Ugqirha, ukunyangwa kwamanye amazwe, kunye ne-orthodontic work
Ukukhusela i-apnea yokulala yimeko echaphazela ukuphefumla ngexesha lokulala kwabo babini kunye nabantwana. Ingaba nefuthe elibalulekileyo ekukhuleni, ekuphuculweni nasekuziphatheni kulutsha oluchaphazelekayo. Ziziphi ezinye zeempawu ezihambelana nokulala kancinci kubantwana kunye nentsha? Ziziphi iindlela zonyango ezikhethekileyo kula maqela? Funda indlela yokuphatha ukukhupha ukugula okungapheliyo kubantwana nakwishumi elivisayo, kubandakanya iindima zokuhlinzwa, ukunyanga kwezilwanyana, i-orthodontics, ukulahleka kwesisindo, kunye nezinye iindlela ezifana nokunyangwa kwe-myofunctional.
Yintoni ekhusela i-Apnea yokulala?
I-apnea yokulala yokuvuthwa ibonakaliswa ngamaxesha okuphefumla okwenzeka ngexesha lokulala. Ezi ziqendu zibangelwa ukuwa ngokukodwa okanye okugqibeleleyo kwendlela ephezulu , echaphazela izicubu ngaphakathi komqala (njengeetoni, i-adenoids, okanye i-palate soft) okanye kwisiseko seelwimi. Ichaphazela malunga neepesenti ezi-1 zabantwana.
Iziganeko zokulala ze-apnea zingaphelanga ubuncinane imizuzwana eyishumi kwaye zidibaniswe kunye nokulahla kumanqanaba e-oksijeni yegazi (kunye ne-saturation eyancipha ngamaphesenti amathathu), ukwanda kwinqanaba le-carbon dioxide, okanye ukuvusa ukuba iziqhekeza zilele. Ngokungafani nabantu abadala, apho i -index ye-apnea-hypopnea index (i-AHI) ephakamileyo kunesihlanu ithathwa njengesiqhelo, ezi ziqendu zinokuthi zivele ngexesha elilodwa kwiyure kubantwana kwaye zibonwe zibalulekileyo.
Ukuvuthwa kwe-apnea yokuvuthwa ngokuqhelekileyo kubangelwa ngenxa ye- anatomy eye ebangela ukukhutshwa kwendlela yokuhamba. Inokuba yingozi kakhulu ngenxa yokugula okanye ukuchazwa komsi wecuba.
Indawo yokulala, ingakumbi yokulala ngasemva, inokunyusa ukwenzeka. Ukuzuza inzuzo kunokuthatha inxaxheba kubantwana abagqithiseleyo okanye abagqithiseleyo.
Ziziphi iimpawu kunye neeMpawu zoKulala kwe-Apnea kwaBantwana?
Nangona kufana nokufana nendlela yokukhusela i-apnea yokuphazamiseka kubangelwa ngabantu abadala, abantwana banokuba neempawu ezikhethekileyo kunye nemiqondiso yentleba.
Ezinye zezi ziphumo ziquka:
- kuhlutha
- wabona ubungqina bokuphefumla
- ukutshitshisa okanye ukukhahlela
- umlomo ophefumulayo
- amazinyo ayagaya okanye adibanise
- ukukhupha ebusuku
- ukulala ubuthongo
- kuphazamiseka ebusuku
- ukulala
- kulala
- ikhanda
- ubuthongo bemini
- ukulahla kwabantwana abadala
- ingqalelo ingxaki yokuxhatshazwa kwengxaki (ADHD)
- iingxaki zokukhula
Makhe sihlolisise ezimbalwa kwezi ziphumo ezibalulekileyo kwaye sibonise ukuba bangabonisa njani ukuba khona kwe-apnea yobuthongo obunqanda.
Abantwana akufanele bahlale bengahlali. Nangona kubonakala kukuhle, oku kungabonakalisa ubunzima bokuphefumula ngexesha lokulala kwaye akufanele ukunyanzeliswa. Ukuphefumula komlomo kubonisa ingxaki yokuphefumla kwimpumlo. Oku kunokubangelwa ukuxinwa kwendoda ebushushu okanye ngokungapheliyo kwimeko yokutya. Ubuthongo obunamahloni kunye nokungabikho okuphumayo kungabonakalisa ukutshatyalaliswa nokuzama ukuphefumula.
Ukulala kwe-apnea kungahle kuhlulwe izigaba zokulala kwaye kuholele ekuziphatheni kokulala (okubizwa ngokuba yi- parasomnias ) kunye nokulala okuqhubekayo kwithuba eliqhelekileyo lokusombulula. Abantwana banokulala ngexesha losuku, kodwa banokuba banokungasebenzi kwaye banganaki. Ukhula luyakwazi nokuba luncedo kwaye unyango olufanelekileyo lwe-apnea yokulala lungabangela ukuhlawulela ekukhuleni nasekuphuculeni kokuziphatha.
