Chii chinokonzeresa uye maitiro ekurapa neonatal hyperbilirubinemia

Zvemukati

• Zvinokonzera
• 1. Physiological jaundice
• 2. Jaundice mumukaka wemukaka
• 3. Zvirwere zveropa
• 4. Zvirwere zvechiropa
• Iko phototherapy kunoitwa sei

Hyperbilirubinemia yemwana achangozvarwa kana neonatal chirwere chinoonekwa mumazuva ekutanga ehupenyu hwemwana, chiri kukonzerwa nekuunganidzwa kwebilirubin muropa, nekushandura ganda yero.

Chero mwana anogona kukura hyperbilirubinemia, izvo zvikonzero zvikuru zviri kuita shanduko yemuviri mukushanda kwechiropa, kusagadzikana kweropa, senge hemolytic anemia, chirwere chechiropa, chinokonzerwa nehutachiona kana hosha dzechibereko, kana kunyangwe nekuita mukuyamwa. Uyezve tarisa zvinokonzeresa zvepamusoro bilirubin uye jaundice muvakuru.

Kuchengetedza kudzikisa huwandu hwe bilirubin muropa kunofanirwa kutanga nekukurumidza, uye kurapwa nephototherapy ndiko kunonyanya kushandiswa. Mune zvimwe zviitiko, kushandiswa kwemishonga kana kuwedzerwa ropa kunogona kudikanwa, uye unorayirwa nachiremba wevana.

Zvinokonzera

Jaundice inoitika kana mwana asingakwanise kubvisa zvakanaka bilirubin, iyo inogadzirwa nemetabolism yeropa, nekuti, asati aberekwa, iyo placenta yakaita basa iri. Zvinonyanya kukonzera hyperbilirubinemia ichangoberekwa ndeiyi:

1. Physiological jaundice

Zvinowanzoitika mushure memaawa makumi maviri nemana kusvika makumi matatu nematanhatu ekuzvarwa, iri rudzi rwakajairika kwazvo rwejaundice, sezvo chiropa chemwana chisina kugadzirwa zvakanaka uye chingave nematambudziko mukushandura nekubvisa bilirubin kubva muropa kuburikidza nenyuchi. Shanduko iyi inowanzogadzirisa mumazuva mashoma, nekurapwa nephotootherapy uye kuratidzwa kuzuva.

• Kurapa sei: phototherapy ine fluorescent mwenje inobatsira kudzikisa huwandu hwe bilirubin muropa. Muzviitiko zvishoma, kuratidzwa kuzuva kunogona kukwana, asi mune zvakakomba zviitiko, kuwedzerwa ropa kana kushandiswa kwemishonga, senge phenobarbital, inogona kudikanwa kuti uwane mhedzisiro iri nani. Unzwisise zvirinani mabatirwo anoitwa mwana achangoberekwa maseru jaundice.

2. Jaundice mumukaka wemukaka

Rudzi urwu rwekuwedzera kwebilirubin runogona kuitika mazuva gumi mushure mekuzvarwa, mune vamwe vacheche vari kuyamwisa mwana chete, nekuda kwekuwedzera kwemahomoni kana zvinhu muropa zvinowedzera kudzorerwazve kwebilirubin mumatumbo uye kunotadzisa kubviswa kwayo, kunyangwe zvisiri zvakadaro uchiziva chimiro chaicho.

• Kurapa sei: mune zviitiko zvakakosha zvejaundice, phototherapy inogona kuitwa kudzora huwandu hweropa, asi kuyamwisa hakufanirwe kukanganiswa kunze kwekunge kwaudzwa nachiremba wevana. Iyi jaundice inonyangarika zvakasikwa pamwedzi wechipiri kana wechitatu wemwana.

3. Zvirwere zveropa

Zvimwe zvirwere zvinogona kukonzera kuti mwana aunganidze bilirubin, senge autoimmune kana magene shanduko, uye anogona kuve akaomarara uye oonekwa mumaawa ekutanga mushure mekuzvarwa. Zvimwe zvirwere spherocytosis, thalassemia kana kusapindirana neropa raamai, semuenzaniso, asi chikuru ndeche hemolytic chirwere chemwana achangozvarwa, chinozivikanwawo se fetal erythroblastosis.

• Kurapa sei: kuwedzera kune phototherapy kudzora huwandu hwebilirubin muropa, kurapwa kunowanzoitwa nekuwedzerwa ropa uye, mune dzimwe nguva, mishonga inogona kuitwa kudzora hutachiona.

4. Zvirwere zvechiropa

Mwana anogona kuzvarwa aine shanduko mukushanda kwechiropa, nekuda kwezvikonzero zvakawanda, senge bile duct deformities, cystic fibrosis, congenital rubella, congenital hypothyroidism, hutachiona nemavirusi kana bhakitiriya, kana nemajini syndromes, akadai seCrigler-Najjar syndrome, Gilber uye chirwere cheGaucher, semuenzaniso.

• Kurapa sei: kudzora ropa hyperbilirubinemia, pamwechete nefototherapy, marapirwo anotorwa kunatsiridza chirwere chakakonzera kuwedzera kwebilirubin, sekurapa hutachiona nemishonga inorwisa mabhakitiriya, kuvhiyiwa kugadzirisa kusagadzikana kwechiropa kana kutsiva kwehomoni mu hypothyroidism, semuenzaniso.

Mushonga wekudzora muviri wakawedzera zvakanyanya bilirubin, kunyanya phototherapy, inofanirwa kuitwa nekukurumidza mushure mekuona shanduko, sezvo bilirubin yakawandisa mumuviri wemwana inogona kukonzera matambudziko akakura, senge huturu hwehuropi hunozivikanwa se kernicterus, hunokonzera matsi, kufenda, kufenda uye rufu.

Iko phototherapy kunoitwa sei

Phototherapy inosanganisira kusiya mwana aratidzwa kune fluorescent mwenje, kazhinji bhuruu, kwemaawa mashoma, mazuva ese, kudzamara kuvandudzika. Kuti kurapwa kuitike, ganda remwana rinofanira kuve rakazara muchiedza, asi maziso haafanire kufumurwa, saka jira rakakosha kana magirazi anovharwa.

Chiedza chinopinda mukati meganda chinokurudzira kuparadzwa uye kubviswa kwebilirubin kuburikidza nenyuchi, zvichikonzera iyo jaundice uye yero yeruvara kunyangarika zvishoma nezvishoma.

Dzidza zvakawanda nezve maitirwo azvo uye zvimwe zvinoratidza kushandiswa kwefototherapy.