Kunzima ukujonga ukuba i-opiates ihlala ixesha elingakanani kwinkqubo yomntwana ngexesha lokukhulelwa kuba akukho lula okanye kukuziphatha okuhle ukwenza olo phononongo kumntwana ongekazalwa. Ukongeza, ukufumana ii-opiates kwinkqubo yosana olusandul 'ukuzalwa akunakuxela kwangaphambili xa wayevezwa. Ihlala kangakanani i-opiate kwimveku okanye usana olunzima kwaye luxhomekeke kwizinto ezininzi.
Opiates kunye noMama
Kuqikelelwa amaxesha asikiweyo ixesha elidehydrocodoneihlala kumchamo kamama, amathe, igazi kunye neefollic zeenwele. Kukho iindlela ezahlukeneyo zokuvavanya ukufumana i-hydrocodone ngokunjalo. Olu vavanyo lubandakanya:
- Uvavanyo lomchamoenokufumana i-hydrocodone kangangeentsuku ezi-3 ukuya kwezi-4 emva kwedosi yokugqibela.
- Uvavanyo lweSaliva olunokubona i-hydrocodone kangangeyure ezili-12 ukuya kwezi-36 emva kwethamo lokugqibela.
- Uvavanyo lwegazi olunokubona i-hydrocodone ukuya kuthi ga kwiiyure ezingama-24 emva kwedosi yokugqibela.
- Uvavanyo lwezinweleenokufumana i-hydrocodone ukuya kuthi ga kwiintsuku ezingama-90 emva kwedosi yokugqibela.
- Ukuchonga nokunyanga abantwana abazelwe bengamakhoboka eziyobisi
- Yintoni ekufuneka uyazi malunga nokuncancisa kunye neziyobisi
- Kutheni kubalulekile ukhuseleko ezikolweni
Ngaba uMfazi okhulelweyo angamiselwa i-Opiates?
Nangona bukhona ubungqina beziphumo ezibi ze-opioid kwimveku engekazalwa, abanye abantu basetyhini basenokuba njaloopiates ezimiselweyongugqirha ngenxa yeentlungu okanye ukwenzakala. Ngokophando lwe2016 , ukuya kuthi ga kwi-22% yabasetyhini abakhulelweyo banikwe ii-opioids. Nangona kunjalo, ii-opioid ezimiselweyo zinokukhuseleka ngokubanzi ukuba:
- Kuthathwe elona xesha lifutshane linokwenzeka
- Ithathwe ngeyona dosi iphantsi
- Isetyenziswe ngokwemiyalelo kagqirha kwaye naziphi na iziphumo ebezingalindelekanga zichaziwe
- Umama ukhuthele kukhathalelo lwaphambi kokubeleka
Opiates kunye ne-Fetus
Ngokwabaphandi abavela kwi Isibhedlele saseYunivesithi iZurich kunye nezinye, iimpawu ze-opiates zivumela ukuba bawele i-placenta bangene kumntwana ngaphakathi kweyure yokusetyenziswa komama. Kungekudala i-opiate ingena kwizicubu zomntwana kwaye ihlala ixesha elingakanani kwinkqubo yomntwana ngokuxhomekeke kwizinto ezinzima.
Zithini iimpembelelo eziVuselelayo kwimveku engekazalwa?
Xa kungekho luvavanyo lomntu olungekazalwa, izigqibo ezininzi kwizinto ezichaphazela indlela umntwana ophethe ngayo opiates zivela emsebenzini kunye neegusha ezikhulelweyo kunye nolunye uphando lwelebhu. Ngokwencwadi yesikhokelo Ukusetyenziswa gwenxa kweziyobisi koomama kunye neNkqubo yokuKhula kweNervous , emva kwedosi ye-opiate yoomama, ezi zinto zilandelayo zinokuba nefuthe ukuba ichiza lihlala ixesha elingakanani kwimveku engekazalwa:
- Uhlobo lwe-opiate kunye nokuba umntwana ukhawulezisa kangakanani ukumilisela:
- Ukwenza into emfutshaneopiates, ezifana heroin, ngekhe ihlale ixesha elide kwinkqubo engekazalwa. Ii-opiates ezisebenza ngokufutshane zenziwa ngokukhawuleza sisibindi kwaye zikhutshelwe kumchamo womntwana nakwisihlalo.
- Ii-opiates ezisebenza ixesha elide, ezinje nge-methadone, zenziwa kancinci kwaye ziya kuhlala kwinkqubo yakhe ixesha elide.
