mazuļa galvas deformācija; plakans pakausis; plakana galviņa

Mazuļa galvas apkārtmērs

Mazuļa galvas apkārtmērs ir visticamākais mainīgais parametrs pirmajos dzīves mēnešos.

Mazuļa galvai ir jāpielāgojas visātrāk augošajam orgānam – smadzenēm. Jaunākie pētījumi liecina, ka mazuļa smadzenes katru dienu palielinās par aptuveni 1%, un augšana sākas tūlīt pēc piedzimšanas.

Mazuļa galvas apkārtmērs var tikt iedalīts 4 posmos pēc tā pieauguma:

  1. No 0 līdz 3 mēnešiem. Galva aug visstraujāk (apmēram 1,5–2 cm mēnesī), ir ārkārtīgi mīksta un elastīga. Šajā laikā deformāciju risks ir visaugstākais, un korekcija ir visefektīvākā. Vidēji galvas apkārtmērs palielinās no 35 cm līdz 40-42 cm.
  2. No 3 līdz 12 mēnešiem. Galvas augšana palēninās (apmēram 1-0,5 cm / mēnesī). Pakāpeniski plāksnes osificējas, vīles un galvas avotiņi aizveras. Korekcijas efektivitāte pakāpeniski samazinās, ja korekcija, izmantojot konservatīvus pasākumus, sākas no 6 līdz 7 mēnešiem, un, ja deformācija ir mērena vai smaga, korekcija var būt daļēja. Optimālais laiks ortopēdiskai ķiverei ar smagu deformāciju. Vidēji galvas apkārtmērs palielinās no 40-42 līdz 47 cm.
  3. No 12 līdz 18 mēnešiem. Galvas augšana strauji palēninās (6 mēnešos palielinās par aptuveni 2 cm). Galvaskausa posmi ir gandrīz saauguši kopā un galvaskauss kļūst cietāks, biezāks. Ja mazulim līdz šim vecumam nav deformāciju, tad tās arī nebūs. Tomēr korekcija ar ķiveres terapiju būs tikai daļēja, ar konservatīviem pasākumiem – simboliska. Ķiveres terapija parasti tiek piedāvāta līdz 14 mēnešiem. Vēlāk to uzskata par neefektīvu.
  4. Sākot no 18 mēnešiem līdz 36 mēnešiem galva pieaugs vēl dažus centimetrus. Tiek uzskatīts, ka galvaskauss jau ir izveidojies, un korekcija ir maz ticama.

Agrīni novēroto galvas deformāciju ir vieglāk labot, jo šuves ir vājākas. Jo vēlāk problēma tiks novērota, jo lielāka iespējamība, ka korekcija būs tikai daļēja, izmantojot konservatīvus pasākumus.

KOREKCIJAS PLĀNS

Starptautiskais neiroķirurgu kongress 2016. gada beigās, pamatojoties uz iepriekšējiem pētījumiem un novērojumiem, sagatavoja pamatnostādnes rīcības plānam zīdaiņu galvas deformācijas labošanai. Saskaņā ar šiem ieteikumiem ir īpaši svarīgi pamanīt galvas formas izmaiņas jau agrīnā vecumā, kad deformācija joprojām ir maza, un efektīvi ir konservatīvi pasākumi – pozīcijas maiņa, ortopēdiskie spilveni, fizioterapija. Vairāk lasiet šeit.

VAI TAS VARĒTU NEUZLABOTIES?

Ļoti bieži tiek domāts, ka nav vērts uztraukties, plakanai mazuļa galvai (plagiocefālijai) vajadzētu iztaisnoties pašai, kad mazulis sāk sēdēt, rāpot, t.i. kad mazulis mazāk atradīsies guļus un spiediens uz galvaskausa kauliem samazināsies. Tomēr tas būs tikai no 7 mēnešiem. Tiks zaudēts visefektīvākais korekcijas laiks, līdz 3-4 mēnešiem, un situācija var pasliktināties. Turklāt korekcijas atslēga ir spiediens visos virzienos. Kad bērns sēž, galvaskauss netiek nospiests, tāpēc korekcija nav stratēģiska, bet gan spontāna, ciktāl galvaskausa plākšņu kustība to ļauj.

Bieži tiek ieteikts arī gulēt mazulim uz vēdera, taču ar šo pasākumu vien nevar labot nogulētu galvu, jo, piemēram, 3 mēnešus vecs mazulis apmēram 18 stundas pavada uz muguras un 40-60 minūtes uz vēdera, kā arī gulēšana uz vēdera mazina spiedienu uz galvaskausu. Tātad tas ir lielisks profilakses līdzeklis veselīgam bērniņam. Lasiet vairāk par mazuļa gulēšanu uz vēdera šeit.

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