Jaundice Neonatal e izinsana: izimbangela, izimpawu kanye nokwelashwa

Ukuzalwa imvuthu - kuyathokozisa kakhulu abazali. Kodwa ngezinye izikhathi, ikakhulukazi uma kuziwa izibulo, kungashiwo lonakaliswe ngenxa izinguquko ngebala lesikhumba nolwelwesi lwamafinyila ingane. Lo mkhuba, eyaziwa ngokuthi i-jaundice ezisanda kubelethwa, akuyona into engavamile, Ngakho-ke, kulabo maduze azalwe umntwana kufanele ufunde kabanzi ngalo.

izizathu

Okuvela jaundice e izinsana - kuba ngokuphelele evamile. into enjalo kwenzeka uma igazi imvuthu ngenxa ukuwohloka kwamangqamuzana egazi abomvu bilirubin ephakeme kunokuvamile. Kufanele kuqondwe ukuthi ngaphezu amaseli ayo igazi, isidumbu sosana kufanele ukucubungula kabanzi futhi asalile abomvu egazi umama. Ngakho, umthwalo iba abalulekile, futhi ekugcineni aqoqana bilirubin ngokweqile, okuholela yellowing iso sclera nengane isikhumba. Kulokhu, ingane ingekho enye pathologies, kubhekwa ukuba enempilo, futhi ayidingi ukwelashwa.

ifomu bokuphila

Ngokuvamile, izinguquko ukubukeka wengane ngokomzimba kuyagcinwa ezinsukwini 2-5 emva kokuzalwa futhi zinyamalale by 2 amaviki ubudala. Ngesikhathi esifanayo neqhaza ukunyamalala ngokushesha zezimpawu bokuphila zheltushki kungenzeka uma bavame imvuthu kuya webele. Lokhu kuzokwenza kusheshiswe ukukhethwa sezinyawo yasekuqaleni - meconium, okuyinto esuswa umzimba bilirubin ngokweqile. Ngaphezu kwalokho, kunconywa kakhulu njalo ohamba ingane emoyeni opholile.

Bokuphila jaundice ezisanda kubelethwa ngayo lapho usana: Izimbangela

Njengoba sekushiwo, umbala kwemvelo kwesikhumba futhi lwamafinyila ulwelwesi ngokuvamile uyalulama ukuze izinsuku 10-14 ubudala. Kungenjalo ukuthi nginesifo jaundice ezisanda kubelethwa. Kungaba ngoba:

• umntwana ngaphambi kwesikhathi;
• ukukhiqiza ngokwedlulele bilirubin;
• amaseli enzymatic beya isibindi;
• ikhono encishisiwe ukuhlanganisa uxhumano nomsebenzisi igazi serum bilirubin.
• sokugembula jaundice ezisanda kubelethwa (nokunwetshiwe).

Lesi sifo kungaba azalwa naso noma bathenga.

Esimweni sokuqala, jaundice ezisanda kubelethwa kungenzeka kubangelwa:

• Pathology we ulwelwesi lwamangqamuzana egazi abomvu. Lokhu ngesinye isikhathi isifo livela kakade esikhathini ezisanda kubelethwa. Ngokuhamba kwesikhathi, ukwanda ubende kanye kwesibindi, futhi anaemia kamuva.
• Erythrocyte enzyme ukuntula. Kulokhu, jaundice kwenzeka ngosuku lwesibili ziphila. Enye inkomba iyona ukuhwalala umchamo.
• Isici ukuba sibe-hemoglobin zamagama nokwakheka kanye heme. Kubonakala at izinyanga 4-6 zokuphila komntwana.

Ngazuza sokugembula jaundice ezisanda kubelethwa kuba ka ezintathu izinhlobo:

• isifo Hemolytic ka usana, okuyinto umphumela we izingxabano imuunologicheskogo igazi fetus kusukela egazini likamama;
• ukopha e kwezitho zangaphakathi noma cephalohematoma, okwenzeka lapho resorption kwemikhiqizo yegazi angangeni ukuhlukaniswa elithwala umoya-mpilo;
• eziningi nezinye izizathu, ezifana ukwanda kwamangqamuzana egazi abomvu egazini womntwana, a syndrome esakheka nabo igazi eliningi ngesikhathi sokubeletha e pheshana emathunjini usana, khona ukugula imvelo kanina immunopathological, okwelapha, njll hemolysis.

ukwelashwa

Njenganoma jaundice bokuphila, izingane ngokuvamile Kunconywa ukuba bancelise nokwenza emoyeni opholile. Ngaphezu kwalokho, uma i-jaundice wengane ezisanda kubelethwa, phototherapy indlela sisetshenziswa. Siqukethe irradiating le imvuthuluka isithombe ukukhanya. Ngaphansi emaphikweni alo emzimbeni walo yanda yokubola bilirubin, bese it is excreted ku umchamo kanye endleni.

