Ukwelashwa, ukwelashwa kokungezwani komzimba, nomsebenzi we-orthodontic
I-apnea yokulala yokuvimbela isifo esithinta ukuphefumula ngesikhathi sokulala kokubili abadala nabantwana. Kungaba nomthelela obalulekile ekukhuleni, ekuthuthukiseni nasekuziphatheni kwentsha ethintekile. Yiziphi ezinye zezimpawu ezihlobene nokuphefumula kokulala ebantwaneni nasebancane? Yiziphi izindlela zokwelapha ezihlukile kula maqembu? Funda ukuthi ungaphatha kanjani ukuphulukiswa kwe-sleeping obstructive ezinganeni nasebancane, kufaka phakathi izinyathelo zokuhlinza, ukwelashwa kwemithi yokungena emithonjeni, i-orthodontics, ukulahlekelwa kwesisindo, kanye nokunye okukhethwa kukho okufana nokwelashwa kwe-myofunctional.
Yini Okuvimbela U-Apnea Wokulala?
I-apnea yokulala yokuvimbela ibhekwa ngokuphefumula okwenzeka ngesikhathi sokulala. Lezi ziqephu zibangelwa ukuwa okuncane noma okuphelele kwe- airway engenhla , okuthinta izicubu emqaleni (njengama-tonsils, adenoids, noma i-palate ephansi) noma ngaphansi kolimi. Ithinta cishe amaphesenti angu-1 ezingane.
Izenzakalo zokulala ze-apnea zigcina okungenani imizuzwana eyishumi futhi zihlotshaniswa nokudonsa emazingeni e-oksijeni wegazi (nge-saturation eyancipha ngamaphesenti amathathu), ukwanda kwamazinga e-carbon dioxide, noma ukuvusa ukuthi izingcezu zilele. Ngokungafani nabantu abadala, lapho i- apnea-hypopnea index (AHI) engaphezu kwemihlanu ibhekwa njengesijwayelekile, lezi ziqephu zingenzeka ngesikhathi esisodwa ngehora ezinganeni futhi zibhekwe njengeziphawulekayo.
I-apnea yokulala yokuvimbela ngokuvamile ivela ngenxa ye- anatomy ebusweni ebangela ukuvinjelwa kwendiza. Kungase kube yingozi kakhulu ngenxa yemithi noma ukubhema kwentuthu kagwayi.
Ukulala, ikakhulukazi elele ngemuva, kungase kwandise futhi kwenzeke. Inzuzo yesisindo ingaba nendima ezinganeni ezikhulu ngokweqile noma ezikhuluphele.
Ziyini Izimpawu Nezibonakaliso Zokulala Kwe-Apnea Ezinganeni?
Naphezu kokufana nokuthi ukuphefumula kwe-apnea okuvimbela kanjani abantu abadala, izingane nazo zingaba nezimpawu ezihlukile kanye nezibonakaliso zesifo.
Ezinye zalezi zithole zifaka:
- snoring
- wabona ukuhamba okuphefumulayo
- ukuvuza noma ukuchofoza
- umlomo ukuphefumula
- amazinyo agaya noma ahlose
- ukuthuka ebusuku
- ukulala okungenalutho
- ubusuku obusabisayo
- ukulala
- ukulala
- izinhloko zekhanda ekuseni
- ubuthongo bemini
- ukuphumula ezinganeni ezindala
- ukunakekelwa kwephutha lokugula kwengqondo (ADHD)
- izinkinga zokukhula
Ake sihlole ezimbalwa zalezi zithole ezibalulekile futhi sigcizelele ukuthi bangase basikisele kanjani ukuba khona kwe-apnea yokuvimbela ukulala.
Izingane akufanele ziphuze njalo. Nakuba kungase kubonakale kumnandi, lokhu kungaba uphawu lokuthi kunzima ukuphefumula ngesikhathi sokulala futhi akufanele kunganakwa. Ukuphefumula komlomo kubonisa inkinga yokuphefumula emakhaleni. Lokhu kungenxa yokungqubuzana kwamanzi kusuka emakhazeni noma okungahleliwe lapho kutholakala khona imithi. Ukulala okungenangqondo nokuphumula kungase kube isibonakaliso sokugaya futhi kunzima ukuphefumula.
I-apnea yokulala ingase ihlukanise izigaba zokulala futhi iholele ekuziphatheni kokulala (okubizwa ngokuthi i- parasomnias ) ngisho nokulala okuqhubekayo okuqhubekayo esikhathini esijwayelekile sokuxazulula. Izingane zingase zilale ngesikhatsi semini, kodwa kungenzeka ukuthi zingase zenzeke kahle futhi zinganaki. Ukukhula kungaphinda kube nokukhubazeka futhi ukwelashwa okuphumelelayo kwe-apnea yokulala kungabangela ukuguquka kokukhula nokuthuthukiswa kokuziphatha.
