Abazali nezingane, ikakhulukazi abayishumi nambili nabasha, bavame ukukhathazeka uma beqaphela ukuthi bancane kunabaningi babo ontanga nabalingani nabo esikoleni esifanayo.
Nakuba kunezimo eziningi zezokwelapha ezingabangela ukuba izingane zibe nesiqu esifushane, izingane eziningi ezincane zivamile .
Lesi yisikhathi esisodwa lapho izingane zingabalahla abazali babo, noma okungenani amagciwane azo, okuthile.
Iningi lezingane lifushane ngoba linabazali abancane. I-Genetics idlala indima enkulu ekuthi umuntu omude uyakuba mude kangakanani.
Ukuphakama kokuphakama
Abazali bavame ukubuza ukuthi udokotela wabo angazi ukuthi ubude babo bazoba bude kangakanani. Ngenkathi ingane yakho engekho i-crystal ibhola ukuze ubone ukuthi izingane zakho zizobe zide kangakanani uma zikhula, kukhona ifomula elula esebenzisa iziqhingi zabazali ukuwasiza ukuba alinganise ukuphakama kwelitshe lomntwana noma amandla abo okukhulisa. Ngokuvamile, ulinganisa ubukhulu bomzali bokuzalwa ndawonye bese ufaka 2 1/2 amasentimitha uma ingane engumfana, noma ususe 2 1/2 amasentimitha ngentombazane. Ungasebenzisa futhi ukulungiswa kokuphakama kwe- intanethi ukwenza izibalo kuwe.
Ukuqaphela ukuphakama komgomo wengane kubalulekile, ngoba uma ingane ingaphansi kwamandla akhe okuzalwa, lokho kungase kube uphawu lwezinkinga.
Ukukhula okujwayelekile
Izingane zikhula ngokushesha eminyakeni yokuqala yokuphila engama-4 (ikakhulukazi eminyakeni emibili yokuqala), ngamazinga aphakeme ngamasentimitha amane ngonyaka ngonyaka.
Ngemuva kweminyaka engama-4, izingane zivame ukukhula ngesilinganiso esinciphisa kancane esingaba ngu-2 kuya ku-2 1/2 amasentimitha ngonyaka-kuze kube yilapho seziqala ukukhulelwa. Bese bekhula ekukhuleni kwabo ekukhuleni, amantombazane akhula cishe ama-3 kuya ku-3 1/2 amasentimitha ngonyaka, futhi abafana bakhula cishe ngamasentimitha amane ngonyaka. Ngemuva kokukhula kwentsha, ukukhula kwabo kuzohamba kancane kuze kube yilapho befinyelela ukuphakama kwabo abadala abadala, cishe eminyakeni engama-4 ukuya kwengu-5 emva kokukhula kwabo kwezinga eliphakeme.
Abafana namantombazane bavame ukukhula baze baneminyaka engu-14 kuya kwengu-16 ubudala, kodwa lokhu kuncike lapho beqala ukukhulelwa, okungaqala noma kuphi phakathi kuka-8 no-13 kumantombazane no-9 no-14 kubafana. Isibonelo, uma intombazane iqala ukukhulelwa eneminyaka eyisishiyagalombili ubudala, khona-ke ingase ibambe ukukhula kwayo ngesikhathi iseneminyaka eyisishiyagalolunye futhi yenziwe ikhula ngenkathi eneminyaka engu-13 ubudala. Ngakolunye uhlangothi, uma enye intombazane ingaqali ukukhulelwa kuze kube yilapho ineminyaka engu-12 ubudala, khona-ke ingase iqhubeke ikhula ize ineminyaka engu-17 ubudala.
Futhi, khumbula ukuthi amantombazane afinyelela ekukhuleni okukhulayo eminyakeni emibili ngaphambili kunabesilisa, ngakho-ke lapho besencane, amantombazane amaningi aphakeme kunabafana.
Ngaphezu kokuphakama kwabazali babo, lokhu kungezwani ngesikhathi sokuqala kwe-akhawunti yokukhulelwa ngenxa yokuthi kukhona ukungezwani okukhulu ezindaweni eziphakeme zezingane ezineminyaka eyishumi nambili.
