Yibilirubin ngqo anda: Oonobangela kunye nonyango loko. Kuthekani ukuba yibilirubin ngqo kwanda umntwana?

Ngenxa kwawa iiseli ezibomvu kukho into ekhethekileyo - yibilirubin. It ukwabizwa ngokuba mthubi-bomvu sakhi, oko kukuthi elinye izithako zonke enyongweni. Xa serum igazi oko kwenzeka iintlobo ezimbini: ngqo (ezinxulumene) okanye ngqo (free).

ukubonwa kwezifo

Ufumanise ukuba yeyiphi na indlela ngqo yibilirubin, Azinakuba zingezi, ukuba awazi ukuba yintoni na ekufuneka isifundo. Kuyimfuneko ukuba ukuhlola umsebenzi wesibindi nokuxilonga eziliqela izifo iphecana zesisu. Nakuphi na ukutenxa kumgaqo kule index ibonisa ukuba umzimba ayiphumelelanga.

Ukuba yibilirubin ngqo ithe eziphakamileyo, ngoko ugqirha unesizathu sokukholelwa ukuba isigulana onesifo sisibindi okanye engapheliyo okanye enyongweni. Ukuba nayiphi na ukutenxa kumgaqo yale parameter kuyimfuneko ukuba aqhube phambili uviwo yomguli, ukubona yaye ukuqala unyango kwangoko ngokuchanekileyo. Ngokuqhelekileyo, ukwanda kakhulu kwizinga yibilirubin nga ngaphande iimvavanyo kwegazi. Ngapha koko, oku oluhlala kuzo lweliso lakho, inwebu ilastiki, isikhumba kwaye ulunika namona elityheli.

Oonobangela yokwanda yibilirubin

Kwinkoliso Kwiimeko, kubalulekile ukuba ngokuthembeka ukufumanisa oko kubangele ukuba ukugxagxiseka kwesibindi umsebenzi. Kuba kubalulekile ukuqonda ukuba yibilirubin ngqo eziphakamileyo asimsebenzi nje kuba njalo. Ngoko ke, ngaphandle ukuchaza ukugula, nto leyo eyakhokelela ekubeni le meko, kwaye ukuqeshwa unyango olwaneleyo, akazange angawi.

Ukutshintsha inqanaba yibilirubin unokubangwa izinto ezininzi. Zezi:

1. Ukwandisa amandla hemolysis iiseli ezibomvu zegazi.
2. Ukunyhashwa kwesibindi ebangelwe izitshanguba le parenchyma, ngaloo ndlela ziyonakala ulwabiwo umsebenzi yibilirubin.
3. Ukophulwa nencindi inyongo ethunjini.
4. Ukulahleka lwabaphathi ezibalulekileyo elijongene biosynthesis of yibilirubin.
5. Inkqubo ukonakala secretion ngqo ibe ngamaqhezu inyongo.

Kwakhona, le ngxaki ukuze kunokubangelwa anemia hemolytic. Esinye isizathu ingaba imalariya, ziivithamin B12 izivuka, kunye nezinye iingxaki, ngaphantsi kakhulu.

Imeko apho yibilirubin ngqo inyuswe, kukho kwakhona ngenxa yokuba kuveliswe ngenxa hemolysis oluphuculweyo. Ngelo lixa yaphula kwesibindi kukhokelela kukuba akukho nako ukumelana kwaye enze inani elandileyo glucuronides, eziyimfuneko ukuze umzimba.

iSifo eziyingozi

Akufanele siphele, ukuba ugqirha wakho lithethelela ukuba ukhangela isibindi kwaye ithumela ukuba bahlolelwe. yibilirubin ngqo gciwane eziliqela kwezifo kakhulu.

Ngoko ke inqanaba layo ziya kwandiswa ukuba:

- hepatitis (zombini wentsholongwane egazini kunye ityhefu umyalezo weimeyile);

- cytomegalovirus, nto leyo eyakhokelela ekubeni sokosuleleka kwesibindi;

- lesibini okanye negcushuwa ephakamileyo ;

- cholecystitis;

- hypothyroidism ezisanda kuzalwa;

- senyongo yokukhulelwa.

Ukuba yibilirubin zizonke kunye ngqo eziphakamileyo, ngoko ugqirha Basenokukrokrela hepatitis, kunye nezinye izifo ezininzi. Isigulane abe umhlaza wesibindi, ukuqina zaseprayimari, enyongweni. Kwakhona Iimpawu ukutenxa kumgaqo Kunokuba njalo zinabo, iziyobisi okanye utywala ityhefu ephilayo.