Le miphumo ingagwenywa.
Unyango lwe-Apnea yokulala kwaBantwana nakwi-Adolescents
Ngethamsanqa, kukho iindlela zokwenza unyango olufumanekayo kule nkalo kubantwana nakwishumi elivisayo, kuquka:
I-Tonsillectomy ne-Adenoidectomy
Le yonyango oluqhelekileyo unyango lwabantwana abane-apnea yokulala. Kuya kwenziwa xa ugqirha eqonda ukwandiswa kweetoni okanye i-adenoids emva emlonyeni kunye nokulala emqaleni. Abantwana abanama-tons awandisiweyo banokugula ngenxa yezifo ezithathayo, ukukhalaza ngesifo somqala, kwaye banokuba neenguqu kwizwi labo xa izicubu zanda.
Olu uphando lusebenza kakuhle kwaye izinga lokuphumelela lingama-80 ekhulwini. Inkqubo iphela iyure enye kwaye ivela phantsi kwe-anesthesia jikelele. Abantwana babuyela esikolweni ngeveki 1-2. Yenziwa ngugqirha jikelele okanye indlebe, impumlo, nomqala (ENT). Olu vavanyo lungafuna ukudluliselwa kwinqanaba labantwana bakho okanye uchwepheshe wokulala.
Ulwaphulo lwezonyango
Abantwana okanye abatsha abane-rhinitis yokugula (intsholongwane ye-hay fever) banokudibanisa, impumlo ephuthumayo, amehlo enamehlo okanye amaqabunga, okanye i-post-nasal drip. Xa impumlo ivinjiwe, umlomo ukuphefumla kunokwenzeka ukuba kwenzeke. Oku kunokubangela umngcipheko wokugcoba nokulala. Iingxaki zonyango zingaphathwa ngeemfucu zeraline zamanzi, izilwanyana zomlomo ezifana ne-montelukast (ithengiswa njenge-prescription Singulair), okanye i-steroid nasal sprays. Ukudluliselwa kwi-allergenist kungalungiselelwa ukuba kuhlolwe uvavanyo oluthile okanye i-immunotherapy. Ukunciphisa i-turbinates yama-nasal, izicubu ezithwaxwa ngumzimba kwaye zingavimbela impumlo, zinokuthi zenziwe ngutitshala we-ENT.
Unyango lwe-Orthodontic
Abantwana kaninzi badinga iibrasi ukulungisa amazinyo ajika, kodwa ngamanye amaxesha oku kungenelela kunokuphucula ukuphefumula ngexesha lokulala. Iintshukumo zivame ukutyelela i-orthodontist, kodwa abantwana abancinci banokuzuza kwizonyango ezithile. Ukwandiswa kwema-maxillary okukhawulezayo kunokusetyenziswa ukuba kwandiswe isalathisi esinzima kunye neyengqa. Oku kwenziwa ngokubeka i-brace eguquguqukayo kwiphahla lomlomo ngu-orthodontist. Olu unyango lusebenza kakuhle kubantwana abancinci, kwaye alusebenzi emva kokuphela kokukhula kokuphela. Kubantwana abadala, i-headgear ingasetyenziselwa ukuqhubela phambili umhlathi okhula ngokukhawuleza. Oku kunokukunceda xa i-retrognathia ikhona. Konke okunokwenzeka, ukukhutshwa kwezinyo kufuneka kugwenywe. Ubuninzi bamazinyo amakhulu buya kukukhuthaza ukukhula okuqhelekileyo komhlathi ukuze wenze indawo.
Ulwabiwo lweMyofunctional
Ukusetyenziswa kweelwimi kunye nemilomo kunokunyusa i-tone ye-muscle ye-airway kwaye kunciphise umngcipheko wokugubha nokulala. Ezi zifundo zingabandakanya ukukhupha ulwimi, ukuluqhafaza, ukuchofoza, okanye ukulufaka eluphahleni lomlomo. Ingadinga ukufundiswa ngumbhali othethekileyo wokuthetha. Ulwaphulo lwe-Myofunctional alunamathuba amaninzi kwimiphumo emibi. Ezi zifundo kufuneka zenziwe imizuzu engama-45 yemihla ngemihla, nangona kunjalo, kwaye abantwana abanako ukuhambelana neziphakamiso. Kukho ubungqina bokuthi ukudlala izixhobo zokhuni kunye ne-didgeridoo ingaba luncedo.
