I-Neonatal abstinence syndrome

I-Neonatal abstinence syndrome (NAS) yiqembu lezinkinga ezenzeka enganeni esanda kuzalwa eyayichayeka emithini ye-opioid isikhathi eside ngenkathi isesiswini sikamama.

I-NAS ingenzeka lapho owesifazane okhulelwe ethatha izidakamizwa ezinjenge-heroin, i-codeine, i-oxycodone (i-Oxycontin), i-methadone, noma i-buprenorphine.

Lezi nezinye izinto zidlula ku-placenta exhumanisa ingane nonina esibelethweni. Ingane incike kumuthi kanye nonina.

Uma umama eqhubeka nokusebenzisa imishanguzo kungakapheli isonto noma ngaphambi kokubeletha, ingane izoncika kumuthi lapho izalwa. Ngoba ingane ayisatholi umuthi ngemuva kokuzalwa, izimpawu zokuhoxa zingavela njengoba umuthi ususwa kancane ohlelweni lwengane.

Izimpawu zokuhoxa nazo zingavela ezinganeni ezichayeke otshwaleni, i-benzodiazepines, ama-barbiturates, kanye nama-anti-depressants (SSRIs) athile esibelethweni.

Izingane zomama abasebenzisa ama-opioid nezinye izidakamizwa eziluthayo (i-nicotine, i-amphetamines, i-cocaine, insangu, utshwala) zingaba nezinkinga zesikhathi eside. Ngenkathi kungekho bufakazi obucacile be-NAS yezinye izidakamizwa, zingaba nomthelela ebukhali bezimpawu ze-NAS zengane.

Izimpawu ze-NAS zincike ku:

• Uhlobo lwesidakamizwa umama asisebenzisile
• Uphuka kanjani umzimba futhi usule umuthi (uthonywe yizici zofuzo)
• Ubungakanani umuthi abewudla
• Uwusebenzise isikhathi esingakanani umuthi
• Ukuthi ingane izalwe ngokugcwele noma ngaphambi kwesikhathi (ngaphambi kwesikhathi)

Izimpawu zivame ukuqala kungakapheli izinsuku ezi-1 ukuya kwezi-3 ngemuva kokuzalwa, kepha kungathatha kuze kube yisonto ukuvela. Ngenxa yalokhu, ingane izodinga kakhulu ukuhlala esibhedlela ukuze ibhekwe futhi iqashwe kuze kube yisonto.

Izimpawu zingafaka:

• Umbala wesikhumba we-Blotchy (mottling)
• Uhudo
• Ukukhala ngokweqile noma ukukhala okuphezulu
• Ukuncela ngokweqile
• Imfiva
• Izimo ezingasebenzi kahle
• Ukwandisa ithoni yemisipha
• Ukuthukuthela
• Ukudla okungafanele
• Ukuphefumula ngokushesha
• Ukuquleka
• Izinkinga zokulala
• Ukuzuza kancane kwesisindo
• Impumu eminyene, ukuthimula
• Ukujuluka
• Ukuthuthumela (ukuthuthumela)
• Ukuhlanza

Ezinye izimo eziningi zingaveza izimpawu ezifanayo ne-NAS. Ukusiza ukwenza ukuxilongwa, umhlinzeki wezokunakekelwa kwempilo uzobuza imibuzo mayelana nokusetshenziswa kwezidakamizwa komama. Umama angabuzwa ukuthi yimiphi imishanguzo ayidla ngesikhathi ekhulelwe, nokuthi wagcina nini ukuyidla. Umchamo womama nawo ungahlolwe nezidakamizwa.

Ukuhlolwa okungenziwa ukusiza ukuxilonga ukuhoxiswa kwengane esanda kuzalwa kufaka:

• Uhlelo lokufaka amagoli lwe-NAS, olunikeza amaphuzu ngokuya ngesimpawu ngasinye nobukhali baso. Amaphuzu wosana angasiza ekunqumeni ukwelashwa.
• Ukuhlolwa kwe-ESC (ukudla, ukulala, ikhonsoli)
• Isikrini sezidakamizwa somchamo kanye nokunyakaza kokuqala kwamathumbu (meconium). Ucezu oluncane lwenkaba lungasetshenziselwa ukuhlolwa kwezidakamizwa.

