Bilirubin: osanda kuzalwa evamile. Ithebula nyangazonke

Isimo lapho bilirubin egazini ezinsaneni idlula amazinga ukusebenza - akukhona okungavamile ukuba likhithike. Ngokuvamile, into enjalo senzeka ngokuzimela. Nokho, izinga eliphezulu kakhulu zidinga ukwelashwa okwengeziwe, ngoba singaholela ezinkingeni ezinkulu. Ngakho-ke, i-bilirubin okusezingeni eliphezulu okufanele zithathwe ngokucophelela.

Umqondo bilirubin

Bilirubin - umkhiqizo esukela nokwahlukana amangqamuzana abomvu egazi. Uma umjikelezo wempilo yabo sesiphelile, basuke iguqulwe ibe-hemoglobin enobuthi, kusukela lapho kukhona kumiswa udayi.

Zokwelapha ukwaba izinhlobo ezimbili (izingxenyana) yalesi material: nenkhulumombiko. Ekuqaleni kwakhiwa bilirubin engesobala. He is kahle encibilikayo futhi kunzima excreted kusuka emzimbeni. Ngakho okokuqala ibe bilirubin oqondile, olunceleka isibindi, kwase kuba kwabayishumi gallbladder futhi excreted ngokusebenzisa namathumbu.

Umzimba womuntu wenza konke angakwenza ukuze ayibulale ketshezi. Nokho, ekuqaleni kwesibindi usana akakwazi ukubhekana umthwalo ongako. Yingakho ezinsukwini zokuqala zokuphila kubaluleke kangaka ukuba lokhozi ukuthi izinga waphawula ka bilirubin egazini izinsana. Ithebula, equkethe inani embundwini inkomba iklanyelwe ukukusiza ukukwenza.

Izimbangela bilirubin isigqugquzeli

Ziyingozi impilo Isimo sengane lapho value ehlukile etholwe ukuhlaziywa evamile bilirubin e izinsana emini. Ithebula evumela ukuqhathanisa lezi zinyathelo ezimbili lakhiwe ngokuhamba uphenyo eside. Yasungulelwa ukuhlonza izizathu ezibangela lesi simo. Khona-ke abakhululiwe eziyinhloko:

- Ukukhubazeka e fetus ijubane ukuthuthukiswa;

- ekwelapheni abakhulelwe izidakamizwa ubuthi, kanye nokusetshenziswa yabo ngesikhathi sokubeletha;

- hhayi ukuba bancelise;

- esiningi isisindo ukulahlekelwa ingane ngezinsuku zokuqala zokuphila.

Esikhathini indawo ingozi bese izingane ezizalwa omama nge RH negative isici. Bavame Kutholwe ngokweqile lapho ukuqhathanisa Kwenziwa: umphumela ukuhlaziywa kwi bilirubin - izinga ngayo lapho usana (bheka ithebula).

kuyinsakavukela

Thina ingane esanda kuzalwa akuyona zonke izinhlaka abasebenza at zigcwele. Ngakho-ke okwabangela ukuwa ka-hemoglobin fetus akanayo isikhathi ithintane-albumin. Imiphumela iba yinhlanganisela yokukhandleka ezingeni bilirubin sokukhula.

Kulesi inombolo yokuqala izinto ukwanda igazi, bese uqala ukuncipha. Ngaphansi kwezimo ezivamile, cishe ngosuku lwesine ekuphileni, abantwana babe bilirubin ubuncane. osanda kuzalwa Okuvamile (itafula, okumelelwe ngezansi iqukethe inani layo) siyahluka kakhulu ngeminyaka.

Norma Imininingwane bilirubin ngokuvumelana lwemibhalo Ingerleĭb M.

Ubudala wengane	Inani lesilinganiso index, mmol / l
ngosuku lokuqala	esingaphansi 34
ezingu-1-2	24-149
3-5 izinsuku	26-205
izinsuku ezingu-60 5 iminyaka	5-21

Kunenye ithebula esifingqa evamile bilirubin ezingeni ekusakazeni izingxenyana zaso.

