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როგორ უნდა გავუმკლავდეთ ბავშვის ”ტიკებს” და მავნე ჩვევებს - ნევროლოგის რჩევები | ჯანმრთელობა | vidal.ge
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როგორ უნდა გავუმკლავდეთ ბავშვის ”ტიკებს” და მავნე ჩვევებს - ნევროლოგის რჩევები

თარიღი: 16 ივნისი, 2020

რით არის გამოწვეული ბავშვებში უნებლიე მოძრაობები, მაგალითად თვალების პაჭუნი, მიმიკური მოძრაობები, ე.წ. "ტიკები"? რომელ სპეციალისტს უნდა მიმართოს მშობელმა ამ დროს? როგორ არის შესაძლებელი ტიკებისგან გათავისუფლება? როგორ უნდა გადავაჩვიოთ პატარა ბავშვი მავნე ჩვევებს - ამ თემებზე პედიატრიული პრივატკლინიკის ბავშვთა ნევროლოგი ანი ჩოჩია გვესაუბრება:

- უნებლიე მოძრაობები ბავშვთა ასაკში შეიძლება იყოს ცენტრალური ნერვული სისტემის სხვადასხვა დონეზე დაზიანების გამოვლინება. მაგალითად, ქორეული ჰიპერკინეზი თავის ტვინის ქერქქვეშა სტრუქტურების რევმატიული ინფექციის დაზიანების დროს, ინტენსიური კანკალი - ნათხემის დაზიანების შედეგად, ხელების მცირე კანკალი შეიძლება იყოს ჰიპოთირეოზის (ფარისებრი ჯირკვლის უკმარისობის გამოვლინება). ეს უნებლიე მოძრაობები მიეკუთვნება თავის ტვინის ორგანული დაზიანების სიმპტომებს. გარდა ამისა, ბავშვთა ასაკში ხშირია უნებლიე მოძრაობები (ტიკები), რომლის დროს არანაირი ცვლილება ნერვულ სისტემაში არ ვლინდება. ეს ე.წ. სომატოფორმული აშლილობა (ძველად მას ნევროზებს უწოდებდნენ) ხშირია არა მარტო ბავშვთა ასაკში, არამედ მოზრდილებშიც. ბავშვთა ასაკში ტიკი შეიძლება გამოვლინდეს: ხშირი ხამხამით, სახის მიმიკური კუნთების ნაძალადევი მოძრაობებით, მხრების აჩეჩვით, თავისა და თვალების ნაძალადევი მოძრაობებით და მრავალი სხვა. შეიძლება ტიკი უფრო რთული ფორმით გამოვლინდეს და სახის მიმიკური კუნთების შეკუმშვას თან დაერთოს ბგერების უადგილო, უეცარი წამოყვირება (ე.წ. ვოკალიზმები).

- რომელ სპეციალისტს უნდა მიმართოს მშობელმა ამ დროს?
- პირველ რიგში ბავშვთა ნევროლოგმა უნდა დაადგინოს არსებული უნებლიე მოძრაობების ბუნება. არის ის თავის ტვინის ორგანული დაზიანების გამოვლინება თუ ნევროზული აშლილობა, რომლის პროვოკაცია მოხდა მწვავედ ან ქრონიკულად მიმდინარე ფსიქოგენიით. (ხშირი კონფლიქტები ოჯახში, ბავშვის დასჯა ან ცემა, მშობლების გაცილება, ბავშვზე ზეზრუნვა და ა.შ.). ზოგჯერ საჭიროა ყელ-ყურ-ცხვირის ექიმის კონსულტაცია (ტონზილიტის გამოსარიცხად), კარდიორევმატოლოგის კონსულტაცია, ხოლო რთული ტიკების დროს უნდა ჩაერთოს ფსიქოლოგი. ზოგჯერ კეთდება ელექტროენცეფალოგრაფიაც.

