Neonatal kurega chirwere

Neonatal abstinence syndrome (NAS) iboka rematambudziko anowanikwa mumwana achangozvarwa akaoneswa mishonga yeopioid kwenguva yakareba achiri mudumbu raamai.

NAS inogona kuitika kana mukadzi ane pamuviri achitora zvinodhaka zvakadai seheroin, codeine, oxycodone (Oxycontin), methadone, kana buprenorphine.

Izvi nezvimwe zvinhu zvinopfuura nepanzvimbo inobatanidza mwana naamai vake vari muchibereko. Mwana anozotenderera pamushonga pamwe naamai.

Kana amai vakaramba vachishandisa mishonga mukati mevhiki kana kupfuura vasati vasununguka, mwana anozoenderana nemushonga pakuzvarwa. Nekuti mwana haachawane mushonga mushure mekuberekwa, zviratidzo zvekusiya zvinogona kuitika sezvo mushonga uchibviswa zvishoma nezvishoma kubva muhurongwa hwemwana.

Kurega zviratidzo zvakare kunogona kuitika muvacheche vanoburitswa nedoro, benzodiazepines, barbiturates, uye mamwe antidepressants (SSRIs) vachiri mudumbu.

Vacheche vevanaamai vanoshandisa maopioid uye zvimwe zvinodhaka (nicotine, amphetamines, cocaine, mbanje, doro) vanogona kunge vaine matambudziko enguva refu. Nepo pasina humbowo hwakajeka hweNAS yemamwe madhiragi, iwo anogona kubatsira mukuomarara kwezviratidzo zvemwana zveNAS.

Zviratidzo zveNAS zvinoenderana ne:

• Rudzi rwemushonga amai vakashandisa
• Kuparara kunoita muviri uye nekuchenesa mushonga (unokanganiswa nemajini)
• Yakawanda sei yemushonga yaaitora
• Akatora nguva yakareba sei achishandisa mushonga
• Kunyangwe mwana akazvarwa yakazara-nguva kana yekutanga (nguva isati yakwana)

Zviratidzo zvinowanzotanga mukati memazuva matatu kusvika matatu mushure mekuzvarwa, asi zvinogona kutora kusvika pavhiki kuti zvioneke. Nekuda kweizvi, mwana anowanzoda kugara muchipatara kuti atariswe uye kuongororwa kusvika kwevhiki.

Zviratidzo zvinogona kusanganisira:

• Blotchy kuchena kweganda (mottling)
• Manyoka
• Kuchema kwakanyanya kana kuchema kwepamusoro
• Kunyanyisa kuyamwa
• Kupindwa nechando
• Hyperactive mafungiro
• Yakawedzera mhasuru toni
• Kushatirwa
• Kudya zvisina tsarukano
• Kukurumidza kufema
• Kufenda
• Zvinetso zvekurara
• Kunonoka kurema
• Mhino inokamhina, kuhotsira
• Kudikitira
• Kubvunda (kudedera)
• Kusvipa

Mimwe mimwe mamiriro ezvinhu anogona kuburitsa zvakafanana zviratidzo seNAS. Kubatsira kuita kuongororwa, mupi wezvehutano anozobvunza mibvunzo nezve kushandisa kwamai zvinodhaka. Amai vanogona kubvunzwa nezvekuti ndeapi madhiragi avakatora panguva yepamuviri, uye pavakapedzisira kuishandisa. Weti yaamai inogona kuongororwa mishonga zvakare.

Miedzo inogona kuitwa kubatsira kuongorora kubviswa mumwana achangozvarwa inosanganisira:

• NAS yekumisikidza system, iyo inopa mapoinzi zvichienderana nechiratidzo chimwe nechimwe uye nekuomarara kwayo. Chikamu chemucheche chinogona kubatsira kuona kurapwa.
• ESC (kudya, kurara, kunyaradza) kuongorora
• Chirwere chemushonga weti uye chekutanga ura (meconium). Chidimbu chiduku chembilical tambo chinogona zvakare kushandiswa pakuongorora zvinodhaka.

Kurapa kunoenderana ne:

• Mushonga unobatanidzwa
• Hutano hwemwana hwese uye zviyero zvekurega
• Kunyangwe mwana akazvarwa yakazara-nguva kana nguva isati yakwana

Dare rezvehutano rinotarisa mwana achangozvarwa kusvika kwevhiki (kana kupfuura zvichienderana nemabatiro ari kuita mwana) mushure mekuzvarwa kwezviratidzo zvekusiya, matambudziko ekudyisa, uye kuwedzera uremu. Vacheche vanorutsa kana vakanyanya kushayiwa mvura vangangoda kuwana zvinwiwa kuburikidza nemutsinga (IV).

