Yibilirubin: usana eqhelekileyo. ngenyanga Table

Le meko xa yibilirubin egazini lika kuzalwa kune imigangatho yentsebenzo - ivamile. Amaninzi, into enjalo kwenzeka ngokuzimeleyo. Noko ke, amazinga aphezulu kakhulu kufuna unyango ezongezelelweyo, kuba kungakhokelela kubunzima ezinkulu. Ngoko ke, i yibilirubin ephakamileyo kufuneka athathwe ngononophelo olukhulu.

Ingcamango yibilirubin

Yibilirubin - imveliso evela sokonakalisa iiseli ezibomvu zegazi. Ukuba umjikelezo ubukho yabo iphelile, ukuba eziguqulelwe kwi ngehemoglobin ityhefu, ukusuka apho kukho ukubunjwa idayi.

Xa yezonyango ukwaba iintlobo ezimbini (amaqhezu) yale impahla: ngqo nengxelo-ntetho. Ekuqaleni ukusekwa yibilirubin ngqo. Yena ayiqondakali enyibilikayo kwaye kunzima kwazona emzimbeni. Ngoko kuqala iguqulelwa yibilirubin ngqo, apho ungena isibindi, ngoko ukuya senyongo kunye idubule ngokusebenzisa amathumbu.

Umzimba womntu wenza konke okusemandleni ukuba balahle kweziyobisi. Noko ke, ekuqaleni isibindi usana akanako ukumelana umthwalo onjalo. Kungenxa yoko le nto imihla yokuqala yobomi kubalulekile ukugcina umkhondo ukuba izinga ebona yibilirubin kwigazi kubelekwa. Le theyibhile, leyo iqulathe ixabiso umbundu Isalathisi yenzelwe ukunceda ukwenza oko.

Izinto ezibangela yibilirubin ephakeme

Isongela kwimpilo imeko yomntwana xa ixabiso ezahlukeneyo afunyenwe ekuhlalutyeni eziqhelekileyo yibilirubin kwi kuzalwa emini. Table evumela ukuba ukuthelekisa la manyathelo mabini iye yaphuhliswa ngexesha zokuphanda elide. Injongo yawo ukuchonga izizathu ezibangela lo mmangaliso. Ezona ziphambili zezi:

- ezingaqhelekanga nesantya Palsy;

- unyango yetyhefu okhulelweyo kweziyobisi, kwakunye nokusetyenziswa kwazo ngexesha lokuzalwa komntwana;

- ukuba ukuncancisa;

- kakhulu ubunzima ukulahlekelwa umntwana ngemihla yokuqala yobomi.

Xa zone lomngcipheko kunye ufumane abantwana abazelwe amabhinqa ezimbi RH factor. Babedla ibhaqwe kwemfuneko xa kuthelekiswa lwenziwa: ziziphumo uhlalutyo phezu yibilirubin - umyinge wokuphelelwa usana (jonga itheyibhile).

yinto yamihla le

Kutshanje wazalwa umntwana asingawo onke amalungu asebenza kwi ngokupheleleyo. Ngoko okwabangela ukuwa mpilo ezingekazalwa akanawo ixesha lokuba udibane nge albumin. Isiphumo kwinqanaba yibilirubin lokukhula.

Kule nombolo yokuqala kwezinto landa igazi, yaye ke iqala ukuhla. Kwiimeko eziqhelekileyo, malunga Ngosuku lwesine yobomi, abantwana babe yibilirubin ubuncinane. usana Normal (itafile, nto imelwe ngezantsi iqulathe ixabiso layo) utshintshatshintsha kakhulu ngokuhamba kweminyaka.

UNorma yibilirubin iyonke ngokwe kulawulo Ingerleĭb M.

Age of umntwana	ixabiso Umyinge we index, mmol / l
ngosuku lokuqala	ngaphantsi kwe 34
iintsuku 1-2	24-149
iintsuku 3-5	26-205
iintsuku-60 5 iminyaka	5-21

Kukho nenye yitafile lushwankathela inqanaba yibilirubin abaqhelekileyo kwi ukwabiwa amaqhekeza.