- როგორ არის შესაძლებელი ტიკებისგან გათავისუფლება?
- ტიკის მიზეზის დადგენის შემდეგ (რიგ შემთხვევაში ეს დიდ სირთულეს წარმოადგენს) ექიმი ურჩევს მშობელს ბავშვის რეჟიმის შეცვლას. განსაკუთრებული მნიშვნელობა ბოლო წლებში ენიჭება ბავშვების მიერ კომპიუტერული ან მობილური ტელეფონით თამაშებით გატაცებას. ზოგი ბავშვი მრავალი საათის მანძილზე იმყოფება ეკრანთან. სწორედ ამის გამო, ხშირ შემთხვევაში ბავშვებს უვითარდებათ: ქცევითი აშლილობები, აგრესია, ადვილად დაღლა, ძილის დარღვევა და სხვადასვხა სახის ტიკები. მშობლებმა უნდა იცოდნენ, რომ მაგ: ამერიკის შეერთებულ შტატებში 3 წელზე მეტია, ფსიქიატრიის დიაგნოზში შეტანილია ე.წ. ეკრანდამოკიდებული დაავადებები.  ამას უნდა მიექცეს სერიოზული ყურადღება და ჩვენ ვურჩევთ, რომ სკოლამდელ ასაკამდე მობილური ტელეფონები და კომპიუტერული თამაშები აიკრძალოს.

- რამდენად ითვლება მავნე ჩვევად თითის ან საწოვარას წოვა?
- საწოვარას წოვა 1 წლამდე მისაღებია, თუმცა 1 წლის შემდეგ, როდესაც დადის, ლაპარაკობს, დამოუკიდებლად ღებულობს საკვებს, რა თქმა უნდა,  მშობელი უნდა ეცადოს გადააჩვიოს საწოვარას. რაც შეეხება თითის წოვას (უფრო ხშირად ცერა თითის), ცხადია, ამას მეტად ბევრი ზიანი მოაქვს და თუ საწოვარას ადრე თუ გვიან ბავშვი ანებებს თავს, თითის წოვა შეიძლება სხვადასხვა რთული ფსიქიკური გადაძაბვის დროს მას გაჰყვეს მთელი ცხოვრება. გარდა იმისა, რომ ეს არაჰიგიენურია, ბავშვებს ურთულდებათ თანკბილვა, ხოლო თითის კუნთები ატროფიას განიცდიან. ასეთ შემთხვევაში მიმართავენ ფსიქოლოგს. ზოგჯერ კი ბავშვთა ფსიქიატრს.

- რისი მანიშნებელი შეიძლება იყოს ფრჩხილების კვნეტა?
- ონიქოფაგია ასევე მიეკუთვნება სომატოფორმულ აშლილობას. უმეტეს წილად ის იწყება ბავშვთა ასაკში და მშობლის მიერ დროულად შემჩნევა და ჩარევა ზოგჯერ იძლევა დადებით შედეგს, თუმცა რიგ შემთხვევაში ყველანაირი ღონისძიება უშედეგოა და ეს მავნე ჩვევა შესაძლებელია გაყვეს მთელი ცხოვრების მანძილზე. აქაც საჭიროა ჩატარდეს ფსიქოლოგის კონსულტაცია.


- კიდევ რომელ მავნე ჩვევებს ვხვდებით ბავშვთა ასაკში?
- ბავშვთა ასაკში მავნე ჩვევები მრავალფეროვანია. ეს შეიძლება იყოს თმებისა და წარბების ამოგლეჯა, თითების წოვა, ძილის წინ მშობლის სხეულის სხვადასხვა ნაწილზე შეხება, საბნის პირში ჩადება. შესაძლებელია ასევე გამოვლინდეს ბავშვთა ონანიზმი. ეს რიგ შემთხვევაში შესაძლებელია იყოს ან ჰელმინთოზით გამოწვეული ან ჰიგიენის დარღვევით, პამპერსში ხანგრძლივად ყოფნით, ზოგჯერ კი ვულვოვაგინიტის გამოვლინება (გარეთა სასქესო ორგანოების ინფექციით).

- როგორ უნდა გადავაჩვიოთ პატარა ბავშვი მავნე ჩვევებს?
- ეს საკმაოდ რთული და ხანგრძლივი პროცესია. ამაში უნდა მიიღოს მონაწილეობა არა მხოლოდ ექიმმა და ბავშვის მშობლებმა, არამედ ოჯახის ყველა წევრმა. უკანასკნელ პერიოდში სომატოფორმული აშლილობოს დროს სულ უფრო ნაკლებად გამოიყენება მედიკამენტი, თუმცა ამას განსაზღვრავს თითოეულ ინდივიდუალურ შემთხვევაში ნევროლოგი. მშობელი უნდა ასრულებდეს ნევროლოგის და ფსიქოლოგის მიერ მოცემულ რჩევებს, შემდგომ თვალყური ადევნოს ბავშვის დღისა და ღამის რეჟიმს და ასევე იცოდეს იმ სოციუმის შესახებ, რომელშიც იმყოფება მისი შვილი - საბავშვო ბაღი, სკოლა და მეგობრების წრე.