Ukwelashwa kuncike ku:

• Umuthi obandakanyekile
• Impilo ephelele yengane kanye nokuzithiba
• Ukuthi ingane izalwe ngokugcwele noma ingakafiki isikhathi

Ithimba lezokunakekelwa kwempilo lizobheka ngokucophelela usana kuze kube yisonto (noma ngaphezulu kuya ngokuthi ingane iqhuba kanjani) ngemuva kokuzalwa ngezimpawu zokuhoxa, izinkinga zokondla nokuzuza kwesisindo. Izingane ezihlanza noma eziphelelwe amanzi emzimbeni zingadinga ukuthola uketshezi ngomthambo (IV).

Izinsana ezine-NAS zivame ukuxokozela futhi kunzima ukuzola. Amathiphu okubathulisa afaka izinyathelo ezivame ukubizwa nge- "TLC" (ukunakekelwa kothando kwethenda):

• Inyakazisa ingane ngobumnene
• Yehlisa umsindo namalambu
• Isikhumba ukunakekelwa kwesikhumba nomama, noma ukufaka ingane ngengubo
• Ukuncelisa ibele (uma umama ekuhlelo lokwelashwa lwe-methadone noma i-buprenorphine ngaphandle kokunye ukusetshenziswa kwezidakamizwa ezingekho emthethweni)

Ezinye izingane ezinezimpawu ezinzima zidinga imithi efana ne-methadone noma i-morphine yokwelapha izimpawu zokuhoxa nokuzisiza zikwazi ukudla, ukulala nokuphumula. Lezi zingane zingadinga ukuhlala esibhedlela amasonto noma izinyanga ngemuva kokuzalwa. Inhloso yokwelashwa ukunikeza usana umuthi ofana nalowo umama awusebenzise ngesikhathi ekhulelwe futhi wehlise kancane umthamo ngokuhamba kwesikhathi. Lokhu kusiza ukuncelisa ingane emthini futhi kudambise ezinye izimpawu zokuhoxa.

Uma izimpawu zibucayi, njengokusebenzisa ezinye izidakamizwa, umuthi wesibili onjenge phenobarbital noma i-clonidine ungangezwa.

Izingane ezinalesi sifo zivame ukuba nokushaywa okukhulu kwamanabukeni noma ezinye izindawo zokuwohloka kwesikhumba. Lokhu kudinga ukwelashwa ngamafutha akhethekile noma ukhilimu.

Izingane nazo zingaba nezinkinga zokondla noma ukukhula kancane. Lezi zingane zingadinga:

• Ukuphakelwa kwamakhalori aphezulu okunikeza ukondleka okukhulu
• Ukuphakelwa okuncane kunikezwa kaningi

Ukwelashwa kusiza ekunciphiseni izimpawu zokuhoxa. Ngisho nangemva kokuba ukwelashwa kwe-NAS sekuphelile futhi izingane ziphuma esibhedlela, zingadinga i- "TLC" eyengeziwe amasonto noma izinyanga.

Ukusetshenziswa kwezidakamizwa notshwala ngesikhathi sokukhulelwa kungaholela ezinkingeni eziningi zezempilo enganeni ngaphandle kwe-NAS. Lokhu kungafaka:

• Izinkinga zokuzalwa
• Isisindo sokuzalwa esiphansi
• Ukuzalwa ngaphambi kwesikhathi
• Umjikelezo wekhanda omncane
• Isifo sokufa kwezinsana okungazelelwe (SIDS)
• Izinkinga ngentuthuko nokuziphatha

Ukwelashwa kwe-NAS kungahlala kusonto eli-1 kuye ezinyangeni eziyisithupha.

Qiniseka ukuthi umhlinzeki wakho uyazi ngayo yonke imithi nezidakamizwa oziphuzayo ngesikhathi ukhulelwe.

Shayela umhlinzeki wakho uma ingane yakho inezimpawu ze-NAS.

Xoxa nomhlinzeki wakho ngayo yonke imithi, izidakamizwa, utshwala nogwayi.

Cela usizo kumhlinzeki wakho ngokushesha okukhulu uma:

• Ukusebenzisa izidakamizwa okungezona ezokwelapha
• Usebenzisa izidakamizwa onganikwanga zona
• Ukusebenzisa utshwala noma ugwayi

Uma usuvele ukhulelwe futhi uthatha imithi noma imishanguzo ongayinikwanga, khuluma nomhlinzeki wakho mayelana nendlela engcono yokugcina wena nengane niphephile. Eminye imithi akufanele imiswe ngaphandle kokuqondiswa okwelashwa, noma kungavela izinkinga. Umhlinzeki wakho uzokwazi ukuthi angabhekana kanjani kangcono nobungozi.

I-NAS; Izimpawu zokuyeka ukubeletha

• I-Neonatal abstinence syndrome

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