Cot death (SIDS): kudzivirira, zvikonzero, zviratidzo uye mareti emhosva

By Cristiano Antonino On Jul 14, 2022

Inowanzonzi 'cot death' asi zita rayo rakanyatsojeka nderokuti 'sudden infant death syndrome' inozivikanwawo se'sudden infant death syndrome' kana kuti 'unexpected infant death' (SIDS) chiitiko chisati chanyatsotsanangurwa nevatsvakurudzi.

SIDS inozviratidza mukufa kamwe kamwe uye kusingatarisirwi kwemucheche anoita seane hutano, kazhinji mukusavapo kwezviratidzo zvepremonitory uye zvikonzero zvinonzwisisika.

Anenge nguva dzose rufu runoramba rusingatsananguriki kunyange mushure mokuongororwa kwe post-mortem.

Tsigiro yenhamo yemhuri dzakabatwa neSIDS inokosha, sezvo rufu rwomucheche rwuri kamwe kamwe uye sezviri pachena pasina chisakiso, kuchiguma nengwavaira isingafungidziriki uye isingatsananguriki inosiya vabereki vari munhamo isinganyaradzi, isingarambiki kunyange kunguva refu yokurapa kwepfungwa uye tsigiro yemishonga inoderedza kuora mwoyo.

Sezvo rufu rwemubhedha rusina zvapupu, runowanzobatanidzwa nekuferefeta mukutsvaga mhosva inogona kuitika kune mumwe kana vabereki vese.

Mitengo yekufa kwemubhedha

Chirwere ichi chinokanganisa vana mumwedzi gumi nemiviri yekutanga yehupenyu uye ndicho chikonzero chikuru chekufa kwevana vane hutano vanozvarwa munyika dzakabudirira.

MuItaly yaive nechiitiko che 0.5 pachuru muna 2011 (vana makumi maviri nevatatu vari pasi pemakore mashanu, 23% yerufu rwakakwana munguva yereferensi).

Data yemakore 2004-2011 yedunhu rePiedmont inoratidza avhareji yekufa kweSIDS ye0.09 pa1000.

Ndiyo inonyanya kukonzera rufu pakati pemwedzi mumwe negore rekuberekwa.

Inenge 90 muzana yematambudziko anoitika asati asvika mwedzi mitanhatu, uye nhamba yepamusoro yemhosva dziri pakati pemwedzi miviri nemwedzi mina yezera.

SIDS inowanzoonekwa kuvakomana kupfuura vasikana.

SIDS inotora chikamu che80% chekufa kusingatarisirwi kwevacheche (SUIDs).

Pane 'premonitory' zviratidzo zvekufa kwemubhedha, SIDS?

Vabereki vakawanda vanoshamisika kana zvichibvira kutaurira nezviratidzo zviduku zvishoma kuti mwana wavo ari pangozi yekubatwa nechirwere ichi, kuitira kuti vagone kupindira munguva?

Mhinduro inosuruvarisa kuti kwete.

Iko hakuna zviratidzo zvinoonekwa zveSIDS, vacheche vanofa nechirwere ichi havaite sevanotambura nemhando ipi neipi yemarwadzo kana kuratidza humbowo hwepanyama.

Vamwe vaongorori vakaedza kuisa njodzi pakati pezviratidzo zvekufema-sefuruwenza, asi nyaya yacho ichiri kukakavara zvakanyanya.

Kunyange zvazvo pasina zvimwe zvikonzero kana zviratidzo, kune uchapupu hwekuvapo kwemaitiro uye mamiriro ezvinhu angave ari zvinhu zvinowedzera ngozi yeSIDS, uye zvimwe izvo, pane zvinopesana, zvinodzivirira (kuderedza ngozi).

Zvinhu zvinowedzera mukana wekufa kwemubhedha mucheche

Kutarisana nekusakwanisa kugadzirisa chikonzero chisinganzwisisiki, zvidzidzo zve epidemiological zvakaitwa izvo zvakawana kuvapo kwezvimwe zvinodzivirirwa uye zvimwe zvisingadziviriki zvinokonzera njodzi; hapana chimwe cheizvi, zvisinei, ndicho chikonzero chaicho cheSIDS.

