Ingabe ingane yakho esanda kuzalwa inalezi zinkinga? Ake sixoxe nge-Neonatal Opioid Withdrawal Syndrome (NOWS)

Injabulo umama ayizwayo lapho eletha ekhaya umntwana osanda kuzalwa ayichazeki. Kodwa ngezinye izikhathi, uma umntwana eqhubeka ekhala, ekhafula ubisi njalo, noma ebonakala sengathi wenza ngendlela exakile, kungaba yinto eyesabekayo kakhulu kumama. Namuhla sizokhuluma ngesimo esisodwa esesabekayo kodwa esibalulekile okudingeka sisiqaphele. Leso yi -Neonatal Opioid Withdrawal Syndrome (NOWS) ezinganeni ezisanda kuzalwa. Ngaphambilini, yayibizwa nangokuthi i-Neonatal Abstinence Syndrome (NAS) .

Iyini i-neonatal opioid withdrawal syndrome (NOWS)?

Kalula nje, lokhu kwenzeka lapho umama esebenzisa izidakamizwa ezithile (ikakhulukazi ama-opioid) noma ezinye izinto eziluthayo ngesikhathi sokukhulelwa, futhi umntwana uvezwa kulezo zinto ngesikhathi esesibelethweni, kanye nokungakhululeki okwenzeka ngemva kokuba izinto zisusiwe emzimbeni ngemva kokuzalwa. Ubuwazi ukuthi lapho umntwana esesibelethweni, uthola izakhamzimba nomoya-mpilo kumama ngesitho esibizwa ngokuthi i-placenta . Ngokufanayo, eminye imithi nezidakamizwa umama azithathayo nazo zidlula kule placenta ziye enganeni. Ngakho-ke, ngenkathi umntwana esesibelethweni, ujwayela lezi zinto ngandlela-thile, okungukuthi, uqala ukuthembela kuzo. Lapho ukuphakelwa okuvela kumama kuphela ngemva kokuzalwa, umzimba womntwana uba nesikhathi esinzima sokubhekana nakho. Yilapho lezi zimpawu zokuhoxa zivela khona.

Yimiphi imithi engabangela i-NOWS?

Lesi simo sibangelwa kakhulu yizidakamizwa eziku- opioid class. Nazi izibonelo ezimbalwa:

• `( Ama-Amphetamine )`
• `( I-Buprenorphine )`
• `(I-Codeine)`
• `(Iqhawekazi)`
• `( I -Oxycodone )`
• `( I -Hydrocodone )`
• `(I-Morphine)`
• `(I-Methadone)`

Ngaphezu kwalokhu, ezinye izinto nazo zingabangela lesi simo. Lezi yizi:

• Utshwala
• Ama-Barbiturates (ezinye izinhlobo zamaphilisi okulala)
• Ama-Benzodiazepine (amanye ama-sedative)
• I-Nicotine (equkethwe kugwayi )
• Ezinye izinhlobo zemithi yokucindezeleka, ikakhulukazi leyo eseqenjini elibizwa ngokuthi i-Selective Serotonin Reuptake Inhibitors (SSRIs).

Okubaluleke kakhulu, uma ukhulelwe noma uhlela ukukhulelwa, kufanele nakanjani wazise udokotela wakho nganoma yimiphi imithi, izithasiselo, noma ezinye izinto ozithathayo.

Ingabe lesi simo sivamile? Ubani othinteka kakhulu?

Ngeshwa lesi simo se-NOWS kubikwe ukuthi siyanda emhlabeni wonke. Eqinisweni, ngokwezibalo, ngokwezinye izifundo, ingane eyodwa izalwa ne-NOWS njalo ngemizuzu engama-25. Lokho kusho ukuthi cishe izingane eziyisikhombisa kweziyizinkulungwane ezimbili zingaba nale ngozi. Lokhu kuthinta kakhulu izinsana ezisanda kuzalwa ezinonina abasebenzisa ama-opioid noma ezinye izinto eziluthayo ngesikhathi sokukhulelwa. Ukulutheka kwezidakamizwa akulula njengoba kubonakala, kuyinkinga eyinkimbinkimbi.

