txheem
Dab tsi yog pawg ntshav incompatibility?
“Tsis tau ua ntej yug ntawm kuv tus me nyuam tub, kuv puas tau nug kuv tus kheej cov lus nug txog cov ntshav tsis sib haum ntawm nws thiab kuv. Kuv yog O +, kuv tus txiv A +, rau kuv tsis muaj rhesus incompatibility, tsis muaj teeb meem. Kuv muaj huab cua tsis muaj cev xeeb tub thiab yug me nyuam zoo meej. Tiamsis kev xyiv fab sai sai ua rau muaj kev ntxhov siab. Saib ntawm kuv tus menyuam, kuv tam sim ntawd pom tau tias nws muaj xim questionable. Lawv hais rau kuv tias tej zaum jaundice. Lawv muab nws los ntawm kuv thiab muab tso rau hauv lub teeb kho cov cuab yeej. Tab sis qib bilirubin tsis poob qis thiab lawv tsis paub yog vim li cas. Kuv txhawj xeeb heev.
Tsis nkag siab qhov uas tshwm sim yog qhov phem tshaj plaws rau cov niam txiv. Kuv pom tau tias kuv tus menyuam tsis nyob hauv lub cev, nws tsis muaj zog, zoo li ntshav ntshav. Lawv tau teeb tsa nws hauv neonatology thiab kuv tus me Leo nyob tsis tu ncua hauv lub tshuab hluav taws xob. Kuv tsis tuaj yeem nrog nws rau nws thawj 48 teev. Lawv coj nws los rau kuv noj xwb. Txaus los hais tias qhov pib ntawm kev pub niam mis yog chaotic. Tom qab ib lub sijhawm, cov kws kho mob tau hais txog kev tsis sib haum xeeb ntawm pawg ntshav. Lawv hais rau kuv tias qhov teeb meem no tuaj yeem tshwm sim thaum leej niam yog O, leej txiv A lossis B, thiab tus menyuam A lossis B.
Thaum lub sij hawm yug me nyuam, muab nws yooj yim, kuv cov tshuaj tiv thaiv kab mob ua rau kuv tus menyuam cov qe ntshav liab puas lawm. Thaum peb paub tseeb tias nws muaj dab tsi, peb muaj kev zoo siab heev. Tom qab ob peb hnub, qib bilirubin thaum kawg poob thiab hmoov zoo tsis txhob tso ntshav.
Txawm hais tias txhua yam, kuv tus me tub tau siv sijhawm ntev los rov qab los ntawm qhov kev txom nyem no. Nws yog ib tug me nyuam mos, feem ntau mob. Koj yuav tsum ceev faj heev vim nws lub cev tsis muaj zog. Thawj ob peb lub hlis, tsis muaj leej twg puag nws. Nws txoj kev loj hlob tau saib xyuas zoo heev los ntawm tus kws kho mob. Hnub no kuv tus tub zoo lawm. Kuv cev xeeb tub dua thiab paub tias muaj caij nyoog zoo uas kuv tus menyuam yuav muaj qhov teeb meem no dua thaum yug los. (Nws tsis pom thaum cev xeeb tub). Kuv tsis ntxhov siab vim kuv qhia kuv tus kheej tias tsawg kawg tam sim no peb paub. “
Teeb pom kev zoo los ntawm Dr Philippe Deruelle, obstetrician-gynecologist, Lille CHRU.
- Dab tsi yog pawg ntshav incompatibility?
Muaj ob peb hom ntshav incompatibility. Lub rhesus incompatibility uas peb paub zoo thiab uas yog qhia los ntawm loj anomalies nyob rau hauv utero, tab sis kuj muaj covincompatibility ntawm pawg ntshav hauv ABO system uas peb tsuas pom thaum yug los.
Nws cuam tshuam txog 15 txog 20% ntawm kev yug menyuam. Qhov no tshwm sim tsis tau tias thaum leej niam yog pab pawg O thiab hais tias tus me nyuam yog pawg A lossis B. Tom qab yug me nyuam, qee leej niam cov ntshav sib xyaw nrog tus me nyuam. Cov tshuaj tiv thaiv kab mob hauv niam cov ntshav tuaj yeem rhuav tshem tus menyuam cov qe ntshav liab. Qhov tshwm sim no ua rau muaj qhov txawv txav ntawm bilirubin uas tshwm sim thaum ntxov jaundice (jaundice) hauv cov menyuam mos. Feem ntau cov kab mob jaundice ntsig txog kev tsis sib haum xeeb ntawm pawg ntshav yog me. Qee zaum COOMBS xeem yog siv los txheeb xyuas qhov tsis zoo no. Los ntawm cov ntshav kuaj, nws ua rau nws muaj peev xwm soj ntsuam seb leej niam cov tshuaj tiv thaiv kab mob txuas lawv tus kheej mus rau tus menyuam cov qe ntshav liab puas puas.
- Ntshav pab pawg incompatibility: kho
Cov qib bilirubin yuav tsum tiv thaiv kom tsis txhob nce ntxiv vim tias qib siab tuaj yeem ua rau lub paj hlwb puas tsuaj rau tus menyuam. Phototherapy kev kho mob yog teem caij. Lub hauv paus ntsiab lus ntawm kev kho duab yog kom nthuav tawm cov tawv nqaij ntawm cov menyuam mos rau lub teeb xiav uas ua rau bilirubin soluble thiab tso cai rau nws tshem tawm hauv nws cov zis. Kev kho mob ntau dua tuaj yeem tsim kho yog tias tus menyuam tsis teb rau kev kho mob phototherapy: immunoglobulin hloov pauv uas tau txhaj tshuaj intravenously lossis exsanguino-transfusion. Cov txheej txheem kawg no yog hloov ib feem loj ntawm tus menyuam cov ntshav, nws tsis tshua muaj ua.