Ukuhlola ingane encane
Uma uhlola izingane ezincane, okubaluleke kakhulu kunokuthi bekuphi ishadi lokukhula ukuthi banda kanjani. Ukuze ubuke leli phethini lokukhula, noma izinga lokuphakama kwengane, ngokuvamile kufanele ubheke iminyaka eminingana yokukhula.
Izingane ezikhula ngendlela evamile kufanele zilandelele ijika layo lokukhula ngokucophelela, ngakho-ke ngisho noma zingama-percentile e-5 noma amathathu, uma zihlala lapho, khona-ke zikhula ngokujwayelekile.
Uma ingane yakho iwela i-percentile noma imigqa ekhaleni lokukhula, kungenzeka kube khona inkinga yezokwelapha eyenza ukuthi ibe mfushane. Khumbula ukuthi izingane zivame ukuwela ama-percentile eminyakeni embalwa yokuqala yokuphila, futhi empeleni lokhu kutholakala okuvamile kubantwana abanomzali omfushane noma ukubambezeleka kokukhula komthethosisekelo (ngezinye izikhathi kuthiwa "i-bloomers sekwephuzile").
Amanye amafulege abomvu angabonisa ukuthi inkinga yokukhula ihlanganisa isimo sengqondo esingelapheki noma ezinye izimpawu ezingapheli, njengokuhlanza, isifo sohudo, umkhuhlane, ukulahlekelwa isisindo, ukungondleki kahle, ukudla okunomsoco, ukukhanda ikhanda kanye nokukhulelwa kwentsha. Ukuba nesimo esifushane esingavamile kungaba isibonakaliso se- chromosomal disorder , njenge-dwarfism esondayo, futhi kokubili nokufiphala ngokweqile kungabonisa inkinga ye-endocrine noma ye-hormonal.
Ingxenye ebaluleke kunazo zonke yokuhlola ingane ngesimo esifushane ibuyekeza amarekhodi abo okukhula noma ishadi lokukhula. Uma ingane encane ibe nezingane ezingaphezu kweyodwa, ke umqondo omuhle ukuthola wonke amarekhodi omdala omntwana ndawonye ukuze udokotela wezingane okhona manje ubuyekeze. Uma zifushane nje kodwa zikhula ngokujwayelekile, akukho ukuhlolwa okungaphezulu okudingekayo. Udokotela wakho anganquma ukubona ukukhula kwengane yakho ngaphezu kwezinyanga ezintathu kuya kwezi-6 ezilandelayo ukuqinisekisa ukuthi uyaqhubeka ekhula ngokujwayelekile.
Izingane ezincane ezivivinyayo
Ngezinye izikhathi ukuhlolwa kwezingane ezincane kuyadingeka, noma ukugwema isimo sezokwelapha esingase sibangele isiqu esifushane noma ukuqinisekisa ingane encane noma umzali ukuthi ukhula ngokujwayelekile.
Esinye sezivivinyo ezibaluleke kakhulu yithemba lesithambo. Ukuze unqume iminyaka yengane yengane yakho, udokotela wakho uzoyala i-x ray yesandla somntanakho. I-ray-ray iqhathaniswa nochungechunge lwezandla ezijwayelekile x-ray kusuka ezinganeni ezijwayelekile zeminyaka ehlukene. Isibonelo, uma i-x-ray yesandla somntwana wakho ibukeka sengathi i-x-ray eneminyaka eyisishiyagalolunye ubudala, ingane yakho kuthiwa ineminyaka engu-8 ubudala.
Uma inkathi yethambo lakho lomntwana liphansi kakhulu kunesikhathi sakhe sokulandelana noma langempela, khona-ke kungenzeka ukuthi namathambo akhe angakhula ukuze akhule emva kweminyaka lapho ngokuvamile ungalindela ukuthi kakade ayeke ukukhula. Amantombazane avame ukukhula kuze kube yiminyaka engaba ngu-14 ubudala, kanti abafana bayeke ukukhula emva kwethambo leminyaka engama-16 (ngezinga eliphakeme lokukhula ematheni aneminyaka eyi-14). Ukuba ne-bone elibambezelekile noma elithuthukile lingaba isibonakaliso senkinga edinga ukuhlolwa okuqhubekayo.
