Bilirubin: yachibadwa akhanda. Table pamwezi

The vuto pamene bilirubin mu magazi a ana akuposa miyezo ntchito - ndi si zachilendo. Nthawi zambiri, chotero chodabwitsa chikuchitika paokha. Komabe, mitengo kwambiri amafuna chithandizo zina, chifukwa iwo kungayambitse mavuto aakulu. Choncho, mkulu bilirubin ayenera kumwedwa mosamala kwambiri.

Lingaliro la bilirubin

Bilirubin - mankhwala chifukwa azingokhala maselo a magazi. Ngati vuto la moyo wawo yatha, iwo n'kukhala hemoglobin poizoni, yomwe mapangidwe mmadzi.

Mu zochiritsira kuonetsetsa mitundu iwiri (tuzigawo twa) wa nkhaniyi: mwachindunji kapena kudzera m'njira zina. Poyamba anapanga mozungulira bilirubin. Iye ndi bwino sungunuka ndi zovuta excreted thupi. Choncho, choyamba n'kukhala bilirubin mwachindunji, amene akulowa chiwindi, ndiye kuti ndulu ndi excreted kudzera matumbo.

Thupi la munthu kuyesetsa kuchotsa chinthu. Komabe, poyamba wakhanda chiwindi sangathe tilimbane ndi katundu wina. N'chifukwa chake mu masiku oyamba a moyo ndi wofunika kwambiri kwa mungawononge ngati mlingo ananena za bilirubin mu mwazi wa ana. Tebulo, lomwe lili pakhomo mtengo wa chizindikiro ithandiza kuchita izo.

Zimayambitsa bilirubin okwera

Loopsa thanzi la zinthu mwanayo pamene mtengo osiyana analandira mu kusanthula yachibadwa bilirubin mu akhanda ndi tsiku. Table kuti amalola kuyerekeza zonsezi awiri yapangidwa mu njira ya kufufuza yaitali. cholinga chake chinali kudziwa zifukwa zimene zimachititsa zodabwitsazi. The akuluakulu ndi:

- kuvutika mu yoopsa liwiro chitukuko;

- mankhwala a kawopsedwe pakati mankhwala, komanso ntchito zawo pobereka;

- osati kuyamwitsa;

- kwambiri kuwonda mwana wa m'masiku oyambirira a moyo.

M'dera chiopsezo ndi ana obadwa kwa akazi ndi RH zoipa china. Kawirikawiri wapezeka owonjezera pamene kufanana ikuchitika: zotsatira za kuwunika pa bilirubin ndi - mlingo wa akhanda (onani gome).

wakudziko

Ife wobadwa posachedwapa mwana si ziwalo zonse akugwira ntchito mphamvu zonse. Choncho chifukwa cha kugwa kwa hemoglobin yoopsa alibe nthawi yokhudzana ndi albumin. Chifukwa ndi mlingo bilirubin kukula.

Mu nambala iyi yoyamba ya zinthu mu ukuwonjezeka magazi, ndipo kenako umayamba kuchepa. Pansi bwinobwino zinthu, za tsiku lachinayi la moyo, ana ndi bilirubin osachepera. Normal akhanda (tebulo, amene ankaimira pansipa lili mulingo wake) zimasiyanasiyana kwambiri ndi zaka.

Norma okwana bilirubin malinga chikwatu Ingerleĭb M.

M'badwo wa mwana	Avereji ya mtengo wa index ndi, mmol / l
tsiku loyamba	zosakwana 34
masiku 1-2	24-149
masiku 3-5	26-205
masiku 60 5 zaka	5-21

Pali tebulo lina kuti chifupikitso cha yachibadwa bilirubin mlingo mu kufalitsa ting'onoting'ono.

