Kubata zvinyoro zvingangodaro maumbirwo emangwana ekuvandudzwa kwehupi
Preterm vacheche vanoshandisa mavhiki avo ekutanga ehupenyu hutachiwana neonatal yakasimba yekuchengetedza (NICU) . Nesimba, NICU inharaunda yakakura uye inoparadzanisa. Uyezve, vana vari paNICU vanoiswa mumitemo yakasiyana-siyana inorwadza. NICU yakasiyana nedzimwe mamiriro ezvinhu umo vana vese venguva refu vanokura uye vakakura. Kusiyana uku kunogona kuchinja kukura kwehuropi.
Asi zvisingaiti uye kuzviisa pasi kweNICU inogona kuonekwa, vana vachipinda muNICU vachiri kuda ruzhinji rworudo uye kutarisirwa. Muchidzidzo che 2017 chakabudiswa mu Current Biology , Maitre uye vashandi vanoratidza kuti vacheche vacheche vanogamuchira rubatsiro, ganda-kanda kugunzva (kusanganisira kuyamwisa) zvakave nekuvandudza mhinduro dzeuropi uye zvakanakisisa zvinogadziriswa neurodevelopmental.
Chii Chinotanga Kutaura?
Gore negore, mamiriyoni gumi nemashanu vacheche vanoberekwa. Muna 2008, 12.3 muzana yevana vose vakaberekerwa muUnited States vakanga vasati vasvika kana kutangira. Preterm vacheche vanoberekwa musati mavhiki makumi matatu ekuberekwa.
Zvichienderana nemakore ekuberekwa, vana vacheche vanoona matambudziko akasiyana-siyana kusanganisira zvinotevera:
- kunetseka kuyamwa, kumedza, nekufema
- chipembenene chisina kuchena
- heart defects
- immature metabolism inotungamirira ku kusaenzana mumuviri wenyama
- immature kidney function
- kuoma kunonwisa mishonga kuburikidza nemvura
- njodzi yakawanda yehutachiona
- kushaya muviri mumuviri kunogona kutungamirira kutsika yakadzika yepasi uye shuga shoma yeropa
- kuwedzera kukura kwemidziyo yeropa muuropi iyo inogona kukonzera kuora ropa
Chii chinonzi NICU?
Nenzira yakanaka, kufambira mberi uye kuvandudzwa kwehutachiwana uye hutano husina kubereka zvakagadziridza kupona pakati pevana vasati vasvika.
Kutanga vana vacheche uye vamwe vana vane zvinetso zvakakomba zvezvechirwere, zvakadai sekudzika kwekuberekwa, zvinoda kutarisirwa mune chikamu chakasiyana chechipatara chinonzi NICU.
NICU dzimba dzimba yepamusoro yekombiki uye inoshandiswa nevadzidzisi vezvoutano vakadzidziswa zvikuru.
Zvose zvesayenzi uye zvigadzirwa paNICU inoita mabasa akasiyana-siyana kusanganisira zvinotevera:
- kudzivirira kugadzirisa kuchengetedza muviri wakasimba
- kutarisa kwemaitiro emwoyo, kufema, ropa, uye oxygen saturation
- nutritional support
- fluid uye electrolyte therapy
Heano vamwe vevashandi vehutano vanoshanda paNICU :
- neonatologist (imwe nyanzvi yechiremba wevana yakadzidziswa kutarisira vana vanorwara uye vasati vasvika)
- kuporesa therapists
- therapists occupational
- nyanzvi dzemakadzi
- pharmacists
- neonatal mukoti vadzidzisi
- dietitians
- vashandi vomunharaunda
- chaplains
Ruzhinji rwevana muNICU harudiki kana kuti harwere kurwiswa nehombodo. Nokudaro, vanoda kudyirwa uye kupiwa mvura uye mishonga kuburikidza nemidziyo yavo yeropa; Mitsara yechina uye catheters inogadzirirwa kupa ruzivo rwekupararira kweropa. Kunyange kana mishonga inorwadza kana sucrose inoshandiswawo, izvi zvinoratidzika zvinorwadza.
