Ciwon ƙaura na yara

Neonatal abstinence syndrome (NAS) rukuni ne na matsalolin da ke faruwa a cikin jariri wanda aka nuna shi ga magungunan opioid na tsawon lokaci yayin cikin mahaifar uwa.

NAS na iya faruwa yayin da mace mai ciki ta sha kwayoyi kamar su heroin, codeine, oxycodone (Oxycontin), methadone, ko buprenorphine.

Wadannan da sauran abubuwan suna ratsa mahaifa ne wadanda suke hada jariri da mahaifiyarsa a mahaifar. Jariri ya zama mai dogaro da ƙwaya tare da mahaifiyarsa.

Idan mahaifiya ta ci gaba da amfani da magungunan a cikin mako ko fiye kafin ta haihu, jaririn zai dogara da maganin lokacin haihuwa. Saboda jaririn baya samun magani bayan haihuwa, alamun cirewa na iya faruwa yayin da sannu a hankali aka tsarkake maganin daga tsarin jaririn.

Hakanan alamun bayyanar cirewa na iya faruwa a jariran da aka fallasa ga barasa, benzodiazepines, barbiturates, da wasu masu maganin rage damuwa (SSRIs) yayin cikin.

Yaran uwaye masu amfani da opioids da wasu kwayoyi masu sa maye (nicotine, amphetamines, cocaine, marijuana, alcohol) na iya samun matsaloli na dogon lokaci. Duk da yake babu cikakkiyar shaidar NAS ga wasu kwayoyi, suna iya taimakawa ga tsananin alamun alamun jariri.

Kwayar cutar ta NAS ta dogara ne akan:

• Nau'in maganin da mahaifiya ta yi amfani da shi
• Ta yaya jiki ya rushe kuma ya kawar da miyagun ƙwayoyi (wanda ya shafi tasirin kwayar halitta)
• Yaya yawan maganin da take sha
• Yaya tsawon lokacin da ta yi amfani da miyagun ƙwayoyi
• Ko an haifi jaririn cikakken lokaci ko wuri (wanda bai kai ba)

Kwayar cututtukan sukan fara ne tsakanin kwana 1 zuwa 3 bayan haihuwa, amma na iya ɗaukar sati guda kafin su bayyana. Saboda wannan, galibi jariri zai buƙaci zama a asibiti don kulawa da kulawa har zuwa mako guda.

Kwayar cutar na iya haɗawa da:

• Batun launin fata fata (mottling)
• Gudawa
• Yawan kuka ko kuka mai karfi
• Yawan shan nono
• Zazzaɓi
• Hanyoyin motsa jiki
• Toneara sautin tsoka
• Rashin fushi
• Rashin ciyarwa
• Saurin numfashi
• Kamawa
• Matsalar bacci
• Rage nauyi mai nauyi
• Hancin hanci, atishawa
• Gumi
• Rawar jiki (rawar jiki)
• Amai

Yawancin yanayi da yawa na iya samar da alamun bayyanar kamar NAS. Don taimakawa yin ganewar asali, mai ba da sabis na kiwon lafiya zai yi tambayoyi game da amfani da ƙwayoyi uwar. Ana iya tambayar uwar game da irin ƙwayoyi da ta sha yayin ɗauke da juna biyu, da kuma lokacin da ta sha na ƙarshe. Za a iya duba fitsarin uwar don magunguna.

Gwaje-gwajen da za a iya yi don taimakawa wajen gano cirewar cikin jariri sun haɗa da:

• Tsarin tsarin NAS, wanda ke ba da maki bisa ga kowace alama da kuma tsananinta. Sakamakon jariri zai iya taimakawa wajen ƙayyade magani.
• ESC (ci, barci, console) kimantawa
• Allon magani na fitsari da farkon hanji (meconium). Hakanan za'a iya amfani da ƙaramin igiyar cibiya don gwajin magani.

Jiyya ya dogara da:

• Magungunan da ke ciki
• Scoresarancin lafiyar jariri da ƙauracewa
• Ko an haifi jariri cikakke ko bai isa ba

Careungiyar kula da lafiya za su kalli jariri a hankali har zuwa mako ɗaya (ko fiye dangane da yadda jaririn yake) bayan haihuwa don alamun janyewa, matsalolin ciyarwa, da ƙimar kiba. Yaran da ke amai ko kuma waɗanda suka bushe sosai na iya buƙatar samun ruwa ta jijiya (IV).

