Alamomi da maganin ƙarancin ruwan jiki (Dehydration)

 Gabatarwa:

Ruwan jiki abubuwa ne masu muhimmancin gaske a jikin duk wata halitta. Jikin ɗan adam yana buƙatar ruwan jiki domin aiwatar da ayyuka da dama, kamar irin su daidaita zafi da sanyin jiki, ƙirƙirar wasu sinadarai masu amfani a jiki, taimaka wa jini domin jigilar abinci da iskar oxygen zuwa sauran sassan jiki da dai sauran su. Ƙaranchin ruwan jiki alama ce ta wata cuta, saboda mafi akasari tana zuwa ne sanadiyyar wata cuta. Yara ƙanana da jarirai su ne suka fi yawan samun matsalar ƙarancin ruwan jiki saboda sun fi manya buƙatar ruwan jiki[¹]

Mene ne ƙarancin ruwan jiki?

Likitoci masu ƙwarewa ta musamman a fannin kula da lafiyar yara sun fassara ma'anar ƙarancin ruwan jiki da, rashin isashen ruwan jikin da zai taimaka wa jiki yayi dukkan ayyukan da ya kamata, ko kuma jiki ya kasance yana hasarar ruwa fiye da yanda yake samu.

Ko wane bil adama akwai yawan ruwan da ake buƙatar yasha kulum, wanda ya kamata yayi daidai da yawan ruwan da yake hasara kullum ta hanyar fitsari, ban haya da kuma zufa domin a tabbatar da daidaituwa a tsakanin ruwan jiki (water balance)[¹].

Yana da kyau a fahimta cewa a duk lokacin da mutum yayi hasarar ruwan jiki toh hakan zai sa ya iya hasarar waɗansu sinadarai tare da ruwan, kamar irin su sinadarin sodium (Na+), sinadarin potassium (K+) sinadarin chloride (Cl-) da dai sauransu.[²]

Alamomin ƙarancin ruwan jiki

Alamomin ƙarancin ruwan jiki sun danganta da girman marar lafiya da kuma tsananin ƙarancin ruwan, kamar yadda muka ambata a baya, yara sune suka fi shan wahala a lokacin da suka sami matsalar ƙarancin ruwan jiki. Muhimmai daga cikin alamomin da ƙarancin ruwan jiki yake nuna wa sun haɗa da;

1. Rashin ƙarfin jiki

2. Bushewar baki

3. Rashin isashen yawu a baki

4. Yaro yana kuka ba hawaye

5. Raguwar fitsari

6. Ganin juwa

7. Jiri

8. Kasala

9. Yawan jin ƙishirwa.

10. Ruɗewa

11. Fita hayyaci; idan ƙarancin yayi tsanani 

12. Fitsari mai duhu.

13. Ciwon kai

Kashe-kashen ƙarancin ruwan jiki

Masana sun kasa ƙarancin ruwan jiki kashi uka yayin da suka yi la'akari da yawan ruwan jikin da marar lafiya ya rasa.[²]

1. Ƙarancin ruwan jiki mai sauƙi; Shi ne ƙarancin ruwan jikin da ke faruwa a lokacin da mutum ya rasa ruwan da bai kai kimanin kashi biyar (5) na daga nauyin jikin sa ba a lokacin da yake lafiya lau. (Less than 5% of body weight).

2. Ƙarancin ruwan jiki matsakaici: Shi ne ƙarancin ruwan jikin da ke faruwa a lokacin da mutum ya rasa ruwan da zai kai kimanin kashi biyar (5) zuwa kashi goma (10) na nauyin jikin sa a lokacin da yake lafiya lau.

3. Ƙarancin ruwan jiki mai tsanani: Shi ne ƙarancin ruwan jikin da ke faruwa a lokacin da mutum ya rasa ruwan da zai kai kimanin fiye da kashi goma cikin ɗari na nauyin sa a lokacin da yake lafiya lau.

Abubuwan da ke kawo ƙarancin ruwan jiki

Ƙarancin ruwan jiki yana faruwa ne  a lokacin da mutum ya rage samun isasshen ruwan sha ko kuma  hasarar ruwan jikin da yakeyi ya rinjayi ruwan da yake samu a jikin sa ko kuma dukan biyu. Muhimman abubuwan da ke kawo ƙarancin ruwan jiki ga ɗan adam sun haɗa da[³].

1. Ciwon atuni (ɗiɗɗira)

2. Amai da gudawa

3. Rashin samun isasshen ruwan sha kamar lokacin azumi ga manya.

4. Zazzaɓi ko masassara

5. Yawan fitsari, kamar masu ciwon suga da ƙoda

6. Yawan zufa.

Yadda ake maganin ƙarancin ruwan jiki a asibiti

Da farko dai likita zai yi tambayoyi masu zurfi ga marar lafiya domin gane yanda abin ya fara da kuma mi ye musabbabin kawo ƙarancin ruwan jiki. Idan ƙaramin yaro ne, mahaifiyar sa ko wanda ke kula da yaron shi ke da alhakin amsa waɗannan tambayoyi. Bayan gama ɗaukar bayanai likita zai duba marar lafiyar akan gadon asibiti domin ƙara tabbatar da bayanan da ya ɗauka[¹].

