Izimpawu ze-jaundice

Ngaphandle kwemiphumela yayo yobuhle, ukuguqulwa kombala we- integuments (isikhumba nolwelwesi lwamafinyila) akunayo imiphumela ye-pathological. Ngokuya ngezimbangela ze-jaundice, ezinye izibonakaliso zingase zihlotshaniswe, okungenzeka zenze kube lula ukuqondisa ukuxilongwa: ubuhlungu besisu, umkhuhlane, ukulunywa, ukukhathala, ubuhlungu obuhlangene, njll.

I-bilirubin yamahhala, ngakho-ke “engakahlangani” esibindini, inobuthi ebuchosheni. Ezinsaneni ezisanda kuzalwa, ukunqwabelana kwayo ngenani elikhulu kakhulu kungaba yingozi ikakhulukazi ebuchosheni futhi kudinga ukwelashwa okuphuthumayo.

Ziyini izimbangela?

Ngaphandle kobuthi be-bilirubin yamahhala ebuchosheni (i-neurotoxicity), ezimweni eziningi, izimbangela ze-jaundice zinquma ukubikezela, ukugula noma ukuqina kuye ngokuthi icala. Ngokufanayo, ukwelashwa kuyehluka kuye ngokuthi i-jaundice isukaphi. Ngakho-ke ukuxilongwa okuqondile kubalulekile. Ukuze benze lokhu kuxilonga, odokotela basebenzisa ukuhlolwa komtholampilo kokuqala, ukuhlolwa kwegazi kanye ne-ultrasound yesisu. Okunye ukuhlola kungase kudingeke: i-CT scan, i-MRI, i-cholangiography, i-endoscopy, i-biopsy, njll.

Njengoba i-jaundice iwuphawu hhayi isifo, ayitheleleki.

Ngokuyisisekelo, kunezinhlobo ezimbili ezihlukene ze-jaundice:

• Kungase kube ukwanda kokukhiqizwa kwe-bilirubin yamahhala
• Noma kungaba conjugated bilirubin.

Esimweni sokuqala, ngesikhathi sokwanda kwe-bilirubin yamahhala, ukweqisa kungase kuhlotshaniswe nokwanda kokubhujiswa kwamangqamuzana abomvu egazi (i-hemolysis) noma ukuhlanganiswa okungalungile kwe-bilirubin esibindini. Isimo sokuqala sivame ukudala i-anemia (ukwehla kwezinga le-hemoglobin) futhi singaphakamisa isifo segazi, noma ukutheleleka, imbangela yezidakamizwa, ukulimala kwe-immunological, njll.

Endabeni ye-jaundice ngenxa yokwanda kwe-bilirubin ehlanganisiwe, i-jaundice ivame ukuhlotshaniswa nesifo sofuzo (isifo sikaGilbert) esibangela ukuhlangana okwanele kwe-bilirubin. Lesi sifo sikaGilbert noma i-Gilbert's syndrome siyingozi ezimweni eziningi.

Esimweni sesibili, lapho i-bilirubin ehlanganisiwe idlulele, ukwanda kokuqedwa komchamo okuthatha umbala omnyama ohambisana nokuguquguquka kwendle. Zimbili izinhlobo zezimbangela ezingasoleka. Okokuqala, ukulimala kwesibindi (i-hepatitis, i-cirrhosis, i-parasitosis, njll.) noma isithiyo ku-bile ducts. lapha  ukuvimbela ukukhishwa kwe-bilirubin. Kulesi simo sakamuva, ikakhulukazi sibheka isibalo, esivimba indlela, isimila sendawo esicindezela imigudu yenyongo… Ezinye izimbangela ezingavamile ze-hepato-biliary nazo zingadala i-jaundice.

Icala elikhethekile le-jaundice ezinganeni

Enganeni esanda kuzalwa, kunezimbangela eziningana ze-jaundice eziqondile kule nkathi yokuphila.

Isibindi kwesinye isikhathi asivuthwa ngokwanele ukuthi sihlanganise i-bilirubin. Kodwa-ke, lokhu kwanda kakhulu ngoba usana kufanele "lushintshe" i-hemoglobin ye-fetus ibe yifomu lomuntu omdala, okubangela ukubhujiswa kwamangqamuzana amaningi abomvu egazi ngesikhathi esifushane kakhulu, into engaba imbangela ye-jaundice.

Ijaundice obisini lukamama ingabonakala nasezinsaneni ezincela ibele.

Ukungezwani kwegazi phakathi kombungu kanye nomama wayo kungaba nesibopho sokubhujiswa kwamangqamuzana egazi abomvu futhi ngenxa yalokho ukunqwabelana okuqinile kwe-bilirubin. Kunjalo lapho umama engena-Rh nengane yakhe ine-Rh. Umama ube esegonyelwa i-Rhesus factor esembungwini wakhe futhi enze amasosha omzimba adlula ku-placenta ukuze abulale amangqamuzana abomvu egazi omntwana. Uma nje ingane ingakazalwa, i-bilirubin ikhishwa yi-placenta, kodwa, ngemva kokubeletha, ukuqoqwa kwayo kubangela i-jaundice.

Ngaphandle kwezinye izimbangela ezihlobene nezifo zokuzalwa, ama-hematomas abalulekile angenzeka ngesikhathi sokubeletha angakhulula futhi i-hemoglobin eningi futhi ngenxa yalokho. ekugcineni i-bilirubin.

Ukwelashwa kwe-jaundice

Ukuvimbela i-jaundice akunakwenzeka kuzo zonke izimo. Noma kunjalo, izinyathelo zokuphepha zivumela izimbangela ezithile ukuba zibe nomkhawulo.

Nazi izinyathelo ezingavimbela ukuqala kwezifo ezingaholela ku-jaundice: 

• Ukuphuza utshwala ngokumaphakathi,
• Gonyelwa ihepatitis B noma A,
• Yenza ucansi oluphephile,
• Hlonipha imithetho yenhlanzeko emazweni asengozini yokutheleleka ngezifo by Ukudla,
• Gwema ukuzila ukudla noma ukukhipha amanzi emzimbeni uma une-Gilbert's syndrome.

Ukwelashwa kwe-jaundice yimbangela yayo: 

• Ngezinye izikhathi akukho ukwelashwa okudingekile: lokhu kunjalo ngefa likaGilbert, elingabangela ukuqubuka kwe-jaundice ngokuvamile kungabi yingozi, ikakhulukazi ngesikhathi sokuzila ukudla noma ukuphelelwa amandla kwamanzi.
• Kwezinye izimo, ukuxazululwa kwembangela kuholela ekutheni i-jaundice (i-hepatitis, i-resorption ye-hematomas, njll.).
• Ku-jaundice yobisi lukamama, ukushisa okwakamuva ku-60 ° C, noma ukushintshela kwifomula, ngokuvamile kuxazulula isimo.
• Ku-jaundice "yokuphila" yosana olusanda kuzalwa, ukuchayeka ekukhanyeni okuluhlaza kusiza ukuqedwa kwe-bilirubin. Ngezinye izikhathi lesi silinganiso asaneli futhi, uma kubhekwa ingozi yezinzwa, kuyadingeka ukwenza i-exsanguino-transfusion (lonke igazi lomntwana liyashintshwa futhi lifakwe esikhundleni sokumpontshelwa). - Kwezinye izimo, ukuhlinzwa kuyadingeka (amatshe, izimila), noma ukuphathwa kwezidakamizwa ezithile (izifo, izifo zegazi, umdlavuza).