Ukuthinta ngeso lengqondo kungenzeka kubumbe ukuthuthukiswa kwengqondo esikhathini esizayo
Izinsana zokuqala zichitha amasonto abo okuqala okuphila ezinyunini zokunakekelwa kwezingane ezibelethwe yi- neonatal (NICU) . Ngokwemvelo, i-NICU imvelo ekhulayo futhi ehlukanisa. Ngaphezu kwalokho, izinsana ze-NICU zenzelwe izinqubo ezihlukahlukene ezibuhlungu. I-NICU ihlukile kwezinye izindawo lapho izinsana zesikhathi esigcwele zikhula futhi zivuthiwe. Lokhu kungezwani kungathinta ukuthuthukiswa kobuchopho.
Kodwa kungabonakali futhi ukuphoqa i-NICU ingase ibonakale, izinsana ku-NICU zisadinga kakhulu uthando nokunakekelwa. Esifundweni sika-2017 eshicilelwe ku- Current Biology , uMaitre kanye nozakwethu bakhombisa ukuthi abantwana abathintekayo abathola ukwesekwa, isikhumba sesikhumba (okubandakanya ukubeletha) isipiliyoni sithuthukise izimpendulo zobuchopho kanye nemiphumela engcono ye-neurodevelopmental.
Lithini Ukuqala?
Njalo ngonyaka, izingane eziyizinkulungwane ezingu-15 zizalwa. Ngo-2008, amaphesenti angu-12.33 azo zonke izingane zokuzalwa e-United States ayengaphambi kwesikhathi noma ngaphambi kwesikhathi. Izinsana zokubeletha zizalwa ngaphambi kwamasonto angu-37 wokubeletha.
Kuncike eminyakeni yobudala ekuzalweni, izinsana zangaphambi kokuzalwa zihlangabezana nezinkinga ezihlukahlukene kuhlanganise okulandelayo:
- kunzima ukuswa, ukugwinya nokuphefumula
- ukuphumula kokuphumula
- izinkinga zenhliziyo
- i-metabolism engakafiki eholela ekungalingani emanzini omzimba
- umsebenzi wezinso omncane
- ubunzima obunciphisa izakhi ngamanzi
- ingozi eyengeziwe yokutheleleka
- ukungabi namafutha omzimba okungabangela ukushisa komzimba okuphansi kanye noshukela ephansi wegazi
- ukuthuthukiswa komzimba kwemithambo yegazi ebuchosheni obungabangela ukubola kwesisu
Iyini i-NICU?
Ngenhlanhla, ukuthuthuka nokuthuthukiswa kokunakekelwa kwezinkinga ezinganeni nokubeletha kuye kwathuthukisa ukusinda phakathi kwezinsana ezingakafiki.
Izinsana ezingaphambi kokuqala kanye nezinye izingane ezinenkinga enkulu yokwelashwa, njengokuzalwa okuphansi, zidinga ukunakekelwa endaweni engavamile yesibhedlela esibizwa nge-NICU.
I-NICU igcina ubuchwepheshe obukhethekile futhi isebenza ngabasebenzi abaqeqeshiwe kakhulu bezempilo.
Yonke ubuchwepheshe kanye ne-instrumentation ku-NICU yenza imisebenzi ehlukahlukene kuhlanganise nalokhu okulandelayo:
- ukushisa ukugcina ukushisa komzimba okuzinzile
- ukuqapha izinga lokushaya kwenhliziyo, ukuphefumula, ukucindezelwa kwegazi, kanye nokugcwala kwe-oxygen
- ukwesekwa okunomsoco
- ukwelashwa oketshezi kanye ne-electrolyte
Nakhu abanye ochwepheshe bezempilo abasebenza ku-NICU :
- i-neonatologist (uhlobo olukhethekile lwesazi sesidokotela oluqeqeshwe ukunakekela izingane ezigulayo nezangaphambi kwesikhathi)
- Therapists
- ochwepheshe bezokwelapha
- ochwepheshe be-lactation
- abemithi
- abahlengikazi ababelethwe yi-neonatal
- izidakamizwa
- abasebenzi bezenhlalakahle
- amakhanda
Iningi lezingane eziseNICU zizincane kakhulu noma zihluleka ukudliwa ibhodlela. Ngakho-ke, badinga ukondliwa nokuphathwa ngamanzi kanye nemithi ngokusebenzisa imithwalo yegazi; Imigqa ye-IV ne-catheters zibekwe ukuhlinzekela ukufinyelela kwegazi. Ngisho noma imithi yokwelashwa noma i-sucrose nayo isetshenziswa, lezi zinqubo zisalokhu zibuhlungu.