- Umthamo we-opiate osetyenzisiweyo kwaye ukuba umfazi uyithatha kangaphi inefuthe elibi kwindlela opiates ekhawulezileyo eyenziwe ngayo.
- Amanye amachiza akhoyo anokuchaphazela ukuba i-opiate ikhawuleze kangakanani ukuba ifike kwimetabolism okanye iwele ipascenta iye kumntwana.
- Impilo ye-placenta inokuchaphazeleka kwiingxaki zonyango ezinjengesifo seswekile; Oku kuyakuchaphazela ukuba lingakanani ichiza elingena kwimveku engekazalwa.
- Njengoko ukukhulelwa kuqhubela phambili kwikota yesithathu, iziyobisi zisebenzisa umzimba ngokukhawuleza kwaye zingena kancinci kwimveku engekazalwa.
- Izinto zemvelo kwimveku engekazalwa inokumisela ukuba ukhawuleza kanjani atyhale i-opiate kwaye ayikhuphe kumchamo nakwizitulo zakhe.
Iziphumo ze-Opiates ekukhulelweni nakwi-Fetus
Ngokwababhali be Ukusetyenziswa gwenxa kweziyobisi kwabafazi kunye nenkqubo yovalo luvo, Kukho imithombo emibini ephambili yeziphumo ze-opiate kwimveku engekazalwa:
- Iziphumo ezingqalileyo kuphuhliso lwenkqubo yemithambo-luvo yomntwana, indlela yokuziphatha kunye nempilo yomntwana, kunye nesiphumo sokukhulelwa.
- Ukuncipha ekusebenzeni kweplasenta ethi ichaphazele ukondla, ukukhula kunye nokukhula komntwana ongekazalwa.
Iziphumo kwiNkqubo yeNervous yeNervous kunye nokuziphatha
Ngoku ka Ukusetyenziswa gwenxa kweziyobisi koomama kunye neNkqubo yokuKhula kweNervous ireferensi, ngeedosi ezisezantsi kunye nokusetyenziswa okwexeshana, ii-opiates ziyayivuyisa inkqubo ye-nervous central kodwa ziyicinezele kwiidosi eziphezulu kunye nezide. Eminye yemisebenzi yemveku echaphazelekayo ibandakanya:
- Umzekelo wokuphefumla
- Inqanaba lentliziyo
- Intshukumo
- Imijikelezo yokulala, ekhokelela kukuphazamiseka kwipateni yokulala
- Iipateni ze-EEG zobuchopho
Ukuxhomekeka ku-Opiate kunye nokuRhoxa
Njengakumama, ukuboniswa ixesha elide kwii-opiates kunokukhokelela ekuxhomekekeni kweziyobisi emzimbeni. Umbungu uya kubonisaiimpawu zokurhoxaukuba umama uphose idosi. Ukuxhomekeka kwe-fetal opiate kunxulunyaniswa nomngcipheko okhulayo wokufa komntwana. Ukuxhomekeka ngokwasemzimbeni kunye nokurhoxa kunqabile ukuba unyango lwe-methadone olwaneleyo lukamama ngexesha lokukhulelwa.
Iziphumo kwiZiphumo zokuKhulelwa kunye nokuKhula kweFetal
Ngokwe- Ikholeji yaseMelika yoNyango kunye neeGynecologists , ukuba uthatha ii-opiates ngexesha lokukhulelwa, okanye uzimise ngesiquphe, unyusa umngcipheko woku:
- Ukuphuma kwesisukunye nokuzala intshontsho
- Umsebenzi wokuqala kunye nokuzalwa kwangaphambi kokuzalwa
- Ukuqhekeka kwangaphambili kweembrane
- Ukwahlula kwangaphambili i-placenta
- Ukuhamba kwe-meconium ngomngcipheko wokulangazelela i-meconium
- Ukukhula okungalunganga kwe-intrauterine kosana olungekazalwa (isithintelo sokukhula kosana olungekazalwa), kukhokelela kubunzima bokuzalwa komntwana
Abafazi abakhulelweyo abagcinwa kunyango lokutshintsha endaweni ye-methadone ngalo lonke ixesha lokukhulelwa basemngciphekweni omncinci wokuzalwa kwangaphambi kokubeleka okanye iintsana ezinesisindo esiphantsi. Kukho ubungqina obungathandekiyo bokwanda komngcipheko wokukhubazeka kokuzalwa ngokusetyenziswa komama kuyo nayiphi na i-opiate, kodwa kunokubakho umngcipheko omncinci kwitrimester yokuqala.
