Амьгүй, дутуу төрөлт яагаад нэмэгдэв?

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Сүүлийн үед амьгүй, дутуу төрөлт нэмэгдэх хандлагатай талаар эмч, мэргэжилтнүүд ярих боллоо. Монгол Улсад 2010 оноос жирэмсний хугацааг 22 долоо хоног, ургийн жин 500 гр-аас дээш байхыг дутуу төрөлтөд тооцож ДЭМБ-ын удирдамжийн дагуу бүртгэж эхэлсэн байна. Тухайлбал, жирэмсний 22-37 долоо хоног хүртэлх хугацааг дутуу төрөлт гэдэг аж. Дэлхийд 10 хүүхэд бүрийн нэг нь дутуу төрж байна. Тиймээс энэ талаар Эх, хүүхдийн эрүүл мэндийн үндэсний төвийн Дутуу тээлт судлалын тасгийн эрхлэгч Б.Батхишигээс тодруулахад “Ямар шалтгааны улмаас дутуу болон амьгүй төрөх эрсдэлд орсноос хамааран эмчилгээний хувьд харилцан адилгүй байдаг. Дутуу төрөлтөд таван үндсэн шалтгаан байдаг. Нэгдүгээрт, үрэвсэл халдварын шинжтэй эх дутуу төрөх өндөр магадлалтай байдаг. Жирэмсэн эх ямар нэг үрэвсэлт халдвартай эсэхээ хяналтад орж оношлуулах шаардлагатай. Жирэмсний эхний гурван сард хяналтад орсноор нарийн мэргэжлийн эмч нараар дамжуулан эхийн архаг хууч өвчинг тодорхойлж, хүүхэд тээхэд асуудал байгаа эсэхийг хугацаа алдалгүй тогтоох боломжтой. Ихэвчлэн үтрээний ариун цэврээс хамаарсан бэлгийн замын халдварт өвчнүүд гол шалтгаан болдог. 32 долоо хоногоос өмнө төрж байгаа эхчүүдийн 80-85 хувь нь үрэвслийн шалтгаантай байдаг тул жирэмсэн эхчүүд эмчийн хяналтад орж нарийн шинжилгээ хийлгэх хэрэгтэй.

Хоёрдугаарт, жирэмсний хожуу хордлогоос үүдэн дутуу төрөх эрсдэл байдаг. Энэ нь жирэмсний 24 долоо хоногоос хойш хордлого өгч, даралт ихсэх, хавагнах шинж тэмдгээр илэрнэ. Ихэвчлэн жирэмсэн биш үедээ даралт ихэсдэг, бөөр өвддөг эхчүүдэд түлхүү тохиолддог учраас эхийн эрүүл мэнд маш чухал. Гуравдугаарт, ургийн өсөлтийн саатлаас болж дутуу төрдөг. Хүүхэд хугацаандаа өсөхгүй тохиолдол байдаг. Үүнийг эхогоор оношлуулах шаардлагатай.

Дөрөвдүгээрт, умай хэт их сунаснаар дутуу төрөх магадлал өндөр болдог. Энэ нь ихэр жирэмслэлт болон ураг орчмын шингэн ихдэлтээс болж үүсдэг. Ураг орчмын шингэн ихдэлтийн шалтгаан нь үрэвсэлт халдвар, чихрийн шижин өвчин. Иймд эмчийн хяналтад орох нь зүйтэй. Тавдугаарт, дутуу төрдөг ээж нар байдаг. Шалтгааныг нь тодорхойлох боломжгүй буюу өмнө нь дутуу төрсөн ээж дахин дутуу төрөх магадлал өндөр. Эрүүл эхээс эрүүл хүүхэд төрдөг. Тиймээс жирэмслэлтийг төлөвлөж байж төрөх нь хамгийн чухал юм. Жирэмслэхээсээ өмнө эрүүл мэндийн нарийн мэргэжлийн шинжилгээнд хамрагдаж хүүхэд тээх боломжтой эсэхээ тогтоох нь эх болон урагт эрсдэл учруулахгүй” гэсэн юм.

