Jaundice yevana vachangoberekwa haisi chirwere chakadaro, asi chiratidzo chacho. Iyo inoratidzirwa nekupenya kweganda uye maziso emeso emwana. Nekuberekwa kwekutanga, mikana ye jaundice inowedzera uye inosvika 100%. Urwu ruvara rwejerice - chirwere muvana vanenge vachangoberekwa kakawanda. Nokuti iwe uchave wakakodzera kudzidza pamusoro peizvi zvakare.
Izvi zvinoitika sei?
Kushanda kweganda recheche kunokonzerwa nekuwedzera bilirubin (iyo inonyanya chikamu chevanhu bile bile pigments) nemhaka yehemoglobin - iyo pigment tsvuku yeropa. Mukati, masero matsvuku eropa (erythrocytes) anoparadzwa uye hemoglobin yakabudiswa kubva kwavari inoshandurwa kuva bilirubin. Inotakurirwa muropa serumisi kuchiropa. Chikamu che bilirubin, chinotakurwa kuburikidza nemuviri, inonzi yakasununguka kana isina kuiswa. Icho chinokonzera mafuta-asi chinosvibiswa mumvura. Muropa, bilirubin inotorwa kubva kumakomba ne albumin. Saka bilirubin inoumbwa, inosvibiswa mumvura, iyo inopinda mumukumbo, iyo yakasvibiswa nemasese. Kukwanisa kutora muviri weBheterubin inoberekwa uye kusunga glucuronic acid inoshaya. Kubudirira kwehutachiona hwechiropa mucheche zvakanyanya kudarika pane vanhu vakuru.
Nei izvi zvichiitika?
Kune zvikonzero zvakasiyana-siyana zve jaundice - chirwere muzvitsva. Izvo zvose ndezvehupenyu uye hutachiona. Zvisinei, ndinoda kutaura zvakanyanya.
Fetal fetal hypoxia
Izvo fetus inorarama uye inokura pasi pemamiriro ezvinhu emuhuri hypoxia. Vana vacheche vanozvarwa nechepamusoro ye hematocrit uye hemoglobin, ine yakawanda yemasero matsvuku eropa muropa. Mazuva ehupenyu emajeri achangobva kugadzirwa anoderedzwa. Mhedzisiro ndeyokuti, nekuda kwehuwandu hwemasero matsvuku eropa, chirwere checheche chiri kuwedzera. Chimwe chiyero chikuru che hemoglobin inowanikwa kune spleen.
Nhengo dzisina kuchena dzechirwere
Asati aberekwa, mwana anodyiswa kubva kuna amai vake. Kubvira pamaawa okutanga ehupenyu hwake mushure mokuberekwa, anokurumidza kukurumidza kuramba meconium - chimwe chinhu chakakonzerwa mumatumbo emucheche kunyange nehupenyu hwepatiraine. Iri ndiro basa rokutanga rechecheche. Mwana akaberekwa asati apera, kana kuti amai vake vakanga vasina kudya zvokudya panguva yekuzvitakura, vaine matambudziko nematumbo. Basa rayo rakanganiswa, zvichiita kuti kuwedzerwa kwehuwandu hwebilirubin muropa.
Rhesus-kukakavara
Izvi zvinopesana neR Rh chinokonzera amai nevana - kana mwana ari Rh-positive uye amai vaRh-negative. Kuonga immunoglobulin prophylaxis (mushure mokuberekwa kwomwana, amai vanogamuchira anti-Rh-D immunoglobulin mukati maawa 72, iyo inodzivirira maitiro ezvirwere zvezvirwere kubva kumakumbo kusvika kuropa remwana), amai havaiti zvirwere zvinogona kutyisidzira mwana panguva yekuzvitakura kunozotevera.
Ikoko kunogonawo kuva nekupesana kwemazana makuru eropa. Semuenzaniso, mukadzi ane chirwere cheboka III ane masikirwo emasikirwo emasero anosangana neboka reVII. Mumamiriro ezvinhu akadaro, kukakavara kunonyanya kutaurwa panguva yekuzvitakura kwekutanga. Mumitambo inotevera, njodzi yekukakavadzana kwakadaro inoderera.
