Okuqukethwe
Abazali abaningi baba ne-neonatal jaundice. Lokhu kuyiqiniso ikakhulukazi ezinganeni ezizalwa ngaphambi kwesikhathi, ikhula ngamaphesenti angaphezu kuka-80. Kodwa ezinganeni ezizalwa ngesikhathi, lokhu kubuye kube yinto evamile - kwenzeka kumaphesenti angu-50-60 wamacala.
I-jaundice iqala ezinsukwini ezimbalwa zokuqala ngemva kokuzalwa kwengane, futhi ukushintsha kombala wesikhumba ngokuvamile kubonakala ngosuku lwe-3-4, lapho nje umama nomntwana bebuyela ekhaya bevela esibhedlela.
Kungani lokhu kwenzeka? Konke mayelana ne-bilirubin. Kunoma yimuphi umuntu, kwakheka ngesikhathi sokuwohloka kwamangqamuzana egazi abomvu (amangqamuzana egazi anesibopho sokuthutha umoya-mpilo) kukho konke ukuphila futhi akhishwa kalula emzimbeni ngosizo lwesibindi. Kodwa kusana olusanda kuzalwa, lona, njengezinye izinhlelo eziningi zomzimba, alukakavuthwa ngokugcwele, ngakho isibindi somntwana asikabi nawo ama-enzyme anele okusidiliza futhi sisikhiphe. Futhi izinga le-hemoglobin egazini lomntwana osanda kuzalwa liphezulu kakhulu. Ngenxa yalokho, i-bilirubin inqwabelana egazini, futhi isikhumba somntwana osanda kuzalwa siphenduka sibe phuzi. Amhlophe emehlweni nawo angase abe namabala.
Ngesikhathi esifanayo, ingane izizwa kahle. Lokhu kubizwa ngokuthi yi-physiological jaundice yezingane ezisanda kuzalwa, engadingi ukwelashwa futhi inyamalala ngokuphelele ekupheleni kwenyanga yokuqala yokuphila. Kodwa kukhona futhi i-jaundice ye-pathological ezinganeni ezisanda kuzalwa. Lesi vele kuyisimo esibi kakhulu esingaba nemiphumela emibi enganeni. I-jaundice enjalo idinga ukwelashwa okuphoqelekile.
Izimbangela ze-jaundice ezinganeni ezisanda kuzalwa
Ngokungafani ne-physiological, i-jaundice ye-pathological ivame ukukhula emahoreni okuqala ngemva kokuzalwa kwengane. Kungase kube nomchamo omnyama nokushintsha kombala kwendle, i-anemia, nesikhumba esiphaphathekile. Ngesikhathi esifanayo, izinga le-bilirubin liphezulu kakhulu - lingaphezu kuka-256 µmol ezinganeni ezizalwa ngesikhathi, ezinganeni ezizalwa ngaphambi kwesikhathi - ngaphezu kwe-171 μmol.
"I-jaundice ye-pathological ingabangelwa izizathu eziningana," kusho udokotela wezingane u-Anna Levadnaya, I-Candidate of Medical Sciences, umbhali webhulogi mayelana nezifo zezingane. - Okuvame kakhulu ukwenyuka kwe-hemoglobin ngenxa yokungqubuzana kwe-Rhesus noma ukungqubuzana kohlobo lwegazi phakathi kukamama nengane. Futhi, imbangela ye-jaundice ingaba i-pathology yesibindi noma i-pathology yokukhishwa kwe-bile emathunjini. Ngaphezu kwalokho, i-jaundice ingaba uphawu lokutheleleka, i-hypothyroidism (ngenxa yokuncipha kokusebenza kwegilo), i-polycythemia (izinga elikhulayo lamangqamuzana egazi abomvu egazini), ukuvinjelwa kwamathumbu, noma i-pyloric stenosis (lokhu ukuncipha kokuzalwa kokuzalwa). ingxenye yesisu ngaphambi kokungena emathunjini, okwenza kube nzima ukuthi ukudla kudlule). kuyo). Kungenzeka ngemithi ethile nangezinye izizathu.
