Abazali nabantwana, ngokukodwa abafana nabaselula, badla ngokuxhalaba xa bebona ukuba bancinci kuneentanga zabo kunye nabalingana nabo esikolweni esifanayo.
Nangona kukho iimeko ezininzi zonyango ezingabangela ukuba abantwana babe nesigqityu esifutshane, abaninzi abantwana abancinci baqhelekile .
Eli lixesha elinye apho abantwana banokumangalela abazali babo, okanye ubuncinci babo begciwane, into ethile.
Uninzi lwabantwana lufutshane ngoba banabantwana abafutshane. I-Genetics idlala indima enkulu ekuthi umntu omude kangakanani.
Ukuphakanyiswa kokuphakama
Abazali bavame ukubuza ukuba ugqirha wabo unokukwazi ukubona indlela abade baba ngayo. Nangona udokotela wakho wezingane azinayo ibhola ye-crystal ukuze abone indlela abade bakho abaza kuba ngayo xa bekhula, kukho imodeli elula esebenzisa iziphakamileyo zabazali ukubanceda baqikelele ukuphakama kwekhagethi lomntwana okanye amandla abo ekuveleni. Ngokuqhelekileyo, ulinganisa ubukhulu bomzali ngokuzalwa waza wongeza 2 1/2 intshi ukuba umntwana uyinkwenkwe, okanye ususe 2 1/2 intshi enye intombazana. Ungasebenzisa kwakhona ukuphakama kwe- intanethi ukukwenza ukubala.
Ukuqaphela ukuphakama komgubo kubalulekile, kuba ukuba umntwana ungaphantsi kweendlela zakhe zokuzalwa, oko kungabonakalisa ingxaki.
Ukukhula okuqhelekileyo
Abantwana bakhula ngokukhawuleza kwiminyaka yokuqala yoku-4 yobomi (ngokukodwa kwiminyaka yokuqala yesi-2), kwizinga eliphakamileyo njenge-intshi ezingama-4 ngonyaka.
Emva kweminyaka engama-4, abantwana bavame ukukhula ngesantya sokuhla kwezinga eliphantsi elingaphantsi kwe-2 ukuya ku-2 1/2 intshi ngonyaka-kude kube baqala ukukhulelwa. Emva koko xa bebetha ukukhula kwabo kwintshukumo ekukhuleni, amantombazana akhula malunga ne-3 ukuya kwe-3 / 1/2 intshi ngonyaka, kwaye abafana bakhula malunga no-4 intshi ngonyaka. Emva kokuba abatsha bethinte ukukhula kwabo, ukukhula kwabo kuya kuhamba ngokukhawuleza baze bafikelele ekuphakameni kwabo abadala, malunga ne-4 ukuya kwe-5 kwiminyaka emva kokukhula kwabo.
Amakhwenkwe namantombazana bahlala bekhula kuze kube yilapho beneminyaka eyi-14 ukuya kwe-16 ubudala, kodwa oku kuxho mekeke xa beqala ukukhulelwa, okuya kuqala naphakathi kwama-8 no-13 kumantombazana kunye no-9 kunye no-14 kubafana. Ngokomzekelo, ukuba intombazana iqala ukutshatshulwa eneminyaka eli-8 ubudala, ngoko iyakwazi ukutshitshisa ukukhula kwayo ekupheleni kweminyaka elithoba kwaye ibe yenziwe ngokukhula ngelixesha elineminyaka eli-13 ubudala. Ngakolunye uhlangothi, ukuba enye intombazana ingaqali ukutshatyalaliswa kwaze kwaba yilapho eneminyaka eyi-12 ubudala, unako ukuqhubeka ekhula de ibe neminyaka eli-17 ubudala.
Kwakhona, khumbula ukuba amantombazana afinyelela ekukhuleni kwawo okutshatyalaliswayo kwiminyaka emibini ngaphambi kokuba amakhwenkwe, ngoko-ke, ebusheni bokuqala, amantombazana amaninzi aphakamileyo kunamakhwenkwe.
Ukongezelela ekuphakameni kwabazali babo, le ntlukwano ngexesha lokuqala kwe-akhawunti yobushushu ngenxa yezinto ezininzi ezahlukileyo kwiindawo eziphakamileyo zabantwana phakathi kwexesha elidala kunye nolutsha oluselula.
