{"id":4258,"date":"2018-02-22T10:56:53","date_gmt":"2018-02-22T09:56:53","guid":{"rendered":"https:\/\/health.acibademsistina.mk\/al\/?p=4258"},"modified":"2024-03-04T14:34:14","modified_gmt":"2024-03-04T14:34:14","slug":"cfare-duhet-te-dini-per-qendrimin-ne-nicu","status":"publish","type":"post","link":"https:\/\/healthacibadem.unet.mk\/sq\/cfare-duhet-te-dini-per-qendrimin-ne-nicu\/","title":{"rendered":"\u00c7far\u00eb duhet t\u00eb dini p\u00ebr q\u00ebndrimin n\u00eb NICU"},"content":{"rendered":"

Kujdesi dhe trajtimi i foshnjave t\u00eb lindura para kohe k\u00ebrkon shum\u00eb njohuri dhe p\u00ebrvoj\u00eb nga ekipi, dhe m\u00ebnyra e udh\u00ebheqjes duhet t\u00eb jet\u00eb multidisiplinare. Dr. Simonida Spasevska, pediatre neonatologe, thot\u00eb se p\u00ebrve\u00e7 shp\u00ebtimit t\u00eb jet\u00ebs, stabilizimit dhe gjendjes s\u00eb p\u00ebrgjithshme m\u00eb t\u00eb mir\u00eb, p\u00ebrpjekjet duhet t\u00eb b\u00ebhen edhe drejt\u00eb stimulimit psiko-motorik\u00a0 dhe socializimit t\u00eb k\u00ebtyre f\u00ebmij\u00ebve. Rol t\u00eb r\u00ebnd\u00ebsish\u00ebm n\u00eb k\u00ebt\u00eb proces luajn\u00eb edhe prind\u00ebrit, dhe informimi i tyre \u00ebsht\u00eb nj\u00eb faktor i r\u00ebnd\u00ebsish\u00ebm p\u00ebrsa i p\u00ebrket besimit dhe trajtimit t\u00eb suksessh\u00ebm. Dr. Spasevska iu p\u00ebrgjigjet pyetjeve m\u00eb t\u00eb zakonshme t\u00eb cilat drejtohen nga prind\u00ebrit e foshnjave t\u00eb lindura para kohe dhe foshnjave t\u00eb s\u00ebmura n\u00eb gjendje kritike.<\/p>\n

Cilat foshnja t\u00eb porsalindura konsiderohen t\u00eb jen\u00eb n\u00eb gjendje kritike?<\/h2>\n

Foshnja t\u00eb rrezikuara apo t\u00eb s\u00ebmur\u00eb n\u00eb gjendje kritike, konsiderohen foshnjat organizmi i t\u00eb cil\u00ebve vuan n\u00eb zhvillimin e hersh\u00ebm intrauterin, p\u00ebrgjat\u00eb vet\u00eb aktit t\u00eb lindjes ose menj\u00ebher\u00eb pas lindjes. Ato jan\u00eb foshnja n\u00eb depresion dhe zakonisht me frym\u00ebmarrje t\u00eb dob\u00ebsuar apo me munges\u00eb t\u00eb frym\u00ebmarrjes, me rrahje jo t\u00eb rregullt t\u00eb zemr\u00ebs dhe k\u00ebrkojn\u00eb trajtim intenziv, reanimim primar\u00eb dhe stabilizim n\u00eb dhom\u00ebn e lindjes, dhe m\u00eb pas trajtim n\u00eb departamentin e kujdesit intenziv neonatal.<\/p>\n

Statistikisht, 6-8% e numrit total t\u00eb lindjeve mund t\u00eb p\u00ebrfundojn\u00eb si t\u00eb rrezikshme dhe rrezikojn\u00eb jet\u00ebn e foshnj\u00ebs. Foshnjat e lindura para kohe b\u00ebjn\u00eb pjes\u00eb n\u00eb grupin m\u00eb t\u00eb madh t\u00eb t\u00eb rrezukuarve (foshnjat e lindura para jav\u00ebs s\u00eb 37-t\u00eb t\u00eb shtatz\u00ebnis\u00eb) si dhe foshnjat e lindura me pesh\u00eb t\u00eb vog\u00ebl. N\u00eb mbar\u00eb bot\u00ebn ka rreth 15 milion\u00eb foshnja t\u00eb lindura para kohe \u00e7do vit. Tek 50% e tyre, shkaqet e lindjes s\u00eb parakohshme mbeten t\u00eb panjohura.<\/em><\/p>\n

