I-jaundice yabantwana abasandul 'ukuzalwa asisifo njengesifo, kodwa isifo sayo. Ubonakaliswa ngokuphuka kolusu kunye neeliso zomntwana. Ngaphambi kokuzalwa kwangaphambili, amathuba okunyuka kwe-jaundice anyuke kwaye afikelela kwi-100%. Olu hlobo lwe-jaundice - isifo kubantwana abasandul 'ukuzalwa sisoloko. Ngenxa yokuba uya kulungela ukufunda ngale nto.
Oku kwenzeka ntoni?
Ukuqhwala kwesikhumba seentsana kubangelwa ukwandisa i-bilirubin (iqela eliphambili le-pigment). Ngenxa ye-hemoglobin - i-pigment ebomvu yegazi. Ngentsimbi, iiseli ezibomvu zegazi (i-erythrocytes) zonakaliswa kwaye i-hemoglobin ekhutshwe kuzo iqhutshwa kwi-bilirubin. Kuthuthwa kwi-serum yegazi kwisibindi. Icandelo le-bilirubin, elithunyelwa emzimbeni, libizwa ngokuba likhululekile okanye lingabikho. Liyinxalenye ye-fat-soluble, kodwa ayixubeki kakuhle emanzini. Esibindi, i-bilirubin ithathwa kwi-compounds ne-albumin. Ngoko i-bilirubin ibunjwa, idibeneyo emanzini, edlulela emathunjini, apho idityaniswe ngamanzi. Ukukwazi ukumbamba umzimba we-bilirubin osandul 'ukuzalwa kwaye ubophe i-glucuronic acid ibuthathaka. Ukusebenza kwama-enzyme yesibindi kwiintsana kuncinci kakhulu kunabantu abadala.
Kutheni oku kwenzekayo?
Kukho izizathu ezahlukahlukeneyo zesifo se-jaundice - isifo kwiintsana. Zizo zombini kunye nezifo. Nangona kunjalo, ndifuna ukukhankanya okuqhelekileyo.
I-hypoxia yobusana obuhlobene
Umntwana uhlala kwaye ukhula phantsi kweemeko ze-hypoxia esondeleyo. Iintsana zizalwe ngenqanaba eliphezulu le-hematocrit kunye ne-hemoglobin, eninzi yamaseli obomvu egazini. Ubomi beentsholongwane ezandululweyo zancitshiswa. Isiphumo kukuba, ngenxa yenani elikhulu lamaseli egazi abomvu, isela lomntwana landa. Inani elikhulu le-hemoglobin linikezelwa kwipeni.
Ukunyakaza okungavamile
Ngaphambi kokuzalwa, umntwana unondliwa ngumama wakhe. Ukususela kwiiyure zokuqala zobomi bakhe emva kokuzalwa, ngokukhawuleza uqala ukugatya i-meconium - into eqokelele emathunjini omntwana kwanokuba ubomi bentrauterine. Lo ngumsebenzi wokuqala weintsana. Umntwana ozelwe ngaphambi kwesikhathi, okanye ukuba unina wayengenasondlo ngexesha lokukhulelwa, unokufumana iingxaki ngamathumbu. Umsebenzi walo uphazamiseka, okubangela ukwanda kwinqanaba le-bilirubin egazini.
I-Rhesus-impi
Le ngxabano yenkqutyana yeR Rh yomama nomntwana - ukuba umntwana ungumama oyiR Rh-positive kunye no-Rh. Ngombulelo kwi-immunoglobulin prophylaxis (emva kokuzalwa komntwana, unina ufumana i-immunoglobulin yokulwa ne-Rh-D ngaphakathi kweeyure ezingama-72, ekhusela isimiso somzimba sokuzikhusela sisuka kwi-blood to the baby), unina akavelisi izifo eziza kusongela umntwana ngexesha lokukhulelwa okulandelayo.
Kukho noxa kukho ukungqubana kwamaqela amakhulu egazi. Ngokomzekelo, ibhinqa enegazi leqela III linamachiza omzimba anqamlekileyo malunga neeseli zeqela IV. Kwiimeko ezinjalo, ingxabano ibonakala kakhulu ngexesha lokukhulelwa kokuqala. Ekukhulelwe okulandelayo, umngcipheko wezo mpi zinciphisa.