Ukuvavanya umntwana omfutshane
Xa uvavanya abantwana abancinci, kubaluleke ngakumbi kunokuba bahlala kwiteksi yokukhula njani bebekhulile. Ukujonga le pateni yokukhula, okanye ukuphakama komntwana, kufuneka ukhangele iminyaka emininzi yokukhula.
Abantwana abakhula ngokuqhelekileyo kufuneka balandele ukukhula kwabo ngokukhawuleza, ngokunjalo nangona bekhona kwi-5 okanye ye-3 percentile, ukuba ngaba behlala behlala bekhona, ngoko bahlala bekhula ngokuqhelekileyo.
Ukuba umntwana wakho uwela i-percentile okanye imigca kwi-curve yokukhula, mhlawumbi kunokuba neengxaki zonyango ezibangela ukuba abe mfutshane. Qhubeka ukhumbule ukuba abantwana banokuqhelana ngokuphindaphindiweyo kwimigca embalwa kwiminyaka yokuqala yobomi, kwaye ngoku kunene ukufumana okuqhelekileyo kubantwana abanomzali omfutshane okanye ukulibaziseka kokukhula komgaqo-siseko (ngezinye izihlandlo kuthiwa "i-bloomers late").
Ezinye iiflegi ezibomvu ezingabonakalisa ingxaki yokukhula ziquka ukuba nesifo esingapheliyo okanye ezinye iimpawu ezingapheliyo, ezifana nokuhlanza, isifo sohudo, umkhuhlane, ukulahleka kwesisindo, ukungondleki, ukungondleki kakuhle, ukuphathwa kwentloko, kunye nokulibazisa. Ukuba nesimo esincinci esifutshane singabonakalisa isifo se- chromosomal , njenge-achondroplastic dwarfism, kwaye ukugqithisa nokugqithiseleyo kunokubonisa inkinga ye-endocrine okanye ye-hormonal.
Inxalenye ebaluleke kakhulu yokuvavanya umntwana ngesigxina esifutshane uhlaziya iirekhodi zokukhula okanye isatifiketi sokukhula. Ukuba umntwana omfutshane unabantwana besigqirha abangaphezu kweyodwa, ke ingcamango enhle yokufumana onke amarekhodi endala yomntwana ndawonye kunye nezingane zabo zangoku. Ukuba zifutshane nje kodwa zikhula ngokuqhelekileyo, ngoko akukho mvavanyo efunekayo. Ugqirha wakho unokugqiba ukugcina ukukhula komntwana wakho kwiinyanga ezi-3 ukuya kwezi-6 ukuqinisekisa ukuba uyaqhubeka ekhula ngokuqhelekileyo.
Abantwana abafutshane
Ngamanye amaxesha ukuvavanya abantwana abancinci kuyadingeka, nokuba kunjalo, ukulawula imeko yonyango engabangela ukufutshane okanye ukuqinisekisa umntwana omfutshane okanye umzali ukuba ukhula ngokuqhelekileyo.
Enye yeemvavanyo ezibalulekileyo yithuba lesithambo. Ukuze ugqibe ixesha lomntwana wengonyama, ugqirha wakho uya kuyala i-x-ray yesandla somntwana wakho. I-x-ray ithelekiswa kwinqanaba lezandla eziqhelekileyo x-ray ukusuka kubantwana abaqhelekileyo bamaxesha ahlukeneyo. Ngokomzekelo, ukuba isandla sakho somntwana x-ray sibonakala sithandana ne-x-ray ubudala eneminyaka eyi-8 ubudala umntwana wakho uthi uneminyaka engama-8 ubudala.
Ukuba ixesha lentsana lomntwana lingaphantsi kwexesha lakhe lexesha okanye ngokoqobo, ngoko mhlawumbi kusekhona ithuba lokuba amathambo akhe akhule emva kweminyaka ebeyikulindele ukuba ayeke ukukhula. Amantombazana ahlala ekhula kuze kube yiminyaka eyi-14 ubudala, kwaye amakhwenkwe ayayeka ukukhula emva kwethambo leminyaka eyi-16 (kunye nenqanaba lokukhula eliphakamileyo kwi-bone iminyaka eyi-14). Ukuba nexesha lokulibaziseka okanye eliphambili leethambo lingabonakalisa inkcazo efuna ukuvavanywa kwangaphezulu.