Age of umntwana	Meaning yibilirubin, mmol / l
	jikelele	ehlobene	free
kubelekwa	23,09	8,72	14.37
Ngosuku lwesibini	54,22	8,72	45,50
Ngosuku lwesine	90,14	7,87	82,27
ngosuku lwesithandathu	69,10	7.72	63,28
ngomhla wethoba	53,02	8,72	44,30
ngenyanga	11,12	2,57	8,55

Ngexesha umxholo kweziyobisi threshold zokubeleka besukelana 51 Mol / l. Kamva, ngokuthe ngcembe kwandisa, kwaye xa iintsuku 3-4 yobomi izakhiwo. Xa abantwana azalelwe ixesha inqanaba yibilirubin akufunekanga ibe ngaphezulu kwe 256 pmol / L, njengokuzalwa - 171.

senyongo physiologic

Amaxesha amaninzi kukho bokuphila senyongo sosana. UNorma yibilirubin (itheyibhile iyakungqina oku) kwandisa kwiintsuku zokuqala yobomi, kodwa ke inani izinto ngokunokwabo kufuneka incitshiswe ukuya kwiiveki ezimbini ubudala.

Oogqirha unikeze inombolo kweempawu esirhesha ubukho senyongo umntwana ukusebenza komzimba;

- ivela ngosuku lwesibini yobomi;

- izinga yamanqanaba igazi yibilirubin kwagqithiswa kancinane;

- ebusweni nasemzimbeni ngaphezu inkaba ephawulwe yellowing kwesikhumba.

Phezu kwayo yonke into, imeko umntwana ngokupheleleyo eqhelekileyo, ukugcina esebenzayo ngokwasemzimbeni. Yibilirubin kufuneka kuthiwe gqolo ukwaluswa sezifo senyongo komzimba ithe yaba yezifo. Ngokwesiqhelo, eneminyaka engama iveki enye kufuneka aqale ukunciphisa inani kwezinto. Malunga 3 kangangeeveki abantwana bazalwa kule kota,-kwinyanga ukuzinza ngaphambi yibilirubin emzimbeni.

senyongo yezifo

ngokukhawuleza kakhulu, lo senyongo komzimba singaqhubela ku yezifo. Iifom ezimandundu zihamba ukwanda okubonakalayo kwinqanaba yibilirubin: malunga 90 Mol / l qho kwiiyure ezingama-24. Ukongeza, xa neonates isenokuba yinto ixabiso eliphezulu kakhulu: ngaphezu kwama-250 micromol / l.

Oko kukuthi, kwimeko enjalo, isixa kweziyobisi egazini iphezulu kakhulu izinga yibilirubin kwi kubelekwa. Uluhlu ngeenyanga inceda ukuthelekisa kwezi zalathisi kunye ukuchaza ingxaki ngexesha. Kodwa kukho ezinye iimpawu senyongo pathologic:

- yellowing wobuso umzimba ngezantsi inkaba;

- izandla orange neenyawo;

- umchamo emnyama kunye ngendle eliqaqambileyo kakhulu.

Esi sifo sidla eqaqamba kwemali ngamaza. Ukongeza, imeko jikelele umntwana kucaphuka: kukho ingcinezelo excitation ngokugqithiseleyo.

Iindidi noonobangela senyongo zophendlo lwezifo

Kukho iintlobo ngeentlobo senyongo pathologic. Bona zabelwe kuxhomekeke izizathu imbonakalo.

1. Hemolytic ebonakaliswa kungquzulwano RH into kwaye unina wosana, ngokunjalo nezifo yemfuza.

2. Parenchymal senyongo kwenzeka xa izitshanguba kwesibindi iintlobo iziphene kwesibindi, cytomegalovirus, abulale.

3. uhlobo conjugation iboniswe kwimeko apho kukho ukungasebenzi kakuhle kwenkqubo enzyme, kwakunye nomphetho owujikelezileyo yibilirubin.

4. senyongo Mechanical kwenzeka xa kuphazamisekile inyongo outflow kwi mgaqweni senyongo kunye imigudu zesibindi.

Guquka yibilirubin

Ukuvavanya umgangatho luyawudyobha arhente egazini, kusetyenziswa uhlalutyo okhethekileyo. I sampuli ukuthathwa ungatyanga. Kodwa ke abantwana imfuno onjalo wenziwa kunqabile, kwiimeko ezigabadeleyo, kucetyiswa ukuba usana lwakho iiyure ezi-4 phambi kokuba isampulu yegazi. Xa kubelekwa, iisampula ezithathwe izithende kungekho tube encinane ezizodwa.

