Mukati
Vabereki vakawanda vane neonatal jaundice. Izvi ndezvechokwadi kunyanya kune vacheche vasati vasvika, inokura mune zvinopfuura 80 muzana. Asi muvacheche vakazvarwa panguva, izvi zvinowanzoitikawo - zvinoitika mu50-60 muzana yematambudziko.
Jaundice inokura mumazuva mashomanana ekutanga mushure mekuberekwa kwemwana, uye kuchinja kweganda kunowanzoonekwa pazuva re3-4, apo amai nemwana vanodzoka kumba kubva kuchipatara.
Nei izvi zviri kuitika? Zvose zvinoenderana nebilirubin. Mune chero munhu, inoumbwa panguva yekuparara kwemasero matsvuku eropa (masero eropa ane basa rekutakura okisijeni) muupenyu hwose uye anobudiswa nyore nyore kubva mumuviri nerubatsiro rwechiropa. Asi mumwana achangoberekwa, iwo, semamwe masystem akawanda emuviri, haasati anyatsokura, saka chiropa chemwana hachisati chave nemaenzayimu akakwana kuti chiparadze nekuchiburitsa. Uye chiyero chehemoglobin muropa remwana achangoberekwa chakanyanya kukwirira. Nekuda kweizvozvo, bilirubin inoungana muropa, uye ganda remwana achangozvarwa rinoshanduka yero. Machena emaziso anogona kunge aine mavara.
Panguva imwecheteyo, mwana anonzwa zvakanaka. Iyi ndiyo inonzi physiological jaundice yevacheche, iyo isingadi kurapwa uye inonyangarika zvachose pakupera kwemwedzi wekutanga wehupenyu. Asi kunewo pathological jaundice muvana vachangoberekwa. Ichi chatova chimiro chakakomba zvikuru chinogona kuva nemigumisiro yakaipa kumwana. Jaundice yakadaro inoda kurapwa kunosungirwa.
Zvikonzero zvejaundice muvana vachangozvarwa
Kusiyana nehupenyu, pathological jaundice inowanzokura mumaawa ekutanga mushure mokuberekwa kwemwana. Panogona kunge paine weti yakasviba uye kushanduka kwetsvina, anemia, uye ganda rakachenuruka. Panguva imwecheteyo, chiyero chebilirubin chakakwirira zvikuru - pamusoro pe256 µmol muvana vanoberekwa nenguva, muvana vasati vasvika - pamusoro pe171 μmol.
"Pathological jaundice inogona kukonzerwa nezvikonzero zvakawanda," anodaro chiremba wevana Anna Levadnaya, Mumiriri weMedical Sciences, munyori weblog pamusoro pevana. - Chinonyanya kuzivikanwa ndechekuwedzera kuparara kwehemoglobin nekuda kwekukakavadzana kweRhesus kana kurwisana kweropa pakati paamai nemwana. Uyewo, chikonzero chejaundice chinogona kuva chirwere chechiropa kana chirwere chekubudisa bile mumatumbo. Mukuwedzera, jaundice inogona kuva chiratidzo chetachiona, hypothyroidism (nekuda kwekuderera kwehutano hwehutano), polycythemia (kuwedzera kwehuwandu hwemasero matsvuku eropa muropa), kuvhara kwematumbo, kana pyloric stenosis (iyi ndiyo kuberekwa kupfupika kweropa). chikamu chedumbu chisati chapinda muura, izvo zvinoita kuti zvive zvakaoma kuti zvokudya zvipfuure). mukati mayo). Inogona kuitika nemimwe mishonga uye nezvimwe zvikonzero.
