirwa bashimika ku kwemera abafise ingorane nyinshi BRUE inzoya (nk’uruyoya urwo ari rwo rwose ruri munsi y’imisi 60 canke uruyoya urwo ari rwo rwose rufise urupfu rwa kabiri) ku bitaro mbere n’igihe uruyoya ruriko ruratwenga kandi runywa icapa mu cumba c’ubuvuzi bw’ivyihutirwa? Kuko mu bana batoyi bafise imitsi y’umubiri itarakura, ibintu indwi bishobora gutera ubuzima bikunda gushika bifise uguceceka, guhagarika umutima canke gucika intege nk’ikimenyetso ca mbere imbere y’uko ibimenyetso vya kera nk’umuriro canke ugukorora bigaragara.

1. Ugutera amatwi n’ugutera imbere kw’amatwi (LCR) kuva ku gusubira inyuma¶

Mu bana bakuze no mu bakuze, iyo itosi ry’aside yo mu nda canke ry’amacandwe rikoze ku mitsi y’ijwi (larynx), igihimba c’ubwonko kiratuma umuntu akorora cane kugira ngo akureho inzira y’impwemu. Ariko rero, ku bana bavutse vuba no ku bana bato bari munsi y’amezi 4 gushika ku 6, umutsi wo hejuru w’amatwi uravyura uburyo bwa kera bwo kurokoka uruyoya bwitwa Laryngeal Chemoreflex (LCR) (igenewe guhagarika uruyoya rwo guhumeka amazi y’umubiri ari mu nda). Iyo akatonyanga gatoyi k’amata asubiye mu mubiri canke aside igaragara yo mu nda ishitse inyuma y’umuhogo w’uruyoya mu gacerere, imitsi y’ijwi irafunga neza mu gutera kw’amajwi yuzuye, uguhema kw’ubwonko bwo hagati kurahagarara, maze umutsi w’umutima uragabanya urugero rw’umutima (bradycardia).

• Ivyo abavyeyi babona mu gihe c' LCR spell: Ico gice gikunda kuba igihe umwana aryamye ku mugongo iminota 15 gushika kuri 60 inyuma yo kugaburirwa (canke inyuma y’ugufungura). Uwo mwana aca agenda bukwi na bukwi, agapfukama, akagurura amaso cane kubera ubwoba, akavuga akanwa gacereje canke akagira ivyiyumviro bigoranye mu gikiriza ata jwi rifise, agahinduka umutuku w’agahama hanyuma akagira ubururu akikuje iminwa, maze amaherezo akarekura ijwi ry’agahomerabunwa (inspiratory stridor) inyuma y’amasegonda 20 gushika kuri 45 uko imitsi y’ijwi irekura.
• Igikorwa co guca ku buriri: Hindukiza uruyoya ku ruhande rwiwe canke urufate rugororotse mu mfuruka y’amadegre 45 ku gikiriza cawe, unyonke amata aboneka mu mazuru n’urushinge rworoshe (kuko uruyoya ruri munsi y’amezi 4 rutegekanijwe guhumeka mu mazuru a**ek). Ntukigere uhatira urutoke mu muhogo.

2. Indwara y’ibicurane (apnée) n’indwara y’ibihaha iterwa na RSV¶

Abavyeyi biteze umwana afise indwara y’ibicurane (Bordetella pertussis) canke Umugera w’ibicurane (RSV) kugira igikomere canke umuriro uvuga cane, utera ubwoba. Mu bana b'inzoya bari munsi y'amezi 3, ivyo bishobora kwica:

• Uguhema imbere y’uko umuntu akorora: Mu bice 50 kw’ijana vy’abana bavutse vuba n’abana bato bari munsi y’indwi 8 bafatwa n’iyo ndwara RSV canke pertussis ivuye ku muvukanyi mukuru canke umuntu akuze afise "ubukonje bubabaza" buke, uguhagarika guhema bukwi na bukwi (guhagarika guhema mu masegonda 20 gushika kuri 60 ugahinduka ubururu) ni ikimenyetso ca mbere cane c'ubuvuzi, kikaba amasaha 24 gushika kuri 48 imbere y'uko umuntu akorora, akagira ububabare, canke umuriro.
• Ukubura "whoop": Abana batoyi ntibagira inkomezi z'uruhome rw'igikiriza kugira ngo bashobore gukora ijwi ry'uguhema ry'"whoop" ry'inkorora. Ahubwo, barapfukama bacereje ku mfuruka y’impwemu ifatanye n’ibintu bitobito cane, bagaruha, bagahagarika guhema, maze bagafatwa n’indwara y’umutima ikomeye cane. Kubera ko uruyoya rufise indwara y’ibicurane canke . RSV birashobora gusa n’ibisanzwe hagati y’ibihe vy’intango hanyuma bikahagarika guhema ubudasiba mu gihe umuntu asinziriye cane haciye amasaha 6, ibisata vy’ivyihutirwa birakora ubuhinga bwo gusinzira cane PCR ibikoresho vyo gupima indwara y’ibicurane n’ RSV kandi bagumye abana batoyi ku bipimo vy’umutima n’ugupima ububabare bw’umutima.

