Kule nkinga, isikhumba nabamhlophe bamehlo bazuza i-hue ephuzi ngenxa yokuqukethwe okungavamile kwe-pigment bilirubin egazini. I-Bilirubin ngumkhiqizo ovamile we-heme-iron ingxenye ye-hemoglobin erythrocytes. Kunezinhlobo ezintathu eziyinhloko ze-jaundice: i-hepatic-cell, i-hemolytic neyokuvimbela. Izimpawu zalezi zimo kufanele zihlolwe ngokucophelela ukuze zithole ukuxilongwa okulungile.
Hemolytic jaundice
I-hemolytic jaundice yimbangela yokubhujiswa kwama-erythrocytes. I-urine kulezi ziguli ngumbala ojwayelekile, ngoba ngaleli fomu le-jaundice, ifomu elingenayo i-bilirubin liqoqa egazini. Ukuba khona kwe-urobilinogen emthonjeni (umsebenzi wesibindi awuphukile) ubapha umbala ojwayelekile.
I-jaundice yokuvimbela
I-jaundice engavimbelayo iqala lapho kukhona ukuvimbela ukuphuma kwebhala. Ezigulini, ukukhwabanisa okubomvu komchamo kubonakala ngenxa yokuhlushwa okuphezulu kwamanzi we-bilirubin, kanye nokwehlukaniswa kwamanzi. Amazinga aphezulu we-bilirubin egazini abangela ukugwinya okukhulu. Isibonakaliso sokuvinjelwa kwamadaysi e-extrahepatic bile angabi nomkhuhlane. Izinga eliphezulu le-bilirubin futhi, ngokufanele, i-jaundice ingathuthuka ngenxa yezinqubo ezintathu eziyinhloko:
- ukubhujiswa okwedlulele kwama-erythrocytes (i-hemolysis) ngokukhululwa ngokweqile kwe-bilirubin engenawo igazi;
- ukulimala kwamangqamuzana e-isibindi, okuholela ekusetshenzisweni okwanele kwe-bilirubin engenawo amanzi;
- ukuvinjelwa (ukuvinjelwa) endleleni yokuphuma kwe-bilirubin engancibilika kwamanzi ekukhanyeni kwamathumbu. Kule nkinga, ngisho nemali evamile ye-pigment ayikwazi ukudonswa ngemifino kanye nomchamo.
Hemolytic jaundice
Ukubhujiswa okwedlulele kwama-erythrocyte kwenzeka:
• ezinganeni ezisanda kuzalwa ezinamaseli abomvu okweqile;
• kuziguli ezine-malariya; kuziguli ezine-anemia ye-sickle cell;
• nge-spherocytosis yefa (ukutholakala kwefomu elingavamile egazini lama-erythrocyte).
I-hepatic-cellular jaundice
I-hepatic-cell jaundice iqala ukutheleleka ngegciwane, ikakhulukazi ku-hepatitis A, B, C, D no-E. Jaundice nayo ihambisana ne-cirrhosis nokusetshenziswa kwemithi ethile. Ukuphila kwama-erythrocyte kungaba izinsuku ezingaba ngu-120, emva kwalokho kubhujiswa esitezini. Kule nkinga, kukhishwa i-bilirubin engekho engxenyeni, engeke idalwe yizinso. Ngokwegazi, ithunyelwa esibindi, lapho liphenduka khona ifomu elincincile amanzi. Kusukela esibindi, iningi le-bilirubin elununcibilikayo lidlula emidayeni ye-bile e-gallbladder, futhi kusukela lapho kuya emathunjini. E-gut lumen, i-bilirubin eguquguqukayo iqhutshwa phambili ngokubambisana nokuhlanganyela kwama-bacterium ukwakha into efaka umbala wobuciko emanzini. I-Urobilinogen - ifomu le-bilirubin elicutshungulwayo - lingenwe ingxenye yegazi futhi lihlushwa yizinso nesibindi.
Kubaluleke kakhulu ukucacisa imbangela ye-jaundice.
• Ukuba khona kweziqephu zobuhlungu kanye ne-jaundice ephakathi kungase kubonise ukuthi i-gallstones.
• I-jaundice ekhulayo njalo ehlangene nesisindo sokulahlekelwa yisisindo kungaba uphawu lomdlavuza we-pancreatic. Ukusetshenziswa kabi kotshwala noma ukusetshenziswa kwesikhathi eside kwezidakamizwa emlandweni kugcizelela ukulimala kwesibindi.
Izivivinyo zokuxilonga
• Ukuhlolwa kwegazi ukucacisa uhlobo nobunzima be-jaundice. Nge-jaundice engavimbelayo, izinga le-enzyme ye-alpine phosphatase landa kakhulu. Ukunqotshwa kwamangqamuzana wesibindi kuhambisane nokwanda kwe-transaminases. Nge-anemia, ukuhlolwa kwegazi kuyothola ukwehla kwenombolo yamaseli abomvu wegazi kanye nokuba khona kwamangqamuzana e-sickle noma ama-spherocytes. Ama-Ultrasound namanye amasu okucabanga azokhumbula ukucacisa uhlobo lokuvimbela. Ukuze kutholakale ukuthi i-hepatitis engapheli, i-biopsy yesibindi ingadingeka. Amaqhinga okwelashwa ancike kuhlobo kanye nesibindi se-jaundice, I-Hepatitis A ayidingi ukwelashwa okulwa namagciwane okukhethekile. Iziguli zeluleka ukuba zilandele ukudla futhi zigweme ukuphuza utshwala. I-hepatitis engapheli ayikwazi ukuphathwa ngezidakamizwa ze-antiviral. I-jaundice engavimbayo ingadinga ukuhlinzeka ngokuhlinzwa ngenxa yesibangela sokuvimbela kanye nokuhlala kwayo. Isibikezelo ezimweni eziningi ze-jaundice sinomusa. Ukusola kwesifo sofuba esingapheli kwenzeka uma:
- izimpawu azixazululwa;
- isibindi sanda;
- ezindaweni zokuhlala ze-biopsy zokufa kwezingqimba zesibindi ziyatholakala;
- Izivivinyo zesibindi zanda ezinyangeni ezingu-6-12.
Isifo sofuba esingapheli futhi ikakhulukazi i-cirrhosis kuyinkinga enkulu futhi kungaholela ezinkingeni ezifana nalezi:
- ukungakwazi ukusebenza kahle;
- ukuphuma egazini.
Ukuthuthukiswa kwe-jaundice - isibonakaliso sezifo eziningi zesibindi - kungavinjelwa. Ukuze kuvikelwe isifo sofuba esithathelwanayo nesifo sokudlulisa ngomlomo (A kanye no-E) lapho uhamba ezindaweni ezingapheli, imithetho elandelayo kufanele ilandelwe:
- Sebenzisa kuphela amanzi abilisiwe noma amabhodlela, ngisho nokuhlanza amazinyo akho;
- Uma usebenzisa amaphilisi okugcoba amanzi, landela ngokucophelela imiyalelo;
- Gwema ukudla ukudla okugcinwe noma okuphekwe ezimweni ezingahlanzekile;
- Ungasebenzisi i-ice ukuze uphuze iziphuzo futhi ungadli ukudla okungenakusebenza okune-thermally;
- hlamba izandla ngaphambi kokudla futhi emva kokusebenzisa indlu yangasese.
Ukuvimbela ukushisa kwesibindi, okudluliselwa ngegazi nangokwecansi (B, C, D), kunikeza:
- ukugwema ubulili obungavamile;
- ukusetshenziswa kwekhondomu.