I-jaundice yezingane ezisanda kuzalwa akuyona isifo esinjalo, kodwa isifo sayo. Kubonakala ngokuphuziza kwesikhumba kanye ne-eyeballs yengane. Ngaphambi kokubeletha, ukutholakala kwe-jaundice kwanda futhi kufinyelela ku-100%. Lolu hlobo lwe-jaundice - isifo ezinganeni ezisanda kuzalwa sisuke sivame kakhulu. Ngoba uzodingeka ufunde ngalokhu okunye.
Lokhu kwenzeka kanjani?
Ukuphuziza kwesikhumba sezingane kubangelwa ukwanda kwe-bilirubin (ingxenye enkulu yezingulube ze-bile) ngenxa ye-hemoglobin - i-pigment ebomvu yegazi. Esikhathini, amangqamuzana egazi abomvu (i-erythrocytes) abhujiswa futhi i-hemoglobin ekhishwe kuzo iqhutshwa ibe yi-bilirubin. Kuthathwa nge-serum yegazi esibindi. Ingxenye ye-bilirubin, ephathekayo emzimbeni, ibizwa ngokuthi ikhululekile noma ivulekile. Kuyinto engxenyeni ye-fat-soluble, kodwa ayihlunga kahle emanzini. Esibindi, i-bilirubin ithunjiswe kusuka kumakhemikhali ne-albinini. Ngakho-ke i-bilirubin yenziwa, ifakwe emanzini, edlulela emathunjini, lapho idonswa khona ngendwangu. Ikhono lokubamba umzimba we-bilirubin esanda kuzalwa futhi libophe i-glucuronic acid libuthakathaka. Ukusebenza kwama-enzyme yesibindi ezinganeni kuncane kakhulu kunabantu abadala.
Kungani lokhu kwenzeka?
Kunezimbangela ezihlukahlukene ze-jaundice - isifo ezinsana. Zombili zenyama kanye nezokwelapha. Noma kunjalo, ngingathanda ukukhuluma okuvame kakhulu.
I-hypoxia yesisu esithandanayo
I-fetus ihlala futhi ikhula ngaphansi kwezimo ze-hypoxia ehlobene. Izinsana zizalwa ngezinga eliphakeme le-hematocrit ne-hemoglobin, enezikhulu eziningi zegazi elibomvu egazini. Isikhathi sokuphila samaseli asanda kudalwa sincishisiwe. Umphumela wukuthi, ngenxa yesibalo esikhulu samaseli abomvu obomvu, isilwane somntwana sanda. Inani elikhulu le-hemoglobin linikezwa ngopeni.
Ukunyakaza okungavamile kwesisu
Ngaphambi kokubeletha, ingane isondliwa kusuka kunina. Kusukela emahoreni wokuqala kokuphila kwakhe emva kokuzalwa, uqala ngokushesha ukulahla i-meconium - into eqoqwe emathunjini yengane ngisho nangomsebenzi we-intrauterine. Lona umsebenzi wokuqala wezinsana. Ingane ezalwa ngaphambi kwesikhathi, noma uma unina engondlekile ngesikhathi sokukhulelwa, uhlangabezana nezinkinga ngamathumbu. Umsebenzi wawo uphazamiseka, okwenza ukwanda kwezinga le-bilirubin egazini.
I-Rhesus-impikiswano
Lokhu kungqubuzana neR Rh factor of the mother and the child - uma ingane ingumama kaR Rh-positive nomama we-Rh. Ngenxa ye-immunoglobulin prophylaxis (ngemva kokuzalwa kwengane, umama uthola i-immunoglobulin anti-Rh-D engakapheli amahora angu-72, evikela isimiso somzimba sokuzivikela emzimbeni ukuya emzimbeni wegazi), umama akakhiqizi izifo ezithathelwanayo ezingasongela umntwana ngesikhathi sokukhulelwa okulandelayo.
Kungase kube khona ukungqubuzana kwamaqembu amakhulu egazi. Isibonelo, owesifazane ophethe i-group III igazi unama-antibodies wemvelo ngokumelene namaseli eqembu le-IV. Ezimweni ezinjalo, ingxabano ibonakala kakhulu ngesikhathi sokukhulelwa kokuqala. Ekukhulelweni okulandelayo, ingozi yokulwa okunjalo iyancipha.
