Mhando dzeJaundice

Zvemukati

• Ndeapi marudzi akasiyana ejaundice?
• Zvese nezve pre-hepatic jaundice
• Zvese nezve hepatic jaundice
• Zvese nezve post-hepatic jaundice
• Zvese nezve neonatal jaundice
• Maonero

Ndeapi marudzi akasiyana ejaundice?

Jaundice inoitika apo bilirubin yakawandisa inovaka muropa rako. Izvi zvinoita kuti ganda rako uye nevachena vemaziso ako vataridze zvinoyevedza.

Bilirubin iri yero yeyadhi pigment inogadzirwa sehemoglobin - chikamu chemasero matsvuku eropa - yakaputsika.

Kazhinji, bilirubin inonunurwa kubva muropa kuenda muchiropa chako. Ipapo, inopfuura nepakati pemachubhu anonzi bile ducts. Iyi ducts inotakura chinhu chinonzi bile mumukati mako. Pakupedzisira, bilirubin inopfuudzwa kunze kwemuviri wako kuburikidza neweti kana chigaro.

Mhando dzejaundice dzakakamurwa nepazvinoitika mukati mekuita kwechiropa kutora uye kusefa bilirubin:

• pre-hepatic: pamberi pechiropa
• hepatic: muchiropa
• post-hepatic: mushure mechiropa

Zvese nezve pre-hepatic jaundice

Pre-hepatic jaundice inokonzerwa nemamiriro ezvinhu anokwidziridza mwero weropa rako wehemolysis. Aya ndiwo maitiro anotsemurwa nemasero matsvuku eropa, achiburitsa hemoglobin nekushandura kuita bilirubin.

Nekuti chiropa chinogona kungogadzira bilirubin yakawanda kamwechete, bilirubin inopfachukira mumatumbu emuviri.

Iyo ye pre-hepatic jaundice ndeiyi:

• malaria, chirwere cheropa chinokonzerwa nehutachiona
• sickle cell anemia, iyo genetic mamiriro ayo masero matsvuku eropa anova akaumbwa-sekirisendi kwete pane akajairwa dhisiki chimiro
• spherocytosis, genetiki mamiriro eiyo tsvuku yero maseru membrane iyo inokonzeresa kuti ive yakaumbwa-yakatenderera pane kuumbwa
• thalassemia, chibereko chinokonzera kuti muviri wako ugadzire rudzi rusina kujairika rwehemoglobin inogumira huwandu hwamasero matsvuku eropa muropa rako.

Zviratidzo zvakajairika zve pre-hepatic jaundice zvinosanganisira:

• marwadzo emudumbu
• fever, kusanganisira kutonhora kana kutonhora ziya
• kuora muviri kushoma
• kunzwa kunhuwa
• weti yakasviba kana chigaro chakachenuruka

Zvimwe zvezvipingamupinyi zvemhando iyi yejaundice zvinosanganisira:

• kushandisa zvinodhaka
• kuva nenhengo yemhuri ine chirwere cheropa
• kuenda kumatunhu ane malaria

Kuti uongorore pre-hepatic jaundice, chiremba wako anogona kuraira bvunzo dzinotevera:

• kuongorora urinal kuyera huwandu hwezvimwe zvinhu mumuti wako
• kuongororwa ropa, senge yakazara ropa kuverenga (CBC) kana chiropa chekuita basa kuyera bilirubin nezvimwe zvinhu muropa
• imaging bvunzo, senge MRI kana ultrasound, kuti uongorore chiropa chako, nduru, uye bile ducts kuti utonge dzimwe nzira dzejaundice
• scan yeHIDA kubatsira kuwana mabhureki kana zvimwe zvinhu muropa, nduru, bile ducts, uye ura hudiki

Chiremba wako angangozviongorora iwe uine pre-hepatic jaundice kana pasina nyaya ne bilirubin iri kugadziriswa nechiropa chako kana mukati meguruva uye mabhaidhi biliary.

