Ubuncwane obunobunzima bubonakala bubumba uphuhliso lwengqondo
Iintsana zokuqala zichitha iiveki zokuqala zokuphila kwiyunithi yokunakekelwa kwe - neonatal enkulu (NICU) . Ngokwemvelo, i-NICU yindawo ekhulayo kunye neyodwa. Ukongezelela, iintsana kwiNICU zixhomekeke kwiinkqubo ezahlukeneyo ezibuhlungu. I-NICU ihluke kwezinye iimeko apho abantwana bexesha elipheleleyo bekhula bakhula. Ezi ntlukwano zinokuchaphazela ukuphuhliswa kwengqondo.
Nangona kunjalo kungabonakali kwaye kufaka i-NICU ibonakala ngathi, iintsana kwi-NICU zisadinga uninzi lwothando kunye nokunakekelwa. Ngophando lwango-2017 olupapashwe kwi- Biology Current , i-Maitre kunye noogxa bakho bacebisa ukuba iintsana zokuqala ezifumana inkxaso, ukunxibelelana kwesikhumba (kubandakanya ukuncelisa i-breastfeeding) amava aphuculwe ngempendulo yeengqondo kunye neziphumo ezingcono ze-neurodevelopmental results.
Uthini Ukuqala?
Unyaka ngamnye, izigidi ezingama-15 zangaphambili zizalwa. Ngo-2008, i-12.3 ekhulwini yazo zonke ukuzalwa e-United States yayingaphambi kwexesha. Iintsana zokuqala zizalwe ngaphambi kweiveki ezingama-37 zesisu.
Ngokuxhomekeke kwiminyaka yokuzalwa, iintsana zokuqala zifumana ubunzima obuhlukahlukeneyo kubandakanywa oku kulandelayo:
- ubunzima bokutshiza, ukugwinya nokuphefumula
- yokuphucula imiphunga
- i ntliziyo
- i-metabolism engapheliyo ekhokelela ekungalingani kwimizimba yomzimba
- umsebenzi wengqondo
- ubunzima bokungenisa izondlo ngegalelo
- ukwanda kwengozi
- Ukungabikho kwamanqatha omzimba anokukhokelela ekushiseni okuphantsi komzimba kunye neshukela eliphantsi kwegazi
- ukuphuhliswa komzimba kwemithambo yegazi kwingqondo engabangela ukubola
Yintoni i-NICU?
Ngethamsanqa, ukuqhubela phambili kunye nokuphuculwa kwenkathalo enobunzima kunye neononatal kuye kwaphucula ukuphila phakathi kweentsana ezingekafiki.
Iintsana ezinokuqala kunye nezinye iintsana ezinemiba enzulu yonyango, njengento yokuzalwa ephantsi, kufuna ukunakekelwa kwingxenye ekhethiweyo yesibhedlele esibizwa ngokuba yiNICU.
I-NICU izakhiwo zobuchwepheshe obuzodwa kwaye zisebenza ngabaqeqeshi bezempilo abanempilo kakhulu.
Yonke iteknoloji kunye ne-instrumentation kwi-NICU yenza imisebenzi eyahlukeneyo kubandakanywa oku kulandelayo:
- ukufudumala ukuze kugcinwe ubushushu bomzimba
- ukubeka esweni kwintliziyo, ukuphefumla, uxinzelelo lwegazi kunye nokufakelwa kwe-oxygen
- inkxaso yokondla
- unyango lwe-fluid kunye ne-electrolyte
Nazi ezinye zeengcali zezempilo ezisebenza kwi-NICU :
- i-neonatologist (uhlobo olukhethekileyo lwezonyango lwabahlengikazi oluqeqeshwe ukunyamekela iintsana ezigulayo nezengaphambi kwexesha)
- abaphefumulayo
- iingcali
- iingcali zecawa
- mayeza
- umongikazi wezonyango
- zondlo
- basekuhlaleni
- ba fundisi
Uninzi lweintsana kwiNICU azincinci okanye zigula ukuba zondliwe ngebhotile. Ngaloo ndlela, kufuneka bakondliwe kwaye balawulwe ngamanzi kunye nemichiza kwimithambo yegazi; Imizila ye-IV kunye ne-catheters zibekwe ukubonelela ukufikelela kwegazi. Nangona ukuba amayeza enhlungu okanye i-sucrose nayo ilawulwa, le nkqubo iyaqhubeka ibuhlungu.
