Kuvhiya, kurapwa kwemazuva ose, uye orthodontic work
Kuvhiringidza kurara kwepabonde ndechiitiko chinokanganisa kufema panguva yekurara kune vanhu vakuru nevana. Iyo inogona kuva nechinonyanya kukosha pakukura, kubudirira, uye mufambiro muvechiri vechidiki. Ndezvipi zvimwe zviratidzo zvine chokuita nekurara kwepabonde muvana nevechiri kuyaruka? Ndezvipi zvirongwa zvakasiyana-siyana zviripo kune mapoka aya? Dzidza maitiro ekurapa kubhembera kwekurara kwevana mudiki nevechiri kuyaruka, kusanganisira mabasa ekuvhiya, kurwisa kwemazuva ose, orthodontics, kurasikirwa nekurema, uye zvimwe zvingasarudzwa sezvinoitwa myofunctional therapy.
Chii Chinovhara Apnea Yokurara?
Kuvharirwa kwepabonde kunokonzerwa nehope kunoratidzirwa nekufema kunoitika panguva yehope. Izvi zvikamu zvinokonzerwa nokudonha kusina kukwana kana kukwana kwemhepo yepamusoro , kunokonzera mishonga mukati memutsipa (sematoni, adenoids, kana chirwere chinotapira) kana kuti nechezasi kwerimi. Inobata anenge 1 muzana yevana.
Kurara kwemafuro ehope kunopera kwemaminitsi gumi uye zvinosanganiswa nedonhi muropa rey oxygen (pamwe nekuwedzera kunopera ne3 muzana), kuwedzera kwe carbon dioxide, kana kuti kumutsa kunoparara. Kusiyana nevanhu vakuru, apo apnea-hypopnea index (AHI) inopfuura yechishanu inofungidzirwa isingaiti, zvikamu izvi zvinogona kuitika nguva imwechete paawa muvana uye zvinonzi ichinyanya kukosha.
Kuvhiringidzika kwekurara kwepabonde kakawanda kunokonzerwa nehutachiona hwemaziso hunoita kuti kuvharwa kwemhepo kuve kunobatsira. Inogona kuwedzera kukuvadzwa nehutachiona kana kuiswa kune utsi hwefodya.
Kurara, kunyanya kurara kumashure, kunogonawo kuwedzera kuitika. Kuwedzera kweupfumi kunogonawo kuita basa kune vana vane kuwandisa kana kuwedzera.
Ndezvipi Zviratidzo uye Zviratidzo zveAkubata Apnea muvana?
Pasinei nokufananidzwa kwekudzivirira kubata kwepabonde kunokonzerwa nevakura, vana vanogona kunge vane zviratidzo zvakasiyana uye zviratidzo zvechirwere .
Zvimwe zvezviwanikwa izvi zvinosanganisira:
- kunyorera
- vakaona kupera mukufema
- kupisa kana kuchingura
- muromo kufema
- meno achikuya kana kuvhara
- sweating usiku
- kurara kusingaperi
- usiku hunotyisa
- sleepwalking
- bedwetting
- mangwanani musoro musoro
- kurara masikati
- kuvhara muvana vakwegura
- kucherechedza kusakwana kwehutano hwehutano (ADHD)
- matambudziko okukura
Ngatimbokurukurai zvishoma zvezviitiko izvi zvinokosha uye kujekesa kuti vangaratidza sei kuvapo kwekudzivirira kuberekwa kwepabonde.
Vana havafanirwi kugara vachirohwa. Kunyange zvazvo zvingaratidzika sedzakanaka, izvi zvinogona kuva chiratidzo chekuoma kufema panguva yehope uye hazvifaniri kuregererwa. Muromo wokufema kunoratidza dambudziko kufema mukati memhino. Izvi zvinogona kunge zvakakonzerwa nekuputika kwemvura kubva kunotonhora kana kusingaperi mumamiriro ekurwara. Kurara uye kusarara kusingagumi kunogona kuva chiratidzo chekupwanya uye kunetseka kufema.
Kurara kwepabhesi kunogona kuparadzanisa kurara uye kunotungamirira kumararamiro ekurara (anonzi parasomnias ) uye kunyange bedwetting iyo inopfuurira kupfuura nguva yakazara yekugadzirisa. Vana vanogona kunge vakarara panguva yemasikati, asi ivo vanowanzova vasina kumira uye vasina kutarisira. Kukura kunogonawo kukanganisa uye kunyatsoshanda kurapwa kwekurara kwepabonde kunogona kukonzera kuwedzera mukukura uye kuvandudzwa mune mufambiro.