Kwenzekani emzimbeni womntwana ngenxa ye-NOWS? Ziyini izimpawu?

Lezi zimpawu, ezaziwa ngokuthi izimpawu zokuhoxa, zingase ziqhubeke kuze kube yilapho ingane isiyeke ngokuphelele ukusebenzisa umuthi. Lokhu kungabangela ingane ukuba ikhale kakhulu, ingabi nakuthula, noma izenze sengathi iyagula. Kunzima kangakanani kumama noma kuyise omusha ukubona ingane yabo encane ihlupheka kanje? Kungaba nzima kakhulu nokududuza ingane phakathi nalesi sikhathi. Kuye ngokuthi izimpawu zengane zibucayi kangakanani, ingane ingadinga ukwelashwa e -Neonatal Intensive Care Unit (NICU) . Lokhu kwenzeka kuze kube yilapho ingane isiyeke ngokuphelele ukusebenzisa umuthi futhi iphila kahle. Izimpawu Ezivamile:

• Ukuhlanza njalo kanye/noma isifo sohudo
• Umkhuhlane nokujuluka
• Ukuphefumula okusheshayo
• Ukukhala okuqhubekayo, okukhulu
• Ukumunca njalo
• Ukuthuthumela
• Ukuqubuka kwenabukeni (ukubomvu kwesikhumba endaweni yezinqe ngenxa yokuqubuka kwenabukeni)

Izimpawu ezengeziwe ezingase zibonakale:

• Ukuqina kwemisipha (i-Hypertonia) kanye nokusabela okusebenzayo ngokweqile
• Ubunzima bokuthola isisindo
• Ubunzima bokulala nokuhlala ulele
• Izinkinga ngokuphuza ubisi
• Ukubonakala kwephethini enamabala, efana ne-marble esikhumbeni (amabala)

Lezi zimpawu zingahluka kusuka enganeni eyodwa kuya kwenye, futhi ubukhali bungahluka. Kuya ngokuthi:

• Kuya ngokuthi hlobo luni lomuthi olusemzimbeni womntwana.
• Kuya ngokuthi umuthi ungakanani emzimbeni.
• Kuncike ekutheni ingane ithole umuthi isikhathi esingakanani ngesikhathi isesibelethweni.

Kuthiwani uma izimpawu ziba zimbi kakhulu?

Uma umntwana enomjovo omningi emzimbeni wakhe lapho ezalwa, angaba nezimpawu ezinzima, ezisongela ngisho nokuphila. Lezi zimpawu zifaka:

• Ukuzalwa ngaphambi kwesikhathi
• Izinkinga zokukhula kanye nokukhubazeka kokuzalwa
• Ukuquleka
• Isifo Sokufa Kwezinsana Okungazelelwe (SIDS)

Izimpawu zivela nini?

Lezi zimpawu zingaqala ukuvela zingakapheli usuku noma ezintathu ngemva kokuzalwa komntwana. Ngezinye izikhathi, izimpawu zingase zingaveli kuze kube yisonto. Phakathi nalesi sikhathi, umntwana uvame ukugcinwa "e-NICU" yesibhedlela kuze kube yilapho into isiphelile ngokuphelele emzimbeni futhi umntwana esephilile ngokwanele ukuba aye ekhaya.

Ingabe i-NOWS ingabangela imiphumela yesikhathi eside?

Lena inkinga ebucayi kakhulu. Imiphumela yesikhathi eside ingahluka kuye ngokuthi isimo se-NOWS sibucayi kangakanani. Njengoba ingane ikhula, ingase ibhekane nezinto ezifana nalezi:

• Ukulibaziseka kokukhula : Ukulibaziseka ekuthuthukisweni kwamakhono okuqonda, ezenhlalo, kanye nokunyakaza komzimba.
• Izinkinga zokuziphatha esikoleni.
• Izinkinga ngenkumbulo yesikhashana.
• Izinkinga zokukhula (ukuphakama, ukwehla kwesisindo).
• Izinkinga zokuzwa nokubona.