Cilat foshnja kan\u00eb nevoj\u00eb p\u00ebr kujdes intenziv?<\/h2>\n

Shkaqet q\u00eb mund ta \u00e7ojn\u00eb f\u00ebmij\u00ebn n\u00eb nj\u00eb gjendje t\u00eb rrezikshme dhe t\u00eb ket\u00eb n\u00ebvoj\u00eb p\u00ebr trajtim intenziv jan\u00eb t\u00eb shumta: nga ana e n\u00ebn\u00ebs (lindja n\u00eb mosh\u00eb shum\u00eb t\u00eb re apo n\u00eb mosh\u00eb m\u00eb t\u00eb rritur, s\u00ebmundjet e pranishme si rritja e presionit t\u00eb gjakut, diabeti, p\u00ebrdorimi afatgjat\u00eb i ila\u00e7eve, infeksionet, shtatz\u00ebnia e shumfisht\u00eb), nga ana e fetusit: (s\u00ebmundjet e trash\u00ebguara, anomalit\u00eb kongjenitale), faktor\u00ebt e mjedisit p\u00ebrreth, problemet me periudh\u00ebn e adaptimit t\u00eb hersh\u00ebm.<\/p>\n

\u201cTrajtimi i tyre b\u00ebhet n\u00eb nj\u00ebsi shum\u00eb t\u00eb specializuara t\u00eb kujdesit intenziv, t\u00eb pajisura sipas standardeve m\u00eb bashk\u00ebkohore t\u00eb p\u00ebrshkruara p\u00ebr k\u00ebto nj\u00ebsi, t\u00eb cilat sigurojn\u00eb diagnostikim, trajtim dhe monitorim 24 or\u00eb. N\u00eb departamentin e kujdesit intenziv neonatal n\u00eb spitalin klinik \u201cAcibadem Sistina\u201d trajtohen f\u00ebmij\u00ebt e porsalindur t\u00eb s\u00ebmur\u00eb n\u00eb gjendje kritike, t\u00eb cil\u00ebt kan\u00eb nevoj\u00eb p\u00ebr mb\u00ebshtetje respiratore dhe kardiocirkulatore, fototerapi, ushqim parenteral total. Angazhimi i plot\u00eb rreth foshnj\u00ebs s\u00eb s\u00ebmur\u00eb t\u00eb rrezikuar n\u00eb gjendje kritike, nuk ka t\u00eb b\u00ebj\u00eb vet\u00ebm me shp\u00ebtimin e jet\u00ebs, por edhe me reduktimin e t\u00eb gjith\u00eb faktor\u00ebve t\u00eb rrezikut t\u00eb cil\u00ebt m\u00eb von\u00eb mund t\u00eb ndikojn\u00eb n\u00eb cil\u00ebsin\u00eb e jet\u00ebs\u201d \u2013 shprehet Dr. Spasevska.<\/p>\n

Cilat jan\u00eb specifikat e foshnjave t\u00eb lindura para kohe?<\/h2>\n

Specifike tek foshnjat e lindura para kohe \u00ebsht\u00eb pjekuria e pamjaftueshme e t\u00eb gjitha sistemeve anatomike dhe funksionale. Klinikisht, foshnjat e lindura para kohe ndryshojn\u00eb n\u00eb raport me foshnjat e lindura n\u00eb m\u00ebnyr\u00eb termale p\u00ebrsa i p\u00ebrket pesh\u00ebs s\u00eb tyre trupore dhe gjat\u00ebsis\u00eb n\u00eb lindje, struktur\u00ebs s\u00eb l\u00ebkur\u00ebs, pjekuris\u00eb s\u00eb sitemit t\u00eb frym\u00ebmarrjes, sistemit digjestiv dhe termolabilitetit.<\/p>\n