Iyi migumisiro inogona kudziviswa.
Mishonga yokurara neApnea muvana uye nevana vaduku
Nenzira yakanaka, kune nzira dzakanakisisa dzokurapa dzinowanikwa mune izvi mumwana nevechiri kuyaruka, kusanganisira:
Tonsillectomy uye Adenoidectomy
Ichi ndicho chirwere chinowanzoshandiswa pakuvhiya kwevana vane obstructive sleep apnea. Ichaitwa kana chiremba achiziva kuwedzera kwema tonsils kana adenoids kumashure kwemuromo uye kuisa pamutsipa. Vana vane toni yakawedzerwa vanogona kutambura nehutachiona hwekare, kugunun'una kwehuro, uye vangave vachinjeka nenzwi ravo apo maviri acho akawedzerwa.
Iyi kuvhiyirwa inoshanda zvakanyatsonaka uye kubudirira kwehuwandu kuri 80 muzana. Nzira yacho inotora awa imwe uye inoitika pasi peanesthesia. Vana vanodzokera kuchikoro mumasvondo maviri. Inogadzirwa nachiremba anovhiya kana nenzeve, mhino, nehuro (ENT) nyanzvi. Iyi kuongorora kunogona kutumira kutumirwa kubva kuchipatara chevana kana kurara.
Allergy Treatment
Vana kana vari kuyaruka vane allergenic rhinitis (hay fever) inogona kunge yakabatana, mumhino unoyerera, mvura kana maziso anocheka, kana kuti mushure mutsva. Kana mhino ikavharwa, muromo unofema unowanzoitika. Izvi zvingaita kuti pave nengozi yekunyorova uye kurara kwepabonde. Kurwara kweropa kunogona kurapwa nemasine rinosuruvara, mishonga yemuromo sezvinoita montelukast (inotengeswa semurairo singulair), kana steroid nasal sprays. Kuendesa kune anoristorite kunogona kurongerwa zvimwe zvekuongorora zvirwere kana kuti immunotherapy. Kugadziriswa kwemajaspine emumhino, masukisi anorema nemakemikari uye anogona kuvhiringidza mhino, inogona kuitwa nenyanzvi ye ENT.
Orthodontic Treatment
Vana vanowanzoda bhodzi kuti varuramise mazino akatsauka, asi dzimwe nguva maitiro aya anogonawo kuwedzera kufema munguva yehope. Vechiduku vanowanzoshanyira anthodontist, asi vana vaduku vanogonawo kubatsirwa nemishonga chaiyo. Kukurumidza kuwedzerwa maxillary kunogona kushandiswa kuwedzera marati akaoma uye ndima yechipfuva. Izvi zvinoitwa nekuiswa kwegadziriro yakagadzirika padenga remuromo nemumwe anthodontist. Iko kurapwa kunoshanda zvakanakisisa kuvana vaduku, uye hakushandisi mushure mokukura kwekukura kunoguma. Muvana vakwegura, misoro inogona kushandiswa mberi mberi nejaya rinokura. Izvi zvingabatsira apo retrognathia iripo. Chero sekukwanisa, kuwedzera kwezino kunofanira kudziviswa. Kuvapo kwemazino akakura kuchakurudzira kukura kwakakwana kwejaya kuitira nzvimbo yavo.
Myofunctional Therapy
Kudzidzira kwerurimi nemiromo kunogona kuwedzera hutema hwemhepo yepamhepo uye kuderedza dambudziko rekuchera uye kurara kwepabonde. Izvi zvinogona kusanganisira kuvhara rurimi kunze, kuuputira, kuichengeta, kana kuisimudzira pamusoro pedenga remuromo. Inogona kuda kurairirwa nemumwe mutauriri wekutaura. Myofunctional therapy ine mikana shoma yemigumisiro. Izvi zvinodzidziswa zvinofanira kuitwa kwemaminitsi 45 zuva rega rega, asi, uye vana vangave vasingateereri mazano. Pane humwe humwe humwe huri kutamba zviridzwa zvehuni uye kunyange didgeridoo inogonawo kubatsira.