Inqubo wenziwa ngendlela elandelayo:

• ingane khumula izingubo ngokuphelele (uma ungumfana, isibunu ngebhandeshi) bese zifakwa ebhokisini esikhethekile usana;
• uvale emehlo imaski opaque nge band nokunwebeka;
• ngemisebe Kwenziwa okungenani 2-3 amahora kokuphazamiseka yokudla;
• ngezikhathi ezithile ingane zanikeza isithombe ugongolo kwadingeka ukufinyelela kuzo zonke izindawo isikhumba.

Ezimweni sina ngokukhethekile, lapho lizinga lelisetulu bilirubin kubalulekile, kuseshini Kwenziwa njalo. Ngesikhathi esifanayo ihora ngalinye ukuthatha ukuhlolwa igazi. Inqubo inqanyulwa kuphela uma ukuhlola kubonisa yalokho eyanelisayo bilirubin.

Contraindication ukuqhubeka phototherapy kuyinto reddening kwesikhumba. Nokho, izenzakalo ezinjalo kuyagcinwa kakhulu kuyaqabukela.

GOIC

Ukwelashwa nokuvikelwa jaundice ezisanda kubelethwa ezimweni ezibucayi engenziwa nge operation exchange igazi. Izinkomba ngoba ukusetshenziswa le ndlela yilezi:

• Imiphumela abanelisi ukuhlolwa laboratory bilirubin amazinga enkabeni intambo igazi ngesikhathi sokuzalwa nokukhula unomphela, ngisho ngaphansi kwesimo phototherapy, nabanye;
• proven sensitization kukamama kanye izimpawu zesifo i ezinzima hemolytic we kuzalwa umntwana wakhe;
• ukubukeka imvuthuluka izimpawu bilirubin ubuthi.

izingxenye zegazi ngenxa yokumpontshelwa odokotela akhethiwe ngokuqinile ngamunye ngengane ngayinye ikhumbula uhlobo igazi ukungavumelani zikamama nomntwana. Ngaphezu kwalokho, GOIC isebenze kuphela emva crossmatch yimpumelelo ngokusebenzisa ipayipi efakwe ku vein enkabeni. Ngesikhathi esifanayo, uqaphele ukuthi ngisho ne ukukhethwa ezifanele ngezinto zokwakha zezinga eliphezulu ukusebenza nokuqashelwa okuqinile inzalo ayikwazi ayifakiwe ezihlukahlukene izinkinga. Ngokwesibonelo, kungase kube i embolism emoyeni, ukuhlukumeza ka enhliziyweni, ukutheleleka, thrombosis, ukushaqeka anaphylactic, nabanye. Ngokuvamile, kwenzeka kuzona ngokwazo 3 amahora yokuqala ngemva GOIC, ngakho sonke lesi sikhathi, izisebenzi zezokwelapha kumele ngokuqinile ukuqapha isimo somntwana.

ezinye izindlela

Ukwelapha kungabuye eyenziwa usebenzisa izidakamizwa kanti ukwelashwa okuphindwe ukumnika. Esimweni sokuqala inikezwa "ziksorin" agar-agar "Karbolit" futhi "Cholestyramine" okuyinto ukukhuthaza ukukhululwa kwe bilirubin emathunjini. izidakamizwa cholagogue nazo ebekiwe. Mayelana yokwelapha ukumnika, bese-ke Kwenziwa izixazululo of sodium chloride kanye glucose, bese isixazululo albumin lasetshenziswa ngesikhathi esincishisiwe amaprotheni ezingeni.

zokuvimbela

Neonatal jaundice izimbangela zazo echazwe ngenhla, kungenzeka kuphela uma kwenzeka noma izimpawu wakhe uhambe ngokushesha uma uthathe izinyathelo ezilandelayo.

• ngokushesha emva kokuzalwa imvuthu ukunamathisela ebeleni;
• Khumulani ingane futhi sishiyele konke ku inabukeni nqunu ukuze isigamu sehora;
• bancelise ngokufunwa;
• Kusukela ezinsukwini zokuqala nengane sishaywe umoya omnandi;
• ukondla umntwana ibele ngalinye imizuzu okungenani 7-10;
• uma ingane uyenqaba bayoncela ubisi lwebele kufanele kuboniswe futhi amnike ngesipuni.

Manje ngoba sewuyazi ukuthi lokho jaundice ezisanda kubelethwa. Izimpawu ezihlukahlukene isifo ziye achazwe ngenhla, ngakho-ke, bebona izibonakaliso zabo, ungakwazi ngokushesha ukukhombisa udokotela imvuthu futhi qinani isikhathi esiyigugu.