Kur \u00ebsht\u00eb i nevojsh\u00ebm q\u00ebndrimi n\u00eb inkubator?<\/h2>\n

Foshnjat e lindura para kohe kan\u00eb nj\u00eb pesh\u00eb m\u00eb t\u00eb vog\u00ebl trupore, kan\u00eb v\u00ebshtir\u00ebsi p\u00ebr tu p\u00ebrshtatur dhe kan\u00eb nevoj\u00eb p\u00ebr t\u00eb q\u00ebndruar n\u00eb inkubator. Nj\u00eb kujdesi i till\u00eb mund\u00ebson nj\u00eb ambient termoneutral dhe lag\u00ebshti p\u00ebr foshnj\u00ebn e porsalindur (t\u00eb p\u00ebrcaktuara sipas pesh\u00ebs dhe gjendjes s\u00eb foshnj\u00ebs), k\u00ebto jan\u00eb parametra t\u00eb r\u00ebnd\u00ebsishme p\u00ebr stabilizimin e situat\u00ebs gjat\u00eb periudh\u00ebs s\u00eb p\u00ebrshtatjes s\u00eb foshnj\u00ebs. Periudha e q\u00ebndrimit n\u00eb inkubator \u00ebsht\u00eb e ndryshme, ajo varet nga java gestatike n\u00eb t\u00eb cil\u00ebn ka lindur foshnja dhe nga pesha trupore q\u00eb ka, si dhe nga gjendja klinike aktuale e foshnj\u00ebs. N\u00eb var\u00ebsi t\u00eb nevoj\u00ebs, edhe oksigjeni mund t\u00eb administrohet n\u00eb inkubator p\u00ebr foshnjat q\u00eb kan\u00eb probleme t\u00eb vogla me frym\u00ebmarrjen. N\u00ebp\u00ebrmjet inkubatorit mund t\u00eb ndiqen m\u00eb mir\u00eb t\u00eb gjitha funksionet vitale si dhe mund t\u00eb kryhet fototerapia.<\/p>\n

Si ushqehen?<\/h2>\n

Ushqimi tek f\u00ebmij\u00ebt e lindur para kohe apo tek f\u00ebmij\u00ebt me v\u00ebshtir\u00ebsi gjat\u00eb periudh\u00ebs s\u00eb adaptimit, zhvillohet sipas protokollit t\u00eb p\u00ebrshkruar n\u00eb baz\u00eb t\u00eb mosh\u00ebs (jav\u00ebs gestatike t\u00eb lindur), pesh\u00ebs\u00a0 dhe gjendjes klinike aktuale t\u00eb foshnj\u00ebs. Foshnjat n\u00eb gjendje t\u00eb q\u00ebndrueshme, ushqehen me an\u00eb t\u00eb sond\u00ebs (tuba t\u00eb holl\u00eb plastik\u00eb) n\u00ebp\u00ebrmjet t\u00eb cil\u00ebs ushqimi mb\u00ebrrin leht\u00eb n\u00eb stomak. Kjo m\u00ebnyr\u00eb ushqimi praktikohet tek foshnjat t\u00eb cilat ende nuk kan\u00eb zhvilluar refleks p\u00ebr tu ushqyer me an\u00eb t\u00eb gjirit dhe p\u00ebr t\u00eb g\u00eblltitur. Foshnjat shum\u00eb t\u00eb vogla dhe t\u00eb papjekura si dhe ato t\u00eb cilat jan\u00eb t\u00eb s\u00ebmur\u00eb r\u00ebnd\u00eb, p\u00ebrdorin ushqim t\u00eb plot\u00eb parenteral, n\u00ebp\u00ebrmjet sistemit t\u00eb infuzionit (kombinim i balancuar i aminoacideve, sheqernave dhe yndyrave, t\u00eb p\u00ebrshtatura n\u00eb baz\u00eb t\u00eb mosh\u00ebs, pesh\u00ebs dhe s\u00ebmundjes s\u00eb foshnj\u00ebs) dhe \u00e7do dit\u00eb regjistrohen t\u00eb dh\u00ebnat ditore t\u00eb marrjes s\u00eb kalorive. Por, edhe kjo kategori e foshnjave ushqehet me an\u00eb t\u00eb goj\u00ebs, me sasi minimale ditore t\u00eb qum\u00ebshtit t\u00eb p\u00ebrshtatsh\u00ebm, por akoma m\u00eb mir\u00eb me qum\u00ebsht gjiri n\u00ebse n\u00ebna ka qum\u00ebsht, me q\u00ebllim p\u00ebr t\u00eb stimuluar sistemin e tretjes s\u00eb ushqimit. N\u00eb rast se n\u00ebna ende nuk ka qum\u00ebsht, foshnjat ushqehen me qum\u00ebsht special t\u00eb adaptuar me formul\u00eb.<\/p>\n

Kur arrijn\u00eb t\u00eb jen\u00eb t\u00eb barabart\u00eb me bashk\u00ebmoshatar\u00ebt?<\/h2>\n

