Jaundice conjugation: ukuxilongwa, izimbangela, ukwelashwa

Jaundice akusona isifo ehlukile, kuyinto nje uphawu pathologies ezithile. Ezimweni eziningi, kungase bokuphila, okungukuthi ezingahlobene yisiphi isifo (ezinsaneni). Isizathu salokhu simo anda bilirubin, onikeza Umbala icteric yesikhumba, nolwelwesi lwamafinyila kanye sclera.

Jaundice: Izinhlobo

Lesi simo kuhlangene ngokungenakuhlukaniswa okuqukethwe bilirubin egazini. Nokho, kudala ukwanda zingase zihluke. Kwezinye izimo, ekutholeni imbangela ngokuvumela zokugula esolwa emzimbeni, okudinga ukwelashwa ngokushesha. Kuye ngokuthi iyiphi inguqulo ye bilirubin umzimba iziyaluyalu kukhona izinhlobo eziningana jaundice:

1. Conjugation jaundice, okuyinto is phetho conjugation kahle ka bilirubin. Lokho-ke kwenzeka izinsana.
2. jaundice Parenchymal eba eziningi pathologies isibindi. Ukunqotshwa kwe-parenchyma komzimba (ukufa samasosha omzimba asebenzayo - hepatocytes) kukwenza kungenzeki ukuba liyobamba bilirubin futhi exchange wayo.
3. jaundice Obstructive, okuyinto eyenzeka ephula outflow ka Bile. Lihlobene nokubhekana ubuso izifo anomthelela elivalayo noma ukuvaleka mafutha anciphisa isikhala esingaphakathi we imbobo Bile. Lokhu kwenzeka ngo-cholelithiasis kanye kumiswa lwesimila.
4. jaundice Hemolytic - zokugula elihlobene ne-nokwahlukana amangqamuzana abomvu egazi. Bilirubin - sombala okwenzeka lapho kuhlukanisa i-hemoglobin, ngakho isigqugquzeli erythrocyte lysis kuholela nokwandisa amazinga.
5. Kernicterus - ezimele futhi iyingozi kakhulu uhlobo. Senzeka kunjalo uma ingane ekhulayo yayivame hypoxia phakathi ukuthuthukiswa noma lokuzalwa asphyxia. Futhi, imbangela kungase kube ukutheleleka kubantu besifazane abakhulelwe. Ingozi iba ukuthi sombala aqoqana amangqamuzana ezinzwa e-ubuchopho, okuholela kwempilo esithinta izinzwa, futhi kungenzeka ukuthi ngisho ukubulala.

Conjugation jaundice e izinsana

Jaundice kwenzeka ezinsaneni kuyinto bokuphila, ngoba ongakaphathelani inqubo sokugembula. Kutfutfukisa lizinga, ngokuvamile ngemva kwezinsuku 3-5 lokuzalwa. Ngokuvamile, amangqamuzana egazi abomvu bavezwa sokuvuselela njalo, okuyinto kuhambisana hemolysis - nokubhujiswa kwabo. Kubantu abadala, isibindi bakheké ngokuphelele, ngakho bilirubin, okuyinto ezikhishwe kwamazinyo kula maseli isikhathi ukuxhumana futhi akusho buthelela egazini.

Isithombe ngeziguli izinsana sihlotshaniswa sokuvuselela okukhulu abomvu egazi ashaye futhi yokwehluleka kwesibindi isihlobo. Lokhu umzimba ayikahlanganiswa bakheké ngokuphelele, avame jaundice enjalo kwenzeka ababelethwa kungakafiki isikhathi. Bilirubin kuphakama egazini, bese aqoqana isikhumba futhi lwamafinyila ulwelwesi, ebanikeza umbala sici. NEKUKHULUMA ngosuku lwesithathu-yesihlanu. ke lezi zimpawu kudlule exchange of bilirubin kancane kancane ukubuyela esimweni esivamile.

Kuyini lokhu?

Conjugation jaundice (ICD-10) ngokwehlukana ngezigaba international akuyona esabiwe. It has P59.0 wekhodi kokubili jaundice ezisanda kubelethwa, okuyinto is phetho ukubeletha singakafiki isikhathi, futhi lihlotshaniswa hyperbilirubinemia. Imininingwane inqubo echazwe ngenhla.

