I-Bilirubin yimibala enobumba obomvu obunobumba obunokutshatyalaliswa kwe-hemoglobin kunye nezinye iiprotheni zegazi kwaye ziqulethwe kwi-plasma. Isiqhelo se-bilirubin egazini lomntu omdala kunye nosana luyahluka. Kubantu abadala kunye nabantwana abangaphezu kweenyanga 1, umxholo wayo uhluka phakathi kwe-8.5 no-20.5 μmol / l. Kwiintsana, inqanaba le-bilirubin linyuselwa kwi-205 μmol / l okanye ngaphezulu.
Amazinga aphezulu anjalo e-bilirubin kwiintsana eziza kuzalwa ziyaqondakala. Ngoxa umntwana esesiswini, akaphefumli ngokwabo. I-oksijeni ifaka izicubu zayo ngoncedo lwe-erythrocytes equkethe i-fetal hemoglobin (fetal hemoglobin). Emva kokuzalwa, le hemoglobin iyatshatyalaliswa, kuba ayisadingeki. Ngenxa yoko, i-bilirubin entsha ingabonwa kwintsana. Oku kungabonakaliyo (ayikhululekile) i-bilirubin, engenayo i-intoluble, ayikwazi ukuxutywa yizintso kwaye iya kujikeleza kwigazi lomntwana de iimeko zayo ze-enzyme zivuthwe ngokupheleleyo. Emva kwexesha elithile, xa ezi zintsana ziza kusebenza ngokusebenzayo, i-bilirubin engacacanga iya kuguqulwa ibe yinto ecacileyo kwaye isuswe emzimbeni.
I-jaundice yeintsana
Ukwandisa i-bilirubin ngaphezu kwesiqhelo kubangela ukubonakala kwe-jaundice kwiintsana ezisanda kuzalwa, ezinokuthi:
- zenyama;
- ne pathological.
I-jaundice yezilwanyana
Kwenzeka malunga ne-70% yazo zonke iintsana, kubonakala kwiintsuku eziyi-3-4 kwaye ekugqibeleni ilahleka ngaphandle kwendlela ngaphandle kokulimaza umzimba. Izinga lokunyuka kwi-bilirubin egazini leintsana lixhomekeke kwinqanaba lokukhula komntwana, kunye nokukhulelwa komama: nokuba kukho na izifo okanye ezinye iingxaki. Ngokuqhelekileyo ukuvela kwe-jaundice kuphazamisa i-hypoxia yobusana be-intrauterine, i-asphyxia, isifo sikashukela sesifo sikashukela sesifo sikashukela.
I-icterus ye-Pathological
Ngokunyuka okukhulu kwi-bilirubin egazini kwiintsana ezisanda kuzalwa kudala i-jaundice ye-pathological, izizathu ezinokuthi:
- ukungqinelani koomama nomntwana ngamacandelo egazi okanye i-Rh factor;
- ukutshatyalaliswa komzimba we-erythrocytes;
- izilonda zesibindi;
- i-jaundice yomatshini;
- isithintelo esiswini;
- I-Gilbert's syndrome (ukungasebenzi komgaqo-siseko);
- iingxaki zehomoni, njl
Njengoko sibona, kukho izizathu ezininzi, kwaye kuphela oyingcali onokuyiqonda.
Indlela ebalulekileyo yokuxilongwa ngophando lokuhlaziywa kwegazi kwiintsana ze-bilirubin kunye namaqhezu awo. Ngokusekelwe kulo mvavanyo kunye nezinye iimvavanyo, ugqirha uya kuhlola kwaye anikezele unyango oluyimfuneko.
Ingozi yezinga eliphakamileyo kakhulu le-bilirubin kwintsana elungileyo kukuba ayikwazi ukuvinjelwa ngokupheleleyo nge-albumin yegazi kunye nokungena kwinkqubo yeentlanzi, ukuyibeka kwimiphumo emibi. Oku kuyingozi kwengqondo kunye namaziko anamagulane. Le meko ibizwa ngokuba yi-bilirubin (nuclear) encephalopathy "kwaye ibonakalisa kwiiyure ezingama-24 zokuqala emva kokuzalwa ngesimo seempawu ezilandelayo:
- ukulala okukhulu;
- ukuphuhlisa i-reflex yokutsala;
- ukuxinwa kunye nokuxhalaba kweemoto;
- ukunciphisa uxinzelelo lwegazi;
- Ukwandiswa kwesibindi kunye nepen.
Xa uneminyaka eyi-6 ubudala, umntwana unokufumana ukulahlekelwa kwindlebe, ukulibala kwengqondo, ukukhubazeka. Ngoko ke, izinga eliphezulu le-bilirubin kwiintsana zintsapho zihlala zifuna unyango olunzulu, kwaye kwixesha elizayo, ukubonwa kwemibandela kwi-neurologist.
Indlela yokunciphisa i-bilirubin kwintsana?
Nge-jaundice yomzimba, indlela ephumelelayo yokunciphisa i-bilirubin ephezulu yonyango olulula (phototherapy). Ngaphantsi kwefuthe lokukhanya okungahambelani, i-bilirubin iguqulwa ibe "i-lumirubin" engeyona inxinxu kwaye iyancipha ngaphakathi kweeyure eziyi-12 kunye nemifuno kunye nomchamo. Kodwa i-photohototherapy ingaba negalelo elibi: i-skin peeling, izitulo ezivulekileyo, ezidlulayo emva kokuphela kokunyanga. Ukuthintela kwaye unyango lwe-jaundice yomzimba luyisicelo sokuqala kwisifuba nokutya rhoqo. I-Colostrum ikhuthaza ukuphuma kwe-meconium (intlanzi yangaphambili) kunye ne-bilirubin.
Kwi-jaundice ye-pathological, ngaphezu kwe-phototherapy kunye nokutya rhoqo kunye nobisi lwebele, unyango lubalulekile ngokuqwalasela imbangela yesifo. Olu unyango lwenziwa esibhedlele sabantwana ngama-neonatologists.
Musa ukulibala, i-bilirubin ephezulu kwintsana ihlala isifundo ngokufutshane kunye nokuqwalasela okuqinileyo.