M'badwo wa mwana	Kutanthauza bilirubin, mmol / l
	akukhudzidwira	okhudzana	ufulu
akhanda	23,09	8,72	14,37
Tsiku lachiwiri	54,22	8,72	45,50
Tsiku lachinayi	90,14	7,87	82,27
tsiku lachisanu ndi chimodzi	69,10	7,72	63,28
tsiku lachisanu ndi chinayi	53,02	8,72	44,30
mwezi	11-12	2,57	8,55

Pobereka pakhomo zili mankhwala akhoza kufika 51 mol / l. Kenako, pang'onopang'ono kumawonjezera, ndipo pa masiku 3-4 moyo maximized. Ana obadwa mu nthawi ya mlingo bilirubin sayenera kuposa 256 pmol / L, asanakwane - 171.

physiologic matenda a chikasu ndiyo

Nthawi zambiri pali thupi matenda a chikasu ndiyo mwa ana akhanda. Norma bilirubin (tebulo akutitsimikizira nkhani imeneyi) kumawonjezera m'masiku oyambirira a moyo, koma chiwerengero cha zinthu paokha ayenera kuchepetsedwa kwa masabata awiri zakubadwa.

Madokotala kuonetsetsa angapo zizindikiro zimene amati pamaso pa matenda a chikasu ndiyo thupi mwana:

- limapezeka pa tsiku lachiwiri la moyo;

- mlingo wa milingo mwazi wa bilirubin kuposa pang'ono;

- Nkhope ndi thupi pamwamba Mchombo wa amalembedwa chikasu pathupi.

Ngakhale zonse, chikhalidwe mwana ambirinso akukhuzidwa ndi kusunga zolimbitsa thupi. Bilirubin ayenera kuunikira mosalekeza dokotala kuti matenda a chikasu ndiyo thupi si inasanduka pathological a. Mwachibadwa, pa usinkhu wa sabata imodzi ayenera kuyamba kuchepetsa chiwerengero cha zinthu. About 3 masabata ana amene anabadwa pa mawu, ndipo ndi mwezi normalization msanga wa bilirubin mu thupi.

Pathological matenda a chikasu ndiyo

mofulumira kwambiri, matenda a chikasu ndiyo thupi mwina patsogolo kuti pathological. mitundu aakulu ali limodzi ndi kuwonjezeka kwambiri mlingo bilirubin: 90 mol / l mawola 24. Komanso, neonates Mwina poyamba kukhala mtengo wapatali kwambiri: zoposa 250 micromol / l.

Ndiko zikachitika, kuchuluka kwa thunthu mu magazi ndi apamwamba kuposa mlingo wa bilirubin mu akhanda. Table ndi miyezi amathandiza kuyerekeza zolozerazi ndi kufotokoza vuto mu nthawi. Koma pali zizindikiro zina matenda a chikasu ndiyo pathologic:

- chikasu pamwamba pa thupi pansipa m'michombo ya;

- lalanje manja ndi mapazi;

- mdima mkodzo ndi ndowe kwambiri yowala.

Matendawa zambiri protracted ndi ukuyenda mwa mafunde. Komanso, mmene ambiri a mwana mwina nazo: pali chinyengo ndi malemeredwe kwambiri.

Mitundu ndi zimayambitsa matenda a chikasu ndiyo pathological

Pali lalikulu zosiyanasiyana za matenda a chikasu ndiyo pathologic. Iwo zigwire malingana zifukwa maonekedwe.

1. Hemolytic akuwonetseredwa mu nkhondo RH Chinthu ndi mayi a mwanayo, komanso matenda chibadwa.

2. Parenchymal matenda a chikasu ndiyo kumachitika pamene zotupa a chiwindi kobadwa nako mitundu ya chiwindi, cytomegalovirus, poizoni.

3. conjugation mtundu zikusonyezedwa nkhani ya wonongeka a dongosolo enzyme, komanso kumanga wa bilirubin.

4. Mawotchi matenda a chikasu ndiyo kumachitika pamene akusokoneza ya ndulu outflow pa anomalies ndulu ndi ducts chiwindi.

Khama la bilirubin

Kuwunika mlingo wa kudetsa wothandizila mu magazi, ndi kusanthula wapadera ntchito. chitsanzo nthawi anatengedwa pa chopanda kanthu m'mimba. Koma kwa ana ngati ankafuna zili kawirikawiri, mu zikafika poipa, izo tikulimbikitsidwa kuti kuyamwitsa mwana wanu 4 maola pamaso zitsanzo zosankhidwazi magazi. Pa ana akhanda, zitsanzo watenga kuchokera zidendene kakang'ono wapadera zingalowe chubu.