Ukulimaza
Ukuzalwa ukulimala kwengane. Kumele afeze umsebenzi onzima - ukucindezela emgodini omncane wokuzalwa. Ngezinye izikhathi le nqubo ayenzi ngaphandle komonakalo. Ama-birthmarks wesifazane kulo mzuzu agcwele igazi, lapho okuqukethwe okuphezulu kakhulu kwe-bilirubin. Uma kubonakalisiwe, leli gazi lifika emntwaneni, i-bilirubin iyawela emzimbeni wakhe. Izinga lenyuke futhi i-jaundice iphakama.
I-Hypoxia
Izinsana zingaba, isibonelo, ziboshwe emgqeni we-umbilical. Ngezinye izikhathi ezimweni ezinjalo, i-jaundice yenzeka ngenxa ye-hypoxia yesibindi, eyandisa ukwehluleka kwayo esikhathini sokubeletha.
Ukubeletha
Inani lokudla ezinsukwini zokuqala zokuphila lingancipha kancane kunengane yakho engathanda ukuyidla. Ngakho-ke, kungase kube khona ukulibaziseka ekudleni kokudla ngokusebenzisa indlela yokugaya ingane. Ngenxa yalokho, i-jaundice ingenzeka.
Kungenzeka ukuthi ingane iphilile, isondliwe kuphela, isondeza kahle, kodwa i-jaundice igcinwa isikhathi eside futhi ingahlala izinyanga ezingu-2-3. Kubangelwa ama-enzyme akhona ebisi lwebele futhi asize ukuhlanganisa i-bilirubin ne-glucuronic acid kanye nomkhiqizo wayo ngemifino. Ngezinye izikhathi izingane ezinjalo zingakwazi ukufinyelela amanani aphezulu we-bilirubin. Noma kunjalo, lokhu akusongeli impilo nempilo yezingane.
Isici sokuphila
Ngokuvamile, i-jaundice - isifo sezingane ezisanda kuzalwa sibhekene nezingane zakuqala ezigulayo. Kungaba ukutheleleka kokubeletha kokubeletha noma kwegciwane. Enye yezimpawu i-jaundice enzima. Kukhona nezifo zofuzo lapho kukhona ukungasebenzi kwesibindi kanye nekhono layo lokubopha i-bilirubin ku-glucuronic acid.
Ngingayiphatha kanjani ingane yami ezinsana ?
Ukwelapha okukhanyayo
Lena indlela ephumelela kakhulu yokwelapha lesi sifo. Ukudlula i-bilirubin yamahhala esikhumbeni kuyahlehla emikhiqizweni engenayo ishukela emanzini, okuvele imane igxiliwe emcinini. Ngalendlela, izinhlobo ezahlukene zokukhanya zingasetshenziswa: ezimhlophe, eziluhlaza okwesibhakabhaka nokuhlaza. Okuphumelela kakhulu kuluhlaza okwesibhakabhaka. I-phototherapy iphumelela kuphela uma ukukhanya kuwela esikhunjeni esingenalutho. Uma ingane yakho ilele esiswini sayo, konke emuva kwayo kukhishwa i-irradiated, uma ilala emhlane - ngaphambili. Amehlo wengane ahlanganiswe ngento ekhethekile engavumeli imisebe. Abafana nabo banama-testes.
Uma kwenzeka i-jaundice enzima, ingane esanda kuzalwa ifakwa egumbini lokunakekelwa okujulile ekamelweni lapho lisebenza khona ngama-phototherapy. Ingane ilele ematithini akhethekile, axhunyiwe emithonjeni yokukhanya ye-fiber-optic futhi ikhanyiswa kusuka phezulu ngensimbi ekhethekile. I-phototherapy ivame ukuhlala izinsuku ezimbili - lokhu, njengokubusa, kwanele. Ngezinye izikhathi inkambo yenziwa ezinsukwini ezintathu.
I-Luminal
Nge-acuity encane ye-jaundice ekwelapheni, i-luminal (phenobarbital) isetshenziswa. Kuyinto epholile futhi i-anticonvulsant ekhuthazwe kahle yizinsana. Ngomthamo ophansi, kuvuselela ukukhiqizwa kwama-enzyme yesibindi futhi kuphuthumise umzimba we-bilirubin. Ngesilinganiso esincane se-jaundice iyithuluzi eliphumelelayo.