Mifananidzo ye Preterm Vana
Maererano naN Nathalie Maitre, munyori wekutanga wekuongorora uku kuongorora huropi hwekupindura kune zvinyoronyoro uye basa rayo rinogona kuitika mune ramangwana kukura kwekufunga:
Preterm vacheche vane mikoro yakakwirira yekunonoka uye kukanganiswa kweeurodevelopmental. Tinoziva kubva pakutsvakurudza kuti izvi zvingave zvakabatanidzwa kune matambudziko okutanga kugadzirisa kune zvinetso muupenyu hwezuva nezuva. Vacheche vane dambudziko rekupindura kune kubata, kurira, kuchinja kwemaonero, uye kuonekwa kunewo matambudziko nekutama, kudzidza mutauro, uye unyanzvi hukuru hwokuziva.
Kunyanya kunyanya, vana vanoberekerwa chibereko chekutanga vanotora mhinduro shoma kune vanobata zvinyoronyoro kana vazobva muchipatara. Preterm vacheche vanowana rubatsiro rukuru rwekusimbisa kana vari muchipatara vachikuridza mhinduro dzakawanda dzekubata kana vabva muchipatara.
Mune mamwe mazwi, vana vanotangira vanogamuchira ganda-ganda-kambani pavanenge vari muNICU vanowanzova nemhinduro kune zvinyoronyoro zvinogona kufanana nevana vakaberekwa panguva yakazara.
Kune rumwe rutivi, vacheche vasati vasvika muNICU vanoona maitiro anorwadza, sekuiswa kweesingani nemakatekta, vanoita mhinduro dzisina kuchena kumeso ekubata. Yeuka kuti mhinduro dzakanaka kune kubata zvinyoro-nyoro zvakakosha pakugadzirwa kwechigarire; rubatsiro runotsigira runobatsira kuvaka hukama hwakanaka muhupano hwevana.
Mumucheche, kubata kunobata basa rinokosha mukufungidzira kwekufungidzira uye kukura kwekubatana kwevanhu. Uyezve, kubata kune imwe yenzira dzokutanga dzekurera mumucheche. Vana vane nguva yakazara vanotanga kugamuchira zvigadziriswe tactile kukurudzira uye mhinduro munguva yechibereko. Izvi zvinowanzoitika panguva dzinokosha panguva yekuvandudzwa kweuropi. Preterm vacheche vanogona kurasikirwa nevhiki dzakawanda dzemhinduro dzakadaro.
Nehurongwa hwekunzwa kunze kwekugunzva, kushayikwa kwezvinokanganisa zvinogona kutungamirira kukudarika kusingaperi. Hazvinyatsozivikanwe kana zvakafanana zvakabata kubata, asi zvinogoneka. Isu tinoita, zvisinei, tinoziva kuti kurasa kwekubata kunogona kukanganisa upenyu hwevatana vacheche.
Zvakare zvakare, maererano naMatrice:
Kubata inokosha yekuvaka chivako chekudzidza kwevana. Inobatsira vacheche kudzidza kudzika, kuongorora nyika yakavapoteredza, uye kuti vataure sei. Kubata vanovabvumira kuti vadzidze unyanzvi uhwu vasati vamboona zviratidzo zvavo zvakanyatsogadzirwa, uye zvirokwazvo vasati vadzidza unyanzvi hwemashoko.
Kutsvakurudza Kubatsira Runyoro Kubata
Muchidzidzo chino, uropi hunopindura madiki 125 vacheche (masikati makumi maviri nemasere makumi matatu nemana ekuberekwa) uye vana venguva yakazara (masikati makumi matatu nemasere makumi maviri nemaviri ekuberekwa kwemakore) vakaongororwa vachishandisa rudzi rweEEG chaiyo. EEG inoshandiswa kuona simba rehupi hwehuropi. Mhinduro dzehupenzi kubva kumwana akazara kwenguva yakazara muimba yevana vanofananidzwa neavo vanoberekwa vacheche muNICU vasati vava kuda kuenda kumba.
Vatsvakurudzi vakatanga kutsvaga kukanganisa kwekugunzva kugona kwevana vese venguva refu. Mhinduro dzeubongo dzakarongedzwa mushure mekunge vana vese venguva yakareba vaisimudzirwa vachishandisa mhepo yakadzika yemhepo kana shamhu yepamusoro (kureva, chifukidzo chenhema chekuenzanisa). Vatsvakurudzi "vakacherechedza maitiro, nzvimbo, uye masimba ekugadzirisa kwekortical kumusana wechiratidzo unovatsanangurira kubva kumashizha emashiripiti mucheche nguva dzose" vachishandisa zvinyorwa zvekutsvaga zvinyorwa.
