Isiqhelo se-bilirubin kwiintsana

Ngeentsuku zokuqala zobomi bokuzalwa, umbala we-icteric wesikhumba kunye neembonakaliso ezibonakalayo ezinobumba zingabonakala-i-jaundice yomzimba yintsana iyavela. Kungenxa yokuba kwimihla yokuqala yobomi be-fetm hemoglobin yegazi ichithwa, ithatha indawo eqhelekileyo, kwaye imveliso yokuchithwa kwe-hemoglobin yi-bilirubin. Ngethuba lokuphazamiseka kwe-hemoglobin, i-bilirubin engabonakaliyo yenziwa, ebophelela kwiprotheni kwisibindi kwaye iguqulwa ukuba iqondise i-bilirubin. I-bilirubin engachangekanga, ayifumanekanga, ayifihliwe umchamo, i-soluble ngokuchanekileyo, ixutywe nge-bile.

Isiqhelo se-bilirubin egazini lentsana

Isiqhelo se-bilirubin esithe ngqo asikho ngaphezulu kwe-25% ye-bilirubin yonke. Kwimeko yokubola kwe-fetm hemoglobin, inqanaba le-bilirubin linyuka, elingenalo ixesha lokubopha nge-albumin. Inqanaba layo liphezulu ngosuku lwesithathu lobomi, emva koko linciphisa iiveki ezi-1-2. Ngeli xesha, i- jaundice yomzimba ibonakala kwaye iphela, leyo, ngokungafani ne-pathological one, iyadlula ngaphandle kwaye ayifuni unyango.

1. Xa umntwana ezalwa egazini legazi, inqanaba le-bilirubin kwiintsana ziza kuqheleka ukuya kwi-51 μmol / l.
2. Ngomhla wokuqala wobomi, ukwanda kwinqanaba le-bilirubin akufanele libe ngaphezu kwe-5.1 μmol / l ngeyure. Ngethuba elifanayo, ukwanda kwenyuka kwizinga le-bilirubin kubantwana abakhule ngokuzeleyo kufikelela kwi-256 μmol / L ukuya kwiintsuku eziyi-3-4 zobomi, ngaphambi kweentsana-ezingaphezulu kwe-171 μmol / l.
3. Umgangatho ophakathi we-bilirubin kwimihla yokuqala yobomi ngokuqhelekileyo ayidluli kwi-103-137 μmol / l, kwaye ukwanda kunenxa ye-bilirubin engacacanga.

Xa i-jaundice yomzimba ingatshintshi imeko epheleleyo yomntwana, umbala we-urine kunye neengxube, kunye nobukhulu besibindi kunye neengxube, ulusu lunomnxeba we-orange, kwaye i-jaundice iyanyamalala ngaphandle kwonyango kwiveki 2-3 yobomi. Iziganga ze-jaundice yomzimba:

• Iqondo eli-1 (umbala we-icteric wobuso nentamo kuphela);
• I-2 degree (umbala we-icteric wesigxina esiphezulu somzimba kwintonga);
• Iidanga ezi-3 (ubuciko be-icteric yobuso, i-trunk kunye neendawo eziphezulu zeengalo nemilenze);
• Iidanga ezi-4 (epheleleyo imibala yombala kumbala we-icteric, kubandakanywa neenyawo kunye neebhondi).

Izizathu zokunyusa i-bilirubin kwiintsana ezisanda kuzalwa

Ukongeza kwi-jaundice yomzimba, kukho i-jaundice ye-pathological in the newborns, apho kuya kubakho umbala ophezulu we-bilirubin kunye nombala ophuzi wesikhumba kunye neembumba. Iintlobo zesifo se-pathological jaundice:

1. Hemolytic. Ngenxa yokuwa kweeseli ezibomvu zegazi kwimpikiswano kwiqela legazi okanye i-Rh into ephakathi komama nomntwana, izifo ze-genetic - i-microspherocytosis, i-anemia yesalente yesalente.
2. I-Parenchymal - ngenxa yokulimala kwesibindi ngokuzalwa kwesifo sofuba, i-cytomegalovirus, i-toxins.
3. Ukudibanisa - kwimeko yokungaqhelekanga kwinkqubo ye-enzyme kunye nokubopha kwe-bilirubin ngqo.
4. Iimpawu - kwiimeko zokwephulwa kwe-bile ye-bile ngenxa yokugqitywa kwe-gallbladder okanye i-fox ne-fox i-anomalies yokuzalwa, umzekelo, i-atresia.

Kwiindawo eziphezulu ze-bilirubin egazini (ngaphezu kwe-324 μmol / l), ingena kwi-barrier brain-barrier kwaye ifana ne-toxin kwingqondo yintsana (i-jaundice yenyukliya). Oku kubangele ukuxiliswa kwexhefu enobungozi ngokunciphisa kuzo zonke iingcamango, ukunganakwa, ukuxinwa kunye nokufa komntwana. Iingxaki ze-jaundice zenyukliya zingaba zikhubazekileyo kunye neparresis, ukulibala kwengqondo nokuva.

Unyango lwezinga lokunyuka kwe-bilirubin kwiintsana ezisanda kuzalwa

I-jaundice ye-physics ayifuni ifuna unyango, kunye nokubala kombala kwesikhumba kunokusebenzisa i-phototherapy, apho ilanga likhawuleza ukubopha i-bilirubin. Nge-jaundice ye-pathological, ngaphezu kwe-phototherapy, ugqirha ngokuqhelekileyo ugunyazisa unyango lwe-detoxification kunye nokutshintshelwa igazi.