Peb cov laus tsis sib luag. Ntxiv rau ntau qhov sib txawv hauv qhov tsos, peb txawv hauv qhov siab thiab qhov hnyav, uas tsis muaj leej twg tshwj xeeb yog kev txhawj txog. Tab sis nws yog ib qho tseem ceeb heev - cov me nyuam me. Cov menyuam yug tshiab (thiab cov menyuam tseem tsis tau xeebtub), cov kev tshwj xeeb raug suav ua ke, qhov hloov ntawm qhov feem ntau hais tias ib yam dab tsi tsis yog rau tus menyuam. Lub cim tseem ceeb yog qhov hnyav. Yog vim li no nws tseem ceeb ua luaj rau tswj nws lub cev tam sim no - ib tug me nyuam hauv plab yuav yog ib txoj kev ua mob loj heev uas tsis yog tas nrog lub neej.
Qhov hnyav ntawm tus me nyuam tam sim tom qab yug me nyuam tseem ceeb heev rau nws txoj kev loj hlob ntxiv, tshwj xeeb tshaj yog hauv thawj xyoo ntawm lub neej. Nws muaj peev xwm los txhawb tag nrho nws kev noj qab haus huv yav tom ntej. Cov me nyuam uas yug los nrog lub cev tsis hnyav hnyav (txog li 2.5 kg), Muaj ntau dua tuaj yeem cuam tshuam rau obstetric complications: lawv muaj ntau heev dua rau lub cev nws tus kheej; Hauv lawv, feem ntau dua li cov me nyuam uas muaj menyuam coob tshaj, cov tshuaj hypohymia tawm tsam, thiab ntau yam kev puas hlwb.
Pathology los yog ib qho ntawm cov kevcai tswjfwm?
Cov kws kho mob tau muaj lub tswv yim zoo li cov kev cai lij choj uas txuam rau cov khoom siv tshiab. Hauv qee tsev neeg, tag nrho cov me nyuam hauv ob peb tiam neeg yug los nrog ib pawg tsawg, tab sis lawv tsis muaj qhov tseem ceeb ntawm txoj kev loj hlob. Cov me nyuam me feem ntau yug nrog cov niam txiv nyias muaj nyias siab tsis siab (tsawg dua 160 cm). Hauv qhov no, txawm tias thaum cev xeeb tub, ib tug me nyuam mos muaj tus mob me me, thiab tom qab ntawd tus menyuam muaj lub cev me me hnyav. Txawm li cas los xij, nws muaj kev noj qab nyob zoo thiab tsis muaj kev nyuaj ntxiv rau lub caij nyoog ntawm kev hloov mus rau neeg laus.
Tab sis kuj yog ib tug me nyuam me muaj peev xwm qhia tau hais tias kev mob loj ntawm cev xeeb tub - qhov tsis taus fetoplacental. Nyob rau hauv cov ntaub ntawv no, xws li ib tug pathology, uas yog ib tug syndrome ntawm fetal kev loj hlob ncua (lwm yam - fetal hypotrophy), yuav tsum tau tshwj xeeb mloog. Tias cov kab mob hypotrophy zoo, thaum tag nrho cov plab hnyuv siab raum ntawm lub cev yog txo kom sib npaug thiab asymmetrically, thaum lub cev pob txha thiab lub hlwb sib tawg mus rau lub sijhawm tam sim no ntawm cev xeeb tub, thiab cov hauv nruab nrog cev tau poob qab hauv kev loj hlob. Qhov ua rau kev mob ntsws no yog kev haus luam yeeb, cawv, chromosomal abnormalities, intrauterine infections.
Qhov ua rau yug me nyuam uas muaj hnyav tsawg
Feem ntau asymmetric hypotrophy tshwm sim nyob rau hauv lub xeem trimester nyob rau hauv muaj teeb meem ntawm cev xeeb tub thiab ntev mob nyob rau hauv leej niam. Txhua yam kev mob uas ua rau kev ua txhaum ntawm cov ntshav kev ua rau ua rau qeeb hauv kev loj hlob thiab kev loj hlob ntawm tus me nyuam hauv plab. Kev mob kab mob ntawm cov poj niam, uas muaj kab mob hauv qhov chaw ua rau qaug zog thiab tsis muaj oxygen tsis tuaj yeem tab sis muaj feem cuam tshuam rau tus me nyuam, uas ua rau txoj kev loj hlob ntawm tib hom hypotrophy.
Cov lus nug ntawm tus ntawm niam lub khoom noj khoom haus rau tom ntej kev loj hlob ntawm lub fetus tseem muaj teeb meem. Raws li kev txheeb cais, cov poj niam uas muaj qhov ceeb thawj ntawm qhov hnyav, ntawm kev noj zaub mov low-calorie, feem ntau muab yug me nyuam uas tsis tshua muaj hnyav li lub cev. Txawm li cas los xij, ib tug tsis tuaj yeem tsis pom cov ntaub ntawv raws li, txawm tias thaum lub sijhawm Leningrad thaiv, cov menyuam yaus (thiab feem ntau heev) cov menyuam muaj qhov siab thiab qhov hnyav tau yug los.
