Ukutshiza ebhedini ebuntwaneni: Ungamnceda njani umntwana wakho oyise

Imfundo yezeMpilo

Ukubethelwa ebhedini kunokuba yimeko yoxinzelelo kubantwana nakwiintsapho zabo. Kukho ukuphazamiseka kokutshintsha izinto zokulala kunye neempahla, iindleko zeemveliso ezinje ngeepads ezingangeni manzi, ukukhathazeka malunga nokuba yinto eqhelekileyo na, kunye neemvakalelo zentloni. Kuba inokuba yinto engathandekiyo ukuthetha ngayo, kuhlala kungathethwa ngayo kwizangqa zentlalo; nangona kunjalo, ukoyiswa ebhedini yinto eqhelekileyo, kwaye kuhlala kuthathwa njengenxalenye yophuhliso lobuntwana oluqhelekileyo.

Kukuthini ukondla ebhedini?

Ukurhwaxwa ebhedini — okubhekiselwa kwezonyango njenge-enuresis yasebusuku — kukuchama ngokungafunekiyo xa ulele ebantwaneni emva kweminyaka yokuba kulindeleke ukuba bahlale bomile ubusuku bonke.

Nazi Iindidi ezimbini wokwehla ebhedini: kwaseprayimari nakwesekondari.

I-enuresis yasebusuku yaseprayimari kuxa abantwana bengazange babe nexesha elide lokuma bomile ebusuku. Ukunkonkoshelwa kweebhedi okuqhelekileyo lolona hlobo luxhaphakileyo lokuhambisa amanzi ebhedini.

I-enuresis yesibini yasebusuku ukuba umntwana ukhe wahlala ngxi ubusuku bonke kangangeenyanga ezintandathu ubuncinci aze aqale ukumanzisa umandlalo kwakhona, oku kuthathwa njengokungcungcutheka kwebhedi yesibini. Olu hlobo aluqhelekanga kangako, kubalwa malunga neepesenti ezingama-25 zokukrakra ebhedini.

Kuqheleke kangakanani ukunkcenkceshelwa ebhedini?

Ukutshiswa kwebhedi kuqhelekile, utshilo ugqirha wabantwana waseBaltimore IAshanti Woods , MD. Ithathwa njengenxalenye yesiqhelo yokukhula komntwana. Inani labantwana abafumana ukutshizwa ebhedini rhoqo liyancipha ngenxa yobudala. Inkqubo ye- inani eliqikelelweyo labantwana Abane-enuresis yasebusuku imi ngolu hlobo lulandelayo:

• 5- ukuya ku-6 ubudala: 15% ukuya ku-20%
• 8- ukuya kwi-10 ubudala: 6% ukuya kwi-10%
• Uneminyaka eli-11 ukuya kweli-13 ubudala: 4% ukuya ku-5%
• I-14- ukuya kwi-16 yeminyaka ubudala: 2% ukuya kwi-3%
• I-17- ukuya kwi-18 yeminyaka ubudala: 1% ukuya kwi-2%

Ngelixa ubumanzi emini bunjalo exhaphake ngakumbi kumantombazana , ukondlula ibhedi exhaphake ngakumbi kumakhwenkwe . Amakhwenkwe enza malunga neepesenti ezingama-75 zabantwana abafumana i-enuresis yasebusuku.

Kukukhula kobudala ebhedini oku kuthathwa njengengxaki?

Ukugcotshwa ebhedini kucingelwa ukuba akuqhelekanga ukuba kuyadlula ngaphaya kweminyaka emi-6 ubudala, utshilo uGqirha Woods, naye oxininisa ukuba nasemva kweminyaka emithandathu kuqhelekile.

Ngelixa ukoyiswa ebhedini kunokuthathwa njengokungenangxaki de kube kwinqanaba lokufikisa, licebo elihle ukudibana nogqirha wakho ukuba umntwana wakho Ndisamanzisa rhoqo ukhuko nge-7 okanye i-8 yobudala ukuze kuthintelwe iimeko ezinokubakho zonyango, okanye ukuba ukoyiswa kwebhedi kubangela iingxaki zengqondo (ezinje ngokuzithemba okuphantsi) komntwana wakho okanye kosapho lwakho.

Akubonakali ngathi kukho ixesha elithile apho ukondla ebhedini kuba malunga-kuyahluka ukusuka kubuchwephesha ukuya kwingcali, kodwa uninzi luyavuma ukuba ukuthintela enye imeko yezonyango, nokuba kunganyangwa okanye kunganyangwa ukondla ibhedi kuxhomekeke kwindlela ekungenelela ngayo.