Ezinye izivivinyo zingabandakanya ukuhlola kwegazi ukuhlola i-hypothyroidism (T4 ne-TSH), amazinga e-hormone yokukhula (ngokuvamile ngokuhlola i-IGF-1 ne-IGF BP3), ukubala okuphelele kwegazi (ukuhlola i-anemia), i-chemistries yegazi (okungabandakanya i-SMA 20 ukuhlola izinso zezinso nesibindi), ukuvuthwa kwe-urinalysis, futhi ngezinye izikhathi i-karyotype ukuhlola okungavamile kwe-chromosomal (ikakhulukazi kumantombazane asolwa ukuthi ane-Turner syndrome).
Izimbangela Zesikhashana Esifushane
Esinye sezizathu ezivame kakhulu zomntwana wakho ukuba abe mfushane kunesiqu esifushane somndeni, okusho ukuthi abazali bomntwana kanye namanye amalungu omndeni nawo afushane. Lezi zingane zivame ukukhula ngesilinganiso esivamile, nakuba zifushane, futhi zilandela ijika elikhula elingase libe ngezansi kodwa lihambisana nezilinganiso ezijwayelekile zokukhula. Ukuhlolwa akudingeki njalo, kepha uma sekuphele iminyaka yesikhumba, umphumela uzoba ovamile futhi ungalibali.
Enye imbangela evamile yesikhashana esifushane kubantwana abavamile kunomkhawulo wokubambezeleka komthethosisekelo. Izingane ezinokuhlukahluka okujwayelekile kokukhula zifushane futhi zikhula noma ngaphansi kwe-3c perleenti ukuphakama kwazo. Isilinganiso sabo sokukhula siyoba sesijwayelekile ku-2 kuya ku-2 1/2 amasentimitha ngonyaka. Lezi zingane zizoba nesitembu sezintambo ezibambezelekile, kubonisa ukuthi kusekhona indawo engaphezulu yokukhula. Kanti futhi bavame ukubambezeleka ekuthomeni kokuqala. Yize kuncane, izingane ezinokulibaziseka kokukhula komthethosisekelo ziyoqhubeka zikhula lapho ezinye izingane ziyeke ukukhula futhi kufanele zifinyelele ekuphakameni kwabantu abadala okude eduze nendawo yabo yokuphakama. Lezi zikhathi ngezinye izikhathi zichazwa ngokuthi " iziqhumane sekwephuzile ", futhi ngokuvamile zikhona amanye amalungu omndeni aphinde aphuthuma futhi alandela le ndlela yokukhula.
Ukwelapha
Nakuba kunezizathu eziningi ezijwayelekile zokuthi ingane yakho ibe mfushane, kunezinye izimo ezibucayi ezidinga ukwelashwa. Izingane ezinemibandela yifushane kodwa futhi ayikhuli ngendlela evamile, ayihambisani nekhasi lokukhula, futhi ibuye iwele amaphesenti angaphansi.
Enye yalezi zimo futhi abazali abavame ukukhathazeka mayelana nokuntuleka kwe-hormone yokukhula. I-hormone yokukhula iyadingeka ekukhuleni okujwayelekile, kanti izingane ezinokukhubazeka kwe-hormone yokukhula zifushane, ngokuvamile zibukeka zincane kunezikhathi ezilandelanayo, futhi zingaba ngokweqile. Ngenkathi bevame ukuba nokulibaziseka emathangeni abo, njengabantwana abanokubambezeleka komthethosisekelo, abantwana abanokukhubazeka kwe-hormone yokukhula bayoba nesilinganiso esincane sokukhula futhi bayoba nekhasi lokukhula eliwela emigqeni evamile yokukhula. Ukwehla kwamakhomikhali e-hormone kungase kube nesisu (ingane izalwa nayo), noma ingase itholakale kamuva ekuphileni ngokulimala kwentloko noma isisu sobuchopho noma ubuningi.
uma udokotela wakho wezingane esho ukuthi ingane yakho ine-hormone yokuntuleka kokukhula, ingahlola amazinga ezingane zakho ze-IGF-1 ne-IGF BP3, ezobe ziphansi komntwana onokuntuleka. Ukuhlolwa kwe-hormone yokugqugquzela i-hormone kungenziwa nangomntwana we-endocrinologist.