Kurapa kwe pre-hepatic jaundice inogona kusanganisira:

Zvemarariya:

• mishonga yekubatsira kuparadza hutachiona uye kudzivirira hutachiona kubva mukutapudza chiropa chako zvakare

Kune sickle cell anemia:

• kuwedzerwa ropa kubva kune anopa hutano
• kugadzirisazve mvura ine intravenous (IV) fluid
• mishonga yechero hutachiona hunogona kukonzeresa jeko maseru dambudziko

Nezve spherocytosis:

• folic acid inowedzera
• kuwedzerwa ropa kwekushaya ropa
• spleen kubvisa kuvhiya kubatsira kubatsira kuwedzera tsvuku masero eropa hupenyu uye kudzikisira mukana wematombo

Zve thalassemia:

• kuwedzerwa ropa
• pfupa remongo
• spleen kana gallbladder kubvisa kuvhiya

Zvese nezve hepatic jaundice

Hepatic jaundice inoitika kana chiropa chako chishoma (chinozivikanwa secirrhosis), chakakuvara, kana kusagadzikana. Izvi zvinoita kuti zvinyanye kushanda pakubvisa bilirubin kubva muropa rako.

Sezvo isingakwanise kusefa mukati megadziriro yako yekugaya kuti ubviswe, bilirubin inovaka kusvika kumatunhu akakwirira muropa rako.

Iyo ye hepatic jaundice ndeiyi:

• chiropa cirrhosis, zvinoreva kuti chiropa matishu ane mavanga nekuratidzwa kwenguva refu kuzvirwere kana zvinhu zvine chepfu, senge yakakwira doro
• hutachiona hepatitis, kuzvimba kwechiropa kunokonzerwa nehumwe hutachiona hwakawanda hunogona kupinda mumuviri wako kuburikidza nechikafu chine hutachiona, mvura, ropa, chigaro, kana kusangana pabonde.
• primary biliary cirrhosis, inoitika kana bile ducts yakanganisika uye isingakwanise kugadzirisa bile, ichikonzera kuti iumbe muropa rako uye nekukuvadza chironda chechiropa.
• chidhakwa hepatitis, umo chiropa chako matishu ane mavanga nekuremerwa, kwenguva refu kunwa doro
• leptospirosis, hutachiona hutachiona hunogona kupararira nemhuka dzine hutachiona kana weti yemhuka kana hutachiona
• gomarara rechiropa, umo masero ane gomarara anokura uye kuwanda mukati mematumbu eropa

Zviratidzo zvakajairika zvehepatic jaundice zvinosanganisira:

• kurasikirwa nenzara
• mhino ine ropa
• kuchenesa ganda
• kushaya simba
• kuora muviri kushoma
• kuzvimba kwedumbu kana makumbo
• weti yakasviba kana chigaro chakachenuruka
• kurwadziwa mumhasuru dzako kana majoini
• kusviba ganda
• kupindwa nechando
• kunzwa kurwara
• kurutsa

Zvimwe zvinokonzeresa zvemhando iyi yejaundice zvinosanganisira:

• kushandisa zvinodhaka
• kunwa doro rakawanda kwenguva yakareba
• kushandiswa kwemishonga inogona kukonzera kukuvara kwechiropa, senge acetaminophen kana imwe mishonga yemwoyo
• hutachiona hwekare hwakabata chiropa chako

Kuti uongorore hepatic jaundice, chiremba wako anogona kuraira bvunzo dzinotevera:

• kuongorora urinal kuyera huwandu hwezvinhu mumurini rako zvine chekuita nechiropa chako chinoshanda
• kuongororwa ropa.
• imaging bvunzo, senge MRI kana ultrasound, kuti uongorore chiropa chako kuti hachina kukuvara kana kuti paine masero ane gomarara
• endoscopy, izvo zvinosanganisira kuisa mutete, wakavhenekerwa chubhu mune diki incision kuti utarise chiropa chako uye utore nyama sampuli (biopsy) kana zvichidikanwa kuti uongorore kenza kana mamwe mamiriro

Chiremba wako angangozviongorora aine hepatic jaundice kana vakaona chiropa chakakanganisika pane yekufungidzira bvunzo kana kuona zvisina kujairika mazinga ezvimwe zvinhu zvechiropa, senge albumin, kana ma antibodies ezvirwere kana cancer.