Ukwaluka ebhedini nako kunako zenzeka kubantu abadala . Oku kuhlala kubangelwa yimeko yezonyango enje ngesifo seswekile, iingxaki kwihormone ye-ADH (antidiuretic), isinyi esingaphezulu, isithintelo se-urethra, ukuqhina, ukuthintela ukuphefumla xa ulala, ilungu le-pelvic prolapse, iingxaki zesakhiwo sesinyi okanye amanye amalungu omchamo, i-Prostate eyandisiweyo, amatye e-urinary tract, okanye usulelo lwe-urinary tract. Inokubangelwa ngamanye amayeza afana neepilisi zokulala okanye ii-antipsychotic ezinje nge-clozapine okanye i-risperidone.

Ukutshatyalaliswa kwabantu ebhedini kubantu abadala kunokuba luphawu lweemeko ezinzulu ezifana nomhlaza wesinyi okanye umhlaza wedlala lobudoda, okanye izifo zengqondo kunye nomqolo njengokuphazamiseka kwengqondo, isifo sokuqina kwemithambo, okanye isifo sikaParkinson.

Unyango olunokukhethwa ekukhuliseni ebhedini kubantu abadala luxhomekeke kwisizathu sokukhululwa ebhedini.

Yintoni ebangela ukoyiswa ebhedini?

Oogqirha babantwana abakasazi esona sizathu sokukothuka ebhedini, utshilo uGqirha Woods. Ukuqwalaselwa okwenziweyo kukuba ukunxila ebhedini kuhlala kuqhuba kwiintsapho.

Ngokuqinisekileyo kukho icandelo lofuzo, ngokutsho kugqirha wabantwana wase-Utah UCindy Gellner , MD. Oososayensi bade bachonga ii-genes zokulibaziseka kokulawulwa kwesinyi ebusuku, uGqirha Gellner utshilo kudliwanondlebe yeYunivesithi yase-Utah yezeMpilo. … Bakwi-chromosomes 8, 12, and 13. Kungenxa yoko le nto sibona oku kuqhutywa kwiintsapho kakhulu.

Ezinye izinto ingabandakanya :

• Abantwana abalala ngokunzulu, abavuki xa isinyi sizele
• Imveliso engonelanga yehormone yokulala i-vasopressin, ebonisa ukuba umzimba wenze umchamo omncinci ebusuku.
• Isinyi esincinci okanye esincinci

Ngamaxesha athile, ukoyiswa ebhedini kunokubangelwa yingxaki enkulu kwezonyango. Ugqirha Woods uthi ezinye zeemeko zonyango oogqirha abazithathela ingqalelo xa ukoyisa umbhede kuthabatha ixesha elide kubandakanya ukuqhina, usulelo lomchamo, isifo seswekile noxinzelelo. Kwiimeko ezinqabileyo… ngenxa yezizathu zokwakheka, utyando lunokuboniswa [njengoku] vimba / ukuncipha okuthintela umntwana ekuchitheni ngokupheleleyo isinyi sakhe.

Ndinokukuyeka njani ukujuluka ebhedini?

Ukuluka ebhedini kuhlala kuphelile, kodwa kukho izinto ezininzi ezinokunceda abanye abantwana.