Kuti amalize kusanthula zinthu anatsimikiza mu mwazi wa tuzigawo twa bilirubin. Izi zimathandiza kudziwa osati mtundu wa matenda a chikasu ndiyo, koma zifukwa kutembenuka ake mu gawo pathological.

Atalandira zotsatira za kuwunika akuyerekezedwa ndi mlingo iwo bilirubin mu akhanda. Table mwezi limapangidwa pamakomo. Ngati kuchuluka kwa mitundu wothandizila ndi apamwamba kuposa vuto lawo kwenikweni amafuna chithandizo.

zotsatira zotheka

Ndende mkulu magazi zikuwononga amakhudza umoyo wa mwana wanu. Makamaka limakhudza imeneyi mlingo si kubwezeretsedwa bilirubin mu neonates (2 miyezi). Tebulo momveka bwino kuti wokalamba mtengo zizigwirizana ndi zomwe zimachitika mu wachikulire wathanzi munthu.

Choyamba, mkulu bilirubin ndi owopsa kwa ubongo ndi mantha dongosolo la mwanayo. Kuopsa ndi kuti colorant akhoza anapeza pano. Zinthu ngati kungachititse kuti kuledzera choopsa cha lake ndi, chotero, kuwonongedwa kwa maselo a mu ubongo ndi mapeto mitsempha. Kenako, izi zingathe kubweretsa mavuto ndi kumva ndi masomphenya, matenda okhudza ubongo, maganizo ndi mavuto ena.

Zonsezi kumabweretsa mfundo yakuti dokotala ndi mosalekeza kuyan'anila pamaso zotheka mwana zheltushki. Ngati kukayikirana aliyense ndi magazi pa maziko amene zimaonekeratu ngati mtengo awiriawiri machesi "wapezeka bilirubin -. Ponseponse wa ana akhanda" Table mothandizidwa madokotala kupanga mapeto zolondola.

Makolo ayenera kudziwa kuti pali zizindikiro, mawonetseredwe limene mwana ndi matenda a chikasu ndiyo akhale chifukwa mankhwala mwamsanga kwa dokotala. Njirazi ndi monga:

- ulesi ndi tulo;

- kuchepetsa wakuyamwa reflex;

- spasms, tics, khalidwe wosakhazikika;

- kukula kukula kwa ndulu ndi chiwindi;

- otsika magazi.

Njira kuchepetsa mlingo wa bilirubin

Nkofunika kudziwa kuti matenda a chikasu ndiyo thupi sikutanthauza chithandizo. Izo ziyenera pochitika paokha. Komabe, popanda mankhwala, sangathe kuchita kukachitika kuti kwambiri kuposa chizindikiro monga bilirubin (yachibadwa akhanda). Tebulo limachititsa osati kwa akatswiri, komanso makolo timvetse kufunika kwa alowererepo zachipatala.

Yambani nkhondo ndi bilirubin mkulu ayenera kudzera kukhudzana kuwala. Iwo ikuchitika mu chipinda chapadera ndi ntchito kuvomerezedwa eyewear zozitetezera. Njira imeneyi akuganiza kuti palibe vuto lililonse kwambiri, koma ndi othandiza kwambiri ndi kusala. Zotsatira zake zoyipa za njirayi akhoza kukhala matenda otsekula m'mimba ndi khungu khungu. Mu chochitika cha kuchotsa mankhwala mavuto kwa izo kwambiri mwamsanga osaonekanso.

Komabe, dziŵani kuti phototherapy amagwira ntchito pokhapokha pamene matenda a chikasu ndiyo thupi. Ngati pa nthawi mlingo wa mankhwala apamwamba kuposa phindu mu mzere "bilirubin Normal makanda 1 month" (tebulo pamwambali) sadzatha kuchita popanda mankhwala.

Anthu ambiri sakhulupirira matenda a chikasu ndiyo mwa ana ndithu vuto lalikulu. Koma m'pofunika kudziwa ndi kuzindikira kuti zimenezi si zoona milandu onse. Popanda chisamaliro choyenera ndi kuchiza vuto mavuto aakulu.