Izimpawu zezingane zangaphambili
Ngokusho kuka Nathalie Maitre, umbhali oyinhloko walolu cwaningo lokuhlola ukuphendula kobuchopho ekuthinteni okunciphisa kanye nendima yayo engaba khona ekuthuthukisweni kwengqondo ezayo:
Izinsana zokuqala zinamazinga aphezulu okulibaziseka kanye nokukhubazeka okungenayo i-neurodevelopmental. Siyazi kusukela ocwaningweni ukuthi lokhu kungaxhunyaniswa nezinkinga zakudala ezithinta izinzwa ekuphileni kwansuku zonke. Izinsana ezinenkinga ekuphenduleni ukuthinta, umsindo, izinguquko zesikhundla, kanye nezinto ezibukwayo nazo zinenkinga ngokunyakaza, ukufunda ulimi, namakhono aphakeme okuqonda.
Ngokuqondile, izinsana ezizalwe kuqala zineempendulo ezinganiselwe ekuthinteni kahle uma ekugcineni ziphuma esibhedlela. Izinsana ezitholakalayo ezithola ukuthinta okwengeziwe ngenkathi esibhedlela zithuthukisa izimpendulo ezijwayelekile uma ziphuma esibhedlela.
Ngamanye amazwi, izinsana zangaphambi kokuthola othintana isikhumba esikhumbeni ngesikhathi seNICU zingase zibe nezimpendulo ekuthinteni okuncane okungafani nezingane ezizalwe ngesikhathi esiphelele.
Ngakolunye uhlangothi, izinsana ezingakafiki ngaphambi kweNICU ezithola izinqubo ezibuhlungu, njengokufaka izinaliti nama-catheter, zakha izimpendulo ezingavamile ukuthinta kahle. Khumbula ukuthi izimpendulo ezifanele zokuthintana kahle zidingekile ekuthuthukiseni okujwayelekile; Ukuthinta ukusekela kusiza ukwakha uxhumano olufanele ebusweni bezingane.
Ezinganeni, ukuthinta kuthatha indima ebalulekile ekuthuthukiseni izinzwa nokuthuthukiswa kokuxhumana kwabantu. Ngaphezu kwalokho, ukuthinta kungenye yezinzwa zokuqala ezinganeni. Izingane zesikhathi esigcwele ziqala ukuthola ukugqugquzela okungathandeki kahle nokuphendula ngesikhathi sisesibelethweni. Le mpendulo kwenzeka ngesikhathi sokubaluleka kokuthuthukiswa kobuchopho. Izinsana zokuqala zingaphuthelwa emasontweni amaningi alawo mazwi.
Ngesistimu yezinzwa ngaphandle kokuthinta, ukungabi nalutho okufakwayo kungabangela ukulahlekelwa okungapheli. Akucaci ukuthi okufanayo kubamba ukuthinta, kodwa kungenzeka. Kodwa-ke, siyazi ukuthi ukulahla ukuthinta kungathinta impilo yezingane ezisencane.
Ngokuphindaphindiwe, ngokusho kukaMaitre:
Ukuthinta kuyisakhiwo esibucayi sokwakhiwa kwezingane. Isiza izinsana zifunde ukuhamba, zithole izwe elizungezile, nendlela yokuxhumana ngayo. Ukuthinta kuvumela ukuba bafunde lamakhono ngisho nangaphambi kokuba umbono wabo uthuthuke ngokugcwele, futhi ngokuqinisekile ngaphambi kokuba bafunde amakhono omlomo.
Ucwaningo Olusekela Ukuthinta Okumnene
Kulesi sifundo, ubuchopho buphendula izinsana ezingama-125 zangaphambili (amasonto angu-24 kuya kwangu-36 okugubha) kanye nezinsana zesikhathi esigcwele (amasonto angu-38 kuya kwangu-42 wokuzalwa kweminyaka) zihlolwe ngokusebenzisa uhlobo olukhethekile lwe-EEG. I-EEG isetshenziselwa ukubona umsebenzi wezobuchopho kagesi. Izimpendulo zobunhliziyo ezivela ezinganeni ezigcwele zesikhathi esigcwele ezakhiweni zaziqhathaniswa nezingane zangaphambi kweNICU ngaphambi nje kokuba zizobuyela ekhaya.
Abacwaningi baqale bahlola umphumela wokuthinta ukukhanya kwezinsana ezigcwele. Izimpendulo zebongo zahlaziywa ngemuva kwezinsana zesikhathi esigcwele zingakhuthazwa ngokusebenzisa i-puff yomoya epholile noma i-puff sham (okusho, ukukhwabanisa okungcolile komoya ukufanisa). Abacwaningi "babone izici zendawo, izikhathi, nezilinganiso ze-cortical izimpendulo ekuthinteni okukhanyayo okuhlukanisa nabo ekuhlaseleni ama-sham in-baby".