Uxinzelelo oluqhubekayo lwe-Airway Press (CPAP)
I-CPAP ingasetyenziselwa kubantwana okanye abaselula abahlala besifo sokulala bendlala ngaphandle kweminye imizamo yonyango. Emva kokungenelela kwamanye amanyathelo, isifundo sokulala singasiluncedo ukuphinda siphumelele imeko. Ukuba iqhubeka, i-CPAP ingaba yindlela efanelekileyo. Nge-CPAP, ukuqhuma komoya okuqhubekayo kuhanjiswa ngomzobo obusongwe phezu kwempumlo okanye ekhaleni kunye nomlomo ngexesha lokulala. Kubalulekile ukuba ukhethe i-mask engayisebenzisi ingcinezelo eninzi ebusweni bobubanzi njengoko kukho iingxelo zokukhawulela ukukhula. Abaninzi abaselula banokuphelelwa ngumdla kwi-CPAP unyango kunye nokunyanzeliswa kwexesha elide kunokuphazamiseka, ngakumbi xa abantwana beselula beya kwiikholeji baze balele kwiindawo zokulala. Ingaba yonyango ebuyiswa kamva njengoko kuyimfuneko.
Ukuqhubela phambili kwaMaxillomandibular
Ngasekupheleni kwexesha leshumi, ukuqhubela phambili kwezocwangca kwemigca ephezulu kunye nezantsi kungenzeka ukuvula indlela yokuhamba. Oku kuboniswe ukuba i-retrognathia ikhona. Olu unyango lungama-85 ekhulwini. Inkqubo ihlala iiyure ezingama-4-5 kwaye ivela phantsi kwe-anesthesia jikelele. Kungathabatha iiveki ezintandathu ukufumana kwakhona ukuphazamiseka kokutya ekuqaleni. Yenziwa ngophalagri yomlomo kunye ne-maxillofacial.
App Oral Appliance
Abafikayo abakhulileyo abaye bagqiba ukukhula baze bagqiba nayiphi na imisebenzi efunekayo yomlomo okanye banokuthi banomdla ekusebenziseni umbane ngomlomo ukuphatha i-apnea yokulala. Oku kuyindlela yokwenza ubuthongo obunzima okanye obuthathaka obushushu bokulala. Ezi zixhobo zifakwe ngodokotela wamazinyo kwaye zilungelelaniswe kwiinyanga eziliqela. Xa igugile, umhlathi ophantsi kunye nolwimi luya kutshintshwa phambili, ukuvula umva we-airway. Ziyakwazi ukukhusela amazinyo ama-eamel kumonakalo ophathelene namazinyo okugaya okanye ukudibanisa. Ukuba iingxaki kwi-temporo-mandibular joint (TMJ) zikhoyo, oku akunakho ukuba unyango olufanelekileyo. Ngenxa yesidingo sokutshintsha ifowuni, kunye nobunzima bokuthintela, abacebisa ukuba abantwana abasakhulayo.
Ukuhla ukusinda
Kubantwana abakhulu kakhulu okanye abagqithisileyo, isicwangciso sokulahleka kwesisindo kunye nesondlo esiphucukisiwe kunye nokunyusa umzimba kunokuboniswa. Ezi zinguqu zimele zenziwe kunye nokulawulwa kwengcali yabantwana. Ukulahleka kokunciphisa ubunzima yinjongo ebonakalayo kunye nemali efunekayo iyahluka ngokusekelwe kwinqanaba lomzimba lomntwana (BMI).
Ukuba unenkxalabo malunga nokuphazamiseka kwengqondo yokulala ebantwaneni bakho, thetha notitshala wakho wezilwanyana uze ufune isiluleko sesigqirha esithembekileyo sokubhalwa kwebhodi esingakwazi ukunika uvavanyo olongezelelweyo, ukukhokelwa kunye nokuhanjiswa njengoko kuyimfuneko. Ukukhusela i-apnea yokukhusela ingakwazi ukuphathwa ngokufanelekileyo kwaye indima yomzali okhuthazayo ekukhuliseni igalelo lezinyathelo ezingenakwenziwa.
> Imithombo:
> Dehlink E kunye noHan H. Ukuhlaziywa kwi-Pediatric Obstructive Sleep Apnea. Umbhalo Wezifo Zesifo . 2016; 8 (2): 224-35.
> Li Z, Celestin J, kunye ne-Lockey RF. I-Baby Sleep Apnea Syndrome: Isibuyekezo. J Allergy Clin Immunol Pract . 2016 Juni 30; S2213-2198 (16) 30105-2.
> Marcus CL et al. Ukuxilongwa kunye noLawulo lwe-Childhood Obstructive Sleep Apnea Syndrome. Pediatrics . Ekuqaleni kwanyatheliswa kwi-intanethi ngo-Agasti 27, 2012; INGXENYE: 10.1542 / iimigca.2012-1671.
> Pereira KD, Jon CK, Szmuk P, Lazar RH, kunye noMitchell RB. Ulawulo lwe-Apnea yokulala ebantwini: Indlela eSebenzayo. I-Ear Nose Intshontsho J. 2016 Jul; 95 (7): E14-22.
> I-Whitla L kunye noLennon P. Ulawulo olungapheliyo lokuLawula i-Apnea yokulala: Ukuphononongwa. I-Int Intle ye-Int Intle yoMntwana . 2016 uMatshi 14: 1-5.