Tus me nyuam mos liab daj ntseg

Menyuam mos cov tawv nqaij tshwm sim thaum menyuam muaj bilirubin ntau ntau hauv cov ntshav. Bilirubin yog cov xim daj uas lub cev tsim thaum nws hloov cov qe ntshav liab qub. Lub siab ua haujlwm pab rhuav tshem cov khoom kom nws thiaj li tshem tawm ntawm lub cev hauv cov quav.

Qib siab ntawm bilirubin ua rau tus menyuam daim tawv nqaij thiab ntsiab muag ntawm lub qhov muag daj. Qhov no yog hu ua jaundice.

Nws yog ib qho uas cov menyuam bilirubin qib nce siab me ntsis tom qab yug tas.

Thaum tus me nyuam loj hlob hauv leej niam lub plab, tus me nyuam tshem tawm cov bilirubin tawm ntawm tus menyuam lub cev. Tus me nyuam yog qhov khoom nruab nrog uas loj hlob thaum cev xeeb tub los pub mis rau tus menyuam. Tom qab yug los, tus menyuam lub siab pib ua txoj haujlwm no. Nws yuav siv qee lub sijhawm kom tus menyuam daim siab thiaj li ua tau qhov zoo.

Cov menyuam mos feem coob muaj qee qhov tawv nqaij daj, lossis tawv nqaij. Qhov no yog hu ua physiological jaundice. Feem ntau pom tau thaum tus menyuam muaj 2 mus rau 4 hnub. Feem ntau, nws tsis ua teeb meem thiab ploj mus tsis pub dhau 2 lub lim tiam.

Ob hom nqaij qau tawv yuav muaj rau cov menyuam mosliab uas noj niam mis. Ob hom no feem ntau tsis muaj kev phom sij.

• Kev pub niam mis rau menyuam mos liab uas tseem pom nyob hauv niam mis thaum thawj lub asthiv ntawm lub neej. Nws muaj peev xwm tshwm sim ntau dua thaum cov menyuam tsis noj mis niam lossis niam cov kua mis los qeeb, ua rau lub cev qhuav dej.
• Cov kab mob niam lub txiv mis tshwm sim hauv qee cov menyuam muaj txiaj ntsig zoo, noj niam mis tom qab hnub 7 ntawm lub neej. Nws feem ntau yuav nce siab nyob hauv lub lim tiam 2 thiab 3, tab sis yuav nyob ntev ntawm theem qis rau ib hlis lossis ntau dua. Qhov teeb meem yuav yog vim li cas cov tshuaj hauv lub mis ua rau muaj kev cuam tshuam ntawm bilirubin hauv daim siab. Qhov ua niam cov kua mis ua pa txhaws txawv dua li qhov uas muaj kua mis.

Cov qog nqaij tawv rau cov menyuam mos liab yuav tshwm sim yog tias tus menyuam muaj mob uas ua rau muaj cov qe ntshav liab ntau ntxiv hauv lub cev, xws li:

• Cov ntshav qog ua haujlwm txawv txav (xws li mob rau cov ntshav ntshav tsis txaus)
• Cov ntshav tsis sib xws ntawm leej niam thiab tus menyuam (Rh tsis sib xws lossis ABO tsis sib xws)
• Los ntshav hauv qab tawv taub hau (cephalohematoma) los ntawm txoj kev xa khoom nyuaj
• Cov qib ntshav liab siab ntau dua, uas muaj ntau dua hauv cov hnub nyoog me me-rau-taw (SGA) menyuam yaus thiab qee tus menyuam ntxaib
• Kab mob
• Tsis muaj qee yam protein tseem ceeb, hu ua enzymes

Tej yam uas nyuaj rau tus menyuam lub cev kom hle bilirubin tuaj yeem ua rau mob tawv nqaij dua, suav nrog:

• Qee yam tshuaj
• Cov kab mob tshwm sim thaum yug los, xws li rubella, mob syphilis, thiab lwm tus
• Cov kab mob uas cuam tshuam rau daim siab los yog mob plab, xws li cystic fibrosis lossis kab mob siab
• Qib Qis Theem (hypoxia)
• Kab mob (sepsis)
• Ntau yam sib txawv ntawm caj ces lossis cov noob caj ceg muaj tsis sib haum

Cov menyuam mos ab uas yug ntxov thiab ntxov (ntxov ntxov) feem ntau yuav muaj lub ntsej muag daj ntseg ntau dua li cov menyuam puv hnub.

Jaundice ua rau muaj xim daj rau ntawm daim tawv nqaij. Nws feem ntau pib ntawm lub ntsej muag thiab tom qab ntawd txav mus rau hauv lub hauv siab, lub plab hauv plab, ceg ceg, thiab lub qab xib taw.

Qee zaum, cov menyuam mos liab uas muaj jaundice hnyav yuav nkees heev thiab pub zaub mov tsis zoo.