Ukunyuka kwegazi
Ukuzalwa kukulimala kumntwana. Kufuneka azalise umsebenzi olukhuni-ukucoca ngomsele ongancinci wokuzalwa. Ngamanye amaxesha le nkqubo ayenzi ngaphandle komonakalo. Iimpawu zokuzalwa zowesifazane kulo mzuzu zizele ngegazi, apho umxholo ophezulu kakhulu we-bilirubin. Ukuba unobungozi, eli gazi liza kumntwana, i-bilirubin iyawela emzimbeni wakhe. Umgangatho wenyuka kwaye i-jaundice ivela.
Hypoxia
Iintsana zinokuthi, ngokomzekelo, zifakwe kwintambo yomlomo. Ngamanye amaxesha kwiimeko ezinjalo, i-jaundice yenzeka ngenxa ye-hypoxia yesibindi, eyandisa ukuhluleka kwayo ngexesha lokubeletha.
Ukuncelisa
Isixa sokutya kwimihla yokuqala yobomi sinokungaphantsi komntwana wakho angathanda ukutya. Ngoko ke, kukho ukulibaziseka kwinqanaba lokutya ngephepha lokugaya umntwana. Ngenxa yoko, i-jaundice ingenzeka.
Kungenzeka ukuba umntwana usempilweni, uqobo lwebele, ukufumana isisindo kakuhle, kodwa i-jaundice igcinwa ixesha elide kwaye inokuhlala ifike kwiinyanga ezi-2-3. Yibangelwa ngama-enzymes akhoyo kubisi lwebele kwaye ancedise ukudibanisa i-bilirubin kunye ne-glucuronic acid kunye nemveliso yayo ngamanzi. Maxa wambi abantwana abanjalo banokufikelela kwixabiso eliphezulu le-bilirubin. Nangona kunjalo, oku akusongeli ubomi kunye nempilo yabantwana.
Isifo sempilo
Ngokuqhelekileyo, i-jaundice - isifo seentsana esasandul 'ukuzalwa sisabantwana bokuqala abagulayo. Ingaba yintsholongwane yebhanka okanye intsholongwane kaGawulayo. Esinye sezibonakaliso sinzima kakhulu. Kukho izifo zofuzo apho kubakho ukukhubazeka kwesibindi kunye nokukwazi ukubopha i-bilirubin kwi-glucuronic acid.
Ndingayiphatha njani umntwana wam osana ?
Uphulo lo kukhanya
Le yindlela efanelekileyo kakhulu yokunyangwa kwesi sifo. Okugqithiseleyo kwi-bilirubin kwi-kliphu iyahlula kwiimveliso ezingenayo isetyhi-yamanzi, ezithe zenziwa nje ngomchamo. Ngale ndlela, iintlobo ezahlukeneyo zokukhanya zingasetyenziswa: ezimhlophe, eziluhlaza okwesibhakabhaka kunye nohlaza. Eyona ndlela iphumelelayo iyabluhlaza. I-Phototherapy isebenza kuphela xa ukukhanya kuwela esikhwameni esingenalwazi. Ukuba umntwana wakho ulele esiswini sakhe, umva wakhe uphelile, xa elele emhlane wakhe ngaphambili. Amehlo omntwana ahlanganiswe ngento ekhethekileyo engavumelekanga umbane. Amakhwenkwe nawo anamava.
Kwimeko ye-jaundice enzima, usana olusandul 'utsha lubekwa kwigumbi lokunyamekela eliphezulu kwigumbi apho lithathwa khona kwiphototherapy. Umntwana ulele kwigumbi elithile elikhethekileyo, elixhunyiwe kwimithombo yokukhanya ye-fiber-optic kwaye ikhanyiswa ukusuka phezulu kunye nesibane esikhethekileyo. I-Phototherapy isoloko ihlala iintsuku ezimbini - oku, ngokomthetho, kwanele. Maxa wambi ikhosi iya kwandiswa kwiintsuku ezintathu.
Luminal
Ngobuncinane be-jaundice kunyango, i-luminal (phenobarbital) isetyenziswe. Kuyinto ephazamisayo kunye ne-anticonvulsant ekhuthazwe kakuhle yiintsana. Kwiqondo elisezantsi, lenza uveliso lwe-enzyme yesibindi kwaye lukhawuleze imetabolism ye-bilirubin. Ngomlinganiselo omncinci we-jaundice uyisisombululo esisebenzayo.