Амьгүй төрөлтийн шалтгаан нь төрөх үеийн хүндрэлүүд, жирэмсэн эхийн халдвар, даралт ихсэлт, чихрийн шижин, ургийн өсөлтийн саатал ордог аж. Бусад хүнтэй харьцуулахад 15-аас доош настай болон 45-аас дээш настай хүмүүс жирэмсэлбэл амьгүй төрөлтийн тоо 2.4 дахин ихэсдэг. Мөн төрөлтийн тоо ихсэх, тамхидалт, эхийн таргалалт, ихэр жирэмсэн, даралт ихсэлт, бодисын солилцооны эмгэг нь амьгүй төрөлтийн эрсдэлт хүчин зүйл болдог байна. Ахимаг насны эмэгтэйчүүдийн амьгүй төрөлтийн тоо болон өсвөр насны жирэмслэлтийн тоо ихэссэн ажээ. Хожуу хордлогын эрсдэлийн хувь буураагүй тоон үзүүлэлтүүдээс манай улсын хэмжээнд амьгүй болон дутуу төрөлтийн эрсдэл өндөр байгааг харж болно. Эрт дутуу төрсөн урагт шаардлагатай эмчилгээг хийснээр амьдруулах боломжтой ч эмнэлгийн тоног төхөөрөмж, орны хүрэлцээ бага байдаг нь хөдөө орон нутаг, нийслэлийн эмнэлгүүдийн хувьд томоохон асуудал болж байна. Амьгүй болон дутуу төрөлтийн эрсдэлийг бууруулахад эхийн эрүүл мэнд болон эмнэлгийн орчин чухал нөлөөтэй ажээ.

Агаарын бохирдол ургийн жинг бууруулж байгааг тогтоожээ

АШУҮИС-ийн НЭМС-ийн эрдэмтэн багш нар “Агаарын бохирдлын ургийн жин, амьгүй ба дутуу төрөлтөд үзүүлж буй нөлөөлөл”-өөр 2013-2015 онд судалгаа хийсэн байна. Улаанбаатар хотын агаарыг бохирдуулагч бодисуудын ихэссэн агууламж нь ургийн жинг бууруулахад нөлөөлж байгааг тогтоожээ. Тухайлбал, хүхрийн давхар исэл 30.48 грамм, азотын давхар исэл 42.96 грамм, нүүрстөрөгчийн дутуу исэл 29.96 грамм, том ширхэгт тоосонцор 34.88 граммаар буюу 138.28 граммаар жирэмсний тээлтийн хугацаанд ургийн жинг бууруулж байна. Баянгол, Чингэлтэй дүүрэгт бага жинтэй төрсөн нярайн түвшин харьцангуй өндөр байна. Бага жинтэй нярай өвлийн улиралд хамгийн их төржээ.

Дутуу төрөлт хавар ихсэх хандлагатай байна

Дутуу төрөлтийн түвшинг судлахад Баянгол дүүргийн эхчүүдэд 1000 амьд төрөлтөд 15.5 байсан бөгөөд дутуу төрөлт хавар ихсэх хандлагатай байгаа аж. Хүхрийн давхар исэл ба том ширхэгт тоосонцрын бохирдол нөлөөлснөөр ураг хэвийн хугацаанаас 12.1 долоо хоног ба 8.89 долоо хоногийн өмнө дутуу төрөх магадлалтай байна.

Амьгүй төрөлтийн ихэнх нь Сонгинохайрхан, Баянзүрх дүүрэгт

Амьгүй төрөлтийг судлахад эхчүүдийн ихэнх нь Сонгинохайрхан 24.2, Баянзүрх 23.4 дүүргийн харьяалалтай байжээ. Хүхрийн давхар ислийн агууламж тээлтийн эхний, дунд, сүүлийн гурван сард 10 нэгжээр ихсэхэд ураг амьгүй болох эрсдлийг нэмэгдүүлдэг. Азотын давхар исэл тээлтийн эхний гурван сард ихссэнээр амьгүй төрөх эрсдлийг нэг дахин нэмэгдүүлдэг байна. Харин нүүрстөрөгчийн дутуу исэл тээлтийн бүх хугацаанд нөлөөлснөөр амьгүй төрөх эрсдлийг мөн нэг дахин нэмэгдүүлжээ.

Т.НАМУУН

Эх сурвалж: “Зууны мэдээ” сонин


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