Ana amfani da ma'aunin Apgar ta hanyar obstetricians don tantance tsarin aiki na jariri. Ana gudanar da tsari a cikin gandun daji a cikin minti na farko bayan haihuwar jariri. Bari mu duba dalla-dalla akan algorithm na kimantawa, zamu gano: yadda aka ƙidaya maki a kan sikelin Apgar, da abin da suke nufi.
"Scale Apgar" - mece ce?
Bayan da aka sanar da mahaifiyar labarun gwagwarmaya, tambayar da abin da Apgar yake nufi shi ne abin da ake amfani da ita a cikin tunanin sabon jariri. Wannan dabarar ta hada da ƙayyade manyan alamu na aiki waɗanda ke nuna yanayin jaririn a farkon minti na rayuwarsa. Sakamakon sakamakon yana taimakawa wajen tantance yanayin ƙwayar katako.
Girman Apgar, wanda aka yi amfani da ita a haife shi, ya nuna daidai aiki na gabobi masu muhimmanci da kuma tsarin. Bisa ga binciken, likitoci sun bada karin haske game da iyawar ɗan yaron, da bukatar buƙatarwa. Binciken jihar a kan ma'auni na Apgar ya taimaka wa yara don samun bayanai game da jariri a farkon minti bayan haihuwa.
Matar Apgar - tarihin bayyanar
Jihar farko na jariri a kan Apgar sikelin an gwada shi ta farko daga likitan likitancin likitancin Amurka. Nan da nan an kira sunan ta hanyar da kanta. An amince da matakin ƙididdigar a cikin karni na 20, a wani taron zane-zane. A wannan biki, Virginia Apgar ya ba da shawarar tantancewar jariri ba kawai a kan aikin jikinsa ba, amma har da la'akari da yiwuwar tasowa a cikin kwakwalwa a cikin jiki. Nan da nan bayan majalissar, an yi amfani da matakan Apgar da aka yi amfani dashi a cikin obstetrics.
Menene aka tantance a kan sikelin Apgar?
Binciken wani jariri a kan Apgar sikelin yana nuna gudanar da taƙaitaccen taƙaitaccen hukunce-hukuncen 5 a lokaci guda. Kowace waɗannan alamun suna kiyasta akan ma'auni uku (maki 0-2). Sakamakon ya nuna kimantawa a cikin kewayon daga 0 zuwa 10. Ya kamata a lura da cewa wannan jigidar ita ce, tare da nauyin nauyi da tsawo, alamun mahimmanci da aka ruwaito ga sabon mama. Kira na farko a kan samfurin Apgar an yi shi a farkon minti na rayuwa.
Domin mafi yawan haddacewar masu nuna alamun da aka gudanar da asibitocin, dan jaririn Josef Butterfield ya nuna amfani da sunan APGAR a matsayin raguwa:
- A - bayyanar - launin fata;
- P - bugun jini - adadin heartbeats;
- G - grimace - reflexes;
- A - aiki - sautin tsoka;
- R - respiration - yawan motsi na numfashi.
Yaya yanayin yanayin jariri?
Binciken jihar na jaririn a kan ma'auni na Apgar baya buƙatar kasancewa da kayan kida na musamman da kida. A cikin wannan hanya, jaririn ya fallasa nan da nan 2 alamomi: bayan haihuwa da kuma minti 5. A wannan yanayin, ana nuna alamun farko a cikin adadi, lambobi na biyu a cikin maƙillan. Bincike na jihar na jaririn ya ƙunshi cikakkiyar dukkanin alamun 5:
- Skin - suna da ruwan hoda mai ruwan hoda, daga kodadde zuwa haske. Don wannan ba da maki 2. Tare da ƙyallen cyanotic da kafafu - 1 aya, uniform blue inuwa fata - 0.
- Zuciyar zuciya - matsakaicin matsakaici ga jarirai shine 130-140 dari a minti daya. Duk da haka, a cikin kimantawa da magungunan magungunan masu amfani da wadannan ka'idoji ana amfani dashi: fiye da 100 batutu - maki 2, kasa da dari 100 - 1 aya, rashin bugun jini - 0 (buƙatar sake buƙata).