3. Indwara z’umutima (Indwara y’igihe kirekire, WPW, n’ubumuga bushingiye ku mitsi y’umutima)¶

Igihe gitunguranye aho uruyoya ruhinduka umweru, imvi, canke ivu (pallor) kandi akagenda acumbagira nk’igipupe c’impuzu ni kenshi c’umutima canke c’umubiri aho kuba c’uguhema. Uruyoya rwose rwasuzumwa kugira ngo rubone BRUE (bompi bafise ingorane ntoyi n’abafise ingorane nyinshi) bakwiye guhabwa igipimo c’umutima c’amabara 12 (ECG:

• Indwara y'igihe kirekire c'ivuka (LQTS) na Brugada Syndrome: Inenge ziri mu nzira y’umuyagankuba y’umutima zishobora gutuma umuntu agira ububabare bw’umutima bufise imiterere myinshi (torsades de pointes). Mu gihe c’amasegonda 20 y’uguhungabana kw’umutima, ubushobozi bw’umutima buragabanuka bukaja kuri zero, bigatuma umwana agira umuhondo n’ugucumbagira; iyo umudiho wisubiye ku muvuduko usanzwe w’ibihaha, umwana aravyuka asa neza, gushika aho urugendo rukurikira rutuma umutima uhagarara bukwi na bukwi (SIDS).
• Wolf-Parkinson-Umweru (WPW) n’umutima utera cane (SVT): Abana b’inzoya bafise inzira y’umuyagankuba y’inyongera mu mutima barashobora gusimbuka bukwi na bukwi gushika ku rugero rw’umutima rutera 240 gushika ku 300 ku munota, bikaba bituma urukoba rwabo rugira ibitotsi, urukoba rugaca rugira amabara, rugafungura nabi, canke rugapfa mu gihe gito.
• Indwara y'umutima ivutse iva ku nzira y'amaraso canke ALCAPA: Ibintu nk’ugufatanya kw’umutsi w’amaraso canke umutsi w’amaraso w’ibubamfu udasanzwe uva ku mutsi w’amahaha (ALCAPA) birashobora gutuma umuntu arira bukwi na bukwi, akagira icuya, akagira ibara ry’agahama be n’ugucika intege mu gihe ariko aragerageza kugaburira.

4. Indwara zidasanzwe z’abana bavutse vuba n’iz’abana bato (harimwo n’indwara y’ibicurane vy’abana bato)¶

Mu buryo butandukanye n’abana bakuze bafise ibicurane vy’uguhungabana bitagira uko bingana, abana bato bari munsi y’amezi 6 barafise ubumuga bwo mu bwonko butatunganye. Ivyo bituma, indwara y’igicuri itangura mu bice vy’igihe canke mu bwonko akenshi igaragara nk’ibintu vy’umubiri vyigenga canke vy’umubiri bitaboneka:

• Indwara y’uguhema: Umwana w’uruyoya arahagarika guhema bukwi na bukwi, akareba ku ruhande rumwe n’amaso ameze nk’ay’ibirahuri, akagira amaguru atera iminwa, atera ururimi canke atera igare, maze agahinduka ubururu buzize amasegonda 30 gushika kuri 60.
• Infantile Spasms (West Syndrome): Gutangura hagati y’amezi 3 n’umunani**, igihe umwana avyutse canke asinziriye, umwana agira igihe gitoyi, gitunguranye c’ugukomera kw’imbugita mu masegonda 1 gushika ku 2, igihe cose igihimba c’umubiri gikomeye. Amasegonda 5 gushika kuri 15 kandi kenshi abavyeyi bavyihenda ngo ni "reflux cramps" canke ngo bibe ivy'ugutangara. Amasanamu y’imbere y’igihe yafashwe n’abavyeyi be n’ivy’ubuhinga bw’imitsi y’abana bwihutirwa (EEG) ni ngirakamaro kugira ngo umuntu ntasubire inyuma ubudasiba mu bijanye n’iterambere.