Foshnjat e lindura para kohe i arrijn\u00eb bashk\u00ebmoshatar\u00ebt e tyre nd\u00ebrmjet vitit t\u00eb par\u00eb dhe t\u00eb tret\u00eb. Se sa shpejt\u00eb foshnja e lindur para kohe do t\u00eb arrij\u00eb bashk\u00ebmoshatar\u00ebt, kjo varet nga java gestatike n\u00eb t\u00eb cil\u00ebn ka lindur, periudha e adaptimit (koha e q\u00ebndrimit n\u00eb spital, komplikimet dhe nga mb\u00ebshtetja respirative), stimulimi psiko-motorik dhe ambienti shoq\u00ebror n\u00eb t\u00eb cilin do t\u00eb rritet.<\/p>\n

P\u00ebr sa koh\u00eb duhet t\u00eb ndiqen pas largimit nga spitali?<\/h2>\n

Periudha e ndjekjes (monitorimit) ndonj\u00ebher\u00eb zgjat edhe me vite. Ajo q\u00eb ndiqet zakonisht tek ta \u00ebsht\u00eb gjendja e shikimit, d\u00ebgjimit si dhe b\u00ebhet kontroll ekosonografik i trurit. Shum\u00eb e r\u00ebnd\u00ebsishme \u00ebsht\u00eb edhe ndjekja e zhvillimit psiko-motorik n\u00eb p\u00ebrputhje me mosh\u00ebn dhe k\u00ebshillimin e zhvillimit. N\u00eb spitalin klinik \u201cAcibadem Sistina\u201d punon qendra p\u00ebr zbulimin dhe trajtimin e hersh\u00ebm t\u00eb \u00e7rregullimit apo pengesave n\u00eb zhvillim. N\u00eb k\u00ebt\u00eb qend\u00ebr punon nj\u00eb ekip multidisiplinar i pediat\u00ebrve p\u00ebr zhvillim, pediat\u00ebr neurolog dhe terapist zhvillimi, t\u00eb cil\u00ebt mund\u00ebsojn\u00eb trajtim individual me nj\u00eb plan t\u00eb kryer m\u00eb par\u00eb, p\u00ebr nj\u00eb pun\u00eb e cila jep rezultate t\u00eb suksesshme.<\/p>\n","protected":false},"excerpt":{"rendered":"

Kujdesi dhe trajtimi i foshnjave t\u00eb lindura para kohe k\u00ebrkon shum\u00eb njohuri dhe p\u00ebrvoj\u00eb nga ekipi, dhe m\u00ebnyra e udh\u00ebheqjes duhet t\u00eb jet\u00eb multidisiplinare. Dr. Simonida Spasevska, pediatre neonatologe, thot\u00eb se p\u00ebrve\u00e7 shp\u00ebtimit t\u00eb jet\u00ebs, stabilizimit dhe gjendjes s\u00eb p\u00ebrgjithshme m\u00eb t\u00eb mir\u00eb, p\u00ebrpjekjet duhet t\u00eb b\u00ebhen edhe drejt\u00eb stimulimit psiko-motorik\u00a0 dhe socializimit t\u00eb k\u00ebtyre […]<\/p>\n","protected":false},"author":4,"featured_media":5034,"comment_status":"closed","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"_acf_changed":false,"footnotes":""},"categories":[346],"tags":[],"doktori":[],"class_list":["post-4258","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-bremenost-novorodencinja-sq"],"acf":[],"_links":{"self":[{"href":"https:\/\/healthacibadem.unet.mk\/wp-json\/wp\/v2\/posts\/4258","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/healthacibadem.unet.mk\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/healthacibadem.unet.mk\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/healthacibadem.unet.mk\/wp-json\/wp\/v2\/users\/4"}],"replies":[{"embeddable":true,"href":"https:\/\/healthacibadem.unet.mk\/wp-json\/wp\/v2\/comments?post=4258"}],"version-history":[{"count":0,"href":"https:\/\/healthacibadem.unet.mk\/wp-json\/wp\/v2\/posts\/4258\/revisions"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/healthacibadem.unet.mk\/wp-json\/wp\/v2\/media\/5034"}],"wp:attachment":[{"href":"https:\/\/healthacibadem.unet.mk\/wp-json\/wp\/v2\/media?parent=4258"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/healthacibadem.unet.mk\/wp-json\/wp\/v2\/categories?post=4258"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/healthacibadem.unet.mk\/wp-json\/wp\/v2\/tags?post=4258"},{"taxonomy":"doktori","embeddable":true,"href":"https:\/\/healthacibadem.unet.mk\/wp-json\/wp\/v2\/doktori?post=4258"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}