Uyewo, kune jaundice muvana vachangoberekwa kubva mumukaka wezamu, apo chiyero chebilirubin mucheche chinokwira nekuda kwekupinza kwemamwe mahomoni ari mumukaka waamai mumuviri wemwana. Jaundice iyi inogona kugara kusvika mavhiki matanhatu. Kana, apo HB yakadzimwa kwemazuva 6-1, chiyero chebilirubin chinotanga kuderera, uye yellowness inonyangarika, ipapo kuongororwa kwakadaro kunoitwa. Asi nemaitiro akanaka, kubviswa kwekuyamwisa hakudiwi, kunotangazve mushure memazuva 2-1. Panguva yekumbomira, amai vanofanira kunyatsozvitaura kuti vachengetedze lactation pamwero unodiwa.
Kurapa kwejaundice muvana vachangoberekwa
Physiological jaundice yevacheche, sezvatareva, haidi kurapwa. Dzimwe nguva vanachiremba vevana vanokurudzira kuwedzera vana vakadaro nemvura, asi chete kana lactation yakasimbiswa uye kushandisa chipunu, kwete bhodhoro.
Kana iri pathological jaundice yemwana achangoberekwa, inoda kurapwa kunosungirwa, iyo inorayirwa nachiremba.
Mushonga unoshanda wechirwere ichi nhasi phototherapy. Kuti uite izvi, shandisa mwenje unokosha ne "blue" chiedza: pasi pesimba re ultraviolet radiation, bilirubin inoputsika uye inobudiswa kubva mumuviri wemwana achangoberekwa nehuni uye tsvina. Kusimba uye nguva yephototherapy zvinoenderana nehuremu hwemuviri wemwana pakuzvarwa uye huwandu hwebilirubin, iyo inogara ichiongororwa. Sezvo mutemo, masangano emaawa matatu pasi pemwenje anorayirwa nekuzorora kwemaawa 2-3. Mwana achangozvarwa anofanira kubviswa hembe, asi maziso anofanira kuchengetedzwa, vakomanawo vane nhengo dzakavandika.
Mumatambudziko akaoma eineonatal jaundice, apo hupenyu hwomwana huri pangozi, kuwedzerwa ropa kunogona kurongerwa.
- Zvakakosha kuziva kuti ikozvino nyanzvi dzakawanda dzinobvumirana kuti kugadzwa kwe sorbents, zvinodhaka zvakadai se phenobarbital, Essentiale, LIV-52, kubviswa kwekuyamwisa, UV (ultraviolet blood enrichment), electrophoresis kana kunyanya infusion therapy ye jaundice haibatsiri ( uye ye phenobarbital uye isina kuchengeteka) - anodaro Anna Levadnaya.
Migumisiro yejaundice muvana vachangoberekwa
Iyo physiological jaundice yevachangozvarwa, sezvatakatoona, inopfuura yega uye haina kutakura chero mhedzisiro yakaipa kune hutano hwemucheche. Asi migumisiro yechirwere chejaundice mucheche inogona kunge yakakomba zvikuru, kunyanya kana kurapwa kusina kutanga nenguva.
- Kunyanya kuwedzera kwehuwandu hwebilirubin muropa kunogona kukonzera kukanganisa kwehuropi, - anodaro Anna Levadnaya. - Sezvo mutemo, izvi zvinoitika muvana vane chirwere chehemolytic maererano neRh factor, nekuwedzera kwehuwandu hwebilirubin pamusoro pe 298-342 μmol / l. Uye iyo yakakwira mwero webilirubin, inowedzera njodzi ye encephalopathy.
Kudzivirira jaundice muvana vachangoberekwa
Kudzivirirwa kwakanakisisa kweineonatal jaundice ndiyo mararamiro ane hutano kune amai panguva yekuzvitakura, kurega tsika dzakaipa, kudya kwakanaka.
Kuyamwisa zvakare kwakakosha zvikuru. Mukaka waamai ndicho chikafu chakanakisisa chemwana achangoberekwa, zviri nyore kugaya, ura hunokurudzirwa nokukurumidza, hunozadzwa ne microflora inobatsira, uye ma enzyme anodiwa anogadzirwa. Zvose izvi zvinobatsira muviri wemwana achangoberekwa kurarama nejaundice nekukurumidza uye zvakanyanya.