Ukusetyenziswa kwe-Opiate kunye neZiphene zokuzalwa
Ngokophando olukhokelwe ngamaZiko oLawulo lweZifo, ikhonkco lafunyanwa phakathiiziphene zokuzalwa kunye nokusetyenziswa kwe-opioidngumama. Oku kubandakanya:
- Ispina bifida nguisiphene kuphuhliso lomqolo.
- Iziphene zentliziyo yokuzalwa ezibandakanya; i-ventricular kunye ne-atrial septal defects, i-tetralogy ye-Fallot kunye ne-pulmonary valve stenosis.
- I-Gastroschisis sisiphene sokuzalwa apho amathumbu aphuma ngaphandle komzimba wosana ngomngxunya esiswini.
- IHydrocephaly engamanzi agqithisileyo kwingqondo yosana.
Opiates kunye noNtsana
I-opiate isenokubonakala kwinkqubo yosana olusandul 'ukuzalwa xa luzalwa. Ngokwe- IAmerican Academy yePediatrics (AAP) , nokuba ikho kwaye iyabonakala xa kuzalwa kwaye ihlala ixesha elingakanani kwinkqubo yakhe emva koko ixhomekeke:
Umbala weenwele olungele ukugquma iinwele ezingwevu
- Nguwuphi umzekelo osetyenziselwa ukufumanisa iziyobisi kusana olusandul 'ukuzalwa
- I-opiate kunye nokuba ngokukhawuleza ichiza lifakwa njani sisibindi esingekazalwa kwaye lakhutshwa kumchamo ngaphandle kwenkqubo yosana
- Xa umama wathatha idosi yakhe yokugqibela
- Unina uthathe ixesha elingakanani ichiza ngexesha lokukhulelwa
Ezinye ii-opiates, ezinjenge-heroin, zikhawulezisa ukwenziwa komzimba kwaye azinakufunyanwa kumchamo wosana olusandul 'ukuzalwa okanye kwigazi kungekudala emva kokuzalwa, kodwa ubungqina bokuvezwa kwexesha elide bunokubonakala kwezinye iisampulu.
Ukuchonga iiOpiates kusana olusanda kuzalwa
Ngokwe- Umbutho waseMelika wePediatrics Isalathiso, kusana olusandul 'ukuzalwa' akukho mzekelo webhayoloji othi, xa ufunyanwa ngokungacwangciswanga, uchonge ukusetyenziswa kweziyobisi ngaphambi kokubeleka ngokuchaneka kwe-100%. ' Ngamanye amagama, ukuba isampulu ayilunganga ayikukhupheli ngaphandle ukubonakaliswa kweziyobisi kutshanje.
Nganye kwezi zinto zintathu zixhaphakileyo ezisetyenziselwa ukufumanisa ii-opiates kunye nezinye iziyobisi kusana olusandul 'ukuzalwa zinika ngokubanzi, hayi into ethile, umbono wokuba umntwana uvezwe ixesha elingakanani:
- Umchamo Umchamo yeyona nto isetyenziswa rhoqo ekufumaneni ukubhencwa kutsha nje kwi-opiates kusana olusandul 'ukuzalwa. Ubukho be-opiates kumchamo emva kokuzalwa kubonisa ukusetyenziswa ngumama kwiintsuku nje ezimbalwa zokuhanjiswa. Ukuvavanywa komchamo kuyakhawuleza, kodwa iziphumo ezingalunganga azikhuphi ngaphandle kokuba umama asebenzise ii-opiates ngexesha lokukhulelwa, ngakumbi ukuba isampulu yomchamo wosana olusanda kuzalwa incinci kusuku lokuqala lobomi.
- Meconium : Opiates kwi-meconium inokubonisa ukubonakaliswa kwezi nyanga zimbalwa zidlulileyo, kodwa iziphumo zithatha iintsuku ezimbalwa. Iipilisi kunye nezinye iziyobisi kucingelwa ukuba ziqokelele kwi-meconium ukusuka kwikota yesibini yesibini ukuya phambili. Ukuchaneka kweziphumo kunokuchaphazeleka sisixa sesitulo naxa kuqokelelwa.
- Iinwele : Ubukho beziyobisi kwizinwele bubonakalisa iinyanga ezininzi zokuvezwa njengezinto zihlala iinwele ixesha elide. Ukuvavanywa akukho lula, kwaye ezinye izinto ezingcolisayo kwisampulu zinokuchaphazela iziphumo zovavanyo lwe-opiates.
Ukufumanisa i-opiates kwigazi le-umbilical cord kwangoko xa kuzalwa kubonakalisa ukusetyenziswa koomama kutshanje kunye nokuvezwa komntwana kodwa akakwazi ukukhomba ukuba ichiza lithathiwe okanye lide kangakanani kwinkqubo yomntwana.