Cov kws saib xyuas kev noj qab haus huv yuav saib xyuas cov tsos mob daj ntseg ntawm lub tsev kho mob. Tom qab tus me nyuam mos liab mus tsev, cov neeg hauv tsev neeg feem ntau yuav pom tus mob daj ntseg.

Cov menyuam mos uas zoo li jaundiced yuav tsum muaj qhov ntsuas bilirubin ntau dua tam sim ntawd. Qhov no tuaj yeem ua tau los ntawm kev kuaj ntshav.

Ntau lub tsev kho mob tshawb xyuas tag nrho cov qib bilirubin rau txhua tus menyuam thaum muaj 24 teev. Cov tsev kho mob siv probes uas tuaj yeem kwv yees qib bilirubin tsuas yog kov cov tawv nqaij xwb. Yuav tsum muaj qhov kev ntsuas siab ntau nrog cov ntshav ntsuas.

Kev ntsuam xyuas uas tej zaum yuav ua tiav muaj xws li:

• Ua kom tiav cov ntshav suav
• Coombs kuaj
• Reticulocyte suav

Tej zaum yuav tau muaj kev kuaj ntxiv rau cov menyuam mosliab uas xav tau kev khomob lossis nws tus lej bilirubin nce ceev tshaj li uas tau npaj tseg.

Txoj kev kho yog tsis xav tau feem ntau.

Thaum xav tau kev kho mob, hom yuav nyob ntawm:

• Theem tus me nyuam qib bilirubin
• Ceev npaum li cas qib tau nce siab
• Txawm hais tias tus menyuam yug thaum ntxov (menyuam yaus yug ntxov ntxov feem ntau yuav raug kho rau qib qis bilirubin)
• Tus menyuam mos muaj pes tsawg xyoo

Ib tug menyuam yaus yuav xav tau kev kho mob yog tias qib bilirubin ntau dua lossis nce nrawm dua.

Ib tug menyuam uas muaj jaundice yuav tsum haus dej kom ntau nrog lub mis lossis mis mos:

• Pub mis rau menyuam kom tsis tu ncua (txog 12 zaug hauv ib hnub) los txhawb kom nquag plob tsis so tswj. Cov no pab tshem cov bilirubin tawm ntawm cov quav. Nug koj tus kws kho mob ua ntej muab cov mis rau koj cov menyuam mos tshiab.
• Muaj qee zaus, qee zaum cov menyuam mos yuav tau txais dej ntau los ntawm IV.

Qee tus menyuam yug tshiab yuav tsum tau kho ua ntej lawv tawm hauv tsev kho mob. Lwm cov yuav tsum tau rov mus pw hauv tsev kho mob thaum lawv muaj ob peb hnub. Kev kho mob hauv tsev kho mob feem ntau kav 1 rau 2 hnub.

Qee zaum, lub teeb tshwj xeeb xiav tau siv rau ntawm cov menyuam mos uas nws qib muaj ntau heev. Cov teeb no ua haujlwm los ntawm kev pab zom bilirubin hauv daim tawv nqaij. Qhov no hu ua kev thaij duab.

• Tus menyuam mos tau muab tso rau hauv qab cov teeb nyob rau hauv ib lub txaj sov, nrog pw kom tau kub thiab txias tas li.
• Tus me nyuam yuav hnav tsuas daim pawm thiab cov npog qhov muag tshwj xeeb kom tiv thaiv lub qhov muag.
• Kev pub mis rau menyuam noj yuav tsum muaj kev txuas ntxiv thaum lub sijhawm thaij duab, yog tias ua tau
• Muaj qee zaus, qee zaum tus menyuam yuav xav tau txoj hlab ntshav (IV) kom xa dej tuaj.

Yog tias qib bilirubin tsis nce siab lossis tsis nrawm dua, koj tuaj yeem ua cov duab ci rau hauv tsev nrog daim ntaub fiberoptic, uas muaj cov teeb pom kev me me nyob hauv nws. Koj tuaj yeem siv lub txaj uas ci ntsa iab los ntawm daim txaj.

• Koj yuav tsum khaws cov kev kho lub teeb rau koj tus menyuam cov tawv nqaij thiab pub mov rau koj tus menyuam txhua 2 rau 3 teev (10 txog 12 zaug hauv ib hnub).
• Tus nais maum yuav tuaj rau hauv koj lub tsev los qhia koj txog kev siv pam vov lossis txaj, thiab tshuaj xyuas koj tus menyuam.
• Tus kws tu neeg mob yuav rov qab los kuaj xyuas koj tus menyuam qhov hnyav, pub mis, tawv nqaij, thiab bilirubin npaum li cas.
• Luag yuav kom koj suav pes tsawg lub voom ntub thiab qias neeg.

