Zomwe zimayambitsa komanso momwe mungachiritse neonatal hyperbilirubinemia

Zamkati

• Zoyambitsa zazikulu
• 1. Matenda a jaundice
• 2. Jaundice mu mkaka wa m'mawere
• 3. Matenda amwazi
• 4. Matenda a chiwindi
• Momwe phototherapy imachitikira

Hyperbilirubinemia ya wakhanda kapena wakhanda ndi matenda omwe amapezeka m'masiku oyamba amoyo wa mwana, omwe amayamba chifukwa chakuchulukana kwa bilirubin m'magazi, ndikusintha khungu kukhala lachikaso.

Mwana aliyense amatha kukhala ndi hyperbilirubinemia, zomwe zimayambitsa kusintha kwa thupi m'chiwindi, kusokonezeka kwa magazi, monga kuchepa kwa magazi m'thupi, matenda a chiwindi, omwe amayambitsidwa ndi matenda kapena matenda amtundu, kapena ngakhale poyamwitsa. Onaninso zomwe zimayambitsa bilirubin ndi jaundice mwa akulu.

Kusamalira kuchepetsa kuchuluka kwa bilirubin m'magazi kuyenera kuyambika mwachangu, ndipo chithandizo chogwiritsa ntchito phototherapy ndicho chimagwiritsidwa ntchito kwambiri. Nthawi zina, kugwiritsa ntchito mankhwala osokoneza bongo kapena kuthiridwa magazi kumatha kukhala kofunikira, ndipo amalangizidwa ndi dokotala wa ana.

Zoyambitsa zazikulu

Jaundice imachitika pamene mwanayo sangathe kuthana ndi bilirubin, yomwe imapangidwa ndi kagayidwe ka magazi, chifukwa, asanabadwe, placenta idagwira ntchitoyi. Zomwe zimayambitsa matenda obadwa kumene a hyperbilirubinemia ndi awa:

1. Matenda a jaundice

Nthawi zambiri zimachitika pambuyo pa maola 24 mpaka 36 obadwa, kukhala mtundu wofala kwambiri wa jaundice, chifukwa chiwindi cha mwana sichinakule bwino ndipo chimakhala ndi zovuta pakusintha ndikuchotsa bilirubin m'magazi kudzera mu bile. Kusinthaku nthawi zambiri kumatha m'masiku ochepa, ndikuchiritsidwa ndi phototherapy ndikuwonetsedwa ndi dzuwa.

• Momwe muyenera kuchitira: Phototherapy yokhala ndi kuwala kwa fulorosenti ndiyothandiza kuchepetsa kuchuluka kwa bilirubin m'magazi. Nthawi zochepa, kupezeka padzuwa kumakwanira, koma pamavuto akulu, kuthiridwa magazi kapena kugwiritsa ntchito mankhwala, monga phenobarbital, kungakhale kofunikira kuti mupeze zotsatira zabwino. Mvetsetsani bwino momwe mwana wakhanda amathandizidwira.

2. Jaundice mu mkaka wa m'mawere

Kuwonjezeka kwamtunduwu kwa bilirubin kumatha kuchitika patatha masiku 10 kuchokera pakubadwa, mwa ana ena omwe akuyamwitsa mkaka wokha, chifukwa cha kuchuluka kwa mahomoni kapena zinthu m'magazi zomwe zimapangitsa kuti bilirubin ayambenso kutuluka m'matumbo ndikulepheretsa kuthetsedwa, ngakhale komabe tikudziwa mawonekedwe ake enieni.

• Momwe muyenera kuchitira: pakakhala jaundice wofunika kwambiri, phototherapy itha kuchitidwa kuti muchepetse magazi, koma kuyamwitsa sikuyenera kusokonezedwa pokhapokha atalangizidwa ndi dokotala wa ana. Jaundice iyi imasowa mwachilengedwe mozungulira mwezi wachiwiri kapena wachitatu wamwana.

3. Matenda amwazi

Matenda ena amatha kupangitsa mwana kudzikundikira bilirubin, monga kusintha kwa autoimmune kapena majini, ndipo amatha kukhala owopsa ndikuwonekera m'maola oyamba atabadwa. Matenda ena ndi spherocytosis, thalassemia kapena kusagwirizana ndi magazi a mayi, mwachitsanzo, chachikulu ndi matenda a hemolytic a wakhanda, omwe amadziwikanso kuti fetal erythroblastosis.

• Momwe muyenera kuchitira: Kuphatikiza pa phototherapy kuti muchepetse kuchuluka kwa bilirubin m'magazi, mankhwala nthawi zambiri amachitidwa ndi kuthiridwa magazi ndipo, nthawi zina, mankhwala amatha kupangidwa kuti athane ndi chitetezo chamthupi.

4. Matenda a chiwindi

Mwanayo amatha kubadwa ndi kusintha kwa chiwindi, chifukwa cha zifukwa zingapo, monga zopindika za bile, cystic fibrosis, rubella yobadwa nayo, kobadwa nako hypothyroidism, matenda opatsirana ndi mavairasi kapena mabakiteriya, kapena matenda amtundu, monga matenda a Crigler-Najjar, Gilber ndi matenda a Gaucher, mwachitsanzo.

• Momwe muyenera kuchitira: kuchepetsa magazi a hyperbilirubinemia, limodzi ndi phototherapy, mankhwala amatengedwa kuti athetse matenda omwe adayambitsa kuchuluka kwa bilirubin, monga chithandizo cha matenda opatsirana ndi maantibayotiki, opareshoni kuti athetse kufooka kwa chiwindi kapena kusintha kwa mahomoni mu hypothyroidism, mwachitsanzo.

Mankhwala ochepetsa thupi kuchuluka kwambiri kwa bilirubin, makamaka phototherapy, ayenera kuchitidwa mwachangu atazindikira kusintha, popeza bilirubin yochulukirapo mthupi la mwana imatha kubweretsa zovuta zazikulu, monga poyizoni muubongo yotchedwa kernicterus, yomwe imayambitsa ugonthi, khunyu, chikomokere komanso imfa.

Momwe phototherapy imachitikira

Phototherapy imakhala ndikusiya mwana ali ndi kuwala kwa fulorosenti, nthawi zambiri amakhala wabuluu, kwa maola ochepa, tsiku lililonse, mpaka kusintha. Kuti mankhwalawa agwire ntchito, khungu la mwana liyenera kuwonetsedwa bwino, koma maso sayenera kuwonekera, motero nsalu kapena magalasi apadera amaphimbidwa.

Kuwala kumalowerera pakhungu polimbikitsa kuwononga ndi kuchotsa bilirubin kudzera mu ndulu, ndikupangitsa mtundu wa jaundice ndi wachikasu kutha pang'ono ndi pang'ono.

Dziwani zambiri za momwe zimachitikira komanso zisonyezo zina zogwiritsa ntchito phototherapy.