Ubudala wengane	Okusho bilirubin, mmol / l
	jikelele	ahlobene	khulula
Izinsana	23,09	8,72	14,37
Eyesibili usuku	54,22	8,72	45,50
Ngosuku lwesine	90,14	7,87	82,27
ngosuku lwesithupha	69,10	7,72	63,28
ngosuku lwesishiyagalolunye	53,02	8,72	44,30
ngenyanga	11,12	2,57	8,55

Ngesikhathi sokubeletha embundwini izidakamizwa okuqukethwe bengase bazikhandlele 51 Mol / l. Ngemva kwalokho, kancane kancane kwandisa, futhi ngezinye 3-4 izinsuku zokuphila lenziwe laba likhulu. Ngo abantwana abazalwa esikhathini ezingeni bilirubin akufanele futhi iyophakama kuno-256 pmol / L, preterm - 171.

jaundice physiologic

Ngokuvamile kukhona bokuphila jaundice kule osanda kuzalwa. Norma bilirubin (ithebula kuqinisekisa lokhu) kwandisa ezinsukwini zokuqala zokuphila, kodwa isibalo izinto bebodwa kumele kungancipha amasonto amabili ubudala.

Odokotela ukwaba eziningi zezimpawu ezikhombisa ukuthi sincome khona jaundice kwengane bokuphila:

- livela ngosuku lwesibili ziphila;

- ngesilinganiso amazinga igazi bilirubin kudlulwe kancane;

- ebusweni nomzimba ngaphezu inkaba imakwe yellowing kwesikhumba.

Naphezu kwakho konke, isimo somntwana ngokuphelele evamile, ukugcina umzimba. Bilirubin kufanele uqashelwe njalonjalo sezifo zezingane jaundice bokuphila ayibuyi ibe sokugembula. Ngokuvamile, lapho ngineminyaka engu-iviki elilodwa kufanele kuqale ukunciphisa isibalo izinto. Mayelana 3 amaviki ezinganeni azalelwa ngesikhathi eside, futhi-ngenyanga ukuzinza kwesikhathi bilirubin emzimbeni.

jaundice sokugembula

Ngokushesha okukhulu, le jaundice bokuphila kungase ukuthuthukela sokugembula. amafomu Sinzima ahambisana nokwanda okuphawulekayo bilirubin ezingeni: 90 Mol / l njalo ngemva kwamahora angu-24. Ngaphezu kwalokho, e neonates kungaqalisa kube lenani eliphakeme kakhulu: abangaphezu kuka-250 micromol / l.

Okungukuthi, uma ubhekene nesimo esinjena, yokuthi liphansi egazini kunalelo ngesilinganiso bilirubin e izinsana. Ithebula esenezinyanga kusiza ukuqhathanisa lezi izinkomba kanye ukuchaza inkinga ngesikhathi. Kodwa kunezinye izimpawu jaundice pathologic:

- yellowing of ebusweni umzimba ngezansi inkaba;

- orange izandla nezinyawo;

- umchamo onombala bese indle kuxhopha kakhulu.

Lesi sifo ngokuvamile eside futhi ageleza ngamaza. Ngaphezu kwalokho, isimo jikelele ingane ingase uphatheke kabi: kukhona ukucindezela kwabantu nokungabi khona excitation ngokweqile.

Izinhlobo izimbangela jaundice sokugembula

Kukhona ezihlukahlukene enkulu jaundice pathologic. Basuke labelwe kuye izizathu ukubukeka.

1. Hemolytic ebonakaliswa ukungqubuzana RH isici kanye unina wosana, kanye nezifo ngenxa yezakhi zofuzo.

2. Parenchymal jaundice kwenzeka uma izilonda isibindi amafomu azalwa naso isifo sokusha kwesibindi kohlobo, cytomegalovirus, ubuthi.

3. conjugation Uhlobo kuboniswe endabeni ukungasebenzi uhlelo enzyme, kanye yokubopha bilirubin.

4. jaundice Mechanical kwenzeka uma kwaphazamisa Bile outflow at anomalies gallbladder futhi Amapayipi isibindi.

Ukunqunywa bilirubin

Ukuze ukuhlola ezingeni staining ejenti egazini, ukuhlaziya ekhethekile isetshenziswa. Isampula ngokuvamile kuthathwe esiswini esingenalutho. Kodwa ukuze izingane edingeka kangaka yenziwa akuvamile, ezimweni ezibucayi, kutuswa ukuba ondle ingane yakho 4 amahora ngaphambi igazi izibonelo zalokho. Ngo izinsana, amasampula ethathwe izithende endaweni encane ekhethekile cleaner tube.