Iimpawu zeBerg Preterm
Ngokutsho kukaN Nathalie Maitre, umbhali oyintloko wolu pho nonongo ophengulula impendulo yengqondo kunye nokuthatha inxaxheba yayo ekuphuhlisweni kwengqondo ezayo:
Iintsana zokuqala zinezinga eliphezulu lokulibaziseka kunye nokukhubazeka kwe-neurovelopmental. Siyazi ngokuphanda ukuba le nto inokudibaniswa neengxaki zakuqala ezithintekayo kwiimvakalelo zobomi bemihla ngemihla. Iintsana ezinobunzima bokuphendula kwisithintelo, isandi, utshintsho lweemeko, kunye neendwendwe nazo zinengxaki ngokunyakaza, ulwimi lokufunda kunye nezakhono eziphezulu zokuqonda.
Ngokukodwa, iintsana ezizalwe kuqala zineempendulo ezingapheliyo xa zithinteka xa ziphuma esibhedlele. Iintsana zokuqala ezifumana inkxaso xa kunesibhedlele zenza iimpendulo eziqhelekileyo zokuthintela xa ziphuma esibhedlele.
Ngamanye amazwi, iintsana ezisemncinci ezithobela uxhumano lwe-skin-to-skin xa zihlala kwi-NICU ziyakwazi ukufumana iimpendulo kumnxeba omnene onokufaniswa neentsana ezizalwe ngexesha elipheleleyo.
Ngakolunye uhlangothi, iintsana ezingaphambi kweNICU ezifumana iinkqubo ezibuhlungu, njengokufakelwa kweenaliti kunye neengcatheters, zenze iimpendulo ezingavumelekanga kumnxeba omnene. Khumbula ukuba iimpendulo ezifanelekileyo ekuthinteni ngenyameko ziyimfuneko ekuphuhliseni okuqhelekileyo; ukunxibelelana okuncedisayo kunceda ukwakha uxhulumaniso olufanelekileyo kwiibhokhwe zeintsana.
Kwiintsana, ukuthintela kuthatha indima ebalulekileyo ekuphuculweni kwengqondo kunye nokuphuhliswa kwentsebenziswano phakathi kwabantu. Ngaphezu koko, thintela ngenye yeengqiqo zokuqala ukukhula kwiintsana. Iintsana zexesha elipheleleyo ziqala ukufumana ukunyusa okuthe tye kunye nengxelo ngenkathi isibeleko. Le ngxelo iqhubeka ngexesha lokubaluleka kwengqondo. Iintsana zokuqala zingaphoswa kwiiveki ezininzi zengxelo.
Ngeendlela ezinengqondo ngaphandle kokuthintela, ukungabikho kokufakelwa kweengcamango kungakhokelela ekulahlekeni okusisigxina. Akucaci ukuba into efanayo iya kubamba, kodwa kunokwenzeka. Senza ke, ke, siyazi ukuba ukungabikho komnxeba kunokuchaphazela ubomi bentsana ezisengaphambili.
Kwakhona, ngokweMatrice:
Ukuthintela isakhiwo esibalulekileyo sokwakha abantwana. Inceda iintsana zifunde ukuhamba, zifumane ihlabathi elizungezile, nendlela yokuthetha ngayo. Ukusebenza kubenza bafunde ezi zakhono nangaphambi kokuba umbono wabo uphuhliswe ngokupheleleyo, kwaye ngokuqinisekileyo ngaphambi kokuba bafunde izakhono zomlomo.
Uphando olwaluxhasa ukuChukumisa Gentle
Kule sifundo, impendulo yengqondo yintsana eyi-125 yangaphambili (iintsuku ezingama-24 ukuya kuma-36 zentshukumo yobudala) kunye neentsana ezizeleyo (iintsuku ezingama-38 ukuya kwezingama-42 zeminyaka yobudala) zihlolwe ngokusebenzisa uhlobo olukhethekileyo lwe-EEG. I-EEG isetyenziselwa ukufumana umsebenzi wengqondo kagesi. Iimpendulo zobungqina ezivela kwiintsana ezizeleyo kwiindawo zokugcina iimfuyo zazifaniswa nezo zintsana ezisekuqaleni kweNICU ngaphambi kokuba zihambe ukuya ekhaya.
Abaphandi baqale bahlola umphumo wokuthintela ukukhanya kwiintsana ezizeleyo. Iimpendulo zeBongo zahlaziywa emva kokuba iintsana ezizalisekileyo zithe zavuselelwa nge-puff soft air okanye i-puff-sham (oko kukuthi, ukukhwabanisa kwenkohlakalo yomoya ukuthelekisa). Abaphandi "bafumanisa iimpawu zendawo, i-temporal, kunye ne-amplitude yeempendulo ze-cortical kwi-touch touch eyahlukana nabo kwi-sham stilili kwiintsana ezizeleyo" usebenzisa i-recent in tools analysis analysis.