Nyob rau hauv cov mob hnyav tshaj plaws ntawm jaundice, yuav tsum muaj kev hloov pauv hloov ntshav. Nyob hauv tus txheej txheem no, tus menyuam cov ntshav hloov nrog cov ntshav tshiab. Muab cov tshuaj immunoglobulin rau cov menyuam uas muaj jaundice hnyav yuav ua rau kom txo tau cov bilirubin ntau ntau.

Tus menyuam moslaus lub qhov muag tseem tsis ua mob rau lwm lub sijhawm. Rau feem ntau ntawm cov menyuam, jaundice yuav zoo dua yog tias tsis kho nyob rau hauv 1 rau 2 asthiv.

Ib theem bilirubin ntau tuaj yeem ua rau lub hlwb puas. Qhov no yog hu ua kernicterus. Tus mob yog yuav luag txhua yam kev kuaj mob ua ntej qib yuav siab txaus los ua qhov kev puas tsuaj no. Txoj kev kho yog feem ntau zoo.

Tsis tshua muaj, tab sis muaj teeb meem loj los ntawm cov qib siab bilirubin suav nrog:

• Cerebral palsy
• Cov lag ntseg
• Kernicterus, uas yog lub hlwb raug mob los ntawm cov qib bilirubin ntau heev

Txhua tus menyuam mos yuav tsum mus ntsib tus kws khomob hauv thawj 5 hnub ntawm lub neej kom kuaj pom tus mob qog nqaij tawv:

• Cov menyuam mos uas siv sijhawm tsawg dua 24 teev hauv tsev khomob yuav tsum tau pom thaum muaj hnub nyoog 72 teev.
• Cov menyuam mos uas raug xa mus tsev nyob nruab nrab ntawm 24 mus rau 48 teev yuav tsum tau pom dua thaum muaj hnub nyoog 96 teev.
• Cov menyuam mos uas raug xa mus tsev nyob ntawm 48 thiab 72 teev yuav tsum tau pom dua thaum muaj hnub nyoog 120 teev.

Jaundice yog ib qho xwm txheej ceev yog tias tus me nyuam kub taub hau, tsis hnov ​​dab tsi, lossis tsis noj mis. Jaundice tej zaum yuav muaj kev phom sij rau cov menyuam mos uas muaj feem yuav muaj mob.

Jaundice ib txwm tsis muaj kev phom sij rau cov menyuam yaus uas yug los puv lub sijhawm thiab tus uas tsis muaj lwm yam teebmeem mob. Hu rau tus neeg zov menyuam yog tias:

• Jaundice yog mob hnyav (daim tawv yog xim daj daj)
• Jaundice tseem nce ntxiv tom qab mus kuaj menyuam mos, kav ntev dua 2 lub limtiam, lossis lwm yam tsos mob tshwm sim
• Ob txhais taw, tshwj xeeb tshaj yog lub qab ntuj daj

Nrog koj tus kws zov menyuam tham yog tias koj muaj lus nug.

Hauv cov menyuam mos, qee cov qib siab ntawm jaundice yog qhov qub thiab tej zaum yuav tiv thaiv tsis tau. Kev pheej hmoo rau mob jaundice ntau tuaj yeem txo qis los ntawm kev pub menyuam rau tsawg kawg 8 txog 12 zaug hauv ib hnub rau thawj ob peb hnub thiab ua tib zoo txheeb xyuas cov menyuam mos uas muaj kev pheej hmoo siab tshaj.

Txhua tus poj niam cev xeeb tub yuav tsum kuaj cov ntshav thiab cov tshuaj tiv thaiv kab mob txawv. Yog tias leej niam yog Rh tsis zoo, kuaj kev kuaj mob tus me nyuam cov leeg liab kom ua zoo. Qhov no los ua qhov twg los tau yog tias leej niam cov ntshav hom O zoo.

Saib xyuas zoo txhua tus menyuam mosliab thawj 5 hnub ntawm lub neej tuaj yeem tiv thaiv ntau yam mob ntawm jaundice. Qhov no suav nrog:

• Xam txog menyuam yaus qhov txaus ntshai rau jaundice
• Kev kuaj xyuas qib bilirubin hauv thawj hnub lossis tom qab ntawd
• Teem sijhawm tsawg kawg ib zaug rov qab mus ntsib thawj lub lim tiam ntawm lub neej rau cov menyuam yaus xa mus tsev los ntawm tsev kho mob hauv 72 xuaj moos

Jaundice ntawm lub Cim Yug; Neonatal hyperbilirubinemia; Bili teeb - jaundice; Me nyuam mos - tawv nqaij daj; Tus menyuam mos - tawv daj

• Tus me nyuam mos liab daj - tso zis
• Tus menyuam mos liab daj deev - dab tsi yuav nug koj tus kws kho mob

• Erythroblastosis fetalis - photomicrograph
• Jaundiced tus me nyuam mos
• Hloov pauv ntshav - series
• Tus me nyuam daj daj deev

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