Mune mamwe mazwi, vatsvakurudzi vakashandisa teknolojia itsva kuti vaone kuti kunyorobata kunobata sei zvinokanganisa huropi. Aya data akazoshandiswa kuumba shanduko yekuongorora.
Kushandisa iyi sarudzo yekuongorora, vatsvakurudzi vakagadzirisa kuti chiyero chekushanduka kwakasvibiswa kwakakanganisa sei huro hwehutachiona pamusana wekudzivirira muvana vasati vatanga mushure mekusimudzirwa nemhepo inoputika, iyo yakaita kuti tambo inobata.
Mushure mokunge vatsvakurudzi vakagadzirirwa nehuwandu hwehutachiona uye hutano hwehutano hwemishonga, vakavaka pamigumisiro yavo kuti varatidze kuti chiedza-kugunzva zvakaitika, zvakadai seganda-kune-ganda kusangana nekuyamwisa, zvakabatanidzwa kune zvakasimba zvehupinduri mhinduro; asi zviitiko zvinorwadza, zvakadai sekuiswa kweesina kana tube, zvakabatana nekuderedzwa kwehuropi.
Kakawanda, migumisiro yezviongorori izvi inojekesa kuti kubata kwakanyatsokwanisa kunobatsira sei uropi kuwedzera uye kunobatsira pakufunga, kufungisisa, uye hutano hwekugara.
Zvose Izvi Zvinorevei?
Migumisiro yenyaya ino inotsigira kukosha kwekubata zvinyoro uye kugadzirisa muvana vasati vasvika muNICU. Zviitiko zvakadaro zvinobatsira nehutano hwekuvandudza huro uye hunoita kuti mwana wepakutanga asunungurwe kubva kuchipatara nemhinduro dzeuropi zvakaenzana nevana vanozvarwa panguva. Zvose zvinokonzerwa neuropi zvinokonzera kukanganisa nekugutsikana kwehupfumi.
Chiedza, runyoro, uye kubata kunogona kutora maitiro akasiyana-siyana, kusanganisira kukumbatira, kuyamwisa uye kushambadza . Hazvive pachena kana kubata uku kunofanira kubva kuvabereki; asi, kana vanaamai vachibata zvakadaro, kune zvimwewo zvinobatsira, kusanganisira kushamwaridzana kwepfungwa, kutarisana, uye zvimwe huwandu hwehutano hwakabatsirwa.
Mune chinangwa chepasi pose, maonero akadaro anogona kuvandudza kutarisira paNICU. Chinhu chinogara chiripo pakati pekutarisirwa sezvo chimiro cheo uye kutarisirwa sezvinofanira kuva. Kuvandudzika kwehutano paNICU kunovimbisa kuti vana vanofanotanga vasati vawana kungofanirwa kutarisirwa pane zvikamu asiwo kutarisira kunovabatsira kuti vabudirire kumba. Zvichida kubatanidza zvinyoronyoro mukurapa kwevana vepakutanga zvingave zviri nani kuvigadzirira hupenyu mushure mekuchenesa-hupenyu kumba.
> Sources:
> Maitre, NL, et al. Izvo Zvisikwa Zviviri zveupenyu hwepakutanga-hupenyu paSomatosensory Processing muBhuku reMucheche yeBana. Current Biology . 2017; 27: 1048-1054.
> Raab EL, Kelly LK. Chitsauko 22. Neonatal Resuscitation. Muna: DeCherney AH, Nathan L, Laufer N, Roman AS. eds. KUBATSIRA KUTAURIRWA & KUKURWA: Obstetrics & Gynecology, 11e New York, NY: McGraw-Hill; 2013.
> Rikken, M. Touch Shapes Preterm Babies 'Brains. March 16, 2017. www.researchgate.net.
> Smith D, Grover TR. Mucheche Mutsva. Muna: Hay WW, Jr., Levin MJ, Deterding RR, Abzug MJ. eds. KUCHENGA KUZIVA KUZIVA NOKUTAURWA PEDATATICS, 23E New York, NY: McGraw-Hill.