Futhi, kukhona i-jaundice ezinsaneni ezisanda kuzalwa ezivela ebisi lwebele, lapho izinga le-bilirubin emntwaneni likhuphuka ngenxa yokungenwa kwamahomoni athile aqukethwe obisini lukamama emzimbeni wengane. Le jaundice ingahlala amasonto ayi-6. Uma, lapho i-HB ikhanseliwe izinsuku ezingu-1-2, izinga le-bilirubin liqala ukwehla, futhi ukuphuzi kuyanyamalala, khona-ke ukuxilongwa okunjalo kwenziwa. Kodwa nge-dynamics emihle, ukuqedwa kokuncelisa akudingekile, kuphinda kuqale ngemva kwezinsuku ezingu-1-2. Ngesikhathi sokuphumula, umama kufanele aziveze ngokuqinisekile ukuze agcine i-lactation isezingeni elidingekayo.
Ukwelashwa kwe-jaundice ezinganeni ezisanda kuzalwa
I-jaundice ye-physiological yezingane ezisanda kuzalwa, njengoba sesishilo, ayidingi ukwelashwa. Ngezinye izikhathi odokotela bezingane batusa ukufaka izingane ezinjalo ngamanzi, kodwa kuphela uma i-lactation isungulwe futhi isebenzisa isipuni, hhayi ibhodlela.
Ngokuqondene ne-jaundice ye-pathological yengane esanda kuzalwa, idinga ukwelashwa okuphoqelekile, okunqunywe udokotela.
Ukwelashwa okuphumelelayo kakhulu kwalesi simo namuhla kuyi-phototherapy. Ukuze wenze lokhu, sebenzisa isibani esikhethekile esinokukhanya "okuluhlaza okwesibhakabhaka": ngaphansi kwethonya lemisebe ye-ultraviolet, i-bilirubin iphuka futhi ikhishwe emzimbeni wengane esanda kuzalwa ngomchamo nendle. Ukuqina nobude be-phototherapy kuncike esisindweni somntwana ngesikhathi sokuzalwa kanye nezinga le-bilirubin, elihlala liqashwe njalo. Njengomthetho, amaseshini amahora amathathu ngaphansi kwesibani anqunywe ngekhefu lamahora angu-2-3. Ingane esanda kuzalwa kumele ikhunyulwe, kodwa amehlo avikelwe, abafana nabo banezitho zangasese.
Ezimweni ezinzima ze-jaundice ezisanda kuzalwa, lapho impilo yengane isengozini, ukumpontshelwa igazi kungase kubekwe.
- Kubalulekile ukuqaphela ukuthi manje ochwepheshe abaningi bayavuma ukuthi ukuqokwa kwama-sorbents, izidakamizwa ezifana ne-phenobarbital, i-Essentiale, i-LIV-52, ukuqedwa kokuncelisa, i-UV (i-ultraviolet igazi elinothisa), i-electrophoresis noma ukwelashwa ngokweqile kwe-jaundice akusebenzi. kanye ne-phenobarbital futhi ayiphephile) - kusho u-Anna Levadnaya.
Imiphumela ye-jaundice ezinganeni ezisanda kuzalwa
I-jaundice yempilo yezingane ezisanda kuzalwa, njengoba sesiphawulile, idlula yodwa futhi ayithwali imiphumela emibi empilweni yengane. Kodwa imiphumela ye-jaundice ye-pathological kumntwana osanda kuzalwa ingaba yingozi kakhulu, ikakhulukazi uma ukwelashwa kungaqalwa ngesikhathi.
- Ukwenyuka okuphezulu kakhulu kwezinga le-bilirubin egazini kungaholela ekulimaleni kwengqondo, - kusho u-Anna Levadnaya. - Njengomthetho, lokhu kwenzeka ezinganeni ezinesifo se-hemolytic ngokusho kwe-Rh factor, ngokunyuka kwezinga le-bilirubin ngaphezu kuka-298-342 μmol / l. Futhi lapho izinga le-bilirubin liphakeme, ingozi ye-encephalopathy iyanda.
Ukuvimbela i-jaundice ezinganeni ezisanda kuzalwa
Ukuvimbela okungcono kakhulu kwe-neonatal jaundice yindlela yokuphila enempilo yomama ngesikhathi sokukhulelwa, ukuyeka imikhuba emibi, ukudla okunomsoco.
Ukuncelisa ibele nakho kubaluleke kakhulu. Ubisi lukamama luwukudla okungcono kakhulu komntwana osanda kuzalwa, kulula kakhulu ukugaya, amathumbu avuselelwa ngokushesha, agcwele i-microflora enenzuzo, futhi ama-enzyme adingekayo akhiqizwa. Konke lokhu kusiza umzimba wosana ukuba ukwazi ukubhekana ne-jaundice ngokushesha nangempumelelo.