- Rashin juyayi suna daga cikin kwakwalwar da ba a daɗewa ba a cikin kowane jariri: numfashi na farko, kuka, haɗiye da tsotsa. An kiyasta su a maki 2, rashi babu - 1, cike - 0.
- Sautin murya - bayan haihuwar, an nuna jaririn a cikin kirji, da hannayensu suna kanne a gefuna, hannayensu sun shiga cikin yatsun hannu. Ƙafãfun kafa suna lankwasawa a cikin kwakwalwa da gwiwa. Ƙungiyar ƙungiyoyi ba ta da cikakke - yara suna ɗaukar makamai da ƙafafunsu, kuma a wannan yanayin neonatologists sunyi maki 2. Tare da jinkirin kwakwalwa, an saita maki 1, an ƙaddamar da sautin muscle mai rauni a maki 0.
- Harkokin na numfashi - matsakaicin 40-45 a minti daya. Wannan mita yana da al'ada kuma maki 2 suna cajin shi. A lokaci guda kuma, an yi kira na farko na jaririn, wanda ya kamata ya zama mai ƙarfi da tsanani. Tare da numfashi mai raɗaɗi da murya kamar ƙuƙwalwa - 1 aya ana nunawa, cikakkiyar numfashi ko kuka - 0.
Apar sikelin - tsarawa
Abubuwan da ke a kan Apgar sun ba likitoci damar tantance yanayin jariri, yin hasashen. Saboda haka, yaro mai lafiya a kan ma'auni na Apgar ya tattara a cikin adadin maki 7-10. A lokaci guda kuma, ƙananan ƙananan yara suna karɓar mafi girma. Kwarewa ɗaya shine 7/8 da 8/9. Matsayi na biyu, an saita a minti 5 bayan haihuwar jaririn, 1-2 dabi'u mafi girma. Muhimmiyar rawar da wannan ke takawa ta hanyar hanyar aikawa. A aikace, jariran da waɗannan sassan ne suka haifa sun sami 'yan maki fiye da waɗanda aka haife su ta jiki.
Mene ne ake nufi da Apgar?
Yin amfani da hanyar da aka kwatanta da ma'auni na Apgar, ƙaddamar da ma'anar da jariri ya karɓa ya yi kai tsaye ta hanyar likitoci. A wannan yanayin, likitoci don wannan alamar za su iya nazarin yanayin ɗan yaron nan da nan, ba da shawara akan cin zarafi ba. Don haka, a lokacin da aka kimantawa 5-6 a lokacin haihuwar, masanan neonatologists sun nuna sauƙin sauƙin hypoxia . Idan jaririn yana samun maki 3-4 - yawan nauyin rashin jin dadin iskar oxygen an gano shi, 0-2 - yana nuna mummunan mataki - cin zarafin da ake buƙatar kulawar gaggawa.
Apar sikelin - tebur
An yi la'akari da yarinyar a kan samfurin Apgar ta yin amfani da tebur. Ya lissafa duk sigogi masu yiwuwa da ɓatattun su. Doctors sun tantance ainihin jaririn yayin kallon abin da sigogi ya zama al'ada. Masanan ilimin neonologists zasu iya ba tare da amfani da ingantacciyar hanya ba, ƙayyadaddun damar tantance yanayin jaririn kuma ya fitar da wata ƙira. An shigar da sakamakon a cikin rubutun likita.
Low Apgar yawa
Matsananciyar Apgar zai iya nuna bambancin rashin ciwo da cututtuka a cikin jariri. Daga cikin dalilai masu yawa da ke haifar irin wannan yanayin jariri:
- hypoxia na tayin a lokacin yarinyar da kuma a cikin haihuwa;
- immaturity na jiki - wanda aka nuna ta hanyar yin amfani da shi, rashin karuwa, rashin ƙungiyoyi, kwakwalwa. Yaron yana barci na dogon lokaci, yana da ƙananan abinci.
Idan jaririn ya sami darajar a kan samfurin Apgar a cikin minti na farko, yana da muhimmanci a ƙara wannan sita ta 1-2 points a cikin minti 5. Irin waɗannan canje-canje sun nuna alamar da ta dace. Duk da haka, irin wannan yaron yana buƙatar kulawa ta atomatik, kulawa ta musamman daga ma'aikatan kiwon lafiya. Idan yanayin yaron ya damu, mayarwa yana iya zama dole.