Ezinye iimvavanyo zingabandakanya iimvavanyo zegazi ukujonga i-hypothyroidism (i-T4 ne-TSH), amazinga e-hormone yokukhula (ngokuqhelekileyo ngokujonga i-IGF-1 ne-IGF BP3), ukubala okupheleleyo kwegazi (ukujonga i-anemia), i-chemistries yegazi (engabandakanya i-SMA 20 ukujonga iinjongo kunye nesifo sesibindi), ukuhlaziywa kwe-urinalysis, kwaye ngezinye izikhathi i-karyotype ukukhangela i-chromosomal engafanelekiyo (ingakumbi kumantombazana anqatshelwe ukuba ne-Turner syndrome).
Izizathu zeSigxina esifutshane
Esinye sezizathu eziqhelekileyo eziqhelekileyo zomntwana wakho ukuba abe mfutshane unesiqu esifutshane somntu, oku kuthetha ukuba abazali bomntwana kunye namanye amalungu entsapho afutshane. Aba bantwana bavame ukukhula ngesilinganiso esiqhelekileyo, nangona bafutshane, kwaye balandela ukukhawuleza okukhulayo okungekho ngaphantsi kodwa kufana nokukhula okuqhelekileyo. Ukuvavanya akufuneki rhoqo, kodwa ukuba ixesha lesithambo lenziwe, umphumo uya kuba yinto engavamile kwaye ayilibaleki.
Esinye isizathu esiqhelekileyo sesigxina esifutshane kubantwana abaqhelekileyo sinokulibaziseka komgaqo-siseko wokukhula. Abantwana abanolu hlobo oluqhelekileyo lokukhula lufutshane kwaye lukhula okanye ngaphantsi kwe-3 percentile ngokuphakama kwabo. Isantya sokukhula siya kuba sesiqhelo kwi-2 ukuya kwi-2 1/2 intshi ngonyaka. Aba bantwana baya kuba nexesha lesithambo elilibazisekile, kubonisa ukuba kusekho igumbi elongezelelweyo lokukhula. Kananjalo baninzi banokulibaziseka ekuqalekeni. Nangona lifutshane, abantwana abanokubambezeleka kokukhula komgaqo-siseko baya kuqhubeka bekhula xa abanye abantwana beyekile ukukhula kwaye kufuneka bafikelele ekuphakameni komntu omdala osondele ekujoliswe kuwo. Ngamanye amaxesha aba bantwana bachazwa ngokuba " ngababomi bexesha elide ", kwaye ngokuqhelekileyo amanye amalungu omndeni abuye aphuculwa ngokukhawuleza kwaye alandele le ndlela yokukhula.
Unyango
Nangona kukho ezininzi izizathu eziqhelekileyo zokuba umntwana wakho abe mfutshane, kukho nezinye iimeko ezinzulu ezifuna unyango. Abantwana abanezi meko zifutshane kodwa aziqhelanga ngokuqhelekileyo, abahambelanga ikhefu lokukhula, kwaye bahlala bewela i-percentile.
Enye yezi meko kunye nabazali abahlala bexhalabile malunga nokulahleka kwehommone ye-hormone. Ihommone yokukhula iyadingeka ekukhuleni okuqhelekileyo, kwaye abantwana abanokukhubazeka kwehommone ukukhula, baninzi babonakala bancinci kunexesha lokulandelana kwazo, kwaye banokuba bunzima kakhulu. Ngoxa beza kubakho ukulibaziseka kwiminyaka yabo yethambo, njengabantwana abanokulibaziseka komgaqo-siseko, abantwana abanokukhubazeka kwehommoni yokukhula baya kuba neqondo eliphantsi lokukhula kwaye baya kuba nekhalo lokukhula eliwela kwiindlela eziqhelekileyo zokukhula. Ukukhubazeka kwamakhomitha e-hormone kungenokuba yintlungu (umntwana uzalwa nayo), okanye inokufunyanwa kamva ebomini ukusuka kwintlungu okanye inkohlakalo yengqondo okanye ubunzima.
