Umkhuba we-bilirubin ezinsana ezisanda kuzalwa

Ezinsukwini zokuqala zokuphila komntwana ozelwe usana, umbala we-icteric wesikhumba kanye nezibungu ezibonakalayo ezibonakalayo zingabonakala-i-jaundice yomzimba yengane esanda kuzalwa ivela. Kungenxa yokuthi ezinsukwini zokuqala zokuphila kwe-fetal hemoglobin yegazi ihlakazeka, esikhundleni sokwejwayelekile, futhi umkhiqizo wokubola kwe-hemoglobin yi-bilirubin. Ngesikhathi kuphazamiseka kwe-hemoglobin, i-indirect bilirubin ayikho ngqo, ehlanganisa amaprotheni esesibindi futhi iguqulwa ibe yi-bilirubin. I-indirect bilirubin ayihlulwanga, ayifihliwe nge-urine, i-soluble ngokuqondile, idonswe nge-bile.

Umkhuba we-bilirubin egazini lomsana

Umkhuba we-bilirubin oqondile uqukethe ama-bilirubin angaphezu kuka-25%. Ekubuyeni kwe-hemoglobin fetal, izinga le-bilirubin eliqondile landa, elingenayo isikhathi sokubopha i-albinin. Izinga layo liphakeme ngosuku lwesithathu lokuphila, emva kwalokho linciphisa amasonto amabili. Phakathi nalesi sikhathi, i- jaundice yezinto eziphilayo ivela futhi iphela, okungafani nalesi sifo, idlula ngaphandle futhi ingadingi ukwelashwa.

1. Uma ingane izalwa emzimbeni wegazi, izinga le-bilirubin ezisanda kuzalwa livamile kuya ku-51 μmol / l.
2. Ngosuku lokuqala lokuphila, ukwanda kwezinga le-bilirubin akufanele kube ngaphezu kuka-5.1 μmol / l ngehora. Ngesikhathi esifanayo, ukwenyuka okuphezulu ezingeni le-bilirubin ezinganeni ezikhule ngokugcwele kufika ku-256 μmol / L kuze kube yizinsuku ezingu-3-4 zokuphila, ezinsaneni ezisencane - ezingaphezu kuka-171 μmol / l.
3. Izinga elijwayelekile le-bilirubin ezinsukwini zokuqala zokuphila ngokuvamile alidluli 103-137 μmol / l, futhi ukwanda kungenxa ye-bilirubin engaziqondile.

Uma i-jaundice engokwenyama ingashintshi isimo somntwana jikelele, umbala we-urine nemifino, kanye nobukhulu besibindi nesipelingi, isikhumba sinomhlobiso we-orange, kanti i-jaundice iyanyamalala ngaphandle kokwelashwa ngeviki 2-3 lempilo. Amadijithali we-jaundice yokuphila:

• I-degree eli-1 (umbala we-icteric wobuso nentamo kuphela);
• I-2 degree (umbala we-icteric wesigamu esiphezulu somzimba kuya kwinkaba);
• I-3 degrees (ubuciko be-icteric ebusweni, i-trunk kanye nezingxenye ezingaphezulu zezingalo nemilenze);
• I-4 degree (umbala ophelele womzimba embala we-icteric, kufaka phakathi izinyawo namabhulashi).

Izimbangela zokwanda kwe-bilirubin ezinsana ezisanda kuzalwa

Ngaphandle kwe-jaundice yezinto eziphilayo, kune-jaundice ye-pathological in the newborns, lapho kuyoba khona nombala ophezulu we-bilirubin nombala ophuzi wesikhumba kanye nezibungu ezinomuncu. Izinhlobo ze-jaundice ye-pathological:

1. Hemolytic. Ngenxa yokuwa kwamangqamuzana egazi abomvu ekuxabaneni kweqembu legazi noma i-Rh factor phakathi komama nengane, izifo zofuzo - i-microspherocytosis, i-sickle cell anemia.
2. I-Parenchymal - ngenxa yokulimala kwesibindi nesifo sofuba esibangela ukufa, i-cytomegalovirus, i-toxins.
3. Ukuxilongwa - uma kwenzeka okungavamile ohlelweni lwe-enzyme nokubopha kwe-bilirubin ngqo.
4. I-Mechanical - uma kwenzeka ukwephula ukuphuma kwebhili ngenxa yokugodla iminyango ye-gallbladder noma isibindi nge-anomalies yabo yokuzalwa, isibonelo, i-atresia.

Ezingxenyeni eziphezulu ze-bilirubin egazini (ezingaphezu kuka-324 umgul / l), lifaka ingxenyeni yegazi-ingqondo futhi lenze njenge-toxin ebuchosheni bomntwana osanda kuzalwa (i-nuclear jaundice). Lokhu kubangele ukucindezeleka okunobuthi nokunciphisa kuzo zonke izingqondo, ukunganaki, ukuxuba kanye nokufa kwengane. Izinkinga ze-nuclear jaundice zingaba ukukhubazeka kanye ne-paresis, ukuphuza kwengqondo nokuzithulu.

Ukwelashwa kwezinga elikhudlwana le-bilirubin ezinsana ezisanda kuzalwa

I-jaundice engokwemvelo ayidingi ukwelashwa, lapho umbala wesikhumba ungasetshenziswa ungasebenzisa i-phototherapy, lapho ukukhanya kwelanga kuhamba khona ngokuzibopha kwe-bilirubin. Njengoba i-jaundice ye-pathological, ngaphezu kwe-phototherapy, udokotela ngokuvamile ubeka ukwelashwa kwe-detoxification ngisho nokushintshaniswa kwegazi.