Kuenderera mberi Zvakanaka Airway Pressure (CPAP)
CPAP inogona kushandiswa muvana kana vachiri kuyaruka vanoramba vachirara neaposi pasinei nemamwe mabasa ekurapa. Mushure mokunge mamwe masangano apera, kuongorora kurara kungave kwakakosha kuongorora zvakare mamiriro acho ezvinhu. Kana ichiripo, CPAP inogona kuva sarudzo inoshanda. NeCAPAP, kugara kuripo kwemweya kunowanikwa kuburikidza nechiso chemaziso chinopfekedzwa pamhino kana mumhino nemuromo panguva yekurara. Zvakakosha kusarudza mashekisi asingashandisi kudzvinyirira zvakanyanya kusvika mukati-kati sechiso sezvo pane zviitiko zvekuregererwa kwekukura. Vechidiki vazhinji vanotora zvishoma nezvishoma kufarira mushonga wePCAP uye nguva yakareba yokunamatira kunogona kuvhiringidzika, kunyanya apo vechidiki vanoenda kuchikoro uye vanorara munzvimbo dzekugara. Inogona kuva kurapwa kunodzoserwa kune imwe nguva sezvinodiwa.
Maxillomandibular Kufambira mberi
Mukupera kwevechiri kuyaruka, kufambira mberi kwokuvhiya kwemajaya ekumusoro nechezasi kunogona kuitika kuti uzarure mhepo. Izvi zvinoratidzwa kana retrognathia iripo. Iyi kurapwa ine 85 muzana inoshanda. Nzira yacho inotora maawa 4-5 uye inoitika pasi pese anesthesia. Zvinogona kutora vhiki nhanhatu kuti dzidzoke pamwe nekushaya hutano mukudya pakutanga. Inoshandiswa nemuromo uye chirongwa chechiremba chirwere.
Oral Appliance
Vechidiki vakwegura avo vakapedza kukura uye vakapedza chero basa raidiwa kana orthodontic vangave vachifarira kushandisa muromo wepamuromo kuti vabate chirwere chekurara. Ichi ndicho chisarudzo chekunyorova kana kuenzanisa kwemaitiro ekudzivirira kubata. Izvi zvinogadzirwa nemagetsi zvinogadzirwa nachiremba wemazino uye akachinjwa kwemwedzi inoverengeka. Kana yakasakara, tsaru nechezasi pasi zvinoshandiswa mberi, zvichizarura mushure mutsindo. Vanogonawo kuchengetedza mazino eamel kubva pakakuvadza kwakabatana nemazino okuya kana kuvhara. Kana matambudziko ari mu temporo-mandibular joint (TMJ) aripo, izvi zvingasava kurapa kwakakodzera. Pamusana pekuda kushandura kunze kwechigadzirwa, uye chinogona kugadziriswa, havakurudziri kuvana vaduku vachiri kukura.
Kuonda
Mune vana vane kuwandisa kana kuoma, chirongwa chekureruka kwehutano nehuwandu hwekudya uye kuwedzerwa muviri kunogona kuratidzwa. Iko kuchinja kunofanira kuitwa nekutarisa kwechiremba wevana. Kupera kushaya kurasikirwa kwepfungwa iyi ndeyechokwadi chinangwa uye mari inodiwa ichasiyana ichienderana nemuviri wemwana index index (BMI).
Kana iwe uine hanya nehupombwe hunoita kuti mwana arambe akarara, taura nevana vako uye utsvake mazano kune imwe bhuku rakavimbiswa-unyanzvi hwekurara unyanzvi uyo anogona kupa kuongororwa, kutungamirirwa, uye kutumira sezvinodiwa. Kuvhiringidza kurara kwepabonde kunogona kuporeswa zvinobudirira uye basa remubereki anokurudzirwa mukukwanisa kukanganisa kwezvibvumirano izvi hazvikwanisi kuiswa pasi.
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> Marcus CL et al. Kuongororwa uye Kutarisira Kwevana Kuvhara Kurara kweApnea Syndrome. Pediatrics . Yakatanga kuparadzirwa paIndaneti 27 August 2012; DOI: 10.1542 / peds.2012-1671.
> Pereira KD, Jon CK, Szmuk P, Lazar RH, uye Mitchell RB. Kutarisira Kwekudzivirira Kubata Kwepabonde muvana: Nzira Yakakosha. Nzeve Nzeve Throat J. 2016 Jul; 95 (7): E14-22.
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