Iitoni ezikhulisiweyo, ubuninzi bobukhulu obungathi bangela ukuphazamisa ukuphuza ebusuku
Ukulala ngomoya obhejayo yinto eqhelekileyo kubantu abadala, kwaye kuya kwenzeka nakwizibantwana. Ziziphi izinto ezibangela ukuba i-apnea yokulala ivele kubantwana? Kukho iintlobo ezahlukeneyo ezingakhokelela ekunciphiseni okanye ukungazinzi kwe-airway engenhla, ezinokubangela ikhefu ekuphefumuleni isifo se-apnea yokulala. Njengoko i-apnea yokulala ingabangela imiphumo emibi kubantwana - kubandakanye impembelelo ekukhuleni, kwi-ingqondo kunye nokuziphatha-kubalulekile ukuchonga izizathu ezifanelekileyo.
Xa sicinga ngezinto ezinokubangela ukuba abantwana bakwazi ukuphucula i-apnea yokulala, ezi zingabelana ngezigaba ezininzi:
Iitoni ezikhulisiweyo kunye ne-adenoids
Mhlawumbi omnye umrhumo oqhelekileyo wokulala ne-apnea ebantwaneni uhambelana nokunciphisa ubunzima bomhlaba ophezulu. Izicubu emva emlonyeni nasemqaleni zibizwa ngokuba yi-tonsils kunye ne-adenoids ngokuqinisekileyo. Kungenxa yokuba ukukhuliswa kwezi zicubu zikhoyo akuthethi ukuba umntwana uya kuba ne-apnea yokulala. Nangona kunjalo, abo bantwana abane-apnea yokulala abaye bawandisa i-toni kunye ne-adenoids banokuncedwa kakhulu ngokususa. Phantse iipesenti ezili-10 zabantwana abaphuculanga emva kokuhlinzwa, kwaye banokuba nezinye izinto ezibangela ukuba zabo ziimeko.
Ukunyanya
Ukunyaniseka phakathi kwabantwana kuyanda, kwaye kunokuba inendima enkulu ekubangela ukugula kwe-apnea njengoko le mizila iyaqhubeka. Njengoko inani lamanqwanqwa ahamba ngeenqwelo zomoya likhula, kunokukhokelela ekubanjeni kunye nokunciphisa ngaphakathi kwendlela yokuhamba.
Ngaphandle koko, isisindo esingekho ngaphandle kwendlela yokuhamba ngomoya singasenza uxinzelelo kwaye siholele ukuwa kwe-airway, okubangelwa iziganeko ze-apnea.
I-Craniofacial engafanelekiyo
Kukho ukungaqhelekanga kwintloko okanye ubuso (okubizwa ngokuba yi-craniofacial irmalities) engakhokelela kwingozi enkulu yokuphucula i-apnea yokulala.
Imiqathango eyancipha ubukhulu bempumlo, umlomo, nomqala ingakhokelela ekuhleni kwe-airway ngexesha lokulala. Umzekelo, ulwimi olwandisiweyo (olubizwa ngokuthi i- macroglossia ) lunokufaka isandla. Ezinye iimeko ziquka:
- I-Midfacial hypoplasia (i-under-development of the pints and face face)
- I-Retrognathia okanye i-micrognathia (umhlathi okanye umhlathi omncinci)
- I-arch maxillary encinci (phezulu komlomo)
Abantwana abane-Down's syndrome basengozini enkulu yokuphuhlisa ezi ngxaki.
Mucopolysaccharidoses
Kukho iqela leengxaki ezinqabileyo ezibizwa ngokuba yi-mucopolysaccharidoses, okanye i-mucolipidoses, ezinokubeka abantwana ingozi yokugonya kwe-apnea. Oku kwenzeka ngenxa yezicubu e-airway engenhla eziqokelela i-molecule ezinkulu kunye nokuvuvukala ngobukhulu. Kukho okungaqhelekanga okuphuhliswayo okuvelisiweyo ngexesha lokuzalwa okanye kwasekuqaleni, ngoko ke abazali abaninzi baya kuqonda ukuba umntwana wabo unalo mqathango.
Izinto zeNuromuscular
Ukulahlekelwa kolawulo lwesigxina se-airway engenhla kunokukhokelela ekuphumeni kwe-apnea. Utshintsho lwetoni ye-muscle (ebizwa ngokuba yi-hypotonia ukuba iphantsi, okanye i-hypertonia ukuba iphezulu) inokufaka isandla. Ukunyanzeliswa kwengqondo (njengokuba kwenzeka kwiArnold Chiari ukungalungi okanye kwiimathumba) kunokukhokelela ekuphepheni kwe-apnea.
Kukho ukungaqhelekanga okuphuhlisayo, okufana ne-Down syndrome, ekhokelela ekungciphekweni kwimeko. Ngokubanzi, ezinye iingxaki ziya kuchongwa ngaphaya kwe-apnea yokulala ukubonisa ingozi yezimo ezinzulu.
Ukuba unomdla wokuba umntwana wakho unokufumana iimpawu okanye iimpawu ezibonisa ukugonjwa kwe-apnea, unganqikazi ukuthetha nodokotela wezilwanyana. Ukuba uvakalelwa kukuba ukuxhalabisa kwakho kukhishwa, cinga ngombono wesibini kwizengcali zokulala zonyango. Indlela yodwa yokujonga ngokuqinisekileyo ukugonjwa kwe-apnea kubantwana kukufunda ubuthongo obuninzi kwindawo yokuvavanya; ukunyanzelisa ukuba ufumane enye xa unomdla wokuphefumula komntwana ngexesha lokulala.
Imithombo:
Arens, R et al . "I-Pathophysiology yokhuselo oluphezulu lwangaphakathi: indlela yokuphuhlisa." Ukulala ngo- 2004; 27: 997.
Bixler, EO et al . "Ukulala ukuphazamiseka kokuphefumula kubantwana kwisesampula yabantu jikelele: ubunzima kunye nemingcipheko." Ukulala ngo- 2009; 32: 731.
Rosen, GM et al . "Iinkqubo kunye nezinto ezinokubangela ukuphefumula ekuphefumuleni abantwana." UpToDate Online . Ufikelele ngoNovemba 2, 2009.
I-Verhulst, SL kunye al . "Ukuphefumula okuphefumle ukulala ebusweni nabantwana abagqithiseleyo kunye nabantwana abaselula: ukuxhaphaka, iimpawu kunye nendima yokunikwa kweoli." I-Arch Dis Child 2007; 92: 205.