Ukuze ukugqiba uhlalutyo meko kumiselwa egazini amaqhezu yibilirubin. Oku kunceda ubone nje uhlobo senyongo, kodwa izizathu ukuguquka lwayo eqongeni yezifo.

Emva kokufumana iziphumo zohlalutyo zithelekiswa kwaye izinga yibilirubin xa kubelekwa. Table ngenyanga iquka nezinyuko. Ukuba isixa arhente imibala liphezulu kakhulu imeko yabo ngokuyimfuneko zifuna unyango.

engaba khona

Le xiyimiso ophezulu egazini kuchaphazela impilo yosana lwakho. Ingakumbi ehlobene kwimeko apho izinga ayifakwanga abuyiselwe yibilirubin kwi neonates (iinyanga ezi-2). Le theyibhile yenza kucace ukuba eli phakade ixabiso kufuneka ilingane bayahlelwa kwi omdala onempilo.

Okokuqala, yibilirubin ephakamileyo yingozi ingqondo kunye luvo lwe umntwana. Ingozi kukuba colorant nga eziyintlanganisela apha. Imeko enjalo inokukhokelela ukunxila kakhulu kumzimba kwaye, ngenxa yoko, ukutshatyalaliswa kweeseli zengqondo kunye kwalapho. Kamva, oku kungabangela iingxaki lokumamela kunye nombono, ukuphazamiseka kwengqondo, sengqondo esixhalabisayo kunye nezinye iingxaki.

Konke oku kukhokelela ekubeni udokotela lusoloko esweni ubukho kunokwenzeka of zheltushki umntwana. Ukuba esola luvavanyo igazi ngokusekelwe ngayo kucaca ukuba lomdlalo ixabiso ngababini "ibhaqwe yibilirubin -. Udidi usana" Uluhlu ne amagqirha uncedo kwenza isigqibo esichanekileyo.

Abazali kufuneka ukwazi ukuba kukho iqela iimpawu, ngokubonakala apho umntwana senyongo kufuneka kube nesizathu unyango olukhawulezileyo kwagqirha. Ezi ziquka:

- silale kunye ukozela;

- wokwehla reflex owanyayo;

- aqaqambayo, impu-, ukuziphatha noko amnye ebantwini;

- ukunyusa ubungakanani udakada wesibindi;

- wegazi.

Iindlela ukwenzela ukunciphisa izinga yibilirubin

Kubalulekile ukuqonda ukuba senyongo komzimba ayidingi unyango. Kufuneka sidlule ngokwabo. Nangona kunjalo, ngaphandle unyango, Asinakuyenza kwimeko kwagqithiswa kakhulu ngesalathisi ezifana yibilirubin (usana eziqhelekileyo). Le theyibhile yenza kube lula nje kuphela iingcali, kodwa abazali baqonde kwimfuneko yokungenelela ngoncedo lwezempilo.

Qala umlo kunye yibilirubin ephakamileyo kufuneka ngokusebenzisa sesichengeni ukukhanya. Kuliwa kwisisele ekhethekileyo nokusetyenziswa okugunyazisiweyo izibuko olukhuselayo. Le ndlela ithathwa kakhulu kwezinye, kodwa zisebenza kakuhle kakhulu kwaye ngokukhawuleza. iziphumo ebezingalindelekanga yale nkqubo kungaba urhudo kunye nesikhumba yokuzikhwebula. Kwimeko yokuphelisa iziphumo zonyango ezibi kuyo kakhulu ngokukhawuleza lotshitsha.

Nangona kunjalo, qaphela ukuba phototherapy lusebenza kuphela xa senyongo nokomzimba. Ukuba ngaphezu kwexesha inqanaba iziyobisi ngaphezulu ixabiso kwi kumgca "yibilirubin Eqhelekileyo kwiintsana ngenyanga 1" (itheyibhile eboniswe ngasentla) akayi kuba nako ukuyenza ngaphandle amayeza.

Abaninzi abakholelwa senyongo xa kuzalwa kakhulu yingxaki enkulu. Kodwa kuyimfuneko ukuba wazi futhi uqonda ukuba oku kuyinyaniso kuzo zonke iimeko. Ngaphandle ingqalelo efanelekileyo kunye nonyango lwe ngxaki nemiphumela emibi kakhulu.