Ukucoca
Le ndlela yempikiswano esetyenziselwa unyango lwe-jaundice engapheliyo kwiintsana ezisandula. Izinto ezikhoyo zobisi lwebele kwaye zijongene ne-jaundice zipheliswa kwaye izinga le-bilirubin linciphile. Ungabuyela ekunceliseni iintsuku emva kweentsuku ezimbini okanye ezintathu. Egazini lomntwana kwakhona kuya kuba nokwanda kwe-bilirubin, kodwa kungekho kwizinga eliphezulu.
Ukumpontshelwa igazi
Le yindlela yokugqibela yokunyanga i-jaundice-isifo kwiintsana. I-veinlical vein ifakwe kwi-catheter, apho igazi lomntwana lisuswe kwiincinci ezincinci, kunye negazi lomnikeli lijojowe. Ngako oko umntwana unqatshelwe i-bilirubin engaphezulu. Le ndlela ikuvumela ukuba uhlambulule igazi lezingane ezineengqungquthela kwiiseli zegazi.
Ngamanye amaxesha, nge-jaundice enzima kakhulu, i-albin inganikwa, eyaziwayo, idlulisela i-bilirubin. Ukubaluleka kwe-bilirubin egazini leentsana ezizalisiweyo ngokupheleleyo akuvunyelwanga umntwana osanda kuzalwa. Umncinci umntwana, ubunzima obungaphantsi komzimba, ixabiso elisezantsi le-bilirubin, leyo intsha iyakwazi ukumelana nayo.
Oogqirha be-neonatologists baqwalasela ubunzima bomntwana, isimo sekliniki (kunye nesimo esiyingozi kakhulu, ixabiso le-bilirubin eliphantsi livunyelwe). Ixabiso le-bilirubin ngosuku lwesibini lobomi bomntwana aluvumelekanga kwintsuku yesine nangemva.
Umphumo onobungozi we-bilirubin
I-Bilirubin iyancipha ngokukhawuleza kumafutha, ingena kwinkqubo ye-nervous central, apho ibangela ukuba umonakalo ongenakuguquka. Unoxanduva lokuphuhliswa kwe-encephalopathy. Ukungena kwe-bilirubin kwisistim se-nervous central kunzima kumntwana onesisindo sokuzalwa esincinci ngenxa yokuzalwa kwangaphambi kokuzalwa. Abantwana abanjalo banokusuleleka kwiintsholongwane ezonakalisa i-acidosis. Umngcipheko wokulimala kwinkqubo yesistim ephezulu xa izinga le-bilirubin lidlulile kakhulu.
Kwakukholelwa ukuba ukuxinwa kwe-bilirubin ngama-20 mg. luphawu lokutshintshwa kwegazi. Uncwadi lwehlabathi aluboneleli nge-encephalopathy kubantwana ekunceliseni, mhlawumbi kwixabiso eliphezulu kakhulu le-bilirubin.
Ngaba kukho naziphi iingxaki?
Ukuba i-jaundice ephathwayo kakuhle kwiintsana ezisandul 'ukuzalwa, iya kudlula ngaphandle kwemiphumo. Kwinqanaba langoku lonyango, oku akuwona umsebenzi wokwelapha (okwenene, ngokusebenzisana okuhle nomama womntwana). Abantwana abaye bafumana esi sifo sakha ngokuchanekileyo, akukho ziphulo ekuphuhlisweni kwazo.
I-jaundice yemvelo iyenzeka ngosuku lwesibini okanye lwesithathu yobomi bomntwana kwaye ihlala kwiintsuku eziyi-8, ngelixa izigulana zangaphambili zithatha malunga neveki ezimbini. I-jaundice igula malunga neyesibini kubantwana abathathu abazalwayo. Kwiintsana ezisekuqaleni, zenzeka ngo-80-90%. Ekuqaleni umntwana wazalwa, ephakamileyo ubunokwenzeka be-jaundice kunye ne-100%. I-jaundice kwiintsana ezisempilo ngosuku lokuqala lobomi luphawu lwe-jaundice ye-pathological.