1. Ukuvala ixesha . Fumana abantwana kwishedyuli yokuchama zonke iiyure ezi-2 ukuya kwezi-3 emini, nokuba bayaziva okanye abaziva. Ungabafumanela iwotshi engcangcazelayo ngamaxesha amiselweyo ukubakhumbuza ukuba bahambe.
2. Ukuphinda kabini. Kukho iindlela ezahlukeneyo; okuqhelekileyo umntwana wayechama, aphumle kwindlu yangasese imizuzwana engama-20 ukuya kwengama-30, emva koko achame kwakhona.
3. Ukujonga ulwelo. Khuthaza ukusela kakhulu emini kwaye unciphise ukuphela kwemini nangokuhlwa (ngaphandle kokuba bayabandakanyeka kwezemidlalo kwaye bafuna ukongezwa kwe-hydration.) Kuphephe ukusela ngecaffeine okanye amaqamza, iijusi zesitrasi kunye neziselo zezemidlalo.
4. Unyango lokukhuthaza. Yiba nomonde kwaye ukhuthaze. Zonke iindlela zisebenza ngcono xa usapho lonke lusemgodini. Zama inkqubo yomvuzo, hayi nje ngokuba nobusuku obomileyo, kodwa ngenxa yokuncamathela kwesiqhelo. Ungaze ube neentloni, ukhalimele, okanye wohlwaye umntwana ngenxa yokukhukhumala ebhedini-abayenzi ngabom.
5. Fumana abantwana bathathe inxaxheba. Bancede bazive belawula imeko ethile ngokuza ngesiqhelo kunye. Bayeke bancede ukutshintsha izinto zokulala (kodwa hayi njengesohlwayo).
6. Ukuvuswa kweBhedi . Ezi ziza nesenzi senzwa somswakama esiqhotyoshelweyo kwiingubo zomntwana okanye zokulala. Isilumkiso siza kukhala kwangoko xa umntwana eqala ukumanzisa ibhedi. Le ndlela ifuna ukuzibophelela komntwana nomzali. Ekuqaleni, kusenokwenzeka ukuba kuphela ngumzali oza kuvuka ngealam, kwaye kuya kufuneka bavuse umntwana babase kwigumbi lokuhlambela. Ixesha elingaphezulu, abantwana abaninzi bafunda ukuvuka ngealam kwaye ekugqibeleni bavuke benemvakalelo yesinyi esipheleleyo. Olunye uphuculo lunokwenzeka kwiiveki ezimbalwa, kodwa ialam ihlala ifuna ukusetyenziselwa iinyanga ezintathu ukuya kwezine ukuze isebenze. Le ndlela ayisebenzi kubo bonke abantwana, kodwa xa isebenza iyathanda ukuba nempumelelo ehlala ixesha elide.
7. Amayeza . Amayeza ayisiyonto yokuqala, kodwa kunokuba luncedo kwabanye abantwana. Iluncedo ngakumbi kwimicimbi ekhethekileyo enje nge-sleepover, ukuhamba, okanye inkampu.

Ngaba akhona amayeza anokunceda ukuyeka ukubila?

Ngelixa ingenguye umgca wokuqala wonyango, kukho amayeza anokunceda.

Unyuselwa

Unyuselwa (DDAVP) isetyenziselwa lawula isixa somchamo yenziwe zizintso. Ithathwe ngomlomo, kwaye idosi ixhomekeke kwisigulana nakwimeko. Idla ngokuba lukhetho lokuqala lonyango kunyango lwebhedi kwaye iyasebenza malunga 50% yezigulana .

Ngelixa kukhuselekile ukuthatha ixesha elide, kunjalo ayihlali inceda ekunciphiseni ukuhanjiswa kweebhedi ekuhambeni kwexesha . Ukutsalaliswa ebhedini kuhlala kubuya lakuba iyeza limisiwe.

I-Desmopressin inokuba luncedo kakhulu xa isetyenziselwa imicimbi ekhethekileyo enje nge-sleepover, uhambo olude, inkampu, njl.

Uluhlu olukhethiweyo lwe iziphumo ebezingalindelekanga ezinokubakho inclintloko ebuhlungu, isicaphucaphu, isisu esibuhlungu, okanye ukugungxula ubuso. Iziphumo ezibi kakhulu ezinqabileyo zinqabile kodwa zinokwenzeka. Funa uncedo kwezonyango xa kukho iimpawu zokungavumi.

Eli yeza kunokubangela amanqanaba asezantsi esodiyam egazini. Landela ngononophelo imiyalelo kagqirha malunga nokuba ungasela malini kangakanani ngosuku ngalunye. Oku kubaluleke ngakumbi kubantwana. Abantwana banokubakho umngcipheko wokubanjwa ngenxa yokunxila kwamanzi, okwenza ukuba ukulawulwa kolwelo kuthathwe kubaluleke kakhulu.

Imipramine

Imipramine sisidambisi-zintsholongwane maxa wambi esisetyenziselwa ukulawula ukukhukhumala kwebhedi. Ishumi ukuya kwi-50% yezigulana xela ukoma okupheleleyo , Kwaye abanye banika ingxelo yokuphucuka okuthile.

Akuqondwa kakuhle ukuba lisebenza njani eli chiza, kodwa kucingelwa ukuba lisebenza ngenye yeendlela ezininzi:

• Ngokutshintsha ubuthongo nokuvuka komntwana;
• Ngokuchaphazela ixesha lokuba umntwana abambe umchamo kwisinyi; okanye
• Ngokunciphisa imveliso yokuchama.

I-Imipramine isebenza ngakumbi kubantwana abadala, kwaye ayimiselwanga ngokubanzi kubantwana abangaphantsi kweminyaka emi-6 ukuya ku-7.

Ihlala ithathwa iiyure ezi-1 ukuya kwezi-2 ngaphambi kokulala, kwaye idosi ixhomekeke kubudala bomntwana.

Iziphumo ebezingalindelekanga aziqhelekanga, kodwa zinokubandakanya ukuba nochuku, ukulala, ukozela, ukunciphisa ukutya, kwaye kunqabile, utshintsho kubuntu obungathandekiyo. Iziphumo ebezingalindelekanga zinokubuyiselwa umva ngokunciphisa okanye ukumisa imipramine.