Conjugation uhlobo lesi sifo kwenzeka kaningi izingane. Lokhu jaundice lezivakashi e izinsana, kanye isimo esiholela e ezizalwa ngaphambi kwesikhathi kanye nezingane wadalula asphyxia. Izimbangela zezinkinga ngokuvamile zenani elikhulu eziyifa kanye endocrine zokugula (isib, syndromes Lyutseya-Driskopa futhi Gilbert). Leli qembu lihlanganisa jaundice izidakamizwa.

Bilirubin - kuyini?

Leli gama wanikezwa lesi sakhi, okuyinto umkhiqizo ukubhidlika elithwala umoya-mpilo. Ngezinye lokuhlala ezithile kudala Umbala zesikhumba nolwelwesi lwamafinyila. Bilirubin - umbandela ezibaluleke kakhulu zokuxilonga, njengoba izithelo zawo lembula inqubo sokugembula futhi baqala ukwelashwa. Inani sombala ibonisa isimo isibindi ipheshana biliary.

Emzimbeni, le bilirubin itholakala amafomu amabili - nenkhulumombiko. Umsuka kuphuma umkhiqizo ukuguqulwa yesibili. bilirubin bukhoma kusho amafutha ezinobuthi futhi ugxile. Akafuni excreted kusuka emzimbeni. iziyaluyalu umzimba, leli fomu kungenziwa zanqwabelana, nokunikeza umphumela enobuthi emzimbeni. Ngokuvamile, it is ibe bilirubin eqondile akunabo ubuthi. Conjugation jaundice kwenzeka ngenxa yokwephula umzimba walo.

Exchange bilirubin

Umthombo lo sombala Lisebenzisa i-hemoglobin - ingxenye eyinhloko kwamangqamuzana egazi abomvu. Ngo ukubola abomvu cell-hemoglobin ekhululwa khona futhi wadalula cleavage. Le nqubo wenziwa ezikhethekile macrophage izitho (umnkantsha, isibindi kanye ubende). Ngenxa yalokho we cleavage kwakhiwa heme futhi globin. Eyokuqala siguqulelwa biliverdin - owandulela bilirubin engesobala. Ukwakheka kwabo ka biliverdin ehlangene umsebenzi enzyme ethile, phakathi kwawo - the cytochrome P-450, i-heme oxygenase. Ngaphezu kwalokho bilirubin engaqondile Is guided amaseli isibindi lapho sibopha ukuthi glucuronic acid. kwakhiwa Ngakho bilirubin oqondile, okuyinto lilondolozwe esinyeni nenyongo bese wadalula excretion phakathi duodenum. microflora emathunjini kunomthelela ukunciphisa yayo urobilinogen. Ingxenye singaphansi ukumuncwa, izinsalela aguqulwa ku sterkobilinogena futhi excreted ku indle, wasinikeza a umbala sici.

ukuhlolwa Laboratory ingase ibonise ukuthi bilirubin liphakeme. Kusho ukuthini? Ukwenyuka ezingeni kungenzeka ehambisana nesifo, ezidinga ngokushesha kokuhlaziywa zokuxilonga. ukwanda bokuphila e bilirubin ebonwe izinsana.

emitholampilo isithombe

Naphezu kweqiniso lokuthi i usana libhekene bilirubin yanda, ukubonakaliswa emitholampilo iqinile neze. Uphawu isimo inikezwe - umbala nokubukeka icteric. Lembula hhayi kuphela isikhumba kodwa futhi nolwelwesi lwamafinyila. Physiologic jaundice conjugation sihamba kungaqashelwa, kepha uma kungenjalo, kufanele zokugula okusolwayo.

ukuhlola

Jaundice kungaba akusiso isimo bokuphila, kodwa futhi uphawu lokugula. Uma ingane has a umbala ethile isikhumba kanye nolwelwesi lwamafinyila, idinga ukuqapha njalo ngumuntu wezingane. Futhi ezimweni ezinjalo kudingeka ukulawula ezingeni bilirubin. Ngokuvamile, ezinsukwini zakuqala inombolo yayo yokuphila ifinyelela 60 mmol / l, kodwa engasekho. Ngaphezu kwalokho, kuleli zinga inyuka (amahora 3-7).