Ukugcoba
Lena indlela ephikisanayo esetshenziswa ekwelapheni i-jaundice engapheli ezinsana ezisanda kuzalwa. Izinto ezisetshenziselwa ubisi lwebele futhi ezibhekene ne-jaundice ziqedwa futhi izinga le-bilirubin liyancipha. Ungabuyela ekunceliseni ingane emva kwezinsuku ezimbili noma ezintathu. Egazini lomntwana futhi kuzoba nokwanda kwe-bilirubin, kodwa hhayi ngezinga eliphakeme kangaka.
Ukumpontshelwa igazi
Lena yindlela yokugcina yokwelapha isifo se-jaundice - isifo ezinsana. I-veillical vein ifakwe emgodleni, lapho igazi lomntwana lisuswe khona ezingxenyeni ezincane, futhi igazi lomnikeli lijojowe. Ngakho-ke ingane ingenwa yi-bilirubin ngokweqile. Le ndlela ikuvumela ukuba uhlanze igazi lezingane ezinamagciwane okulwa namaseli egazi.
Ngezinye izikhathi, nge-jaundice enzima kakhulu, i-albin inganikezwa, okuyinto, njengoba yaziwa, idlulisela i-bilirubin. Ukubaluleka kwe-bilirubin egazini lezinsana ezigcwele isikhathi eside akuvunyelwe ingane engakafiki. Ingane encane ingane, isisindo somzimba esincane, ukwehlisa inani le-bilirubin, okuyinto engane engakwazi ukuyenza.
Odokotela abahlinzeka nge-neonatologists bacabangela isisindo somntwana, isimo somtholampilo (ngesimo somtholampilo esibi kakhulu, amanani aphansi e-bilirubin avunyelwe). Inani le-bilirubin ngosuku lwesibili lokuphila kwengane alisamukelekile ezinsukwini ezine nolandelayo.
Umphumela onobuthi we-bilirubin
I-Bilirubin iyancibilika kalula emafutheni, ingena ohlelweni oluyisisekelo senzwa, lapho kubangelwa khona umonakalo ongenakugwetshwa. Unesibopho sokuthuthukiswa kokukhathazeka. Ukungena kwe-bilirubin ibe yisimiso sezinzwa zomzimba kunzima kakhulu kwengane enesisindo sokuzalwa esincane ngenxa yokuzalwa ngaphambi kwesikhathi. Izingane ezinjalo ziyakwazi ukuthola izifo ezithintekayo zibe yi-acidosis. Ingozi yokulimala ohlelweni lwezinzwa zomphakathi luphakeme lapho izinga le-bilirubin lidlula kakhulu.
Uma sekukholelwa ukuthi ukuhlushwa kwe-bilirubin nge-20 mg. iyinkomba yokumpontshelwa igazi ngegazi. Izincwadi zezwe azihlinzeki ngezinkinga zokubeletha ezinganeni ekunceliseni, ngisho nasezindinganisweni eziphakeme kakhulu ze-bilirubin.
Zikhona yini izinkinga?
Uma i-jaundice ephathwa kahle ngezingane ezisanda kuzalwa, idlula ngaphandle kwemiphumela. Emkhakheni wamanje wemithi, lokhu akuwona umsebenzi wokwelapha (Yebo, ngokubambisana okuhle nomama wengane). Izingane eziye zathola lesi sifo zikhula ngendlela efanele, azikho ukwephula ekuthuthukisweni kwazo.
I-jaundice engokwemvelo kwenzeka ngosuku lwesibili noma lwesithathu yokuphila kwengane futhi ihlala kuze kube yizinsuku ezingu-8, kuyilapho iziguli zangaphambi kwesikhathi kuthatha cishe amasonto amabili. I-jaundice igula okungaba yizingxenye ezimbili kwezintathu zamantombazane azalwa njalo. Ezinganeni ezingakabiphi isikhathi kwenzeka ngo-80-90%. Ngaphambili ingane yazalwa, iphakame amathuba okuba i-jaundice futhi isondele ku-100%. I-Jaundice ezinsana ezinempilo ngosuku lokuqala lokuphila kuyisifo se-jaundice ye-pathological.