5. Amakosa yo kuvuka y’uguhindura ibiribwa n’ugutakaza isukari mu mubiri¶

Indwara zidasanzwe zivutse ziterwa n’imitsi (nk’iyi Ubukene bw’imitsi y’umubiri [ 1 ].MCADD], ubumuga bwo guhindura aside y’ibinure, ingorane z’ingendo ya urea, n’indwara y’ibinure) bibuza umwana w’uruyoya guhindura ibinure vyabitswe ngo bibe isukari igihe yisonzesheje hagati y’ibifungurwa. Iyo umwana w’uruyoya asinziriye igihe kirekire gatoyi kuruta uko bisanzwe canke akagaburira nabi, isukari yo mu maraso yiwe iragabanuka cane canke amoniya y’ubumara irarundanywa, bigatuma igira ubunebwe bukwi na bukwi, igacika intege, igacika intege canke igacika intege. Gusuzuma vuba iruhande y’igitanda isukari yo mu maraso, gaze yo mu maraso, electrolytes, na lactate mu kigo c’ubuvuzi bw’ibihe vyihutirwa, bica bimenya ubwo nyene ingorane z’imibiri.

6. Indwara y’imigera y’amaso, indwara y’umusonga, indwara y’amasobe, n’indwara y’ibihaha y’abana bato¶

Mu bana b’inzoya bari munsi y’imisi 60, indwara ikaze y’imigera (nk’indwara y’amasobe, indwara y’umugera wa Streptococcus canke E. coli yo mu mugwi B wa mbere, canke indwara y’umusonga yo mu ntango) kenshi itera ubushuhe buke (ubushuhe bwo mu nzira y’amasobe buri munsi ya degre 36,0 Csihe9. canke guhagarika impwemu mu buryo butunguranye ata muriro n’umwe. Na vyo nyene, mu ntango z’1914. uburwayi bw'uruyoya kuva ku nkoko z’ibidukikije zamizwe zituma umutsi w’umutwe ugira intege nke, guhagarika umutima neza, amacandwe akorakoranya, n’uguhagarika impwemu mu buryo butunguranye.

7. Ihungabana ritagira impanuka (Ihungabana ry’umutwe ry’ububisha) n’ubumara butazi¶

Ivyigwa vy’ubuvuzi vyasubiwemwo n’ishirahamwe AAP yerekana ko hagati ya 1 na 3 kw’ijana vy’abana batoyi bafise ingorane zikomeye canke zisubira . BRUE bafise ugukomeretswa kw’umutwe (shaken baby syndrome) bifise amahematomas y’inyuma y’umutwe ahishije atuma ubwonko bwo hagati buhungabana, mbere n’igihe ata bikomere vyo hanze biri ku mutwe. Abaganga rero barasuzuma neza urukoba kuva ku mutwe gushika ku birenge, bagasuzuma ko hariho igihimba c’imbere c’umubiri (ahantu heza) ko ata n’imwe ipfutse, bagasuzuma imbere mu munwa wo hejuru ko ata n’imwe ishobora gutabuka, bagasuzuma ko ata n’umwe yashikiwe n’imiti itera umunezero (nk’amatotsi y’ubukonje bw’abantu bakuze gebenzo topcamine, diphehydrocamine/ diphehydrocamine bitera indwara ya methemoglobinemie, canke imiti y’ibiyobyabwenge/ibiyayuramutwe bitemewe).