Alamomin da likita zai iya ganin yayin duba marar lafiya mai ƙarancin ruwan jiki

Waɗannan alamomi sun danganta da shekarun marar lafiya da kuma matakin ƙarancin ruwan jiki.

A ƙarancin ruwan jiki mai sauƙi mafi akasarin alamomin basu fara bayyana ba, amma likita kan iya lura da ƙaruwar bugun jini ko kuma bugun zuciya fiye da yanda ya kamata.

A ƙarancin ruwan jiki matsakaici alamomin ƙarancin ruwan jiki sun fara bayyana amma ba sosai ba. A wannan matakin likita zai iya lura da waɗannan[⁴]; 

1. Ƙaruwar bugun zuciya da ake ƙirgawa a hannu fiye da sau ɗari (100) acikin minti ɗaya (1).

2. Idan ƙaramin yaro ne zai kasance mai fitina

3. Maɗigar ƙaramin yaro (ɗan ƙasa da shekara biyu da wata bakwai) zata zurma daga ciki.

4. Idanu sukan shige daga ciki

5. Yaro na iya kuka ba hawaye

6. Bakin yaro zai bushe

7. Idan aka ja fatar marar lafiya da hannu ba zata koma da sauri ba. (Kamar yanda zamu iya gani a hoton da ke ƙasa).

8. Matsa lambar jini zai ragu (Low blood pressure)

9. Rashin ƙarfin jiki.

A ƙarancin ruwan jiki mai tsanani dukan alamomin da muke iya gani a matsakaicin ƙarancin ruwan jiki zasu tsananta, bugu da ƙari marar lafiya zai iya ruɗewa ko ya fita hayyacin sa, idan ba'a samu kulawa da sauri ba marar lafiya yakan iya shiga cikin yanayin shock (zamu ga bayanin shock a illolin ƙarancin ruwan jiki)[⁴].

Gwaje-gwaje masu muhimmanci da ya kamata a yiwa mai ƙarancin ruwan jiki

Bayan likita ya gama duba marar lafiya akan gado to zai aika shi a ɗakin awo domin gudanar da wasu muhimman gwaje-gwaje kamar haka;

E/U/Cr: Wannan gwaji ne na musamman da za'a iya gano sinadaran jiki da aka rasa tare da ruwan jiki.

Urinalysis: Wannan gwajin fitsari ne.

Sauran gwaje-gwajen da za'a iya yi sun danganta da abinda likita yake tunanin shi ne silar kawo ƙarancin ruwan jiki[³].

Yadda ake maye gurbin ruwan da aka rasa a jiki

Maye gurbin ruwan da aka rasa a jiki ya danganta da irin matakin ƙarancin ruwan jiki da kuma yanayin da marar lafiya yake a ciki. 

Maganin ƙarancin ruwan jiki mai sauki da matsakaici

Idan har marar lafiya yana da ƙarancin ruwan jiki mai sauki ko matsakaici kuma yana iya shan ruwa, to yafi dacewa a maye gurbin ruwan da ya rasa a jikinsa ta kafar baki. Ana amfani da wani sinadari da ake kira ORS (Oral rehydration solution) domin cimma wannan burin. Shi ORS wani sinadarin gari ne da ake zubawa cikin ruwa mai tsafta a sha domin ya maye gurbin ruwan jikin da aka rasa. Idan kum marar lafiyar baya iya shan ruwa ko cin abinci to ya wajaba a mayar da ruwan da ya rasa ta hanyar sa masa ruwan jijiya kamar yadda bayani zai zo a nan gaba kaɗan[⁴].

Yadda ake haɗa ORS a gida ta hanyar amfani da gishiri da suga

Idan mutum baya da halin sayen ORS na bature da aka riga aka haɗa ko kuma yana a ƙauye inda baya iya samun sa, toh likitoci sunyi bayanin yanda ake haɗa wannan sindari ta hanyar amfani da gishiri da suga da kuma ruwa mai tsafta (Yana da kyau a dafa ruwan har ya tafasa sannan abarshi ya huce domin tabbatar da tsaftar sa)[⁴].

Yanda ake haɗawa shi ne za'a samu ƙaramin cokali na shayi (tea spoon) sai a auna cokali shida (6) na suga sannan a auna rabin cokali na gishiri sai a gauraye shi a motse a cikin ruwa kimanin lita guda (1). Wannan sindarin yana aiki sosai tamkar sinadarin ORS na bature.