Ngokuvamile, kukhuphuke bilirubin ephephile futhi akunamthelela enobuthi emzimbeni wengane, Nokho, ezingeni kumele singeqi okubizwa ngokuthi ukubaluleka emnceleni - 205 pmol / l. Bilirubin anda - okusho ukuthi ushintsho olunjalo? Jaundice kuyinto sokugembula futhi kudinga ukwelashwa okuphuthumayo. Uma lesi sibalo ilungile, kodwa i-jaundice iqhubeka isikhathi eside, kubhekwa conjugation, okungukuthi, okuyinto imbangela yokungavuthwa izinhlelo isibindi enzyme.

Ukwelashwa conjugation jaundice

Emuva kokuhlolwa, kunqunywa jaundice bokuphila noma sokugembula. Eyokuqala Akudingi ukwelashwa futhi iphela bebodwa futhi benganakwa muntu. jaundice engapheli eyayiqhutshwa (lokuhlanganisa) kwelula ngokwayo nayo lapho uhlelo enzayimu esibindi ekugcineni ovuthiwe. Nokho, uma inombolo idlula ezibucayi bilirubin ezingeni kufanele bavezwe egunjini lokuhlolwa kwezifo. Kungaba i-hepatitis viral, Bile imbobo isimiso, noma i-jaundice hemolytic.

ukusha kwesibindi kohlobo viral

Lokhu zokugula ingadlulela kusuka umntwana onegciwane unina. Ngenxa yalokho, umntwana wakhe esezelwe kwesibindi imvelo ezibangelwa amagciwane. Umthelela igciwane kusaqalwa wokukhula kwengane esiswini kungabangela kwezinso okwengeziwe ngokomzimba. Isici lesi sifo, ngokungafani ukusha kwesibindi kohlobo B e abadala, ukuvuma amaphutha akho kuyinkambo olunzima. Pathology kungaba ukuzibonakalisa ngisho ngaphambi ukuqala i-jaundice. Ngokuvamile kukhona ukwanda lokushisa, ukuwohloka ukudla okuncane catarrhal imihlola. Kwezinye izimo isikhathi preicteric ezinsaneni asymptomatic.

Usola khona-hepatitis B kungaba uzingela izinguquko umbala umchamo kanye endleni. Qedela igazi ukuhlaziywa libhekene Ukwehla leucocyte futhi erythrocyte sedimentation izinga. Monocytes nazo kancane anda. bekulokhu Lapho ifomu icteric nokwanda okuphawulekayo bilirubin, futhi thymol. Ukuze ekuhlonzweni sifo kwenziwe ucwaningo e enzyme isibindi. On inqubo adonsela phansi wathi ukwehla abukhali prothrombin futhi ukwandisa ammonia.

Ukwelashwa kwezingane Kwenziwa, ngokuvamile esibhedlela. Yokwelapha ihlanganisa imithi elwa namagciwane gepatoprotektory, amavithamini, kanye cholagogue. Kunconywe ukuthi ukwelashwa ngokukhishwa kobuthi egazini. Phakathi izindlela non-izidakamizwa umphelelisi pharmacotherapy kudingeka embhedeni ukuphumula okunokuthula.

jaundice hemolytic

Lokhu zokugula lihlotshaniswa hemolysis kwamangqamuzana egazi abomvu, kuyingozi kakhulu. Isizathu sokuba iphutha esivuna RH isici kanye unina wengane, okungukuthi RH ukungqubuzana. Pathology kaningi esiholela ekufeni - izinga lokufa kuyinto 60-80%. Ngaphezu kwalokho, ukuba khona RH ukungqubuzana kungaholela isisu nokuguqulwa.

zokuvimbela

Isiza ukuvimbela ukukhulelwa jaundice yokubambelela ibele futhi kudingeka ukuyohlolwa njalo kudokotela wezingane. Uma i-jaundice nisebancane kodwa ukuthuthukisa, kudinga ukuqapha njalo ezingeni bilirubin egazini.

Iziguli jaundice libhekene ehlukile ngebala lesikhumba nolwelwesi lwamafinyila. Lokhu uphawu kungase kubonise khona isifo noma ukubonisa izinguquko bokuphila emzimbeni (lezivakashi jaundice ezisanda kubelethwa).

isiphetho

Phezu ukuthola jaundice zenziwa ngokushesha ukuze kutholakale izinga bilirubin futhi uphethwe olwengeziwe. Conjugation jaundice e izinsana sihamba lungaphezu lezivakashi, kodwa futhi iphephile. Lo chwepheshe uyanakekela kumelwe aqinisekise abazali lokuqoka luhlolo. Njengomthetho, kube nezinkinga babonakala.