Igenzura ry'ugusinzira neza n'ugusinzira neza inyuma y'isuzuma rya BRUE¶

Ivyiyumviro vyinshi vy’uguhagarika guhema kw’uruyoya be n’uguhagarika guhema kw’uruyoya biterwa n’uguhungabana kw’uruyoya, ivyo bikaba bishika iyo umutwe w’uruyoya uremereye uhengamye imbere (neck flexion) rero ikibuno cabo kirakandagira mu gikiriza cabo, kigaca gipfuka umuyoboro wabo woroshe kandi ufise amagufa (trachea) zifunga, canke igihe imitego y’ibitanda vyoroshe yasohora umwuka w’ikirere ukikuje amazuru yabo. Mu gihe urindiriye gutwara abantu vyihutirwa canke ubwo nyene umaze gusubira i muhira uvuye mu bitaro, kora iki kintu cose Igenzura ry’Ivy’Ugusinzira neza n’Ivy’Imigenderanire y’Imbeho:

• Igenzura ry’Ivyicaro vy’Imodoka, Ivyicaro vy’Abana, Ivyicaro vy’Abana, n’Ivyuma vy’Abana: Ntukigere wemera ko uruyoya ruguma rusinziriye mu ntebe y’imodoka iyo rumaze gukurwa mu modoka, kandi ntukigere ukoresha ivyicaro vy’ugutera, ivyicaro, canke umusego wo kwonsa nk’aho umuntu asinzira. Iyo intebe y’imodoka ikandanywe mu gishingo cayo kiringaniye imbere mu modoka, yicara mu mfuruka nziza yo kwicara; iyo umuntu ayishize hasi mu cumba c’uburaro, iyo ntebe irahindukira imbere, ivyo bikaba bituma umutwe w’umwana aherutse kuvuka asinziriye utera imbere kuva ku kibuno gushika ku gikiriza maze ugafunga mu gacerere inzira y’impwemu (positional asphyxia).
• Igenzura ry'Ibipfukisho vy'Abana n'Ibipfukisho vy'Impuzu Ziyoroshe: Ku bana bari munsi y'amezi 4 batwawe mu gipfukisho canke mu gipfukisho, wama ukurikije T.I.C.K.S. itegeko: ugumize uwutwara Tight, In view igihe cose (ntiwigere upfuka mu maso h'umwana n'impuzu), Cgutakaza bihagije kugira ngo usome hejuru y'umutwe w'umwana, ugumize ikibuno c'umwana Kn ept off yabo (nibura urutoke rumwe rw'umuntu akuze-ubwaguke bw'ikibanza), and**s the back the.
• Gusuzuma igitanda canke igitanda (ABCs of Safe Sleep): Igihe cose umuntu asinzira (igihe co gusinzira n’ijoro) ategerezwa kuba Awenyene, ashizwe ku Back (supine), ku matela ikomeye kandi isongoye Crib canke bassinet ipfutse gusa n’igitambaro gifatanye neza. Kuraho imisego yose, ibipfukisho vy’impuzu, imifuko yo kuryamako iremereye, ibitanda vy’impuzu vy’impuzu vy’i DockATot, ibikoko vy’impuzu, n’ibitambaro vy’impuzu vy’impuzu vy’impuzu.
• Igenzura ry’ubushuhe bwo mu cumba n’ugukorana cane: Gushuha cane bituma ubwonko bw’uruyoya bugira ubushobozi bwo gukangura mu gihe afise ubukene bw’umwuka. Gumana icumba co kuraramwo kiri hagati ya 20 na 22.2 degrees Celsius (68 na 72 degrees Fahrenheit) kandi wambare umwana mu mpuzu imwe y’umubiri mutoyi kuruta iyo umuntu akuze yokwambara neza (nk’impuzu y’ipampa ishobora guhumeka imbere mu mpuzu yo kuryamako idafise uburemere).
• Igenzura ry’Umwotsi w’Ibintu Bikoreshwa mu Rugo n’Ibikoresho vy’Ibikoresho Bikoreshwa mu Rugo: Gukoreshwa n’ibiyayuramutwe, umwotsi w’itabi, canke ivy’ibiyobyabwenge ku mpuzu z’uwujejwe kwitwararika abana, bica bituma umwana agira ubushobozi bwo guhema no kuvyuka (oxygèneauto-resuscitation).

Inomero z'ivyihutirwa zo mu karere n'amategeko y'ibigo¶

Nimba umwana wawe w’uruyoya ahagaritse guhema ata co asigura, ibara ryiwe rihindutse, canke akagira ubumuga bwo kugenda nabi, hamagara igisata c’igihugu cawe co gufasha abagwayi vyihutirwa ubwo nyene maze umenyeshe uwurungitse imyaka nyayo y’umwana mu ndwi canke mu mezi:

• Leta Zunze Ubumwe za Amerika na Canada: Hamagara 911 ubwo nyene kugira ngo ubone ubuvuzi bwihutirwa (EMS) gutwara mu kigo c’ubuvuzi bw’abana gishobora gufasha abana. Ivyo gutoranya abana mu bitaro bikurikira Ishure ry’ubuvuzi bw’abana ryo muri Amerika (AAP) na Ishirahamwe ry’abaganga b’abana ryo muri Kanada (CPS) BRUE amabwirizwa y’ibikorwa vy’ubuvuzi. Niwaba wicura ko umuntu yariye ikintu canke umuti wo mu nzu mu mpanuka, hamagara kandi Ishirahamwe rijejwe kugenzura ubumara kuri 1-800-222-1222 (Amerika) canke 1-844-764-7669 (Kanada).
• Ubwongereza: Hamagara 999 ubwo nyene kugira ngo ubone ambulance y’ivyihutirwa iyo umwana ahagaritse guhema, akagira ubururu canke akagira umuhondo, canke akagenda aracumbagira, hanyuma utware uruyoya mu kigo kiri hafi Impanuka n’Ivyihutirwa vy’Abana (A&E) igisata. Isuzuma ry'ubuvuzi rikurikira Ikigo c'Igihugu c'Ubuzima n'Ukwitwararika (NICE) na Ishure ryisumbuye ry’Ubwami ry’Ubuvuzi bw’Abana n’Ubuzima bw’Abana (RCPCH) gusenyuka bukwi na bukwi inyuma y’ivuka (SUPC) na BRUE amabwirizwa. Ku bibazo vyo gukurikirana inyuma yo gusohoka, hamagara NHS 111.
• Ubumwe bw'Uburaya: Hamagara 112 mu bihugu vyose bigize Ubumwe bw'Uburayi kugira ngo ubone ko abana bashobora gufashwa vyihuse. Amategeko y'ubuvuzi akurikiza Inama y'Uburaya y'Ivy'Ugusubiza Ubuzima (ERC) amabwirizwa y’ishimikiro y’ubuvuzi bw’abana (asobanura impwemu 5 z’intango zo gukiza imbere yo gutangura gufata igifu ku rugero rwa 15:2 ku bamenyerejwe) n’ubuvuzi bw’igihugu bw’abana BRUE ingingo mfatirwako.
• Australiya na Nouvelle-Zélande: Hamagara 000 muri Australiya canke 111 muri Nouvelle-Zélande kugira ngo ambulance ibone vuba. Ibisata vy’ubuvuzi bw’abana vyihutirwa bikurikirana Ubushakashatsi ku bana mu bisata vy’ubuvuzi vyihutirwa Ishirahamwe mpuzamakungu ry’ubuvuzi bw’abana (PREDICT) na Ibitaro vy’abana vy’Ubwami (RCH) Melbourne amabwirizwa y'ibikorwa vy'ubuvuzi vy'umwaka w'2019 BRUE.
• Ubuhinde na Aziya-Pasifike: Hamagara 112 (inomero y’igihugu y’Ubuhindi y’ivyihutirwa), 995 (Singapour), 119 (Ubuyapani na Koreya y’Epfo), canke inomero y’ivyihutirwa yo mu karere kawe (raba vyose inomero z'ivyihutirwa) maze ukaja mu bitaro vy’icigwa ca gatatu bifise Igisata c’Abana bavutse vuba canke abana bavutse cane (NICU/PICU).

Ibibazo bikunda kubazwa¶

Ni kuki mu maso h’umwana wanje aherutse kuvuka hahindutse umutuku ukeye cane maze akahagarika guhema amasegonda 10 mu gihe yariko araboroga kugira ngo ashobore guca mu mara? Mbega ivyo ni UKURI?¶

Oya, iyo uruyoya rufise amagara meza rushaka guca mu mavyi canke mu gazi (ikibazo c’iterambere ry’uruyoya rwitwa infant dyschezia), ruca rufata inzira y’impwemu yugarijwe (ivyo bita Valsalva maneuver), ivyo bikaba bituma mu maso harwo hahinduka umutuku canke umutuku utukura cane, maze rugahagarika guhema mu masegonda 5 canke 10 mu gihe amaguru yarwo ariko aratera hejuru. Kubera ko imvo ari ugukora cane mu mubiri kandi iminwa n’ururimi vyo hagati vy’umwana ntivyigera bihinduka ubururu canke umweru nk’uw’ibinyoma, Ishure ry’Ubuvuzi bw’Abana ryo muri Amerika rirakuraho mu buryo butomoye ugutukura gusanzwe kw’amarira n’ugutera imbere kw’amavyi mu nsobanuro y’IKIBI.