Iingxaki ukukhulelwa

Abanye oomama abakhulelweyo kwithuba leenyanga ezintathu yokugqibela usenokufumanisa ukuba ngaba iziphumo ezihle kakhulu cazululo. Eneneni, abanye babe yibilirubin ngqo kwaphakanyiswa lokukhulelwa. Le imeko ifuna ukuba uviwo mandatory ezongezelelweyo. Eneneni, ukunyuka kule index lubonisa ukunyhashwa kwinkqubo nencindi inyongo esibindini. Esi simo kuthiwa "intrahepatic cholestasis ukhulelwe."

Kwakhona, asinakukwazi ngaphandle eziliqela izifo ezifana hepatitis wentsholongwane egazini, cholecystitis, igazi hemolytic. Kubalulekile ukuba ukufumanisa kwazo ngexesha ukuthintela iingxaki kunokwenzeka.

Kubalulekile ukuqonda ukuba xa ukwanda yibilirubin ngqo, unyango kufuneka zabelwe ngokuqinisekileyo. Emveni kwako konke, le meko ezingagrogrisa zombini eziqhelekileyo ekuhambeni ukukhulelwa, kunye nobomi olungekazalwa usana. Oku kungakhokelela uhlobo edematous sifo hemolytic yosana olungekazalwa, lo gama kukho amathuba eliphezulu yokuzalwa ngaphambi kunye nokufa umntwana osesiswini esizalweni okanye iiyure zokuqala emva kokuzalwa.

Iimpawu hyperbilirubinemia

Amaxesha amaninzi imfuno kwadal liphuma emva kokuba lo mntu ngokwakhe okanye ugqirha uhlolo iingxaki umrhanelwa. Sothi yibilirubin lilonke kwaye ophakamileyo ngqo, ukuze abonise iimpawu ezifana:

- senyongo kwamehlo sclera, inwebu yangaphakathi, isikhumba;

- umkhuhlane;

- wawandisa udakada, oko kubonisa kabi kwi hypochondrium ekhohlo;

- mnyama umchamo, kunokuba limnyama okanye lube mnyama;

- silale, ukudinwa, iyangongoza, yintloko - Ezi iimpawu zibonisa ukuba kwinyama abe ngaphantsi oksijini kwemali.

Ezi mpawu ziwahlasela kakhulu anemia hemolytic. Kufuneka kuqatshelwe ukuba inguqu umbala umchamo lwenzeka akusoloko. Kusenokwenzeka ukutshatyalaliswa iiseli ezibomvu ngaphakathi nempahla kunjalo, kwaye yenzeka kuphela izifo ezithile, ezifana syndrome Marchiafawa Michele.

Kodwa ke igazi hemolytic - nje kuphela into ekhokelela ekubeni le yibilirubin ngqo eziphakamileyo. Izizathu kwakhona kulala ukunyhashwa esibindini. Ukuze uthethe ezi ngxaki kangangoko ukuba isigulane:

- isicaphucaphu, ukungakhululeki emva kokutya, belching ekrakra;

- imvakalelo ubunzima hypochondrium ekunene, ukuba kuvela ngenxa yokwanda kwesibindi;

- ukwehla komsebenzi, kunye buthathaka.

Ngamanye amaxesha kubonakala mnyama umchamo ukuya umbala yotywala okanye iti olomeleleyo. Xa hepatitis load rhoqo nomkhuhlane.

unyango

Ukuzama ukuhlangabezana nengxaki nesibakala, nekufuneka wenziwe unyango, kwanokuba yibilirubin ngqo eziphakamileyo kancinane, akunakwenzeka. Ngapha koko, akunakwenzeka ukuba balahle ingxaki de unobangela uzimisele.

Kwakhona kubalulekile ukuba imisebenzi ubuthi. Oku kuquka okhethekileyo ukutya, ejolise ekunciphiseni umthwalo hepatocytes kunye nee-enzayim noxanduva lokuphelisa ityhefu. Esibhedlele akholisa ukuchitha unyango ukumnika-gazi. Kujongwe ukutshintsha ubume kunye umthamo wegazi, intracellular kunye ulwelo intercellular. Khetha isisombululo eya kwenziwa yegazi, kuphela ugqirha. Kwezinye iimeko mhlawumbi yabelwe isisombululo iswekile, imixube acid acid, saline kunye nezinye arhente.

Ngamanye amaxesha umntu uyacetyiswa ukuba aqhube phototherapy, into leyo eyenza igalelo ukutshatyalaliswa yibilirubin ityhefu. Ukunciphisa amagqirha zinetyhefu badla amisele wamalahle iyasebenza yaye gel eyenzelwe ukususa buthi, umzekelo, lithetha "Enterosgel".