Chinodiwa chemusanganiswa wezvinhu zvinosanganisira kukonzeresa genetic susceptibility, yakatarwa nguva mukukura kwemwana uye kushushikana kwezvakatipoteredza zvakatsanangurwa.

Izvi zvinonetsa kwezvakatipoteredza zvinogona kusanganisira kurara nedumbu kana padivi, kupisa zvakanyanya uye kuratidzwa nehutsi hwefodya.

Kuzarirwa netsaona panguva yekugovana pamubhedha (kunozivikanwawo sekuvete-kurara) kana kutadza kufema kubva pazvinhu zvinyoro zvinogona kuita basa.

Chimwe chisingachinji-chinogadzirisa njodzi ndeye 39 mavhiki gestation.

Zvimwe zvinokonzeresa zvinosanganisira kutapuriranwa, zvirwere zvemajini uye matambudziko emwoyo.

Kunyange zvazvo kushungurudzwa kwevana nenzira yekudzvinyirirwa nemaune kungave kusingazivikanwe seSIDS, izvi zvinotendwa kuti ndezvipi zvisingasviki 5% yezviitiko.

Misiyano yehuwandu yakawanikwa mukuwirirana nehukadzi uye zera remucheche, dzinza, tsika uye hupfumi hwevabereki.

Nzira dzinoderedza zvachose njodzi yeSIDS hadzipo iye zvino, kunyange zvazvo kune nzira dzakawanda dzinogona kuderedza zvakanyanya kuitika kweSIDS muvana.

Ongororo dzakawanda dzinoratidza kuti chimwe chezvikonzero chikuru inzvimbo yekurara kunze kwekunge supine (njodzi yakanyanya kana mucheche akarara nedumbu, kana parutivi).

Saka zvinokurudzirwa zvakasimba nguva dzose kuisa mwana kurara pamusana wake (musana unopikisana nemubhedha, dumbu kumusoro).

Zvinofungidzirwa kuti kana tsika yakachengeteka yokuita kuti vana varare vakafuratira (pamadumbu avo) pachinzvimbo chekurembera (pamatumbu avo) yakanga yapararira kubvira kuma1970, kureva kuti paivepo humbowo hwekutanga hwesainzi uye hwekiriniki panyaya iyi. upenyu hwevacheche vanenge 50,000 XNUMX munyika dzokuMadokero moga hungadai hwakaponeswa.

Zvinochinjika uye/kana zvinodzivirirwa zvine njodzi pakufa kwemubhedha wevacheche

Mamiriro ekudzivirira anodzivirirwa eSIDS anosanganisira:

kuputa fodya mumba
amai vanosvuta panguva yekuzvitakura (zvakafanana nekumira-kusvuta zvigamba);
kusakwana kwekudya uye kutarisirwa kwepamuviri;
doro uye heroin kushandiswa;
kupisa kwakanyanya kwekamuri;
zvipfeko zvakanyanya;
kushandisa magumbeze zvakanyanya;
zvirwere zvekufema;
nzvimbo yekurara kunze kwekunge supine;
nguva yakareba yeQT (inoonekwa ne electrocardiogram).

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Zvisingagadzirike njodzi zvinhu

zera remucheche (mudiki pane 5 mwedzi)
kuzvarwa nguva isati yakwana;
mwaka wechando.

Kugoverana mubhedha wevabereki

Kugovana pamubhedha wevabereki kunoratidzika kuwedzera chiitiko chechirwere, kunyanya kana:

mubereki mumwe kana vose vari vaviri vanosvuta
mumwe kana vabereki vose vanoshandisa doro, zvinodhaka, mishonga;
mumwe kana vabereki vose vane uremu uye kuvaka;
mubereki mumwe kana vose vari vaviri 'vanorara zvikuru';
mumwe kana vabereki vese vanorara pazvigaro zvemaoko, masofa, nzvimbo dzakapfava umo mune mukana we'kunyura'.

Passive uye tertiary kusvuta

Utsi hwechipiri hunoenderana nechirwere ichi: vana vanofa neSIDS vanowanzova nehuwandu hwechikakananda uye cotinine (inoratidza kuratidzirwa kusingaperi kune utsi hwechipiri) mumapapu avo kupfuura vana vanofa nezvimwe zvikonzero.