Ngakho-ke, kubaluleke kakhulu ukuyisa ingane yakho ekuhlolweni kwempilo njalo ukuqinisekisa ukuthi ihlangabezana nezigaba zokukhula ezihambisana nobudala bayo. Izifundo zikhombisile ukuthi izingane ezizalwa zine-NOWS zinamathuba amaningi okuthuthukisa lezi zimo ezilandelayo njengoba zikhula:

• Isifo Sokungakwazi Ukunaka/Ukuphazamiseka Kokusebenza Kakhulu (ADHD)
• Ukukhathazeka
• Ukucindezeleka

Ungasibona kanjani isimo se-NOWS?

Ngenxa yokuthi izimpawu ze-NOWS zingafana nezezinye izimo ezinganeni ezisanda kuzalwa, odokotela bangathola lesi simo kuphela ngemva kokufunda ngemithi umama ayithathile ngesikhathi sokukhulelwa nangemva kokwenza ukuhlolwa kwemithi . Lokhu kuhlolwa kwemithi kungathola ukuthi hlobo luni lomuthi olusemzimbeni womntwana nokuthi lungakanani. Lokhu kungenziwa ngokuhlola isampula yenkaba yomntwana, umchamo, igazi, noma indle yokuqala yomntwana (i-meconium). Ngezinye izikhathi umama angase ahlolwe nemithi ukuqinisekisa ukuxilongwa. Ngaphezu kwalokho, odokotela basebenzisa uhlelo lokuhlola lwe-NAS . Lokhu kusetshenziselwa ukunikeza amaphuzu ngokusekelwe ebunzimeni bezimpawu zomntwana bese behlela ukwelashwa ngokufanele.

Yiziphi izindlela zokwelapha ze-NOWS?

Ukwelashwa okunikezwa ingane kuncike ohlotsheni lomuthi emzimbeni, inani lawo, impilo yonke yengane, kanye nobunzima bezimpawu. Ukwelashwa kungafaka:

• Ukunikeza imithi yokunciphisa kancane kancane izimpawu.
• Uma umntwana ephelelwe amanzi emzimbeni, mnike usawoti ngemithambo yegazi (i-IV fluids).
• Ukufaka okhilimu noma amafutha okugcoba ukuze kutholakale amaqhubu e-nappy kanye nokucasuka kwesikhumba.
• Ukushintsha imvamisa kanye nenani lokuncelisa: Ukuze usize ingane yakho ithole isisindo, nikeza ifomula enamakhalori aphezulu ngamanani amancane, avamile.

Ukwelashwa kungahlala kusukela ezinsukwini ezinhlanu kuya ezinyangeni eziyisithupha, kuze kube yilapho ingane isiphilile futhi kungasekho mithi eseleyo emzimbeni wayo. Ukwelashwa kwesikhathi eside ukunciphisa izimpawu, njengokwelashwa kokuziphatha kwengqondo (i-CBT) , kungadingeka kuyo yonke impilo yengane.

Yiziphi izinhlobo zemithi ezinikezwa i-NOWS?