Hemorrhage
Kuberekwa kukuvadzwa kumwana. Anofanirwa kuzadzisa basa rakakosha-kuti apinde nepakati pedo rakakura rekubereka. Dzimwe nguva izvi hazviiti kunze kwekukuvara. Kuberekwa kwemukadzi panguva ino kwakazadzwa neropa, umo mune zvakanyanya zvakanyanya zvebilirubin. Kana akaparara, ropa iri rinosvika kumucheche, bilirubin zvakare inowira mumuviri wake. Nhamba yacho inowedzera uye jaundice inomuka.
Hypoxia
Vacheche vanogona kuva, semuenzaniso, vakapindira mumutsara wembilical. Dzimwe nguva mumamiriro ezvinhu akadaro, jaundice inoitika nekuda kweshuvha hypoxia, iyo inowedzera kukanganisa kwayo munguva yekuzvarwa.
Kuberekwa
Kuwanda kwezvokudya mumazuva okutanga ehupenyu zvinogona kunge zvishoma zvishoma pane mwana wako angada kudya. Nokudaro, pangangodaro kunonoka mukudya kwezvokudya kuburikidza nehutachiwana hwekudya. Somugumisiro, jaundice inogona kuitika.
Zvinogona kuitika kuti mwana ane utano hwakanaka, anongoberekwa nehutachiwana chete, achiwana uremu hwakanaka, asi jaundice inochengeterwa kwenguva yakareba uye inogona kusvika kusvika kumwedzi 2-3. Inokonzerwa nemakemikari aripo mumukaka webonde uye anobatsira kubatanidza bilirubin ne glucuronic acid uye yakabuda nemasese. Dzimwe nguva vana vakadai vanogona kusvika kune zvakanakisisa zvinokosha zvebilirubin. Zvisinei, izvi hazvisi kupisa upenyu nehutano hwevana.
Pathological factor
Kazhinji, jaundice - chirwere chevana vanozvarwa chinotambura kubva pakutanga vana vanorwara. Inogona kuva kuberekwa kwebhakitiriya kana utachiona hwehutachiona. Chimwe chezviratidzo zvakanyanya jaundice. Kunewo zvirwere zvepabhesi umo kune chiropa chisingaiti uye kukwanisa kwayo kusunga bilirubin kune glucuronic acid.
Ndingaita sei mwana wangu muchecheche ?
Light therapy
Iyi ndiyo nzira yakanakisisa yekurapa chirwere ichi. Kuwedzerwa kwebharenubin yakachena mucheka kunopera muzvinhu zvisina kusvibiswa mumvura-zvigadziriswa, izvo zvinongobva zvichinyorwa mumugini. Nenzira iyi, marudzi akasiyana echiedza anogona kushandiswa: machena, bhuruu uye ruvara. Inonyanya kukosha ndeyebhuruu. Phototherapy inobatsira chete kana chiedza chikawira paganda rakashama. Kana mwana wako akarara pamudumbu wake, iyo yose yakadzoka yakajeka, kana yakarara pamusana wake - mberi. Meso omwana akafukidzirwa nemashoko anokosha asingabvumiri mazaisai. Vakomana vacho vane ma testes.
Mune mamiriro ekurwadza, jacheche inoiswa muimba yekuchengetedza yakawanda yekamuri iyo inosangana phototherapy. Mwana wacho akarara pane rimwe rematirasi chaiwo, ayo akabatana nefiber-optic chiedza chemheni uye anonamirwa kubva kumusoro ane mwenje chaiwo. Phototherapy inowanzopedza mazuva maviri - izvi, sekutonga, zvakakwana. Dzimwe nguva dzidzo inowedzera kusvika mumazuva matatu.
Luminal
Nekusava nechokuita kwejerice mukurapa, luminal (phenobarbital) inoshandiswa. Iyo inotonhora uye anticonvulsant iyo inobvumirwa zvakanaka nechecheche. Muchiyero chakaderera, chinoita kuti kuve nekunyanya kwechiropa kunokonzera maitiro emhepo uye kunowedzera kushandiswa kwemasabolism kwebilirubin. Nechinguva chiduku che jaundice ibasa rinobudirira.