Ngamanye amazwi, abacwaningi basebenzisa ubuchwepheshe obusha kakhulu ukuze babone indlela ukuthinta ngobumnene kuthinta ngayo ubuchopho ngokujwayelekile. Le datha yasetshenziselwa ukusetha uhlaka lokuhlaziya.
Ukusebenzisa loluhlaka lokuhlaziya, abacwaningi baqaphele ukuthi izinga le-prematurity lithinta kanjani impendulo yobuchopho ekuthinteni okukhanyayo ezinganeni zangaphambi kokukhushulwa ngomoya ovuthayo, owenza ukukhanya kokukhanya.
Ngemuva kokuba abacwaningi bephethe ukulawula kokulimala kanye nokuphathwa kwemithi ebuhlungu, bakhela emiphumeleni yabo ukuze bakhombise ukuthi okuhlangenwe nakho okukhanyayo, okufana nokuxhumana kwesikhumba nokuncelisa, kuxhumene nezimpendulo zobuchopho ezinamandla; kanti okuhlangenwe nakho okubuhlungu, njengokufaka kwenaliti noma ithubhu, kwakuxhunywe ekuphenduleni ukuphendulwa kobuchopho.
Ngokuvamile, imiphumela yalezi zifundo ibonisa ukuthi ukuthinta okuncane kungazuzisa kanjani ukukhwabanisa ubuchopho futhi kubambe iqhaza ekuthuthukiseni izinzwa, ukuqonda nokuthuthukiswa komphakathi.
Kwenzekani Konke Lokhu?
Imiphumela yalolu cwaningo lisekela ukubaluleka kokuthinta okunomusa nokunakekela ezinganeni zangaphambi kweNICU. Okuhlangenwe nakho okunjalo kusiza ekuthuthukiseni ubuchopho obuvamile futhi kwenza ingane yokuzalwa ikhishwe esibhedlela ngezimpendulo zobuchopho ezifaniswa nezinsana ezizalwa ngesikhathi. Ukuphendula okujwayelekile kobuchopho kungase kube nengxenye ekuthuthukiseni kwentuthuko kanye nentuthuko yomphakathi.
Ukuthinta okulula, okunene, nokunakekela kungathatha izinhlobo eziningana, kufaka phakathi ukugcoba, ukuncelisa nokusikhipha . Akucaci ukuthi lokhu kuthinta kufanele kuvele kubazali; Kodwa-ke, uma omama bebambelela okunjalo, kunezinye izinzuzo, kubandakanya ukuhlanganiswa ngokomzwelo, ukuphendula, kanye nezinye izinzuzo zezempilo ezikhulayo.
Ngomqondo womhlaba wonke, imininingwane enjalo ingathuthukisa ukunakekelwa ku-NICU. Igebe likhona njalo phakathi kokunakekelwa njengoba isimo quo nokunakekelwa njengoba kufanele. Ukuthuthukiswa kwekhwalithi ku-NICU kuqinisekisa ukuthi izingane zangaphambi kokubeletha azitholanga kuphela ukunakekela okungcono kakhulu kuma-unit kodwa futhi ukunakekelwa okubasiza bakwazi ukuphumelela ekhaya. Mhlawumbe ukufaka ngokuthe ngqo ukuphathwa kahle kwezinsana zangaphambi kokubeletha kungabalungiselela kangcono impilo emva kokukhulelwa-ukuphila ekhaya.
> Imithombo:
> Maitre, NL, et al. Imvelo Eyodwa Yokuphila Kwangaphambi Kokuphila Ekuqhutshekweni Kwe-Somatosensory Ngobuntwana Basebuntwaneni. Biology yamanje . 2017; 27: 1048-1054.
> Raab EL, Kelly LK. Isahluko 22. Ukuvuselelwa kwe-Neonatal. Ku: DeCherney AH, Nathan L, Laufer N, Roman AS. ama-eds. UKUHLOLA OKUPHAKATHI Nokwelashwa: Izifo ze-Obstetrics & Gynecology, 11e eNew York, NY: McGraw-Hill; 2013.
> Rikken, M. Touch Shapes Preterm Izinhliziyo Zengane. Ngo-Mashi 16, 2017. www.researchgate.net.
> Smith D, Grover TR. Insana Esanda Kuzalwa. Ku: Hay WW, Jr., Levin MJ, Deterding RR, Abzug MJ. ama-eds. Ukuhlolwa Kwe-CURRENT & Pediatrics Ukwelashwa, 23e eNew York, NY: McGraw-Hill.