Le miphumela ingagwenywa.
Ukwelashwa Kwe-Apnea Yokulala Kwezingane Nezingane Ezitholakalayo
Ngenhlanhla, kunezinketho zokwelashwa eziphumelelayo ezitholakalayo kule nkinga ezinganeni nasebancane, kufaka phakathi:
I-tonsillectomy ne-Adenoidectomy
Lokhu kuyindlela yokwelapha evamile kunazo zonke izingane ezine-apnea yokuvimbela ukulala. Kuzokwenziwa uma udokotela eqaphela ukukhuliswa kwamathani noma ama-adenoids emhlane nasemlonyeni. Izingane ezinama-tonsil abanzi zingase zihlushwa izifo ezithathelwanayo, zikhononda ngesifo somzimba, futhi zingase zibe nezinguquko ngezwi labo lapho izicubu zikhuliswa.
Lokhu kuvulwa kusebenza kahle futhi izinga lokuphumelela lingamaphesenti angu-80. Inqubo ihlala ihora elilodwa futhi livela ngaphansi kwe-anesthesia jikelele. Izingane zibuyela esikoleni emasontweni amabili. Yenziwa udokotela ohlinzayo jikelele noma ngendlebe, impumu, nomphimbo (ENT). Lokhu kuhlolwa kungadinga ukudluliselwa kubantwana bakho noma ochwepheshe bokulala.
Isifo sofuzo
Izingane noma intsha ene-allergenic rhinitis (i-hay fever) ingaba ne-congestion, impumu ephuthumayo, amanzi noma amazinyo, noma i-drip-nasal drip. Lapho ikhala livinjelwe, umlomo ukuphefumula cishe kungenzeka. Lokhu kungabangela ingozi yokugcoba nokulala kwe-apnea. Izifo zengculaza zingase ziphathwe ngama-rinses omzimba womlomo, izidakamizwa zomlomo ezifana ne-montelukast (ezithengiswa njenge-Singulair yesiguli), noma izipulisi ze-steroid nasal. Ukudluliselwa ku-allergenist kungahlelelwe ukuhlolwa okunye kokuvivinya umzimba noma i-immunotherapy. Ukunciphisa i-turbinates yama-nasal, izicubu ezivuthwa nezifo futhi zingavimba ikhala, zingenziwa ngumchwepheshe we-ENT.
I-Orthodontic Treatment
Izingane zivame ukudinga ama-braces ukuze ziqondise amazinyo ahlasele, kodwa ngezinye izikhathi lezi zingenelelo zingabuye zithuthukise ukuphefumula ngesikhathi sokulala. Ngokuvamile intsha ivakashela i-orthodontist, kodwa izingane ezincane zingase zithole izinzuzo ezithile. Ukwandiswa kwama-maxillary okusheshayo kungasetshenziselwa ukwandisa i-palate elukhuni kanye nemigqa engasese. Lokhu kwenziwa ngokubekwa kwe-brace brace ophahleni lomlomo ngu-orthodontist. Lokhu ukwelashwa kusebenza kangcono ezinganeni ezincane, futhi akusebenzi emva kokuphelela kokukhula. Ezinganeni ezindala, inhloko ingasetshenziswa ukuqhubekela phambili umhlathi okhula kancane. Lokhu kungasiza uma retrognathia ikhona. Kakhulu ngangokunokwenzeka, ukukhipha izinyo kufanele kugwenywe. Ukuba khona kwamazinyo omdala kuzokukhuthaza ukukhula okujwayelekile komhlathi ukuze ubenzele indawo.
Therapy Myofunctional
Ukuzivocavoca kolwimi nezindebe kungakhulisa i-tone muscle yomoya futhi kunciphise ingozi yokugwinya nokulala kwe-apnea. Lezi zivivinyo zingase zihlanganise ukugxila ulimi, ukuluqaqa, ukulichofoza, noma ukuluphonsa ophahleni lomlomo. Kungadinga ukufundiswa ngu-specialist therapist. Imithi yokwelapha ayinamathuba amancane emibi. Lezi zivivinyo kufanele zenziwe imizuzu engu-45 nsuku zonke, kepha, futhi izingane zingase zingahambisani nezincomo. Kunobufakazi bokuthi ukudlala izinsimbi zomuthi kanye ne-didgeridoo kungase kube usizo.