Lub hnub nyoog ntawm leej niam tseem ua ib txoj haujlwm tseem ceeb. Cov poj niam uas muaj hnub nyoog 18 xyoo thiab qis dua thaum muaj hnub nyoog 35 xyoo muaj kev pheej hmoo siab ntawm kev xeeb tub hauv plab thaum cev xeeb tub. Lub cev yog ib tug menyuam mos heev thiab tsis yog npaj rau kev ua haujlwm tom ntej, thiab ob yam ntawm leej niam feem ntau muaj kab mob ntev ntev. Tsis tas li ntawd, txoj kev loj hlob ntawm hypotrophy yog nce los ntawm kev haus luam yeeb, raws li nws ua rau ib tug qhia tau qis ntawm cov hlab ntsha thiab txo qis ntawm cov ntshav qis.
Diagnostics
Qhov tseeb tshaj plaws ntawm txoj kev kuaj mob fetus yog ultrasound. Nyob rau hauv chav kawm ntawm nws, tus kws kho mob ntsuas thiab ntsuam xyuas ntau yam tsis. Qhov tseeb ntawm tus mob tau txiav txim xyuas qhov zoo thiab kev daws teeb meem ntawm lub cuab yeej, tau tsim Doppler. Tsis tas li ntawd, ultrasound tshuaj xyuas kev mob ntawm amniotic kua, tso cai txhawm rau txheeb xyuas cov kev txawv txav hauv kev ua haujlwm ntawm lub tsho me nyuam, thiab kev hloov hauv cov ntshav hauv Doppler.
Yuav kom thaum kawg qhia qhov kev ntsuam xyuas, Doppler txoj kev kawm ntawm lub hlwv thiab cov hlab ntsha ntawm lub fetus thiab cov hlab ntsha ntawm lub tsho me nyuam - thaum tus kws kho mob khiav qhov ceev thiab qhov xwm ntawm cov ntshav khiav ntawm lawv. Ntxiv nrog rau dopplerometry, cardiotocography yog ua kom tiav rau tus cwj pwm ntawm kev hloov hauv fetal lub plawv beats teb rau nws tus kheej perturbation lossis contractions nyob rau hauv lub tsev menyuam. Yog tias dopplerometry thiab CTG qhia tau cov ntaub ntawv tseem ceeb (txawm tias yog me nyuam fetus me), ces qhov no qhia tau tias kev noj qab haus huv ntawm tus me nyuam. Yog tias qhov kev ntsuam xyuas tsis tau qhia yam txawv, ces peb tham txog kev noj qab nyob zoo me nyuam hauv plab. Ib tug poj niam tsuas pom tias tsis muaj kev kho ntxiv.
Kev kho mob
Yog tias tus me nyuam loj hlob zuj zus thaum cev xeeb tub, ces tsis tas yuav kho. Tab sis yog tias muaj kev pheej hmoo los yog muaj pathology hauv kev loj hlob ntawm fetus, ces kev kho ntawm hypotrophy yuav kho tus poj niam cov kab mob thiab cov teeb meem ntawm cev xeeb tub. Tsis tas li ntawd, kev kho ntawm plasmob tsis muaj txhij txhua yog ua tiav. Tus nab npawb ntawm cov vasodilators tau sau rau tus poj niam los txhim kho cov ntshav txaus rau cov hlab ntsha ntawm lub tsev menyuam thiab tus menyuam mos. Tsis tas li ntawd, cov tshuaj tau muab rau kom khov tau cov leeg ntawm lub tsev menyuam, vim hais tias nws cov tone nce compresses cov hlab ntsha thiab ua rau cov ntshav khiav. Thov cov tshuaj uas ua rau tus me nyuam hauv plab hnyuv txhawm rau hypoxia - feem ntau "sib luag" ntawm plab me nyuam hauv plab nyom. Nyob ntawm tus mob ntawm tus me nyuam hauv plab, kev kho yuav ua tau tom tsev los yog hauv tsev kho mob.
Cov qauv thiab lub sijhawm ntawm kev yug yog nyob ntawm qhov loj ntawm qhov fetus. Yog hais tias qhov kev kho mob pab thiab tus me nyuam muaj mob hnyav, ces tsis muaj kev nkag siab ntawm qhov pib qhov kev ua haujlwm. Feem ntau ntawm qhov kawg ntawm cev xeeb tub tus me nyuam nws tus kheej ncav qhov loj me me. Yog tias tus me nyuam tsis nce phaus, txawm tias txoj kev kho mob, ces ua rau yug me nyuam. Nrog lub sij hawm gestation ntawm 36 lub lim piam thiab npaj txhij-yug me nyuam, cov kws kho mob tau tsa los ntawm kev mob hnyav. Qhov kev yug menyuam yog kev tswj hwm. Nrog fetal hypotrophy, kev yug menyuam feem ntau yog ua los tiv thaiv tus keeb kwm yav dhau los ntawm kev siv tshuaj loog los ua kom tau qhov siab tshaj plaws. Tom qab ntawd lub ncauj tsev menyuam ntawm lub tsev me nyuam qhib muaj zog, tus me nyuam txav tau yooj yim dua los ntawm kev yug me nyuam. Tab sis yog hais tias tus me nyuam mos tsis muaj zog li ntawd nws yuav yog ib qho kev kuaj tsis zoo, ces qhov kev ua haujlwm yog ua los ntawm lub cev nqaij daim tawv.