Kurapa kwehepatic jaundice kunogona kusanganisira:

Zvechiropa cirrhosis:

• kurega kunwa
• beta-blockers
• intravenous (IV) mishonga inorwisa mabhakitiriya
• chikafu chine mapuroteni mashoma

Kune hutachiona hepatitis:

• antiviral mishonga
• kubatira hepatitis
• kuzorora kuzhinji uye zvinwiwa

Yekutanga biliary cirrhosis:

• bile acids kubatsira nekugaya
• bile-kudzikisa mishonga
• antihistamines senge diphenhydramine (Benadryl) yekurumwa

Nezvekudhakwa hepatitis:

• kurega doro
• zvinovaka muviri zvinowedzera
• chiropa chekuisa, mune zvakakomba zviitiko

Zve leptospirosis:

• mishonga inorwisa mabhakitiriya yehutachiona
• mhepo yekufema yekunetseka kufema
• dialysis yekukuvara kweitsvo

Nezve kenza yechiropa:

• chemotherapy kana radiation kuti iuraye cancer maseru
• chikamu chiropa resection
• chiropa chekuisa

Zvese nezve post-hepatic jaundice

Post-hepatic, kana inodzivirira jaundice, inoitika apo bilirubin isingakwanise kudhonzwa mushe mukati meiyo bile ducts kana nzira yekugaya nekuda kwekuvharika.

Iyo yeiyo post-hepatic jaundice ndeiyi:

• nduru, dzakaoma calcium inochengeterwa munduru iyo inogona kuvhara bile ducts
• gomarara repancreatic, kukura nekupararira kwemasero egomarara mupancreas, inhengo inobatsira kuburitsa zvinhu zvekugaya
• bile duct kenza, kusimudzira uye kupararira kwekenza maseru mune yako bile ducts
• pancreatitis, kuzvimba kana hutachiona hwepancreas yako
• , chimiro chemajini umo makatetepa kana kushayikwa bile ducts

Zviratidzo zvakajairika zve post-hepatic jaundice zvinosanganisira:

• kunzwa kurwara
• kurutsa
• weti yakasviba kana chigaro chakachenuruka
• marwadzo emudumbu
• manyoka
• kuora muviri kushoma
• kuchenesa ganda
• kuzvimba mudumbu
• kupindwa nechando

Zvimwe zvinokonzeresa zvemhando iyi yejaundice zvinosanganisira:

• kuva mutete
• kudya chikafu chakakora-mafuta, chakaderera-fiber
• kuva nechirwere cheshuga mellitus
• kuva nenhoroondo yemhuri yematombo
• kuva mukadzi
• kuchembera
• kusvuta fodya zvigadzirwa
• kunwa doro rakawanda
• kuva nepancreas kuzvimba kwekare kana hutachiona
• kuve pachena kumakemikari emakambani

Kuti uongorore post-hepatic jaundice, chiremba wako angangoda kuraira bvunzo dzinotevera:

• kuongorora urinal kuyera nhanho dzezvinhu mune yako weti
• kuongororwa ropa, senge yakazara ropa kuverenga (CBC) uye antibody bvunzo yekenza, kana chiropa chekuita bvunzo kutonga kunze hepatic jaundice
• imaging bvunzo, senge MRI kana ultrasound, kuti uongorore chiropa chako, nduru, uye bile ducts yezvipingamupinyi zvakaita sedare kana tumamota.
• endoscopy, iyo inosanganisira kuisa mutete, wakavhenekerwa chubhu pasi peyophagus kuti utarise chiropa chako, nduru, kana bile ducts uye utore sampu yeshuga kana zvichidikanwa kuti uongorore kenza kana mamwe mamiriro

Kana chiremba wako akaona chipingamupinyi pamuedzo wekufungidzira kana akawana mazinga ezvimwe zvirwere zvinogona kuratidza hutachiona kana kenza, vangangozoongorora jaundice yako seyemashure-hepatic.