Iziphumo ze-Opiates kuMntwana osandul 'ukuzalwa
Ngokutsho kwesalathiso se-AAP, iimpembelelo zokusetyenziswa kwe-opiate koomama ngexesha lokukhulelwa kunokubonwa kusana olusanda kuzalwa kwaye kunokuba neziphumo ezihlala zihleli. Ukuqhubeka kweengxaki kwiintsana ezinamakhoboka eziyobisi kubandakanya ukungasebenzi kakuhle, iipateni zokulala kakubi, ixesha elifutshane lokujonga, kunye nenkumbulo engeyiyo ebuntwaneni.
Ezona ngxaki zibalulekileyo kusana olusandul 'ukuvezwa lwe-opiate evezwe kukungabikho kwengqondo kwi-neonatal syndrome, umngcipheko owandayo wokufa komntwana osandul' ukuzalwa okanye isifo sokufa kweentsana ngesiquphe (SÌDS).
Isifo sengqondo sokuNqanda uNonatal
I-neonatal abstinence syndrome (NAS) kubandakanya ukungakhathali, ukutya okungalunganga, ukulala okungasebenzi kakuhle, kunye nokulila okuphezulu. Kwenzeka xa usana oluxhomekeke kwi-opiate luxhomekeke kumama opiates xa kuzalwa. Isifo sengqondo sinokuba nzima kwaye umntwana one-NAS angachitha iiveki ezimbalwa esibhedlele.
Kwenzeka nini kungekudala i-NAS kwaye ubungqongqo bayo buxhomekeke ekubeni umama wagqibela nini ukusebenzisa i-opiate, ukuba iyeza liphuma ngokukhawuleza kangakanani kwinkqubo yosana kwaye liphi elisetyenziswa ngumama.
- Ii-opiates ezihlala ixesha elifutshane : Usana olusandul 'ukuzalwa luvezwe ngexesha lokukhulelwa kwii-opiates ezimfutshane, ezinje ngeheroin okanye iPercocet, okanye i-opiate buprenorphine, iya kuba nayoIimpawu zokurhoxakwiiyure ezingama-48 ukuya kwezingama-72.
- Ixesha elide lisebenza opiates : Ngee-opiates ezinje ngokurhoxa kwe-methadone ziqala kamva, zihlala ziintsuku ezintathu ukuya kwezisixhenxe emva kokuzalwa, kwaye ziba qatha.
Izibalo ezivela kwi- IZiko leLizwe leZiyobisi Qaphela ukuba phakathi kwe-2000 kunye ne-2012 imeko ye-neonatal abstinence syndrome inyuke kahlanu, ehamba nokunyuka okufanayo ekusetyenzisweni koomama kweziyobisi ezingekho mthethweni kunye nonyango ngexesha lokukhulelwa.
Umfazi okhulelweyo angacoca njani kwii-Opiates
Umfazi okhulelweyo akufuneki ayeke opiates turkey ebandayo. Oku kunokubangela iingxaki ezinzima zokukhulelwa kunye nosana. Kukho iindlela umfazi okhulelweyo anokukhupha i-detox ngokukhuselekileyo kwaye ekugqibeleni acoce inkqubo yakhe ye-opiates. Oku kubandakanya:
- Ukufumana uncedo phantsi kweliso lonyango lolona khetho lufanelekileyo.
- I-detox yezonyango yeyona ndlela ikhuselekileyo necocekileyo yokucoceka.
- Ukusetyenziswa kwamayeza ngexesha lonyango olubandakanya i-methadone okanye i-buprenorphine.
- Iinkqubo zonyango ezingalaliswayo apho kufuneka khona iintsuku ezingama-30 ukuya kuma-90 kweli ziko.
- Iinkqubo zonyango lwangaphandle eziguquguqukayo kwaye zihlala ekhaya lukhetho ngexesha lokuchacha.
- Ukuqhubeka nokunyanga ukugcina ukubuyela kwimeko yesiqhelo.
Nika Imbali Echanekileyo
Zininzi izinto ezichaphazela ukuhlala kwe-opiates ixesha elide kwinkqubo yomntwana. Kuba ukusetyenziswa kwe-opiates ngexesha lokukhulelwa kunokuchaphazela impilo yomntwana wakho ngaphambi nasemva kokuzalwa, nika ugqirha wakho okanye umbelekisi ngembali echanekileyo yokusebenzisa kwakho iziyobisi ukuze bakwazi ukubonelela wena kunye nosana lwakho ngononophelo kunye neenkonzo ezifanelekileyo.
