Okuqukethwe
Ukuze odokotela bakwazi ukuhlola imisebenzi ebalulekile yosana olusanda kuzalwa, isikali se-Apgar sahlongozwa ngo-1952. Isikali se-Apgar siqanjwe ngodokotela waseMelika, uchwepheshe wezifo zezingane nezinzwa, uVirginia Apgar. Isifinyezo, esakhiwe kamuva, ngo-1962, sichaza imingcele emihlanu lapho umntwana osanda kuzalwa engaphansi kwayo. Lezi zinhlaka zibhekisela kuphi?
Isilinganiso se-Apgar sinquma ukuthini?
Okokuqala: Isikali se-Apgar isifinyezo esithathwe emagameni esiNgisi: ukubukeka, ukushaya kwenhliziyo, i-grimach, umsebenzi, ukuphefumula. Asho ngokushintshana: umbala wesikhumba, ukushaya kwenhliziyo, ukusabela ekushukumeni, ukungezwani kwemisipha nokuphefumula. Isilinganiso samaphuzu atholwe maqondana nesici esisodwa sisuka ku-0 siye ku-2. Kukuziphi izimo lapho ingane izothola khona u-0 futhi nini amaphuzu angu-2? Ake siqale ekuqaleni.
Umbala wesikhumba: amaphuzu angu-0 - i-cyanosis yomzimba wonke; Iphuzu elingu-1 - i-cyanosis yezitho ezikude, i-pink torso; 2 amaphuzu - umzimba wonke pink.
Pulse: amaphuzu angu-0 - ishayela alizwakali; Iphuzu elingu-1 - ukushaya kwenhliziyo okungaphansi kuka-100 ngomzuzu; Amaphuzu ama-2 - ukushaya kwenhliziyo okungaphezulu kwe-100 ngomzuzu.
Ukusabela ku-stimu ngaphansi kokuhlolwa okubili, lapho udokotela efaka i-catheter emakhaleni futhi ecasula phansi ezinyaweni: amaphuzu angu-0 - asho ukusabela kokubili kokufakwa kwe-catheter nokucasuka kwezinyawo; Iphuzu elingu-1 - isimo sobuso esimweni sokuqala, ukunyakaza konyawo kancane okwesibili; Amaphuzu angu-2 - ukuthimula noma ukukhwehlela ngemva kokufakwa kwe-catheter, ukukhala lapho ama-soles ecasukile.
Ukungezwani kwemisipha: Amaphuzu angu-0 - umzimba wengane esanda kuzalwa i-flaccid, imisipha ayibonisi ukungezwani; Iphuzu elingu-1 - izitho zengane zigobile, ukungezwani kwemisipha kuncane; Amaphuzu angu-2 - ingane yenza ukunyakaza okuzimele futhi imisipha iqine kahle.
Ukuphefumula: 0 amaphuzu - ingane ayiphefumuli; Iphuzu elingu-1 - ukuphefumula kuhamba kancane futhi akulingani; Amaphuzu angu-2 - umntwana osanda kuzalwa ukhale kakhulu.
8 – 10 amaphuzu kusho ukuthi ingane isesimweni esihle; 4 – 7 amaphuzu isilinganiso; Amaphuzu ama-3 noma ngaphansi kusho ukuthi ingane yakho esanda kuzalwa idinga ukunakwa ngokushesha.
Tadisha usebenzisa isikali i-apgarukwenza kube nenjongo, kwenziwe:
- kabili: ngomzuzu wokuqala nowesihlanu wokuphila - ezinsaneni ezizalwa zisesimweni esihle (ezithole amaphuzu angu-8-10 we-Apgar).
- izikhathi ezine: emizuzwini yokuqala, yesithathu, yesihlanu neyeshumi yokuphila - ezinganeni ezisanda kuzalwa ezizalwa endaweni ephakathi (amaphuzu angu-4-7 we-Apgar) kanye nesimo esinzima (0-3 amaphuzu we-Apgar).
Ukuphinda ukuhlolwa Isikali se-Apgar kubalulekile njengoba impilo yengane ingase ibe ngcono, kodwa ngeshwa ingase yonakale.
Kungani i-Apgar Scale Assessment ibaluleke kangaka?
indlela umbala we-Apgar iyasebenza ngoba ikuvumela ukuthi uchaze izinto eziyisisekelo imingcele yezempilo yengane. Kodwa-ke, omunye wemisebenzi yokuqala yosana olusanda kuzalwa oluhlolwa udokotela wokubelethisa ukuthi umntwana uyabonisa yini ukuphefumula okufanele. Ingabe ilinganayo, evamile, evamile? Lokhu kubaluleke kakhulu ngoba usana olusanda kuzalwa lushiya umzimba kanina ezweni eselimusha ngokuphelele kuwo. Kuyamethusa, ngakho enye yezinto zokuqala ukusabela ukuklabalasa. Lokhu kuvumela udokotela ukuthi azi ukuthi umntwana osanda kuzalwa uyaphefumula. Ukuhlola kuyalandela ukuphefumula njalo. Uma kungejwayelekile, kudingeka umoya-mpilo. Izingane ezizalwa ngaphambi kwesikhathi zivame ukuthinteka ukuphefumula okungajwayelekile. Lokhu kungenxa yokuthi amaphaphu awakakhuli kahle. Izingane ezinjalo azitholi amaphuzu aphezulu kakhulu umbala we-Apgar.
Umsebenzi wenhliziyo ojwayelekile futhi kuyisici esibaluleke kakhulu ekuhloleni impilo yengane. Ukushaya kwenhliziyo okungokomzimba kufanele kube ngaphezu kwamabhithi ayi-100 ngomzuzu. Ukwehla okuphawulekayo kwezinga lokushaya kwenhliziyo (ngaphansi kuka-60-70 beats ngomzuzu) kuyisignali yokuthi udokotela enze ukuvuselela.
Ngokwe ukuguqulwa kwesikhumba, kufanele kuqashelwe ukuthi izingane ezizalwa ngamandla emvelo zingase ziphaphatheke kunezisanda kuzalwa onina abahlinzekwe ngokuhlinzwa. Nokho, kungenxa yalesi sizathu ukuthi ukuhlolwa kwenziwa Isikali se-Apgar izikhathi ezine - impilo yengane ingase ishintshe umzuzu nomzuzu.
Ingane encane enempilo kufanele ibonise ithoni yemisipha eyanele futhi ibonise ukumelana nokuqondisa izitho. Uma kungenjalo, kungase kubonise ukuphazamiseka ohlelweni lwezinzwa noma ukungena kwe-oksijeni okwanele komzimba wosana olusanda kuzalwa. Ukuxega kwemisipha nakho kungabonisa isifo esingakatholakali esibelethweni. Ngokusho umbala we-Apgar ingane ekhwehlelayo noma ethimula ngemva kokufaka i-catheter ekhaleni layo ibonisa ukusabela okuvamile komzimba futhi ingathola inani eliphakeme lamaphoyinti ale pharamitha.