Maganin ƙarancin ruwan jiki mai tsanani

Marar lafiyar da yazo da ƙarancin ruwan jiki mai tsanani ko kuma matsakaici wanda baya iya shan ruwa ana maye gurbin ruwan jikinsa ne ta hanyar sa masa ruwan jijiya. Akwai ruwan jijiya daban-daban da bature ya tanada domin cimma wannan manufar kamar irin su;

1. Normal saline

2. Pediatric saline

3. Darrows solution

4. 5% dextrose da dai sauransu

Yadda ake gane ruwan da mai ƙarancin ruwan jiki ya rasa

Ko wane marar lafiya mai ƙarancin ruwan jiki ana sama sa ruwa kashi biyu, na farko kwatankwacin ruwan da ya rasa a jiki, na biyu kwatankwacin ruwan da yake buƙata a ranar. Marar lafiyar da ke hasarar wasu ruwa a lokacin da ake kula dasu kamar masu amai da gudawa ana ƙara musu da kwatankwacin ruwan da suke zubar wa[³].

Yadda ake gane ruwan da mutum ya rasa shi ne idan mutum yana da ƙarancin ruwan jiki mai sauƙi, to ana ƙiyasta ruwan da ya rasa da wannan fomula: 50 × Nauyin marar lafiya (idan an auna nauyin da kilo)

Misali: Yaro mai nauyin kilo goma sha biyu (12kg) yazo da ƙarancin ruwan jiki mai sauƙi. Kwatankwacin ruwan da ya rasa su ne 50 × 12 = 750. Wannan shi ne ya kama mil ɗari bakwai da hamsin kenan (750ml). A lura cewa tunda ƙarancin ruwan jikin nashi mai sauƙi ne to za'a maye masa gurbin ruwan jikinsa ne ta hanyar bashi 750ml  na ORS ba ruwan jijiya ba.

Idan kuma mutum yana da ƙarancin ruwan jiki matsakaici toh wannan itace fomula: 100 × Nauyin jikin marar lafiya.

Misali: Yaro mai nauyin kilo goma sha biyu (12kg) yazo da ƙarancin ruwan jiki matsakaici. Kwatankwacin ruwan da ya rasa su ne 100 × 12 = 1200. Wannan shi ne ya kama mil dubu ɗaya da ɗari biyu (1200ml). A lura cewa tunda wannan ƙarancin ruwan jiki ne matsakaici to za'a duba yanayin lafiyar yaron idan zai iya shan ruwa ta baki to za'a maye masa gurbin ruwan jikinsa ta hanyar bashi ORS ba ruwan jijiya ba. Amma idan baya iya shan ruwa ta baki ko kuma yana yawan yin amai, toh ana maye masa gurbin ruwan jikinsa ta hanyar bashi ruwan jijiya.

Haka kuma idan mutum yazo da ƙarancin ruwan jiki mai tsanani toh fomula ita ce  150 × nauyin marar lafiya[¹].

Misali: Yaro mai nauyin kilo goma sha biyu (12kg) yazo da ƙarancin ruwan jiki mai tsanani. Kwatankwacin ruwan da ya rasa su ne 150 × 12 = 1800ml. Wannan shi ne ya kama mil dubu ɗaya da ɗari takwas kenan (1800ml). A lura cewa shi ƙarancin ruwan jiki mai tsanani ba'a amfani da sinadarin ORS wajen maye gurbin ruwan da aka rasa sai dai ayi amfani da ruwan jijiya kawai.

Yanda za'a gane ruwan da mutum yake buƙata a rana

Fomular gane wannan adadin ruwan da mutum ke buƙata a rana ita ce:

Ko wane mutum yana buƙatar 100ml/kg a kilon sa goma(10) na farko

Yana buƙatar 50ml/kg a kilon sa goma(10) na biyu

Sauran kilon nauyin sa suna buƙatar 20mil/kg.

Misali: yaro mai nauyin kilo talatin da uku (33kg) yana buƙatar a sama sa ruwa, nemo adadin ruwan da yake buƙata a rana.

Amsa: tunda nauyinsa kilo talatin da uku ne za mu iya raba su kamar haka; 10 + 10 + 13 = 33

Kilon goma na farko yana buƙatar 100ml/kg = 100 × 10 = 1000mils

Kilon sa goma na biyu yana buƙatar 50ml/kg = 50 × 10 = 500mils

Sauran kilon nauyin sa duka yana buƙatar 20ml/kg = 20 × 13 = 260mils

Jimlar ruwan da yake buƙatar a rana = 1000 + 500 + 260 = 1760ml

Yadda ake mayar da ruwan da marar lafiya ke hasara ta hanyar gudawa ko  amai a lokacin da ake kula da shi

A ƙa'idance ya kamata a auna duk ruwan da suka fita ta hanyar gudawa ko amai a lokacin da ake kula da marar lafiya, sannan a maye gurbin su da wasu ruwan kwatankwacin su. Amma idan ba'a iya awon, sai a kwatanta ta wannan hanyar. A bawa marar lafiya 10 × nauyinsa × amai ko gudawar da yayi[¹].