Uma ingane yakho inezimpawu ezinzima, odokotela bangase basebenzise imithi ethile ukusiza ukulawula lezi zimpawu zokuhoxa futhi kwenze kube lula ngengane yakho ukudla nokulala. Lokhu kuhilela ukunikeza ingane yakho umthamo ophansi kakhulu womuthi ofana nalowo abawuthole esibelethweni, ukunciphisa umthamo kancane kancane, nokuyekisa ingane yakho kuwo. Lokhu kungenxa yokuthi ukuyeka umuthi ngokuzumayo (i-cold turkey) kungenza izimpawu zibe zimbi kakhulu. Eminye yemithi esetshenziselwa le njongo ihlanganisa:

• `(I-Methadone)`
• `(I-Morphine)`
• `(I-Buprenorphine)`
• `(I-Phenobarbital)`
• `(I-Clonidine)`

Uma ingane yakho idinga ukwelashwa ngale ndlela, kungadingeka uhlale esibhedlela amasonto noma izinyanga ezimbalwa. Lokhu kwenzelwa ukuqinisekisa ukuthi odokotela baphilile ngokwanele ukuthi bangayeka ngokuphelele imithi bese bethumela ingane ekhaya.

Umama angasiza kanjani ekulawuleni izimpawu zomntwana wakhe?

Uma ingane yakho ihlushwa izimpawu zokuhoxa, kungaba nzima kakhulu ukuyiduduza. Kodwa njengomama, ungasiza ngokuthi:

• Hlala useduze nomntwana ngangokunokwenzeka.
• Nciphisa inani lokukhanya okukhulu nomsindo omkhulu endaweni yomntwana.
• Thuthukisa ingane kancane.
• Bamba ingane yakho eduze kwesifuba sakho ( ukuthintana kwesikhumba nesikhumba ). Lokhu kuyaduduza kakhulu ingane yakho.
• Mgoqe kahle umntwana ngendwangu ethambile (indwangu yokumboza).

Ngingamncelisa yini umntwana wami ngenkathi ngisebenzisa izidakamizwa?

Lena inkinga ebaluleke kakhulu. Yebo, izidakamizwa ezifana nama-opioid zingadlulela obisini lwebele lomntwana wakho. Lokhu kungaba nemiphumela emibi eyingozi enganeni yakho. Ngakho-ke, uma usebenzisa izidakamizwa ezingavunyelwe udokotela wakho, ungayincelisi ingane yakho nganoma yisiphi isizathu . Kunalokho, nikeza ingane yakho ifomula noma ubisi lwebele olunikelwe. Kodwa-ke, uma usehlelweni lokwelashwa ngezidakamizwa, okungukuthi, uma uthatha i-opioid enqunyiwe (njenge-methadone) ngesikhathi sokukhulelwa noma ngemva kokubeletha ukuvimbela izimpawu zokuhoxa, ungase ukwazi ukuncelisa. Kodwa kuphela ngemvume kadokotela wakho futhi uma bebona ukuthi iphephile enganeni yakho. Uma unenkinga yezidakamizwa noma umlutha, khuluma nodokotela wakho ngezindlela zokuthola ukwelashwa kwayo. Ukuhlala uphilile kuzokunika amandla okuba khona lapho ingane yakho ikudinga kakhulu.

Ungakuvimbela kanjani i-NOWS?

Ungathatha lezi zinyathelo ukuvimbela ingane yakho ukuthi ingabi nezimpawu ezinzima ze-NOWS:

• Uma ukhulelwa, qiniseka ukuthi utshela udokotela wakho nganoma yimiphi imithi noma izinto ozisebenzisayo. Uma uyeka ngokuzumayo ukusebenzisa umuthi obulokhu uwusebenzisa isikhathi eside, ungase ube nezimpawu ezinkulu zokuhoxa, ezingaba yingozi enganeni yakho engakazalwa. Udokotela wakho uzoncoma izindlela zokwelapha eziphephile kuwe nakumntwana wakho.
• Tshela udokotela wakho nganoma yimiphi imithi kadokotela kanye nezithasiselo ozithathayo. Qiniseka ukuthi ziphephile kuwe nakumntwana wakho. Ungayeki ukuthatha noma yimuphi umuthi kuze kube yilapho udokotela wakho ekutshelile ukuthi wenze kanjalo.
• Sebenzisa indlela yokuvimbela inzalo uze ulungele ukuba nomntwana. Uma uhlanganyela ocansini futhi unenkinga yokusebenzisa izidakamizwa noma uselashwa, yenza ucansi oluphephile uze ube nempilo enhle ngokwanele yokukhulelwa.

