Utyando lokulahleka kobunzima kunye nabantwana

Ukutyeba kakhulu ebantwaneni nakwishumi elivisayo yingxaki enkulu yezempilo. Malunga nomntwana omnye kwabathandathu eUnited States batyebe kakhulu.

Umntwana otyebileyo okanye otyebileyo kunokwenzeka ukuba atyebe okanye atyebe njengomntu omkhulu.

Abantwana abatyebe kakhulu baneengxaki zempilo ezazidla ngokubonakala kubantu abadala kuphela. Xa ezi ngxaki ziqala ebuntwaneni, zihlala zisiba mandundu ebudaleni. Umntwana ogqithiseleyo okanye ogqithiseleyo unakho amathuba okuba neengxaki ezifana:

• Ukuzijongela phantsi
• Amabanga aphantsi esikolweni
• Uxinzelelo

Uninzi lwabantu abadala abanotyando lokulahleka kobunzima bayakwazi ukunciphisa isixa esikhulu sobunzima. Ukuphulukana nobunzima kunokuba nezibonelelo zempilo ezinje:

• Ulawulo olungcono lwesifo seswekile
• I-cholesterol esezantsi kunye noxinzelelo lwegazi
• Zimbalwa iingxaki zokulala

E-United States, imisebenzi yokwehla kobunzima isetyenzisiwe ngempumelelo kulutsha. Emva kwayo nayiphi na into yotyando lokulahleka kobunzima, umntwana wakho uya:

• Yiba nesisu esincinci
• Zive uhluthi okanye wanelisekile kukutya okuncinci
• Ayikwazi ukutya kakhulu kunangaphambili

Owona msebenzi uxhaphakileyo ngoku onikezelwa kulutsha kukuthambeka kwemikhono nkqo.

Ukulungelelanisa i-gastric banding lolunye uhlobo lotyando lokuphulukana nobunzima. Nangona kunjalo, le nkqubo ithathelwe indawo ikakhulu ngumkhono we-gastrectomy.

Yonke imisebenzi yokulahleka kwesisindo inokwenziwa ngokusebenzisa ukusika okuncinci oku-5 ukuya ku-6 esiswini. Oku kwaziwa njengotyando lwe-laparoscopic.

Uninzi lwabantwana abanotyando lokulahleka kobunzima banengxaki zempilo ezinxulumene nobunzima bomzimba obongezelelekileyo.

Isalathiso sobunzima bomzimba (i-BMI) amanyathelo asezantsi asetyenziswa ngoogqirha abaninzi ukwenza isigqibo sokuba ngubani onokuncedwa kakhulu ngoqhaqho lokunciphisa umzimba. Kodwa asingabo bonke oogqirha abavumelana noku. Izikhokelo ngokubanzi zezi:

I-BMI engama-35 okanye ngaphezulu kunye nemeko enzulu yempilo enxulumene nokukhuluphala, enje:

• Iswekile (iswekile ephezulu yegazi)
• I-Pseudotumor cerebri (uxinzelelo olonyukayo ngaphakathi kwekhakhayi)
• Ukuphefumla okuphakathi okanye okunzima (iimpawu zibandakanya ukulala emini kunye nokukrokra okukhulu, ukukhefuzela nokubamba umphefumlo xa ulele)
• Ukudumba okukhulu kwesibindi okubangelwa kukutyeba okungaphezulu

I-BMI engama-40 okanye ngaphezulu.

Ezinye izinto kufuneka ziqwalaselwe ngaphambi kokuba umntwana okanye umntwana ofikisayo enze utyando lokunciphisa umzimba.

• Umntwana akakwazanga ukunciphisa umzimba ngelixa etya kunye nenkqubo yokuzilolonga ubuncinci iinyanga ezi-6, ngelixa ephantsi konyango lukagqirha.
• Umntwana ofikisayo kufuneka agqibe ukukhula (ubukhulu becala iminyaka eyi-13-ubudala okanye ngaphezulu yamantombazana kunye ne-15-ubudala okanye ngaphezulu kwamakhwenkwe).
• Abazali kunye nolutsha kufuneka baqonde kwaye bazimisele ukulandela iindlela ezininzi zokuphila eziyimfuneko emva kotyando.
• Ulutsha aluzange lusebenzise naziphi na izinto ezingekho mthethweni (utywala okanye iziyobisi) kwiinyanga ezili-12 ngaphambi kotyando.

Abantwana abanotyando lokulahleka kobunzima kufuneka bafumane ukhathalelo kwiziko lotyando lwe-bariatric. Apho, iqela leengcali liya kubanika ukhathalelo olukhethekileyo abalifunayo.

Izifundo ezenziweyo kutyando lwe-bariatric kulutsha lubonisa ukuba le misebenzi ikhuselekile kweli qela leminyaka njengabantu abadala. Nangona kunjalo, alukho uphando oluninzi olwenziweyo ukubonisa ukuba ngaba kukho naziphi na iziphumo zexesha elide ekukhuleni kolutsha olufumana utyando lokulahleka kwesisindo.

Imizimba yabakwishumi elivisayo isatshintsha kwaye isakhula. Kuya kufuneka ukuba bakuphaphele ukufumana izondlo ezaneleyo ngexesha lokulahleka kwesisindo emva kotyando.

Utyando ngokudlula kwindlela yokutshintsha kwesisu kutshintsha indlela ezinye izondlo ezifunxwa ngayo. Ulutsha olunolu hlobo lotyando lokuphulukana nobunzima luza kudinga ukuthatha iivithamini kunye neeminerali ubomi babo bonke. Kwiimeko ezininzi, i-sleeve gastrectomy ayibangeli utshintsho kwindlela ezondliwa ngayo izondlo. Nangona kunjalo, ulutsha lusenokufuna ukuthatha iivithamini kunye neeminerali.

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UGahagan S. Ukutyeba kakhulu kunye nokutyeba kakhulu. Ku: Kliegman RM, St Geme JW, Schor NF, Blum NJ, Shah SS, Tasker RC, Wilson KM, ii-eds. Incwadi kaNelson yeNcwadi yePediatrics. Umhla wama-21. IPhiladelphia, PA: Elsevier; 2020: isahluko 60.

UMarcdante KJ, uKliegman RM. Ukutyeba kakhulu. Ku: UMarcdante KJ, uKliegman RM, ii-eds. UNelson oBalulekileyo kwiPediatrics. Ngomhla we-8. Elsevier; I-2019: isahluko 29.

UMechanick JI, uYydim A, uJones DB, et al. Izikhokelo zokuziqhelanisa neklinikhi yesondlo se-perioperative, i-metabolic, kunye nenkxaso yezonyango yesifo sokuhlinzwa ngo-2013: ixhaswe ngumbutho weAmerican Association of Clinical Endocrinologists, uMbutho wokuTyeba kakhulu, kunye noMbutho waseMelika woNyango lweMetabolic kunye neBariatric. Ukuziqhelanisa ne-Endocr. Ngo-2013; 19 (2): 337-372. IINKCUKACHA: 23529351 www.ncbi.nlm.nih.gov/pubmed/23529351.

UPedroso FE, uAngriman F, uEndo A, uDasenbrock H, et al. Ukuphulukana nobunzima emva kotyando lwe-bariatric kulutsha olutyebe kakhulu: uphononongo lwenkqubo kunye nohlalutyo lweemeta. Uqhaqho Obes Relat Dis. Ngo-201; 14 (3): 413-422. IINKCUKACHA: 29248351 www.ncbi.nlm.nih.gov/pubmed/29248351.