txheem
Ntau tus niam txiv muaj mob jaundice. Qhov no yog qhov tseeb tshwj xeeb tshaj yog rau cov menyuam mos ntxov ntxov, nws loj hlob ntau dua 80 feem pua. Tab sis nyob rau hauv cov me nyuam uas yug nyob rau lub sij hawm, qhov no kuj yog ib qho tshwm sim - nws tshwm sim nyob rau hauv 50-60 feem pua ntawm cov neeg mob.
Jaundice tshwm sim thawj ob peb hnub tom qab yug me nyuam, thiab kev hloov ntawm daim tawv nqaij feem ntau tshwm sim rau hnub 3-4, tsuas yog thaum leej niam thiab tus menyuam rov qab los tsev hauv tsev kho mob.
Vim li cas qhov no tshwm sim? Nws yog txhua yam hais txog bilirubin. Nyob rau hauv txhua tus neeg, nws yog tsim thaum lub sij hawm tawg ntawm cov qe ntshav liab (cov ntshav uas yog lub luag hauj lwm rau thauj oxygen) thoob plaws hauv lub neej thiab yog yooj yim tawm ntawm lub cev nrog kev pab los ntawm lub siab. Tab sis nyob rau hauv ib tug me nyuam mos, nws, zoo li ntau lwm lub cev lub cev, tseem tsis tau tag nrho matured, yog li ntawd tus me nyuam lub siab tseem tsis tau muaj txaus enzymes los rhuav nws thiab tso tawm. Thiab qib ntawm hemoglobin hauv cov ntshav ntawm tus menyuam yug tshiab yog qhov siab heev. Yog li ntawd, bilirubin accumulates nyob rau hauv cov ntshav, thiab daim tawv nqaij ntawm tus me nyuam mos hloov daj. Cov dawb ntawm ob lub qhov muag kuj yuav stains.
Nyob rau tib lub sijhawm, tus menyuam zoo siab. Qhov no yog qhov hu ua physiological jaundice ntawm cov menyuam yug tshiab, uas tsis xav tau kev kho mob thiab tag nrho ploj mus thaum kawg ntawm thawj lub hlis ntawm lub neej. Tab sis kuj muaj cov kab mob jaundice hauv cov menyuam mos. Qhov no yog ib qho mob hnyav heev uas tuaj yeem muaj qhov tsis zoo rau tus menyuam. Xws li jaundice yuav tsum tau kho.
Ua rau jaundice hauv cov menyuam mos
Tsis zoo li physiological, kab mob jaundice feem ntau tshwm sim hauv thawj teev tom qab tus me nyuam yug los. Tej zaum yuav muaj cov zis tsaus nti thiab muaj xim tsis zoo ntawm cov quav, anemia, thiab tawv nqaij daj ntseg. Nyob rau tib lub sijhawm, qib ntawm bilirubin yog siab heev - siab dua 256 µmol hauv cov menyuam yug los raws sijhawm, hauv cov menyuam yug ntxov ntxov - siab dua 171 µmol.
"Pathological jaundice tuaj yeem tshwm sim los ntawm ntau qhov laj thawj," hais tias tus kws kho mob menyuam yaus Anna Levadnaya, Tus Neeg Sib Tw ntawm Kev Tshawb Fawb Txog Kev Kho Mob, tus sau ntawm blog txog kev kho menyuam yaus. - Feem ntau yog ib qho kev puas tsuaj ntau ntxiv ntawm hemoglobin vim yog Rhesus tsis sib haum xeeb lossis hom ntshav tsis sib haum xeeb ntawm niam thiab menyuam. Tsis tas li ntawd, qhov ua rau ntawm jaundice tuaj yeem yog pathology ntawm daim siab lossis pathology ntawm cov kua tsib tso rau hauv cov hnyuv. Tsis tas li ntawd, jaundice tuaj yeem yog ib qho kev tshwm sim ntawm tus kab mob, hypothyroidism (vim qhov txo qis hauv cov thyroid ua haujlwm), polycythemia (nce qib ntawm cov qe ntshav liab hauv cov ntshav), plab hnyuv, lossis pyloric stenosis (qhov no yog ib qho kev mob hauv plab. ib feem ntawm lub plab ua ntej nkag mus rau hauv cov hnyuv, uas ua rau nws nyuaj rau cov zaub mov hla). hauv nws). Nws tuaj yeem tshwm sim nrog qee yam tshuaj thiab rau lwm yam laj thawj.