Kuchengeta
Iyi inzira inopesana inoshandiswa mukurapa chirwere chisingagumi mumwana mutsva. Izvo zvinhu zviripo mumukaka wezamu uye zvinokonzerwa nejerice zvinopedzwa uye uwandu hwebilirubin hunoderedzwa. Unogona kudzokera kunwisa mazamu mushure mamazuva matatu kana matatu kubva. Muropa recheche zvakare pachava nekuwedzera mu bilirubin, asi kwete pamwero wakadaro.
Kuwedzerwa ropa
Iyi ndiyo nzira yekupedzisira yekurapa jaundice - chirwere muzvitsva. Imbilical vein inowanikwa mu catheter, iyo iyo ropa romwana inobviswa muzvikamu zviduku, uye ropa romupiro rinoshandiswa. Saka mwana wacho anorega kudarika bilirubin. Iyi nzira inokubvumira kuti uchenese ropa revana vane ma antibodies kune masero eropa.
Dzimwe nguva, ine jaundice yakaoma kwazvo, albumin inogona kupiwa, izvo, sezvinozivikanwa, inotumira bilirubin. Zvinoreva bilirubin muropa revana vese vemazuva mashoma hazvibvumirwi nevana vasati vazvarwa. Zviduku mwana, utoro hushoma huri pasi, kukosha kwebrilirubin, iyo iyo mucheche inogona kumira.
Vanachiremba neonatologist vanofungisisa kuremera kwemwana, kliniki yemamiriro (ane chirwere chinorema zvikuru, mararamiro ekuderedza bilirubin anobvumidzwa). Kukosha kwebilirubin pazuva repiri rehupenyu hwemwana hakuchagamuchirwi pazuva rechina uye rinotevera.
Dhiyabhorosi inoitwa bilirubin
Bilirubin inopera nyore nyore mumafuta, inopinda mumutambo wemagetsi, iyo inokonzera kukanganisa kusingagadziki. Ndiye anokonzera kukurudzirwa kwekuchengetedza. Kupindira kwebilirubin kuva pakati penheyo system kunowedzera kuoma kumwana ane uremu hwekuberekwa kwakadzama sechikonzero chekuberekwa kusati kwaitika. Vana vakadaro vanoita zvirwere zvinotapukira mu acidosis. Ngozi yekukuvadza kunheyo yenheyo yepamusoro iyo yakakwirira apo uwandu hwebilirubin hwakawedzerwa zvikuru.
Pane imwechete yaitenda kuti maitiro ebilirubin ne 20 mg. inoratidza kuwedzerwa kuwedzerwa ropa. Zvinyorwa zvenyika hazviiti kuti vana vanyatsotapurika pavanenge vachiyamwisa, kunyange pamitengo yakakwirira yebilirubin.
Kune matambudziko here?
Kana zvakanyatsorapwa jaundice mumwana achangoberekwa, zvino inopfuura pasina migumisiro. Parizvino mazinga emishonga, iyi haisi basa rerapa (zvirokwazvo, nekubatsirana kwakanaka naamai vemwana). Vana vakawana chirwere ichi chinokura zvakanaka, hapana kutyora mukubudirira kwavo.
Physiological jaundice inoitika musi wechipiri kana wechitatu wehupenyu hwemwana uye inopedza kusvika kumazuva masere, panguva yekutanga vatapi inotora anenge masvondo maviri. Jaundice inorwara munenge pazvikamu zviviri kubva muzvitatu zvevana vacheche vese. Muvana vasati vasvika zvinowanikwa muna 80-90%. Yakazvarwa mwana akaberekwa, iyo yakakwirira yehutano hwe jaundice uye yava pedyo ne100%. Jaundice mumwana mutsva ane hutano muzuva rokutanga rehupenyu chiratidzo chechirwere chinonzi jaundice.