Ngoko ke, xa ngenxa yentshabalalo kakhulu iiseli igazi kwafunyaniswa ukuba anda yibilirubin ngqo, izizathu zale hemolysis kufuneka ifakwe nakanjani. Inyathelo lokuqala kukwazi ukuba yintoni eyabangela ukuba le. Emva gula ayikho iziphumo eziyimfuneko kubangela hemolysis. Ukwenza oku, ukusetyenziswa glucocorticoid iihomoni, ezifana preparatat "Prednisolone". Emva kokususa amanqanaba yibilirubin isizathu ukuze bawe ngokwayo.

Ukuba kwabangela kophulwa iingxaki kwinkqubo nencindi inyongo, oko akakwazi ukwenza ngaphandle ungenelelo lonyango. Oogqirha kwiimeko ezinjalo emiselweyo irejimeni yonyango, enokuquka iindlela ezifana "Ursosan", "Febihol", "Tseruglan", "Ermital", "Papazol", "Gepabene", "Analgin". Therapy ijolise ekuvuseleleni yayikukuphuphuma inyongo, analgesia. Kodwa akukho mfuneko yokuba ukusebenzisa iziyobisi ngaphandle kwemvume kagqirha. Eneneni, kwezinye iimeko, ifuna isibulala-zintsholongwane okanye antiparasitic therapy.

Ngokufuthi unobangela senyongo yi kwesibindi. Kwimeko enjalo kuyimfuneko ukunyanga esibindini. Ukuza kuthi ga ngoku, amachiza alandelayo emiselweyo, "Essentiale", "Methionine", "Geptral".

imithetho emiselweyo

Enoba ubudala yomguli (ngaphandle kuzalwa) izikhombisi kufuneka ibe ngaphakathi kwemida emiselweyo. Ngenxa yoko, ngenxa yemigangatho yibilirubin iyonke zisukela ku-3.4 ukuya 17.1 mmol / l, kunye yibilirubin ngqo egazini kufuneka ungabi ngaphezu kwe-4.3 Mol / l. Le migaqo musa ukutshintsha, ukuba asemthethweni abantu abadala na ubudala, nabantwana. Inqanaba iqhezu ngqo engazimisele ngokwahlukileyo, ukuba zibalwe umahluko kwiziphumo zovavanyo phakathi ubungakanani yibilirubin iyonke kunye ngqo. Kufuneka ngaphezu 13.7 .mu.mol / l. Ukwanda yibilirubin ngqo senyongo hemolytic lweentsana kunye nezinye iyingozi syndromes Rotor, Gilbert, Crigler-Najjar.

Imeko yahlukile nabantwana abangaphantsi kweminyaka kwinyanga 1. Ngosuku lokuqala wobomi kwiimvuthuluka yibilirubin inokuba kuluhlu ukususela 24 ukuya 149 pmol / l. Ngosuku lwesibini Ngosuku zobomi umlinganiselo ophakathi 58-197. Usuku 3-5 yibilirubin kunokuba ukusuka kuma-26 ukuya kuma-205 pmol / l. Kwiintsana elide, eli nani idla nganye ibe-veki ezimbini (ngamanye amaxesha ngenyanga) ubudala.

Oonobangela hyperbilirubinemia kwiintsana

Zonke usana imvuthuluka mali egazini kombala emthubi-obomvu iphezulu kakhulu. Oku kungenxa yokuba i cookies kids ezabe kuphela ekukhanyeni, musa aziphathe Njengabantu abadala. Yena akazange akwazi ukumelana yibilirubin, kwaye iye iqokelelane apha emzimbeni. Yiloo nto abantwana abaninzi inqanaba zakhe zanda.

Musa ukuphaphazela, oku imeko eqhelekileyo, ngaphandle kokuba, kakade, izalathisi musa ukudlula nemigangatho emiselwe abantwana abakule minyaka yobudala. Ngokwesiqhelo, isibindi ngokutsha kwaye uqala ukusebenza ngokuqhelekileyo sele kwiveki yesibini ebomini, yaye inqanaba yibilirubin sesiqhelo ngokwabo.

Xa ugqirha ekrokrela ukuba kusenokubakho iingxaki, oko ukuqhuba uphando okhethekileyo. Ukuba yibilirubin ngqo kwaphakanyiswa kuzalwa ngaphezu mmiselo, oko kudla kucetyiswa ukuphumeza unyango esibhedlele. Ukwala unyango elicetyiswayo yi kunganqwenelekiyo ukuba zenzeke, kuba senyongo olusanda ingabi ekhuselekileyo njengoko abazali abaninzi bacinga.

iingxaki kunokwenzeka kwiintsana

Ngenxa yokuba kubelekwa isibindi into engasebenziyo njengoko abadala, yibilirubin zabo ngqo nengxelo- lungandiswa. Oku kube ngenxa yezi zizathu zilandelayo. Xa inkqubo legazi ekungafuneki kwakhiwa athwala ityhefu - heme, leyo iqalisa ukubola umzimba waguquka yibilirubin. Kule ngqo iqhekeza lawo enganakunyibilika engamanzi, kwaye ke ayikwazi ukuba zivela nomchamo. Emva uyidibanise kunye zizinto ezahlukeneyo ngayo ithuthelwe esibindini apho iguqulelwa yibilirubin ngqo, kunye uthuthela senyongo. Kwiintsana, le nkqubo-hlengiswe apha kwiiveki nje ezimbalwa emva kokuzalwa. Ngoko ke, lo senyongo komzimba Kuyinto eqhelekileyo.