Kurapa kweashure-hepatic jaundice kunogadzirisa chinokonzeresa. Izvi zvinosanganisira:

Nezve gallstones:

• kuchinja chikafu chako kuti chimire kuburitsa maturu
• kubvisa maturu kana nduru yako zvachose
• kutora mishonga kana kurapwa kuputsa nduru

Nezekenza yepancreatic:

• Kuvhiya kubvisa kenza turu kana yako pancreas yese
• radiation kana chemotherapy yekuparadza cancer maseru

Nezve kenza yenyuchi:

• kuvhiya kubvisa bile ducts uye zvikamu zvechiropa chako uye rwatata
• radiation kana chemotherapy yekuparadza cancer maseru
• chiropa chekuisa

Zvepancreatitis:

• zorora
• intravenous (IV) zvinwiwa kana mishonga yekurwadziwa
• kuvhiyiwa kubvisa chero zvikonzero zvekuzvimba (kunge nduru)

Nezve biliary atresia:

• iyo nzira yeKasai yekubvisa uye kutsiva ducts
• chiropa chekuisa

Zvese nezve neonatal jaundice

Neonatal jaundice ndiyo yakajairika mhando yejaundice inoitika kune vacheche vacheche.

Vazhinji vacheche vanozvarwa vaine akawanda maseru matsvuku eropa, uye nekuda kwekuti chiropa hachisati chakwana zvakakwana, bilirubin haigone kugadziriswa nekukurumidza. Nekudaro, mwana wako anogona kunge aine zviratidzo zvejundice mazuva mashoma mushure mekuzvarwa kwake.

Mhando dzeeonatal jaundice dzinosanganisira:

• Zvepanyama. Izvi zvinoitika nekuti chiropa hachisati chaumbwa zvizere.
• Prematurity. Izvi zvinoguma kubva kumucheche achizvarwa nekukurumidza uye achitadza kuburitsa bilirubin zvakanaka.
• Kuyamwisa. Mukaka wemuzamu jaundice unoitika kubva kumwana ane dambudziko rekuyamwisa kana kusawana mukaka wemukaka wakakwana.
• Ropa risingapindirane. Izvi zvinoguma kubva kumucheche naamai vane mhando dzakasiyana dzeropa, izvo zvinogona kukonzera amai kuti vagadzire masoja ekudzivirira anopwanya masero matsvuku eropa emwana wavo.

Neonatal jaundice haiwanzo chikonzero chekufunganya. Asi kana bilirubin ikavaka kusvika pamatanho akakwirira zvakanyanya, mwana wako anokwanisa kukuvara huropi (inozivikanwa se kernicterus) kubva kubilirubin ichipinda mumatumbu ehuropi.

Tsvaga kurapwa kwekukurumidzira kana iwe ukaona kuti mwana wako ane chero cheanotevera zviratidzo:

• nguva refu yekuchema kwepamusoro
• kuputira mutsipa wavo uye musana
• kupindwa nechando
• kurutsa
• ndine dambudziko rekudyisa

Maonero

Jaundice zvakajeka zvinoreva kuti kune bilirubin yakawandisa muropa rako, asi iyo yakakonzera inogona kusiyana zvakanyanya.

Ona chiremba wako ipapo kana iwe ukaona yero yeganda rako kana machena eziso rako. Zvimwe zvikonzero zvinogona kurapwa nekuchinja mukudya kwako kana mararamiro, asi vamwe vangangoda kurapwa nekukurumidza kana kwenguva refu kurapwa.