Ngamanye amazwi, abaphandi basebenzisa iteknoloji entsha ukujonga indlela ukunyamezela ngokuthe ngqo kuthintela ngayo ingqondo. Ezi nkcukacha zazisetyenziselwa ukuseka isakhelo sohlalutyo.
Ukusebenzisa isi sikhokelo sokuhlalutya, abaphandi bafumanisa indlela i-degree of prematurity echaphazela ngayo impendulo yengqondo ekuthintekeni kokukhanya kwiintsana zangaphambili emva kokuvuselela ukukhupha umoya, okwakubonisa ukukhangela okukhanya.
Emva kokuba abaphandi balawulwe ngedinga lokungapheli kokuqala kunye nolawulo lweemvavanyo zonyango, bazakhele kwiziphumo zabo ukuze babonise ukuba amava okuthintela ukukhanya, njengobunqamana nolusu kunye nokuncelisa, anxulumene nezimpendulo zomeleleyo zobuchopho; nangona amava ahlabayo, njengokufakwa kwenaliti okanye ityhubhu, ayexhomekeke ekuphenduleni kweengqondo.
Ngokubanzi, iziphumo zezi zifundo zikhanyisa indlela ukuchukumisa okunyamekileyo kunokunceda ulwaphulo lwengqondo kunye negalelo ekuphuculweni kweengqondo, ukuqonda kunye nentlalo yoluntu.
Kuthetha ntoni Lonke Oku?
Iziphumo zolu pho nonongo zixhasa ukubaluleka komnxeba kunye nokunyusa kwiintsana zangaphambi kweNICU. Amava anjalo anceda ekuphuculweni kwengqondo ngokuqhelekileyo kwaye kunceda umntwana ukuba akhululwe esibhedlele ngeempendulo zengqondo efana neentsana ezizalwe ngexesha. Izimpendulo zengqondo eziqhelekileyo zinokuba nefuthe ekuphuhliseni kwengqondo kamva kunye nentlalo.
Ukukhanya, ubumnene, kunye nokukhupha i-touch inokuthatha iifom ezininzi, kubandakanywa ukumbumbana, ukuncelisa kunye nokuxuba . Akucaci ukuba le mgca kufuneka ivela kubazali; Nangona kunjalo, xa oomama banikela umnxeba onjalo, kukho nezinye iinjongo, kubandakanywa ukuxhaswa kwemvakalelo, ukuphendula, kunye nezinye iinzuzo zezempilo.
Ngomlinganiselo womhlaba wonke, ukuqonda okunjalo kunokuphucula ukunakekelwa kwiNICU. I-gap isoloko ikhona phakathi kokunyamekela njengoko imeko yemo kunye nokunyamekela njengoko kufanelekile. Ukuphuculwa komgangatho kwi-NICU kuqinisekisa ukuba iintsana zokuqala azifumani nje ngononophelo olungcono kuphela kwiiyunithi kodwa nokukhathalela okubanceda baphumelele ekhaya. Mhlawumbi ukubandakanya ngokuthe ngqo ukuthintela unyango lwezinsana ezisengaphambili kungabalungiselela kangcono ubomi emva kokukhulelwa-ubomi ekhaya.
> Imithombo:
> Mantri, NL, et al. Ubume beMveli yoBomi bokuQala kwangaphambili kwi-Somatosensory Processing kwi-Brain Baby Infant. Biology yangoku . 2017; 27: 1048-1054.
> Raab EL, Kelly LK. Isahluko 22. Ukuhlaziywa kwamaNonatal. Ku: DeCherney AH, Nathan L, Laufer N, Roman AS. eds. UKUPHATHWA KWEZINDAWO NOKUPHATHWA KWEZINDAWO: I-Obstetrics & Gynecology, 11e eNew York, NY: McGraw-Hill; 2013.
> Rikken, M. Touch Shapes Preterm Iintsholongwane Zabantwana. Matshi 16, 2017. www.researchgate.net.
> Smith D, Grover TR. Iintsana ezisanda kuzalwa. Ku: Hay WW, Jr., Levin MJ, Ukurhoxiswa kweRR, Abzug MJ. eds. UKUHLAWULWA KWENKCAZO NEMPILO I-Pediatrics, 23e eNew York, NY: McGraw-Hill.