Kernicterus iintsana: iimpawu, iziphumo kunye nonyango

Kernicterus kwenzeka yonke usana wesithathu kuzalwa. Le meko engaqhelekanga yenzeka ulusu icteric ngenxa ekubhobhozeni ngokugqithiseleyo izinto ezifana yibilirubin.

Zikarhulumente eziqhelekileyo neonates umzimba ubola haemoglobin kunye yibilirubin imveliso, kodwa banokusilela apho isibindi Asikwazi ukwenza yonke yibilirubin kwakhiwa. into Iyingozi engena egazini, echaphazela kakubi ngayo iiseli zomzimba kunye luvo. Yibilirubin kuba nefuthe enyukliya, nto leyo esisizathu sokuba esi sifo igama layo.

Le Pathogenesis kunye umyalezo sifo

Ifuthe yibilirubin ebuchotsheni kwaye luvo nga kumiselwa yi xi kwento egazini. Kwinqanaba emandundu 425 micromoles kuvela nesifo ekuthiwa kubelekwa kernicterus. Isebenza kuphela ukuba iintsana ngokupheleleyo-term. Ukuba ukuzalwa kwenzeka phambi elide, ngoko ke ubhalo bomtya lifinyele. Kulo mzekelo, ukunciphisa izinga nempembelelo intrauterine hypoxia yosana olungekazalwa kunye nosulelo ezahlukeneyo.

Ukongeza, ukungavumelani igazi umntwana unina ngumba iingcinga kuphuhliso kernicterus. Kukho ungquzulwano izinto RH igazi.

Kutheni umzimba womntwana oluhlala yibilirubin

Yibilirubin - into leyo ebonakala ngenxa ukuhluzwa haemoglobin emzimbeni bomntwana. Kukho iintlobo ezimbini zenkqunto: enyibilikayo ezingenakunyibilika. yibilirubin Forms kufuneka nje ubenesahlulo ethile emzimbeni, egqalwa eqhelekileyo, u-1 ukuya ku-3 Isibindi abaguquka insolubilizing kweziyobisi ngendlela ezinokunyibilika liyasuswa umzimba kusetyenziswa amachiza endalo kunye nomchamo kunye ngendle.

Xa kubelekwa kwesibindi ubuthathaka, yaye ngoko, ukusetyenzwa kusihla. Ngenxa yoko, lo mbala ngokuthe ngcembe oqokelela, engakhange abe ukuqhubekekiswa, akukho kernicterus. Imiphumo yale zezifo kakhulu.

Elide kunye njengokuzalwa nabantwana kuchaphazela isixa kwinqanaba ezibalulekileyo ze yibilirubin egazini. Lo mahluko kuthetha 100 micromolar. Lo mahluko kungenxa imeko emzimbeni usana - kwiintsana ngaphambi kwexesha kunye ubunzima ngokuzalwa esezantsi zange ziphuhliswe ngokupheleleyo enyama yangaphakathi, ngoko umzimba osezantsi nokuqwalaselwa yibilirubin. Ngowe-80% amatyala nokubeleka ngaphambi waphawula kernicterus.

iimpawu

Kuhlaselwa sesi sifo kwisithuba ngeveki enye. Ukuba senyongo hemolytic liqulunqe usana, esi sifo esizibonakalisa ngembonakalo ngosuku kamva.

Ukuba ekuphuhliseni nuclear senyongo lweentsana, iimpawu yokukhupha kuyo, ukuze kwenziwe ngolu hlobo lulandelayo:

• Ngokuguquguquka elibukhali kwi imeko jikelele umntwana.
• Lo mntwana waphawula status convulsive okanye umoya.
• noviwo lwangaphandle ibonisa ubukho izihlunu ehleliyo.
• Ngokwenene kernicterus ngequbuliso ukuzoba umva intloko umva.
• Ne indlela ngakumbi esi sifo singabanjwa a baswele engqondweni.
• Iimpawu kwezonyango kernicterus niyandingqinela ukuba intloko ezitshangubeni ebuchotsheni usana.

Ukuvela kernicterus: Oonobangela

Izizathu eziphambili zale sifo zibandakanya:

• Ungquzulwano phakathi RH ngumba igazi usana kunye nonina, oko kukuthi iqela igazi akukho ezihambelana.
• Yokunqongophala kwi kumzimba iivithamini usana ezifana K, kwakunye neziphumo ekukhuleni kosana olungekazalwa kwamayeza athile obuselwe ngumama ngexesha lokukhulelwa.
• hematoma Generic emntwaneni.
• Yokunqongophala kwe-oksijini olungekazalwa okanye ukutya ayilunganga.
• yofuzo.
• amalungu zangaphakathi ngokwaneleyo.

Xa over-yemveliso yibilirubin kwiintsana baphawula senyongo ibala. Iimpawu kernicterus phantse zonke efanayo. Kwanele ukuba ukuhlola umntwana lulawulo Cramer esithi: iintende senyongo, iinyawo kunye isisu izinto ezingaqhelekanga usana yellow.

Imiphumela kernicterus

Imiphumo sifo zinokuba nomahluko, ngumbandela ixesha lonke kwaye nokuphilisa ngexesha kernicterus. Kusenokubakho kubakho uphuhliso Encephalopathy, yaye kwiimeko oluphambili ukungeva buso nokungaboni. Ukongeza, xa kungekho unyango ngexesha kwandisa umngcipheko ukonakala kwengqondo, nto leyo ke ngenxa ngokuqatha kernicterus.

Emva kokoyiswa zobuchopho abantwana ezi Webhsayithi ndibuthathaka, musa ukuphendula okungaphandle, kwanalo ilizwi yabazali.

Ekuchongeni zokuqala iimpawu senyongo kufuneka zisingathwe ngumntu oqeqeshiweyo, oya kunceda ukuqinisekisa okanye ukuphikisa uxilongo.

ukunakekela abanezakhono

Kwiminyaka embalwa edlulileyo ukuba unyango lokusetyenziswa kernicterus glucose kunye namanye amachiza angasebenzi. Xa yesilungu, indlela ezininzi ezisetyenziswayo ngokuqhelekileyo of phototherapy - ukuvuleleka emzimbeni usana radiations ethile evela isibane okhethekileyo ncedo ngemali. Ngenxa radiation yibilirubin yi ngaphantsi ziyityhefu kwaye liyasuswa umzimba ngokwemvelo, ngamanye umchamo kunye ilindle.

Ukwenzela ukuphepha imiphumo ebuhlungu kernicterus, emva kokuzalwa igazi ithathwa ukwenzela uhlalutyo. Uphando lwenziwa ukuze kuchongwe isixa yibilirubin egazini wosana. Xa imali ngokugqithiseleyo kweziyobisi ababelwe iziyobisi ezizodwa, nokukhawulezisa inkqubo yokususwa ebala ityhefu. Ukuba umntwana usemngciphekweni ophezulu, ngoko wenza ngexesha elinye-ukuqaliswa plasma lwangaphakathi.

Ukuba ukunyuka kernicterus, i-plasma iveliswa uvuza ukumnika ngokusebenzisana phototherapy. Ukuba akukho ngcono kuyimfuneko ukubhenela ukutofelwa igazi ngokupheleleyo.

Phambi umntwana kernicterus iphantsi kweliso luvo. Athwala lo lweengcali yesiqhelo unyango kunceda ukubuyisela imisebenzi aphazamiseke.