Kunyange kusvuta kunze kwemba, zvisinei, kunofumura mwana kuhuwandu hwehutsi hwepamusoro, saka kuitira kuti abvise zvachose njodzi, zvinokurudzirwa kuti vabereki vasiye zvachose kusvuta, izvo zvichavandudza hutano hwenhengo dzose dzemhuri. uye zvakare kuderedza njodzi yekusvuta mwana akura.

Rufu rwemubhedha uye majekiseni: pane chinongedzo here?

Mishonga HAisi njodzi yeSIDS. Kusiyana neizvi, maererano nezvimwe zvidzidzo, mune dzimwe nguva majekiseni ane simba rekudzivirira kune SIDS: iyo diphtheria-tetanus-pertussis vaccination, somuenzaniso, inopindirana nekuderedza SIDS.

Cot kufa uye cardiac arrhythmias

Pamwe chete nezvidzidzo zvakawanda pamusoro pepathogenesis yeSIDS, idzo dzinobata neine genetically based cardiac arrhythmias, kureva channelopathies uye kunyanya refu QT syndrome, zviri kuwedzera kukosha.

Kunyange zvazvo mune dzimwe nhamba shoma dzimwe nguva dzeSIDS dzakabatanidzwa neBrugada syndrome, pfupi QT syndrome uye catecholaminergic polymorphic ventricular tachycardia.

Kudzivirira kufa kwemubhedha wevacheche

Tichifunga nezve njodzi, pane mamwe mazano ekudzikisa njodzi yeSIDS:

mwana anofanira kurara padumbu rake (supine);
hapafaniri kuva nokusvuta munzvimbo yaanogara kana kuti yokurara uye mumba;
nharaunda yaanorara haifanirwe kunge yakanyanya kupisa, (microclimate yekamuri yacho yakanaka kana tembiricha iri pakati pe18°C ne20°C uye kana kushanduka kwakanaka kwemhepo kuchibvumira mwando kunenge 50%) haafanire kudaro. anofanira kuvata ari kure namanyuko okupisa;
kana fivha, mwana anofanira kuvharwa zvishoma;
zvinokurudzirwa kuti mwana arare muimba yevabereki vake mumubhedha wake uye kwete pamubhedha wevabereki vake;
kushandiswa kwe dummies iko zvino kunoonekwa sechinhu chinoderedza njodzi.

Nzira yekuronga sei kiredhi kudzikisa njodzi yekufa kwemubhedha wevacheche?

Kuti uderedze njodzi yeSIDS, hapana zvinhu zvingatadzisa mwana kufema (semuenzaniso zvidhori, mhuka dzakatutira, mapiro, machira akaunyana) zvinofanirwa kunge zviripo mumubhedha.

Bepa harifanirwe kuiswa pamusoro wemwana asi rinongovhara kusvika pachipfuva uye maoko anofanira kuvhurwa kuitira kuti kufamba kwawo kurege kuita kuti bepa rivhare musoro nemhepo.

Kuyamwa nerukukwe rufu rwemucheche

Chidzidzo che2005 chakaratidza kuti kushandisa dummy kwakaderedza njodzi yechirwere ichi ne90%.

Izvi zvinoratidzika kunge zvakakonzerwa nekuti mesencephalic nucleus ye trigeminal nerve, inoshandiswa nekushandisa dummy, inomutsa Arousal kuburikidza nekushandiswa kwekugadzirisa reticular formation.

Izvi zvinobvumira kutonga kwemabasa akakosha emucheche (kurova kwemoyo, kufema, pH uye tembiricha yeropa), izvo zvisina kudaro, kunyanya muvacheche vasati vakura, zvinogona kukundikana pasi pemamiriro ekusarudzika kwezvakatipoteredza (muhope).

Muitisi weaya mabasa ndiyo neurotransmitter Glutamate inogadzirwa, chaizvo, ne mesencephalic nucleus ye trigeminal pakukurudzira, mune iyi kesi, ye dummy.

Pedyo nekupotsa SIDS

Kana vakanunurwa nekukasira, vamwe vacheche veSIDS vanogona kumutswa uye mune iyi nyaya tinotaura nezve 'near miss SIDS', zvisinei, pachine njodzi yakanyanya yekukuvara kwakanyanya kana kushoma kwekusingaperi kwehuropi nekuda kweanoxia nekuremara kunobvira.