Isifo sikashukela se-Congenital siyisifo esingajwayelekile, kodwa esiyingozi esithinta abasanda kuzalwa. Izimpawu zalesi sifo ziqala ukubonakala ezinganeni kusukela ezinsukwini zokuqala ngemuva kokuzalwa, okudinga ukunakwa okukhethekile nokunakekelwa okufanele kwezokwelapha.
Ngokwe-pathogenesis kanye nezimpawu, isifo sikashukela sokuzalwa kwengane sisho uhlobo 1 sikashukela, okungukuthi, kubhekelwa ekuqothulweni okuphelele kokuqashelwa kwe-insulin yayo emzimbeni. Imvamisa, izingane ezinalolu hlobo lokuxilonga zizalwa emindenini lapho oyedwa noma bobabili abashade nabo benenkinga yesifo sikashukela.
Kubalulekile ukuqonda ukuthi isifo sikashukela esizalwa naso siyisifo esihlukile, ngakho-ke akufanele kudidaniswe nesifo sikashukela esitholwayo, esingenzeka ezinganeni ngisho zisencane kakhulu.
Izizathu
Uhlobo lwesifo sikashukela esitholakele yisifo esivame ukwenzeka ngenxa yokuqalwa kwenqubo ye-autoimmune emzimbeni, ngenxa yokuthi amasosha omzimba womuntu aqala ukuhlasela amaseli e-pancreatic akhiqiza i-insulin.
Isifo sikashukela se-Congenital sisuselwa ku-intrauterine pathology ye-fetus, lapho i-pancreas ingakhiwa kahle, ephazamisa ukusebenza kwayo okujwayelekile. Lokhu kuholela ekuphazamiseni okunamandla kwe-metabolic enganeni, okudinga ukwelashwa okuphoqelekile.
Njengoba kushiwo ngenhla, ukuthuthukiswa kwesifo sikashukela engokwemvelo enganeni kuholela ekwakhiweni okungafanelekile kwephancake esiteji sokukhulelwa kukamama. Ngenxa yalokhu, ingane izalwa inezinkinga ezibucayi zesitho esivimba amaseli ayo ekutholeni i-insulin.
Isifo sikashukela sokuzalwa kwengane singakhula ngenxa yezizathu ezilandelayo:
- Ukuthuthukiswa okunganele (i-hypoplasia) noma ukungabikho (i-aplasia) emzimbeni wengane yamakhanse. Ukwephulwa okunjalo kuhlobene ne-pathologies yokukhula kwe-fetus futhi ayikwazi ukwelashwa.
- Ukwemukelwa kowesifazane ngesikhathi sokukhulelwa kwezidakamizwa ezinamandla, ngokwesibonelo, ama-antitumor noma ama-antiviral agents. Izakhi eziqukethwe kuzo zinomthelela ongemuhle ekwakhekeni kwezicubu ze-pancreatic, okungaholela ku-gland hypoplasia (ukungabikho kwamangqamuzana akhiqiza i-insulin).
- Ezinganeni ezizalwe ngaphambi kwesikhathi, isifo sikashukela singenzeka ngenxa yokungavikeleki kwezicubu zesikhumba namangqamuzana e-B, ngoba zazingenaso isikhathi sokwakha ngaphambi kokujwayelekile ngenxa yokuzalwa ngaphambi kwesikhathi.
Ngaphezu kwalezi zizathu ezingenhla, kunezici ezibeka engcupheni ezikhulisa kakhulu amathuba okuba nesifo sikashukela sokuzalwa kwengane. Kunezici ezimbili kuphela, kepha iqhaza labo ekwakhekeni kwalesi sifo likhulu kakhulu.
Izinto ezengeziwe ezivusa ukuthuthukiswa kwesifo sikashukela ezinganeni ezisanda kuzalwa:
- Isizungu. Uma omunye wabazali enesifo sikashukela, khona-ke kulokhu, ingozi yokuthola lesi sifo enganeni ngesikhathi sokuzalwa inyuka ngo-15%. Uma ubaba nonina benokuxilongwa kwesifo sikashukela, khona-ke kulesi simo ingane ifa lesi sifo ngamacala angama-40 kwayi-100, okungukuthi, kulezi zimo, isifo sikashukela sizuzwe njengefa.