Yaran da ke tare da NAS yawanci suna da saurin fushi kuma suna da wahalar nutsuwa. Nasihu don kwantar da hankalin su sun haɗa da matakan da ake kira "TLC" (kulawa mai taushi):

• A hankali girgiza yaron
• Rage hayaniya da fitilu
• Fata ga kulawar fata tare da mahaifiya, ko shafa jaririn cikin bargo
• Shayar da nono (idan uwa tana cikin maganin methadone ko magani na buprenorphine ba tare da wasu haramtattun kwayoyi ba)

Wasu jariran da ke fama da mummunan alamomin suna buƙatar magunguna kamar su methadone ko morphine don magance alamomin janyewar kuma taimaka musu su iya cin abinci, barci da annashuwa. Wadannan jariran na iya bukatar zama a asibiti na tsawon makonni ko watanni bayan haihuwa. Manufar magani ita ce sanya wa jariri magani irin wanda uwa ta yi amfani da shi yayin daukar ciki kuma a hankali ya rage maganin a kan lokaci. Wannan yana taimakawa yaye jaririn daga maganin kuma yana taimakawa wasu alamun bayyanar.

Idan alamun sun kasance masu tsanani, kamar idan aka yi amfani da wasu magunguna, ana iya ƙara magani na biyu kamar su phenobarbital ko clonidine.

Jarirai masu wannan yanayin galibi suna da zafin kyallin tsummoki ko wasu yankuna na lalacewar fata. Wannan yana buƙatar magani tare da man shafawa na musamman ko cream.

Hakanan jarirai na iya samun matsala ta ciyarwa ko saurin girma. Waɗannan jariran na iya buƙatar:

• Ciyarwar calori mafi girma wanda ke ba da abinci mai gina jiki
• Givenananan ciyarwar da aka bayar sau da yawa

Jiyya na taimakawa wajen taimakawa bayyanar cututtuka na ficewa. Ko bayan an gama jinya NAS kuma jarirai sun bar asibiti, suna iya buƙatar ƙarin "TLC" na tsawon makonni ko watanni.

Amfani da kwayoyi da barasa yayin daukar ciki na iya haifar da matsalolin lafiya da yawa a cikin jariri ban da NAS. Waɗannan na iya haɗawa da:

• Launin haihuwa
• Weightananan nauyin haihuwa
• Haihuwar da wuri
• Headananan kewayewar kai
• Ciwon mutuwar jarirai kwatsam (SIDS)
• Matsaloli tare da ci gaba da ɗabi'a

Maganin NAS zai iya wucewa daga sati 1 zuwa watanni 6.

Tabbatar cewa mai ba da sabis ya san game da duk magunguna da kwayoyi da kuke sha yayin ciki.

Kirawo mai bayarwa idan jaririnku na da alamun cutar NAS.

Tattauna dukkan magunguna, kwayoyi, giya da shan taba tare da mai samar muku.

Tambayi mai ba ku taimako da wuri-wuri idan kun kasance:

• Yin amfani da kwayoyi ba likita ba
• Yin amfani da kwayoyi ba a ba ku ba
• Yin amfani da giya ko taba

Idan kun riga kun kasance ciki kuma ku sha magunguna ko kwayoyi waɗanda ba a ba ku ba, yi magana da mai ba ku hanyar da ta fi dacewa don kiyaye ku da jaririn lafiya. Bai kamata a tsayar da wasu magunguna ba tare da kulawar likita ba, ko rikitarwa na iya faruwa. Mai ba da sabis ɗinku zai san mafi kyawun sarrafa haɗarin.

NAS; Neonatal abstinence bayyanar cututtuka

• Ciwon ƙaura na yara

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Hudak ML. Yara jarirai masu amfani da abubuwa. A cikin: Martin RJ, Fanaroff AA, Walsh MC, eds. Fanaroff da Martin's Neonatal-Perinatal Medicine. 11th ed. Philadelphia, PA: Elsevier Saunders; 2020: babi na 46.

Kliegman RM, St. Geme JW, Blum NJ, Shah SS, Tasker RC, Wilson KM. Abstinence cuta. A cikin Kliegman RM, St. Geme JW, Blum NJ, Shah SS, Tasker RC, Wilson KM, .eds. Nelson Littafin koyar da ilimin yara. 21st ed. Philadelphia, PA: Elsevier; 2020: babi na 126.