Tsis tas li ntawd, muaj tus kab mob jaundice nyob rau hauv cov me nyuam mos los ntawm cov kua mis, thaum theem ntawm bilirubin nyob rau hauv tus me nyuam nce vim noj cov tshuaj hormones uas muaj nyob rau hauv niam cov kua mis rau hauv tus me nyuam lub cev. Cov kab mob jaundice no tuaj yeem kav ntev txog 6 lub lis piam. Yog tias, thaum HB raug tso tseg rau 1-2 hnub, qib ntawm bilirubin pib txo qis, thiab yellowness ploj, ces qhov kev kuaj mob no tau tsim. Tab sis nrog kev ua haujlwm zoo, kev tshem tawm ntawm kev pub niam mis tsis tas yuav, nws rov pib dua tom qab 1-2 hnub. Thaum lub sij hawm ncua, leej niam yuav tsum tau qhia nws tus kheej kom tswj tau lactation ntawm qib uas yuav tsum tau ua.
Kev kho mob jaundice hauv cov menyuam mos
Physiological jaundice ntawm cov menyuam yug tshiab, raws li peb tau hais, tsis tas yuav kho. Qee lub sij hawm cov kws kho mob pom zoo kom ntxiv cov me nyuam xws li dej, tab sis tsuas yog tsim lactation thiab siv rab diav, tsis yog lub raj mis.
Raws li rau cov kab mob jaundice ntawm tus menyuam mos, nws yuav tsum tau kho, uas yog kws kho mob tau sau tseg.
Kev kho mob zoo tshaj plaws rau tus mob no niaj hnub no yog phototherapy. Txhawm rau ua qhov no, siv lub teeb tshwj xeeb nrog lub teeb "xiav": nyob rau hauv kev cuam tshuam ntawm ultraviolet hluav taws xob, bilirubin tawg thiab raug tshem tawm ntawm lub cev ntawm tus menyuam mos nrog zis thiab quav. Qhov kev siv thiab lub sijhawm ntawm kev kho duab yog nyob ntawm tus menyuam lub cev qhov hnyav thaum yug los thiab qib ntawm bilirubin, uas tau saib xyuas tas li. Raws li txoj cai, peb-teev kev sib ntsib hauv qab lub teeb tau sau nrog kev so ntawm 2-3 teev. Cov menyuam mos yuav tsum tsis hnav ris tsho, tab sis qhov muag yuav tsum tiv thaiv, cov tub hluas kuj muaj qhov chaw mos.
Nyob rau hauv cov xwm txheej hnyav ntawm tus menyuam yug tshiab jaundice, thaum lub neej ntawm tus menyuam muaj kev pheej hmoo, kev txhaj tshuaj ntshav yuav raug sau tseg.
- Nws yog ib qho tseem ceeb uas yuav tsum nco ntsoov tias tam sim no cov kws tshaj lij feem ntau pom zoo tias kev teem caij sorbents, tshuaj xws li phenobarbital, Essentiale, LIV-52, kev tshem tawm ntawm kev pub niam mis, UV (ultraviolet blood enrichment), electrophoresis lossis kev kho mob ntau dhau rau cov mob daj ntseg tsis zoo ( thiab rau phenobarbital thiab tsis nyab xeeb) - hais tias Anna Levadnaya.
Qhov tshwm sim ntawm jaundice hauv cov menyuam mos
Lub cev nqaij daim tawv nqaij ntawm cov menyuam mos, raws li peb twb tau sau tseg, dhau los ntawm nws tus kheej thiab tsis muaj qhov tsis zoo rau kev noj qab haus huv ntawm tus menyuam. Tab sis qhov tshwm sim ntawm pathological jaundice nyob rau hauv tus me nyuam mos tuaj yeem loj heev, tshwj xeeb tshaj yog tias kev kho tsis tau pib raws sij hawm.
- Ntau dhau qhov nce qib ntawm bilirubin hauv cov ntshav tuaj yeem ua rau lub hlwb puas, - hais tias Anna Levadnaya. - Raws li txoj cai, qhov no tshwm sim hauv cov menyuam yaus uas muaj kab mob hemolytic raws li Rh yam, nrog kev nce qib ntawm bilirubin siab dua 298-342 μmol / l. Thiab qhov siab dua qib ntawm bilirubin, qhov kev pheej hmoo ntawm encephalopathy ntau dua.
Kev tiv thaiv kab mob jaundice hauv cov menyuam mos
Kev tiv thaiv zoo tshaj plaws ntawm tus menyuam yug tshiab jaundice yog lub neej noj qab nyob zoo rau leej niam thaum cev xeeb tub, muab cov cwj pwm phem, noj zaub mov zoo.
Kev pub niam mis kuj tseem ceeb heev. Niam cov kua mis yog cov khoom noj zoo tshaj plaws rau cov menyuam mos, nws yooj yim heev rau zom, cov hnyuv tau nrawm dua, nws muaj cov txiaj ntsig microflora, thiab tsim cov enzymes tsim nyog. Tag nrho cov no yuav pab lub cev ntawm tus menyuam mos kom tiv nrog jaundice sai dua thiab zoo dua.