- Imiphumela yemithi yobuthi eyingozi embusweni ngesikhathi sokukhulelwa.
Kungakhathalekile ukuthi iyini imbangela yalesi sifo, ingane inezinga ushukela wegazi ophakeme kakhulu, okuthi kusukela ezinsukwini zokuqala zokuphila kube nomthelela olimazayo ezingxenyeni nasezinhlisweni zalo zangaphakathi.
Isifo sikashukela se-Congenital, njengohlobo lwesifo sikashukela sokuqala, singadala izinkinga ezinkulu, okuthi, ngenxa yeminyaka encane yesiguli, singaba yingozi enkulu empilweni yakhe.
Izimpawu
Kunezinhlobo ezimbili zesifo sikashukela esizalwe kabusha, ezahluka kubukhulu besikhathi nobude besifo, okungukuthi:
- Isikhashana. Lolu hlobo lwesifo sikashukela lubonakala ngenkambo emfushane, hhayi ngaphezulu kwezinyanga eziyi-1-2, ngemuva kwalokho idlule ngokuphelele ngokuzimela ngaphandle kokuthola ukwelashwa ngezidakamizwa. Uhlobo lwesikhashana lubalwa cishe ama-60% azo zonke izimo zesifo sikashukela esizalwa nazo ezinganeni. Imbangela yangempela yokuvela kwayo ayikakacaciswa, noma kunjalo, kukholelwa ukuthi kwenzeka ngenxa yesiphene kuhlobo lwe-6 lwe-chromosome olubhekele ukuthuthukiswa kwama-pancreatic b-cell.
- Okwaphakade. Akujwayelekile futhi kutholakala cishe ezingamaphesenti ama-40 ezingane ezinesifo sikashukela esizalwa naso. Uhlobo oluhlala njalo luyisifo esingalapheki njengohlobo lwesifo sikashukela, futhi sidinga imijovo ye-insulin yansuku zonke. Isifo sikashukela esihlala njalo sithambekele ekuqhubekeni phambili ngokushesha kanye nokukhula kwezinkinga kusenesikhathi. Lokhu kungenxa yokuthi kunzima kakhulu ukukhetha indlela efanelekile yokwelashwa kwe-insulin enganeni esanda kuzalwa, ngenxa yokuthi ingane kungenzeka ingakutholi ukwelashwa okwenele isikhathi eside.
Noma ngabe uluhlobo luni lwesifo sikashukela esizalwa naso, lesi sifo sikhonjiswa yizimpawu ezilandelayo:
- Ingane esanda kuzalwa iziphatha ngokweqile, ikhala kakhulu, ilala kabi, ikhafulela ukudla okungaphilisiwe, ine-colic esiswini sayo;
- Lapho kuzalwa, usana lune-underweight;
- Indlala enkulu. Ingane ihlala idinga ukudla futhi ihahela ibele ngokuhaha;
- Umile njalo. Umntwana uvame ukucela isiphuzo;
- Naphezu kokudla okuhle nokudla okufanele, ingane ikhula kahle;
- Izilonda ezahlukahlukene, ezinjenge-diaper rash kanye ne-maceration, zivele esikhunjeni sengane zisencane kakhulu. Isikhathi esiningi zivame ukwenziwa endaweni ethangeni nasemathangeni wengane;
- Ingane iba nezifo zomchamo. Ebafaneni, ukuvuvukala kwejwabu kungabonakala, nasemantombazaneni e-veva (genitalia yangaphandle);
- Ngenxa yokuqukethwe ushukela omningi, umchamo wengane uyaqina, futhi ukuchama kuningi. Ngaphezu kwalokho, ukuhlanganiswa okumhlophe okubonakalayo kuhlala kwizingubo zengane;
- Uma isifo sikashukela sidingida ukungasebenzi kahle kwe-endocrine pancreatic dysfunction, khona-ke kule ndaba ingane ingakhombisa nezimpawu ze-steatorrhea (ukuba khona kwenani elikhulu lamafutha ezinduneni).