Kodwa ke kukho iimeko xa inqanaba yibilirubin lugqithe ngaphaya umda. Oku kunokuba imeko yingozi ngenxa yongeniselo yakhe ezondeleyo kuba yimiqobo sophuhliso okuqhelekileyo ingqondo, kungakhokelela zezigulo ezahlukeneyo engqondweni, obe ubaqhiphukisa ukungeva, ukubona, okanye ukukhubazeka engqondweni. Oku kungenxa yokuba yibilirubin phezulu ngokugqithiseleyo, albumin akuthethi ukubhloka imiphumela yayo ityhefu. Kwaye oku kukhokelela kukuba luvo ubunzima.

ukuphathwa kwabantwana

Ngokugqithiseleyo okwandayo ngqo yibilirubin egazini idla yokuba usana ekuqaleni yokuphatha ngxi esibhedlele okanye idluliselwe wabantwana esibhedlele. Indlela esisiseko kuthathwa phototherapy. Le itakane va ukhanyiso ekhethekileyo ubukhaphukhaphu luguqula yibilirubin ityhefu zaza engeyongozi. Bona zivela emzimbeni kwiiyure ezili-12 ukusuka endleni kunye nomchamo. Le ndlela iye neziphumo zalo; kodwa ke, kamsinya nje igqityiwe ikhosi konyango. Ngoko ke, umntwana inokuqala iyaxobuka kancinane ulusu, urhudo kunye ukuvela hypersomnia.

Kodwa kwezinye iimeko umzimba ukukhawulezisa ukurhoxiswa yibilirubin ufuna olunye uncedo. Kulo mzekelo esibhedlele bume babelwa isibeki kunye iswekile, cholagogue machiza asetyenziswa, ascorbic asidi.

Indlela ephambili zokuthintela zheltushki lweentsana ebizwa nokuncancisa. Yilaa umthubi kunempembelelo isisu kwi usana kwaye inceda ukuqinisekisa ukuba yibilirubin ethe chatha egazini ngokuthe zibuyela esiqhelweni. Kodwa ke kukho iimeko apho ingxaki kusekelwe ubisi yabantu. Kulo mzekelo, kucetyiswa ukuba indawo lokuncancisa umxube iintsuku eziliqela. Ukuba ngaba amanqanaba yibilirubin ziyaqala ukuhla, ngoko senyongo kwabangelwa ngobisi lwebele. Kodwa akukho sizathu sokuba akukho uncancisa. Ngokuqhelekileyo, ukuzinza kwiimvuthuluka Kwanele iintsuku ezi-3 umxube zokuxheshisela, emva koko uyakwazi kwakhona ukubeka ndingusisi ibele.

Iingxaki kubantwana

Kodwa ukwanda kwenani yellow nebomvu mbala kwi igazi kuphela kubelekwa. Noko ke, ukuba ukunyuka yibilirubin ngqo kwi umntwana, ngoko oko kuyimfuneko enkulu ukuba bahlolisise ngenyameko. Ukuba umntwana uthe wabe sele asinyothule kwiphakade usana, oonobangela senyongo Awehlukanga kwezo nto ibangele iingxaki abadala.

Nokuba ukukhangela unobangela oko kwakhokelela ekwandeni yibilirubin, kubalulekile ukuba umntwana zithotyelwe kwizidlo ekunene. Iyakwazi uncedo wesibindi kwenkqubo yibilirubin yityhefu kwaye ukuthumela yona ibe simahla emanzini-awonayo zamaqhezu. Ngoko ke, ukutya ngaphandle zonke okunamafutha kunye nokutya, nowento ekroqiweyo, iimveliso ipepile, nezihlwahlwazayo. Kwakhona, abazali kufuneka bazi ukuba kwimeko apho anda yibilirubin ngqo umntwana, yena ngokubonakalayo maxongo impilo. Ngoko ke, imisebenzi ezigulela ejoliswe ngokucoca umzimba amaqhezu baby ityhefu kufuneka kuqaliswe kwangethuba kangangoko kunokwenzeka.