Ukucindezela Komoya Okumnandi Okuqhubekayo (CPAP)
I-CPAP ingase isetshenziswe ezinganeni noma ezinsheni ezinokuphefumula okuqhubekayo kokulala naphezu kwemizamo yokwelashwa. Ngemuva kokunye ukungenelela kwenziwa, isifundo sokulala singasiza ukuphinda ubuyekeze lesi simo. Uma iphikelela, i-CPAP ingaba inketho ephumelelayo. Nge-CPAP, ukugeleza komoya okuqhubekayo kukhishwa ngesikhumba sombuso esigqoke phezu kwekhaleni noma ekhaleni nomlomo ngesikhathi sokulala. Kubalulekile ukukhetha i-mask engayisebenzisi ingcindezi enkulu ebusweni obuphakathi njengoba kunemibiko yokunciphisa ukukhula. Intsha eningi kancane kancane inganaki isithakazelo se-CPAP kanye nokunamathela isikhathi eside kungaphazanyiswa, ikakhulukazi lapho intsha ihamba ekolishi futhi ilala ezindaweni zokulala. Kungaba ukwelashwa okubuyiselwa kamuva uma kudingeka.
Ukuthuthukiswa kwe-Maxillomandibular
Ngasekupheleni kweminyaka yobudala, ukuthuthuka okuhlinzekwayo kwemigqa engenhla nephansi kungenzeka ukuvula umoya womoya. Lokhu kuboniswa uma i-retrognathia ikhona. Le ukwelashwa ngamaphesenti angama-85 asebenza kahle. Inqubo ihlala amahora angu-4-5 futhi kwenzeka ngaphansi kwe-anesthesia jikelele. Kungathatha amasonto ayisithupha ukuba alulame nokukhubazeka okuthile ekudleni ekuqaleni. Lenziwa ngumhlinzeki ohlinzayo okhulunywe ngomlomo kanye ne-maxillofacial.
I-Oral Appliance
Intsha ekhulile eseqedile ukukhula futhi igcwalise noma yimiphi imisebenzi edingekayo ye-orthodontic ingase ibe nesithakazelo ekusebenziseni umshini womlomo ukuphatha i-apnea yokulala. Lokhu kuyindlela yokuphefumula okulula noma okulinganiselayo yokuvimbela ukulala ubuthongo. Lezi zixhobo ezifakelwayo zenziwa ngudokotela wamazinyo futhi zilungiswe ngaphezu kwezinyanga ezimbalwa. Uma igqoke, umhlathi ophansi kanye nolimi ziyashintsha phambili, evula ngemuva komoya. Zingavikela futhi ama-koqweqwe amazinyo kusuka emonakalweni ehlobene namazinyo okugaya noma ukugcoba. Uma izinkinga ezihlangene ne-temporo-mandibular (TMJ) zikhona, lokhu kungase kungabi yindlela yokwelapha efanelekile. Ngenxa yesidingo sokushintsha idivayisi, futhi okungenzeka kubekwe ukuvinjelwa, akukhuthazwa izingane ezincane ezisakhula.
Ukulahlekelwa kwesisindo
Ezinganeni ezinzima ngokweqile noma ezikhuluphele, uhlelo lokulahlekelwa isisindo olunomsoco oluphuculweyo nokwenyuka kokuvivinya umzimba kungaboniswa. Lezi zinguquko kufanele zenziwe ngokuphathwa kwezingane zakudala. Ukulahlekelwa kwesisindo esincane kungumgomo ongokoqobo futhi inani elidingekile lizohluka ngokususelwa ekuhloleni komzimba womntwana (BMI).
Uma ukhathazekile nge-obstructive sleep apnea enganeni yakho, khuluma nodokotela wakho wezingane bese ucela iseluleko sophethiloli oqinisekisiwe webhodi eliqinisekisiwe elinganikeza ukuhlolwa okuqhubekayo, ukuqondiswa, nokudluliselwa lapho kudingeka. I-apnea yokulala engavinjelwe ingaphathwa ngendlela efanele futhi indima yomzali okhuthazayo ekukhuliseni umthelela walezi zindlela ezingenelela angeke yenziwe phansi.
> Imithombo:
> I-Dehlink E no-Tan H. Ukuvuselelwa kokuvimbela izingane ukulala. I-Journal ye-Thoracic Disease . 2016; 8 (2): 224-35.
> Li Z, Celestin J, noRowkey RF. Izingane zokulala ze-Apnea Syndrome: Isibuyekezo. J Allergy Clin Immunol Pract . 2016 Jun 30; S2213-2198 (16) 30105-2.
> Marcus CL et al. Ukuxilongwa Nokuphathwa Kwezingane Ukuvimbela Ukulala Apnea Syndrome. Izingane zokwelapha . Ishicilelwe ekuqaleni ngo-Agasti 27, 2012; I-DOI: 10.1542 / i-peds.2012-1671.
> Pereira KD, Jon CK, Szmuk P, Lazar RH, noMitchell RB. Ukulawulwa Kokuvimbela I-Apnea Yokulala Ezinganeni: Indlela Yokusebenza. I-Ear Nose Inhlanzi J. 2016 Jul; 95 (7): E14-22.
> U-Whitla L noLennon P. Ukuphathwa Okungavunyelwe Ukuvimbela Ukulala I-Apnea: Ukubuyekeza. I-Intanethi ye-Int Intanethi yezingane . 2016 Apr 14: 1-5.