Uma ingane yami ine-NOWS, yini okufanele ngiyilindele?

Ingane etholakale ine-NOWS ivame ukuhlala esibhedlela cishe izinsuku ezingu-20 ukuqinisekisa ukuthi iphilile ngokwanele ukuya ekhaya. Ngezinye izikhathi ukwelashwa kwe-NOWS kungathatha izinyanga eziyisithupha. Odokotela bazoqapha izimpawu zengane yakho eduze futhi bazithumele ekhaya kuphela ngemva kokuba imithi isiphelile ngokuphelele ohlelweni lwayo. Udokotela wakho uzokunikeza iseluleko sendlela yokuncelisa ingane yakho nokuthi ungayinakekela kanjani ingane yakho. Khumbula, uma usebenzisa izidakamizwa, ungancelisi, njengoba imithi ingadlulela enganeni yakho ngobisi lwebele futhi ibangele izimpawu ezingathinta impilo yayo. Ngemva kokuletha ingane yakho ekhaya isuka esibhedlela, ingane yakho izodinga uthando lwakho olwengeziwe kanye nokusekelwa amasonto noma izinyanga eziningana, futhi mhlawumbe kuyo yonke iminyaka yobuntwana. Nakisisa ukukhula kanye nentuthuko yengane yakho. Uma ingane yakho ingahlangabezani nezigaba zokukhula zobudala bayo, tshela udokotela wakho ngokushesha.

Kufanele ufune nini ukwelashwa okuphuthumayo?

Uma ingane yakho inalezi zimpawu ezinzima, iya eMnyangweni Wezimo Eziphuthumayo (ETU) ngokushesha noma ushayele u-1990:

• Umkhuhlane omkhulu ohlala isikhathi esingaphezu kwamahora angama-24.
• Uma ungaphuzi ubisi, noma uma uhlanza ngemva kokuphuza ubisi.
• Uma kwenzeka ukuxhuzula.
• Uma ukushaya kwenhliziyo kungavamile.
• Uma unenkinga yokuphefumula.

Yimiphi imibuzo ebalulekile okufanele uyibuze udokotela?

• Yimiphi imithi ephephile ukuyithatha ngesikhathi sokukhulelwa?
• Ukuyeka kanjani ukusebenzisa isidakamizwa esiluthayo?
• Ingabe izimpawu zomntwana wami zizomthinta isikhathi eside?
• Ngingamduduza kanjani umntwana wami ngesikhathi sokwelashwa?

Okokugcina, okufanele ukukhumbule (Umyalezo Wokuya Ekhaya)

Ukuluthwa izidakamizwa kuyinto enzima kakhulu futhi eqeda amandla. Uma ukhulelwe, le mizwa ingaba namandla kakhulu, futhi ungase uzizwe sengathi awazi ukuthi wenzeni. Kodwa khumbula, awuwedwa.

Kunezindlela zokwelapha ezitholakalayo zokusiza wena nomntanakho niphile impilo ejabulisayo nenempilo. Into ebaluleke kakhulu ukwethembeka kudokotela wakho ngayo yonke imithi nemithi oyiphuzayo ngesikhathi sokukhulelwa kwakho. Lokhu kuzosiza udokotela wakho ukuthi anqume ukwelashwa okungcono kakhulu kuwe nomntanakho. Akukho okubi ngokucela usizo, kuyakunika amandla.

I-Neonatal Opioid Withdrawal Syndrome, I-Neonatal Abstinence Syndrome, i-NOWS, i-NAS, ukuyeka usana, ukuchayeka ezidakamizweni zezingane, ukukhulelwa kokulutheka kwe-opioid, ukukhulelwa kwezidakamizwa, izinsana ezisanda kuzalwa, imiphumela yezidakamizwa enganeni