Ibiganza n’ibirenge vy’umwana wanje birasa n’ibitukura gatoyi iyo nfunguye umupfuko wiwe, naho nyene ariko arahumeka neza. Noba nshobora guhamagara ambulance?¶

Ibara ry’ubururu rigarukira gusa ku biganza, ku ntoke, ku birenge no ku mano ku mwana aherutse kuvuka canke mutoyi vyitwa acrocyanosis, kandi ni ikintu kidatera ingorane, gisanzwe gitera imitsi iyo umuntu akoresheje umuyaga ukonjera, igihe utugingo ngengabuzima dutoduto two ku ruhande rw’umwana dufatanya kugira ngo umutima w’umwana ugume ushushe. Imisi yose nusuzume utugingo ngengabuzima two hagati tw’umwana: urabe iminwa, ururimi, amano n’igikiriza co hagati iyo hari umuco mwiza. Iyo ururimi n’iminwa bishushe kandi bifise ibara ry’agahama ry’agahama kandi umwana ariko arahumeka neza kandi ari maso, ni indwara y’umutima (acrocyanose) idashobora gutera ingorane; iyo iminwa, ururimi canke mu maso bihindutse ubururu, umutuku w’agahama, umutuku canke umutuku w’agahama, ni cyanose yo hagati kandi bisaba ko umuntu ahita ahamagarwa vyihutirwa.

Mbega gushikirwa n’indwara ya BRUE y’akaga gatoyi bisigura ko umwana wanje agiye gupfa n’indwara ya SIDS (Indwara y’urupfu rw’uruyoya rutunguranye)?¶

Ivyigwa vyinshi vy’ubuvuzi bw’abana vyerekana ko abana b’inzoya bafise ibisabwa vyose kugira ngo bashobore kugira BRUE y’akaga gatoyi (barengeje imisi 60, bavutse mu ndwi 32 z’ubuvyeyi canke inyuma y’aho, ikintu kimwe gitoyi kiba munsi y’umunota umwe, nta CPR ikenewe, kandi n’ikibazo c’umubiri gisanzwe n’ivy’ubuhinga bwa ECG) bafise ingorane nto cane z’urupfu rwo mu 1990. igitigiri c’abantu. Kwimenyereza ingeso zikomeye zo gusinzira neza (wenyene, ku mugongo, mu gitanda gikomeye ata co gifise) biraguma ari ngirakamaro ku mwana wese w’uruyoya.

Ni kuki umuganga wo mu cumba c’ubuvuzi bwihutirwa yampaye impanuro yo kudasaba ko umwana wanje BRUE afise ingorane ntoyi amupima amaraso, akamupima mu mugongo, akamupima ubwonko?¶

Iyo umwana w’uruyoya afise imisi irenga 60 yuzuza neza ingingo ngenderwako yose y’ubumuga bwo mu mutwe (Low-Risk BRUE criterion) kandi afise ikizame c’umubiri gisanzwe, ivyigwa vyinshi vy’ubuvuzi birimwo ibihumbi vy’abana b’inzoya vyerekana ko gukura amaraso, gutobora mu rubavu, gupima igifu, no gupima ubwonko bishobora gutuma umuntu agira ingorane nyinshi. uruyoya ku mishwarara, ububabare, ibisubizo vy’ibinyoma, n’indwara ziterwa n’ibitaro. Ahubwo, amabwirizwa yemewe ya AAP asaba amasaha 1 gushika ku 4 yo gukomeza kwihweza umuvuduko w’amaraso, ECG y’amabara 12 idatera, gufata igipimo co mu mazuru iyo umuntu akeka ko afise indwara y’ibicurane, no gukurikirana cane umuganga wawe w’abana mu masaha 24.