Ukuze uqedele ukuhlaziya isimo kunqunywa egazini bilirubin izingxenyana zaso. Lokhu kusiza ukucacisa hhayi kuphela uhlobo jaundice, kodwa izizathu ukuguqulwa ku esigabeni sokugembula.

Emva kokuthola imiphumela yokuhlaziya uqhathaniswa futhi izinga labo bilirubin e izinsana. Ithebula nyangazonke yakhiwa imibundu. Uma inani Umbala ejenti iphakeme kakhulu kunanoma isimo sabo ngempela zidinga ukwelashwa.

imiphumela kungenzeka

I emakamu eliphezulu egazini kubathinta kabi impilo ingane yakho. Ikakhulukazi sihlobana isimo lapho kulinganisela awabuyiswanga bilirubin e neonates (2 izinyanga). Ithebula likwenza kucace ukuthi ngalesi yobudala ukubaluleka kumele luhambisane ukuthi okuyinto eyenzeka omdala onempilo.

Okokuqala, bilirubin okusezingeni eliphezulu kuyingozi ebuchosheni futhi uqondiswe isimiso sezinzwa esiyinhloko ingane. Ingozi iba ukuthi colorant kungenziwa zanqwabelana lapha. isimo okunjalo kungaholela ukudakwa okunzima umzimba futhi ngenxa yalokho, ukubhujiswa amangqamuzana obuchopho kanye kwalapho kuhlangana khona imizwa. Ngemva kwalokho, lokhu kungabangela izinkinga bokuzwa futhi umbono, okuthile engqondweni, komqondo kanye nezinye izinkinga.

Konke lokhu kuholela yokuthi wezingane ngokuqhubekayo ukuqapha khona okungenzeka zheltushki ingane. Uma kukhona izinsolo uhlolo igazi ngesisekelo okuyinto kuyacaca ukuthi inani ngazimbili umdlalo "Kutholwe bilirubin -. Yinto evamile ukukhuluma ngosana ' Ithebula ne odokotela usizo wenze esiphethweni esinembile.

Abazali basuke bedinga ukwazi ukuthi kukhona eziningi izimpawu, ukubonakaliswa okuyinto ingane nge-jaundice kufanele kube yisizathu ukwelashwa ngokushesha kudokotela. Lezi zihlanganisa:

- ukucobeka futhi ukozela;

- wokwehla reflex oncelayo;

- zibe, tics, ukuziphatha inzwa yebhayomethrikhi

- okwandisa ubukhulu ubende kanye isibindi;

- umfutho ophansi wegazi.

Izindlela ukwehlisa ezingeni bilirubin

Kubalulekile ukuqonda ukuthi i-jaundice bokuphila akudingi ukwelashwa. Kumelwe kudlule bebodwa. Nokho, ngaphandle kokwelashwa, abakwazi ukwenza esimweni kakhulu kudlulwe inkomba ezifana bilirubin (osanda kuzalwa evamile). Ithebula kwenza kube nokwenzeka ukuba ningabi nje kuphela ochwepheshe, kodwa futhi abazali baqonde ukuthi kungani kwakudingeka kokungenela wezokwelapha.

Qala ukulwa nge bilirubin okusezingeni eliphezulu kufanele kube esebenzisa ukuchayeka ukukhanya. It wenziwa esitokisini esikhethekile nokusetshenziswa esiyisibopho izibuko zokuzivikela. Le ndlela kubhekwa engalimazi kakhulu, kodwa ngempumelelo kakhulu futhi okusheshayo. imiphumela emibi le nqubo kungaba sohudo isikhumba uyaxebuka. Esimweni ekunqanyulweni yokwelashwa engemihle kuwo kakhulu ngokushesha ababhubhayo.

Nokho, qaphela ukuthi phototherapy kuphumelela kuphela uma bokuphila jaundice. Uma ngokuhamba kwesikhathi ezingeni efana ephakeme kwenani emgqeni "bilirubin Jwayelekile ezinsaneni 1 inyanga" (ithebula eboniswe ngenhla) ngeke bakwazi ukwenza ngaphandle imithi.

Abantu abaningi abakholelwa jaundice e izinsana ngempela inkinga engathí sina. Kodwa kubalulekile ukuba bazi futhi baqonde ukuthi lokho akulona iqiniso kuzo zonke izimo. Ngaphandle ukunakisisa izimpawana kanye nokwelashwa inkinga kungaba nemiphumela emibi.