Misali: Marar lafiya mai nauyi kilo (9kg) yayi amai sau biyu(2) gudawa sau uku (3), nemo adadin ruwan da ya kamata a maye gurbin ruwan da ya rasa ta hanyar aman da gudawar

Amasa: Ruwan da ya kamata a bashi saboda aman da yayi = 10×9×2 = 180mls

Ruwan da ya kamata a bashi saboda gudawar da yayi = 10×9×3 = 270mls

Jimlar ruwan da ya kamata a bashi saboda amai da gudawar da yayi = 180+270 = 450mls

Wannan yana nufin cewa bayan an ba marar lafiyar adaddin ruwan da ya rasa a jikin sa tare da adadin ruwan da yake buƙata a rana to dole sai an ƙara masa da adadin 450mls domin kula da ruwan da ya rasa ta hanyar amai da gudawar da yayi.

Jimlar ruwan da ake ba mai ƙarancin ruwan jiki

Ko wane mai ƙarancin ruwan jiki idan baya hasarar wasu ruwa ta hanyar amai da gudawa a lokacin da ake kula dashi ana bashi kwatankwacin ruwan da ya rasa ne tare da ruwan da ya kamat yasha a rana. Idan kuwa akwai hasarar wasu ruwa, to sai a ƙiyasta adadinsu kamar yanda bayani ya gabata sai a haɗa dasu cikin jimlar ruwan da za'a ba marar lafiya.

Yanda ake badawa shi ne za'a bada kashi biyu cikin uku (2/3) na ruwan da ya rasa tare da kashi ɗaya cikin uku (1/3) na ruwan da yake buƙata a rana sai a bada su cikin awa takwas (8) na farko. Sauran ruwan sai a game su a bada cikin awa goma sha shida(16). A taƙaice za'a maye gurbin dukan ruwan cikin awa ashirin da huɗu(24) wanda shi ne yayi dai dai da kwana ɗaya[⁴].  

Illolin ƙarancin ruwan jiki

1. Shock

2. rauni ga ƙoda.

3. Fita hayyaci

4. Rauni ga ƙwaƙwalwa

5. Rasa sinadaran jiki

Ya zan kare kaina ko yarona da samun ƙarancin ruwan jiki?

Ana kare samun ƙarancin ruwan jiki ta waɗannan hanyoyi:

1. Shan ruwa akai-akai

2. Shayar wa yanda ya kamata ga yaron dake shan mama

3. Saurin ɗaukar mataki a lokacin da mutum ya fara amai da gudawa.

4. Yawan shan ƴaƴan itace masu ruwa a jiki

Bayanin rufewa

Ƙarancin ruwan jiki shi ne rashin isashen ruwan jiki da zai wadaci jiki ya aiwatar da ayyuka da ya kamata, munga cewa muhimman abubuwan da ke kawo ƙarancin ruwan jiki su ne ciwon atuni (ɗiɗɗira), amai da gudawa da kuma rashin shan ruwa yanda ya kamata, haka kuma munga manyan alamomin ƙarancin ruwan jiki sun haɗa da: kasala, rashin ƙarfin jiki,  bushewar baki da idanu da dai sauransu.

Mai tambaya ya ajiye ta a cikin akwatin komment dake ƙasa.

Idan kuna da tambaya sai kuyi a cikin akwatin sharhi dake ƙasa, Insha Allah zamu karba ba tare da jinkiri ba. Haka kuma zaku iya shiga group dinmu na WhatsApp domin kasancewa damu damu a koda yaushe da kuma samun ingantattun bayanan mu a cikin sauki. Ku danna wannan domin shiga: Lafiyata Group 3. 

Nassoshi

1. Azubuike JC, Nkanginieme KEO. Paediatrics and Child Health in a Tropic Region. 2ND Edition. African Educational Services Owerri 2007; 250.

2. Colletti J.E. Brown K.M. Sharieff G.Q. et al. The management of children with gastroenteritis and dehydration in the emergency department. J Emerg Med. 2010; 38: 686-698

3. Evaluation and Management of Dehydration in Children Genevieve Santillanes, MD Emily Rose, MD Published:February 10, 2018

4. King CK, Glass R, Bresee JS, Duggan C; Centers for Disease Control and Prevention. Managing acute gastroenteritis among children: oral rehydration, maintenance, and nutritional therapy. MMWR Recomm Rep. 2003 Nov 21;52(RR-16):1-16. PMID: 14627948.

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