Ukwelashwa kokuntuleka kwe-hormone ukukhula kuhlanganisa ukukhula kwe-hormone esikhundleni. Ezinye izimo lapho i-hormone yokukhula okwamanje isetshenziswa ngokuphumelelayo kuhlanganisa i- Turner syndrome , ukwehluleka kokuqeda izintambo, kanye ne-Prader-Willi syndrome.
Ukwelashwa kwe-hormone ye-Growth usanda kuvunyelwa ukwelashwa kwesikhashana kwezingane ezineziqu ezincane ze-idiopathic, futhi okuthiwa yi-hormone yokukhula engenamkhawulo esifushane, uma zingaphezu kuka-2.25 ukwehluka okujwayelekile ngaphansi kwencazelo yobudala nobulili, noma phakathi okuncishisiwe ama-1.2 amaphesenti wezingane.
Kubalulekile ukuthi uqaphele ukuthi ukukhuphula i-hormone shots kuyabiza, ngokuvamile kunikezwa izingane ezincane ezinsukwini eziyisithupha kuya kweziyisikhombisa zesonto kuze kube sekupheleni kwesikhathi sokubeletha, futhi ngokuvamile kuzothola umntwana ukukhula okungaphezulu kokubili kuya kwezingu-3. Ngakho-ke ingane encane enokuphakama okubikezelwe kuka-5'6 ", nokuthi ubani onesimo esifushane se-idiopathic, cishe ngeke ibe ngu-6 ubude ubude nje ngoba uthola ukukhula kwe-hormone shots.
I-hormone yokukhula ingasetshenziselwa futhi izingane ezizalwa ezincane iminyaka yobudala futhi zingabambeki ekukhuleni kwabo ngenkathi beneminyaka emibili ubudala.
Izingane Ezincane
Ukugcina amarekhodi amahle okuphakama nesisindo somntanakho kungenza kube lula kakhulu ukuhlolisisa ingane enesiqu esifushane. Qinisekisa ukuthi uvakashela ingane yakho evamile ukuvakashelwa nengane yakho, ngisho nalapho uvakashele ukugula, bacele ukuba balinganise ukuphakama kwengane yakho uma kungakenziwa okwamanje. Nakuba iningi labahlengikazi lingakwazi ukuqala ukuhlolwa kwengane encane, uma kudingwa ukuhlolwa okungeziwe, noma wena noma ingane yakho udinga ukuqinisekiswa, ukuvakashela i-endocrinologist yezingane kungaba usizo.
Imithombo:
Isiqondiso somkhuba we-American College of Medical Genetics (ACMG): Ukuhlolwa kwe-Genetic kwesimo esifushane. I-Genetic in Medicine: June 2009 - Umqulu 11 - Issue 6 - iphe 465-470.
I-Gubitosi-Klug RA. Isikhathi esifushane se-Idiopathic. I-Endocrinol Metab Clin North Am, Septemba 2005; 34 (3): 565-80.
Kronenberg: Williams Bookbook of Endocrinology, 11th ed.
Leschek EW. Umthelela wokwelashwa kwe-hormone ukuphakama kwabantu abadala kuma-peripubertal ne-idiopathic isiqu esifushane: isilingo esilawulwa ngokungahleliwe, esine-double blind, esiphethwe yi-placebo. J Clin Endocrinol Metab, Julayi 2004; 89 (7): 3140-8
Quigley CA. Ukwelashwa kwamahomoni okukhula okungahambi kahle ekukhuleni kwe-hormone. I-Endocrinol Metab Clin North Am, Mashi 2007; 36 (1): 131-86