Vacheche vane NAS vanowanzo gumbuka uye zvakaoma kudzikama. Matipi ekudzikamisa anosanganisira matanho anowanzo kunzi "TLC" (tarisiro yerudo):

• Zvinyoro nyoro mwana
• Kuderedza ruzha nemwenje
• Ganda kuganda rinotarisirwa naamai, kana kuputira mwana mugumbeze
• Kuyamwisa (kana amai vari mune methadone kana buprenorphine chirongwa chekurapa pasina kumwe kushandiswa zvisiri pamutemo kwezvinodhaka)

Vamwe vacheche vane zviratidzo zvakakomba vanoda mishonga senge methadone kana morphine yekurapa zviratidzo zvekusiya uye kuvabatsira kuti vakwanise kudya, kurara uye kuzorora. Vacheche ava vangangoda kugara muchipatara kwemavhiki kana mwedzi mushure mekuberekwa. Chinangwa chekurapa ndechekugadza mucheche mushonga wakafanana neuyo waishandiswa naamai panguva yekuzvitakura uye zvishoma nezvishoma kudzikisa muyero nekufamba kwenguva. Izvi zvinobatsira kurumura mwana kubva pamushonga uye kunoderedza zvimwe zvekusiya zviratidzo.

Kana zviratidzo zvakakomba, senge kana mimwe mishonga yaishandiswa, wechipiri mushonga wakadai se phenobarbital kana clonidine unogona kuwedzerwa.

Vacheche vane chirwere ichi vanowanzo kuve nekukasira kwekukwirisa kana dzimwe nzvimbo dzekupunzika kweganda. Izvi zvinoda kurapwa nemafuta chaiwo kana kirimu.

Vacheche vanogona zvakare kuve nematambudziko nekudyisa kana kunonoka kukura. Vacheche ava vangangoda:

• Yakakwirira-koriori feedings iyo inopa hukuru hwakanyanya chikafu
• Zvidiki zvidyiso zvinopihwa kazhinji

Kurapa kunobatsira kubvisa zviratidzo zvekurega. Kunyangwe mushure mekurapwa kweNAS kwapera uye vacheche vabuda muchipatara, vangangoda imwe "TLC" kwevhiki kana mwedzi.

Kushandisa zvinodhaka uye doro panguva yekuzvitakura kunogona kutungamira kumatambudziko mazhinji ehutano mumwana kunze kweNAS. Izvi zvinogona kusanganisira:

• Kuremara kwekuzvarwa
• Kurema kwekuzvarwa uremu
• Kuberekwa kusati kwasvika
• Musoro mudiki wedenderedzwa
• Kamwe kamwe kacheche kufa syndrome (SIDS)
• Matambudziko nekuvandudza uye maitiro

NAS kurapwa kunogona kupera kubva pa1 vhiki kusvika kumwedzi mitanhatu.

Ita shuwa kuti mupi wako anoziva nezveese mishonga nemishonga yaunotora panguva yekuzvitakura.

Dana mupi wako kana mwana wako ane zviratidzo zveNAS.

Kurukurai mishonga yese, zvinodhaka, doro uye fodya kushandisa nemupi wako.

Kumbira mupiki wako kuti abatsirwe nekukurumidza sezvazvinogona kana iwe uri:

• Kushandisa zvinodhaka zvisiri zvemishonga
• Kushandisa zvinodhaka zvisina kunyorerwa iwe
• Kushandisa doro kana fodya

Kana iwe uchitova nepamuviri uye uchitora mishonga kana mishonga yausina kupihwa kwauri, taura nemupi wako nezvenzira yakanakisa yekuchengetedza iwe nemwana kuchengeteka. Mimwe mishonga haifanire kumiswa pasina kuongororwa nevechiremba, kana matambudziko anogona kutanga. Wako mupi achaziva nzira yekugadzirisa nenjodzi.

NAS; Neonatal zviratidzo zvekurega

• Neonatal kurega chirwere

Balest AL, Riley MM, Bogen DL. Neonatology. Mune: Zitelli BJ, McIntire SC, Nowalk AJ, eds. Zitelli naDavis 'Atlas yePediatric Panyama Kuongorora. 7th ed. Philadelphia, PA: Elsevier; 2018: chits. 2.

Hudak ML. Vacheche vevanoshandisa zvinodhaka. Mune: Martin RJ, Fanaroff AA, Walsh MC, eds. Fanaroff naMartin's Neonatal-Perinatal Mushonga. 11th ed. Philadelphia, PA: Elsevier Saunders; 2020: chits. 46.

Kliegman RM, St. Geme JW, Blum NJ, Shah SS, Tasker RC, Wilson KM. Kuzvidzivirira syndromes. MuKliegman RM, St. Geme JW, Blum NJ, Shah SS, Tasker RC, Wilson KM, .ed. Nelson Chinyorwa chePediatrics. 21st ed. Philadelphia, PA: Elsevier; 2020: chap 126.