Ngokubalulekileyo, Ukugqithisa libanda kunokubangela ukufa ebantwaneni, kwaye kukho iingxelo zokudlula ngengozi. Imipramine kufuneka igcinwe kwindawo ekungenakufikelelwa kuyo ngabantwana kwaye ivalelwe kwisingxobo esingangeni bantwana okanye ngekepusi engenakuthintela abantwana.

Njengakwi-desmopressin, ukubetheka ebhedini kuthanda ukuphinda kwenzeke xa i-Imipramine iyekile.

I-Oxybutynin kunye neHyoscyamine

Oxybutynin kwaye IHyoscyamine ziianticholinergics ezisetyenziselwa ukunyanga iingxaki zomchamo kunye nesinyi.

Azinakunceda ngokubanzi kubantwana abanobusuku bokumanzisa kuphela xa besetyenziselwa ngokwabo, kodwa i-anticholinergic inokusetyenziswa ngokudibanisa ne-desmopressin ukunceda abanye abantwana ngokukrakra ebhedini, ngakumbi abantwana abaye banciphisa amandla omsebenzi wesinyi.

Idosi yala mayeza iyahluka ngokobudala kunye nobunzima. Iziphumo eziqhelekileyo zibandakanya umlomo owomileyo kunye nokugungxwa kobuso. Ukugqithisa komzimba kunokubangela ukuphazamiseka kombono kunye nemibono.

Itolterodine

Itolterodine yenye ye-anticholinergic eneziphumo ebezingalindelekanga ezimbalwa ezichaziweyo kwaye icace gca kwisenzo sayo kwisinyi. Ayivunyelwanga abantwana abangaphantsi kwe-12.

Ungakulawula njani ukondla iibhedi okokoko?

Ngelixa ulinde unyango ukuba lusebenze okanye umntwana wakho akhuphe ukothula umbhede, kukho ezinye izinto onokuzenza ukwenza ixesha lokulala lilawuleke ngakumbi kwaye libe mnandi.

1. Iimveliso ezingafunekiyo okanye ezingangeni manzi. Iimpahla zangaphantsi ezinokuphinda zisebenze zinokuphinda zisebenziseke kunokuba luncedo xa ulele kude nekhaya. Ekhaya, iipads ezilahlayo okanye ezinokuphinda zisetyenziswe okanye izikhuseli sematrasi zinceda ukukhusela izinto zokulala.
2. Utshintsho olulula lwexesha lasebusuku. Beka iimpahla zakho zokutshintsha ukuze umntwana wakho atshintshe kuzo xa evuka emanzi ebusuku. Cinga ngokufaka amashiti ngeepads ezingangeni manzi ukwenzela ukuba kube lula ebantwaneni ukususa iibhedi ezimanzi ebusuku nasekuseni.
3. Ukuhlamba. Qinisekisa ukuba umntwana wakho uhlamba okanye ahlambe yonke imihla ukususa iphunga lomchamo.
4. Hlonipha ubumfihlo. Ukuba umntwana wakho ukhetha ukuzitshintsha eyedwa, mvumele. Musa ukuxoxa ngokulala kwabo ebhedini ujikeleze abanye abantu ngaphandle kokuba utyelele ugqirha.
5. Nika ukhuthazo. Thetha nomntwana wakho kwaye umazise ukuba ukondla ebhedini ayilotyala lakhe kwaye uyazi ukuba akenzi ngabom. Mxelele ukuba kuqheleke kangakanani, kwaye kusenokwenzeka ukuba abanye babahlobo bakhe bamanzise ibhedi ngoku okanye benza ngamanye amaxesha ngokunjalo. Mqinisekise ukuba akanangxaki kwaye izakulunga. Ukuba kukho naliphi na ilungu losapho elikhulileyo kusapho lwakho olumanzisa ibhedi njengabantwana, bacele ukuba bathethe nomntwana wakho ngamava abo ngendlela ethuthuzelayo. (Hlonipha ubumfihlo kwaye ucele imvume yomntwana wakho ngaphambi kokuba wenze njalo.)

Ukutshatyalaliswa kwebhedi kunzima, kodwa kubalulekile ukuba ukhumbule ukuba kuqhelekile, kuyanyangeka, kwaye kuhlala kuphelile. Ukuba ezinye iimeko zonyango kunye nokuqunjelwa kugwetyelwe ngaphandle, ubukhulu becala ngumdlalo wokulinda. Yiba nomonde, ube nobubele, kwaye nonke niya kudlula.