Ukuba ugqirha wezilwanyana unobangela ukuba umntwana wakho unobunzima bokukhula kwehommoni, unokujonga iinqanaba lomntwana wakho we-IGF-1 kunye ne-IGF BP3, eya kuba yinto ephantsi kumntwana onokusilela. I-hormone yokukhula yokuvusa inokuthi iqhutywe ngumntwana we-endocrinologist.
Ionyango zokunqongophala kwehommoni yokukhula ziquka ukukhula kwehommoni yokutshintsha. Ezinye iimeko apho i-hormone yokukhula isebenzisa ngokuphumelelayo i- Turner syndrome , ukungaphumeleli kwindlovu engapheliyo kunye ne-Prader-Willi syndrome.
Ulwaphulo lwe-hormone ye-Growth luye lwavunywa ngokusasazeka kwexesha elide labantwana abane-idiopathic esifutshane, esabizwa ngokuba yi-hormone yokukhula engenako ukukhula okufutshane, ukuba ngaba bangaphezu kwe-2.25 ukuphambuka komgangatho ongaphantsi kwintsimi yobudala kunye nesondo, okanye phakathi I-1.2 yepesenti yabantwana.
Kubalulekile ukuba uqaphele ukuba ukunyuka kwamahomoni e-hormone kuyabiza, kaninzi kunikwa abantwana abancinci iintsuku ezintandathu ukuya kweyisixhenxe kwiveki ade bazalise ubusuku, kwaye ngokuqhelekileyo bafumana umntwana u-2 ukuya ku-3 intshi yokukhula. Ngoko umntwana omfutshane onokulinganisela kokuphakama kwe-5'6 ", kwaye ngubani onesidima esifutshane se-idiopathic, mhlawumbi akayi kuba ngama-6 ubude ubude nje ngokuba ufumana ukukhula kwe-hormone shots.
I-hormone yokukhula ingasetyenziselwa abantwana abazalelwe emncinci kwiminyaka yobudala kunye nabangabandakanyeki ekukhuleni kwabo ngelixesha abaneminyaka emibini ubudala.
Abantwana abancinane
Ukugcina iirekhodi ezilungileyo zokuphakama komntwana wakho kunye nesisindo kunokukwenza kube lula ukuvavanya umntwana ngesigxina esifutshane. Qinisekisa ukuba uye ekutyelelweni kwakho rhoqo umntwana kunye nomntwana wakho, kwaye nangona utyelelo olugulayo, bacele ukuba balinganise ukuphakama komntwana wakho ukuba akukwenziwanga kutshanje. Nangona uninzi lwabahlengikazi lunokuqalisa ukuvavanywa komntwana omfutshane, ukuba ngaba uvavanyo olongezelelweyo lufunekayo, okanye wena okanye umntwana wakho ufuna ukuqinisekiswa, ngoko ukutyelela kwi-endocrinologist yezilwanyana kunokuba luncedo.
Imithombo:
Isikhokelo sendlela yokuqhuba isifundo se-American College of Medical Genetics (ACMG). I-Genetics kwiMida: NgoJuni 2009 - Umqulu 11 - Issue 6 - iphe 465-470.
Gubitosi-Klug RA. Idiopathic esifutshane. I-Endocrinol I-Metab Clinic North, ngoSeptemba 2005; 34 (3): 565-80.
I-Kronenberg: Iincwadi ze-Williams ze-Endocrinology, ngomhla we-11.
Leschek EW. Impembelelo yonyango lwe-hormone yokukhula emphakathini omdala kumntwana onesifo esine-idiopathic esifutshane esifutshane: isilingo esilawulwa ngokungaqhelekanga, esibini-imfama, esilawulwa yi-placebo. J Clin Endocrinol Metab, Julayi 2004; 89 (7): 3140-8
Quigley CA. Ukunyanga kwama-hormone ekukhuleni kokungabikho kokukhula kwe-hormone-ukukhubazeka kokukhula kokungabikho. I-Endocrinol I-Metab Clinic North, ngoMatshi 2007; 36 (1): 131-86