Noba nogura igikoresho co gupima guhema c’abaguzi canke clip-on diaper inyuma y’aho umwana wanje afise BRUE?¶

Ishure ry’ubuvuzi ry’abana ryo muri Amerika be n’ishirahamwe ry’ivy’ibifungurwa n’imiti ryo muri Amerika rigira inama abavyeyi ko badakwiye kwizigira amasoseti y’ubwenge, amafoto canke amasogisi y’abaguzi kugira ngo bakingire SIDS canke ngo bakurikirane umwana w’uruyoya amaze gufatwa n’indwara y’ibicurane, kubera ko ibikoresho vy’abaguzi kenshi bibura hypoxemie mu gihe bitera inkengeri z’ibinyoma. Iyo umwana wawe w’uruhinja asuzumwe ko afise BRUE y’akaga gakomeye, ko avuka atarashika cane, canke ko afise ubumuga bw’umutima/inzira y’impwemu busaba ko akurikiranwa muhira, umuhinga mu vy’impwemu azokwandikira igikoresho co kugenzura umutima n’impwemu gifise urugero rw’ubuvuzi rwemewe na FDA hamwe n’amahugurwa y’abavyeyi yo gucungera impwemu.

Ni itandukaniro irihe riri hagati y’UBRUE mu mwana w’amezi 2 n’ubupfumu bwo gufata impwemu mu mwana w’amezi 14?¶

BRUE igaragara cane cane ku bana bato bari munsi y’amezi 12 kandi ntibisigura, akenshi igaragara mu gihe umuntu asinziriye, aruhutse canke afungura. Mu buryo butandukanye n’ubwo, igihe co guhagarika impwemu gikunda gushika ku bana batoyi bafise amezi 6 gushika ku myaka 6 inyuma y’aho ikintu gitomoye giteye: haba ari ukurira bivuye ku kubabara (cyanotic blue spell) canke akabombo gatoyi gatunguranye canke ubwoba (pallid white spell). Ivyo vyose bisaba ko umuntu asuzumwa n’abaganga igihe bibaye ubwa mbere, harimwo n’ugupima ECG kugira ngo abone ko afise ibihe vy’umubiri bifise ibara ry’agahama.

Inyobora zifitaniye isano¶

• Gufata impwemu (ubururu n'uguhungabana) n'ugutoranya impwemu y'uruyoya
• CPR y'abana n'inzoya no kunyiganyiga
• Botulisme y'uruyoya, kurya ubuki butagiramwo ibinure, indwara y'abana batoyi, n'ugufata inda
• Umuhondo w'umwana aherutse kuvuka, kernicterus, ubunebwe, n'ukubura amazi mu mpuzu zitose
• Inomero z'ivyihutirwa

Amasoko n'ubuyobozi buzwi¶

• Ishure ry'ubuvuzi bw'abana ryo muri Amerika (AAP, Leta Zunze Ubumwe za Amerika): Ingingo ngenderwako y’Ibikorwa vy’Ubuvuzi: Ibintu Vyabaye Bitasobanuwe Vyatowe Mu Ncamake (BRUE) (Ibintu vyari bigaragara ko bishobora gutera ubuzima) n’ugusuzuma abana b’inzoya bari mu kaga gatoyi (Tieder n’abandi, Pediatrics) na Ishirahamwe ry’abajejwe ivy’urupfu rw’abana b’inzoya ry’impanuro zijanye n’ugusinzira neza.
• Ishirahamwe ry'abaganga b'abana ryo muri Canada (CPS, Canada): Iciyumviro c’Ivyigwa ca Komite y’Ukwitwararika Abarwayi: Gucungera Ivyabaye Bidasobanutse Vyatowe umuti Mu Bugufi Bifise Akaga Gatoyi (BRUE) mu Bana b’Inzoya.
• Ikigo c'Igihugu c'Ubuzima n'Ukwitwararika (NICE) n’Ishure ryisumbuye ry’Ubwami ry’Ubuvuzi bw’Abana n’Ubuzima bw’Abana (RCPCH, Ubwongereza): Ingingo ngenderwako zo gukora itohoza ku bijanye n’ugusenyuka kw’umwana ataco yiteze inyuma y’ivuka (SUPC) n’Ibintu Biboneka ko Bitera Ubuzima Mu Kaga Mu Buto.
• Ibigo bijejwe kugenzura no kwirinda indwara (CDC, Leta Zunze Ubumwe za Amerika): Ibiranga indwara y’ibicurane (Igicurane) n’Indwara y’Uguhagarika umutima mu bana bato bari munsi y’amezi 6.
• Ishirahamwe mpuzamakungu ry'ubuzima (WHO) na Komite Mpuzamakungu y’Ihuza ry’Ivy’Ugusubiza Ubuzima (ILCOR): Ubufasha bw'ubuzima bw'ishimikiro bw'abana (PBLS) Uguhuriza ku vyerekeye siyansi n’impanuro z’ubuvuzi.