Lapho kukhona okungenani izimpawu ezimbalwa ezingenhla, kuyadingeka ukuthi kutholakale isifo sikashukela nengane yakho.
Ukuxilonga
Kungenzeka ukuthi uyihlole kahle ingane futhi unqume ukuthi unayo i-mellitus yesifo sikashukela engakazalwa ngaphambi kokuzalwa kwengane. Ukuxilongwa okufika ngesikhathi kwe-fetus ngokuhlolwa okuningiliziwe kwama-pancreas kuyasiza ukwenza lokhu.
Esimweni sobungozi obukhulu besifo phakathi nalolu cwaningo, kutholakala iziphazamiso ekukhuleni kwesitho enganeni. Lokhu kutholwa kubaluleke kakhulu ezimweni lapho omunye noma bobabili abazali benesifo sikashukela.
Izindlela zokuthola isifo sikashukela ezinganeni ezisanda kuzalwa:
- Ukuhlolwa kwegazi ngomunwe ushukela;
- Ukuxilongwa komchamo wansuku zonke we-glucose;
- Ukutadisha umchamo oqoqwe ngasikhathi sinye sokuhlushwa i-acetone;
- Ukuhlaziywa kwe-glycosylated hemoglobin.
Yonke imiphumela yokuxilonga kumele inikezwe udokotela we-endocrinologist, oyothi, ngokwesisekelo sabo, azokwazi ukunika ingane ukuxilongwa okuyikho.
Ukwelashwa
Ukwelashwa kwesifo sikashukela ezinganeni kufanele kwenziwe kuphela ngaphansi kokuqashwa kwe-endocrinologist. Kulokhu, abazali bezingane abagulayo kufanele bathenge imitha yeglucose esezingeni eliphakeme nenani elidingekayo lemivimbo.
Isisekelo sokwelapha uhlobo lokuzalwa lukashukela, njengohlobo 1 sikashukela, ukujova nsuku zonke kwe-insulin.
Ukuze kulawulwe ngempumelelo ushukela wegazi ekwelapheni ingane, kuyadingeka ukusebenzisa i-insulin, isikhathi esifushane nesesikhathi eside.
Ngaphezu kwalokho, kubalulekile ukuqonda ukuthi ukuthunyelwa kwe-insulin ye-hormone akuyona ukuphela komsebenzi wamanyikwe. Iphinde ifake ama-enzyme adingekayo ekusebenzeni okuvamile kohlelo lokugaya ukudla. Ngakho-ke, ukuze uthuthukise imisebenzi yamapheshana esiswini futhi uguqule ukuguqulwa kokudla, ingane iyanconywa ukuthatha izidakamizwa ezinjengeMezim, Festal, Pancreatin.
Ushukela ophakeme ngokweqile ubhubhisa izindonga zemithambo yegazi, engadala ukuphazamiseka kokujikeleza kwegazi ikakhulukazi emaphethelweni aphansi. Ukuze ugweme lokhu, kufanele unikeze ingane yakho umuthi wokuqinisa imithambo yegazi. Lokhu kufaka phakathi zonke izidakamizwa ze-angioprotective, okungukuthi iTroxevasin, iDetralex neLyoton 1000.
Ukubambelela ngokuqinile ekudleni okubandakanya konke ukudla okunokuqukethwe okunoshukela okuningi ekudleni kwesiguli esincane kubalulekile ekwelashweni kwesifo sikashukela ezinganeni.
Kodwa-ke, akufanele ulahle ngokuphelele amaswidi, ngoba angasiza ekusizeni ingane ngehle ishukela elibukhali ngenxa yedosi ye-insulin eyeqisayo. Lesi simo sibizwa nge- hypoglycemia, futhi singaba yingozi enganeni.
Kwividiyo ekulesi sihloko, uDkt Komarovsky ukhuluma ngesifo sikashukela sabantwana.
