Dab tsi ua rau thiab yuav kho tus mob neonatal hyperbilirubinemia li cas

Zoo Siab

• Cov tseem ceeb ua
• 1. Lub cev nqaij daim tawv
• 2. Qhov muag daj nyob rau hauv niam mis
• 3. Ntshav kabmob
• 4. Mob siab mob siab
• Kev yees duab ua tiav li cas

Hyperbilirubinemia ntawm cov menyuam mos los yog lub cev xeeb tub yog ib tus kabmob uas tshwm nyob rau thawj hnub ntawm tus menyuam lub neej, tshwm sim los ntawm kev txuam nrog bilirubin hauv cov ntshav, thiab tig rau daim tawv nqaij daj.

Txhua tus menyuam yaus tuaj yeem txhim kho hyperbilirubinemia, qhov tseem ceeb ua rau lub cev hloov pauv hauv lub siab ua haujlwm hauv lub siab, ntshav tsis txaus, xws li hemolytic anemia, kab mob siab, tshwm sim los ntawm kev kis tus kabmob lossis kab mob caj, lossis txawm tias tshwm sim los ntawm kev pub niam mis. Kuj tseem xyuas seb yog vim li cas ntawm bilirubin siab thiab jaundice rau cov neeg laus.

Kev saib xyuas los txo qis cov bilirubin hauv cov ntshav yuav tsum pib sai, thiab kev kho mob nrog phototherapy yog qhov feem ntau siv. Muaj qee kis, kev siv tshuaj los yog txhab ntshav yuav tsim nyog, thiab qhia tswv yim rau kws kho mob menyuam yaus.

Cov tseem ceeb ua

Jaundice tshwm sim thaum tus me nyuam tsis muaj peev xwm tua tau cov bilirubin, uas tsim los ntawm cov metabolism hauv cov ntshav, vim tias, ua ntej yug los, cov me nyuam tau ua txoj haujlwm no. Cov laj thawj tseem ceeb ntawm cov me nyuam mos hyperbilirubinemia yog:

1. Lub cev nqaij daim tawv

Nws feem ntau tshwm sim tom qab 24 txog 36 teev tom qab yug, yog qhov muaj ntau tshaj plaws ntawm kev daj ntseg, vim tus menyuam lub siab tsis zoo thiab yuav muaj qee qhov kev nyuaj ntawm kev hloov pauv thiab tshem tawm bilirubin los ntawm cov ntshav los ntawm bile. Qhov kev hloov no feem ntau daws nyob hauv ob peb hnub, nrog kev kho mob nrog kev thaij duab thiab kev tiv tshav ntuj.

• Yuav kho li cas: phototherapy nrog lub teeb fluorescent yog pab tau kom txo qis ntawm bilirubin hauv cov ntshav. Hauv qee qhov mob me, kev tiv thaiv tshav ntuj tuaj yeem ua tau txaus, tab sis yog muaj mob hnyav, yuav ntxiv ntshav lossis siv cov tshuaj noj, xws li phenobarbital, yuav tsim nyog kom tau txais cov txiaj ntsig zoo dua. Nkag siab zoo dua txog kev kho mob tus menyuam lub cev nqaij daim tawv txhawm rau kho tau.

2. Qhov muag daj nyob rau hauv niam mis

Qhov kev nce bilirubin no tuaj yeem tshwm sim nyob ib ncig ntawm 10 hnub tom qab yug me nyuam, nyob rau qee tus menyuam yaus tshwj xeeb rau lub mis, vim tias qhov tshwm sim hauv cov tshuaj hormones lossis cov tshuaj nyob rau hauv cov ntshav uas nce resorption ntawm bilirubin nyob rau hauv txoj hnyuv thiab cuam tshuam nws kev tshem tawm, txawm tias tsis tsis tau paub pes tsawg daim ntawv.

• Yuav kho li cas: Yog tias muaj teeb meem tseem ceeb dua, kev siv tshuaj kho kab mob tuaj yeem ua kom tswj ntshav tau, tab sis kev pub mis niam yuav tsum tsis txhob cuam tshuam tshwj tsis yog tus kws kho menyuam yaus. Qhov mob ntsej muag no ploj zoo ib ncig ntawm ob hlis lossis thib peb ntawm tus menyuam.

3. Ntshav kabmob

Qee yam kab mob tuaj yeem ua rau tus menyuam mos bilirubin ntau dua, xws li hloov kho lub cev lossis caj ces hloov, thiab nws tuaj yeem hnyav thiab tshwm sim hauv thawj teev tom qab yug. Piv txwv li qee cov kab mob yog tus mob spherocytosis, thalassemia los yog tsis sib haum nrog leej niam cov ntshav, piv txwv, tab sis qhov tseem ceeb tshaj plaws yog tus kab mob hemolytic ntawm tus menyuam yug tshiab, tseem hu ua kev mob plab orythroblastosis.

• Yuav kho li cas: ntxiv rau kev kho duab kom tswj tau qhov nyiaj ntawm bilirubin hauv cov ntshav, kev kho mob feem ntau yog ua nrog cov ntshav ntxiv thiab, qee qhov xwm txheej, tshuaj tuaj yeem ua kom tswj tau kev tiv thaiv.

4. Mob siab mob siab

Tus menyuam muaj peev xwm yug tau los ntawm kev hloov pauv hauv lub siab ua haujlwm, vim muaj ntau yam ua rau mob, xws li bile duct deformities, cystic fibrosis, Congenital rubella, Congenital hypothyroidism, kis los ntawm kab mob lossis kab mob, lossis los ntawm caj ces syndromes, xws li Crigler-Najjar syndrome, Gilber thiab Gaucher kab mob, piv txwv.

• Yuav kho li cas: los tswj ntshav hyperbilirubinemia, ua ke nrog kev kho duab, kev kho mob yog coj los txhim kho tus kab mob uas ua rau kev nce bilirubin, xws li kev kho mob ntawm kev kis mob nrog tshuaj tua kab mob, phais kom kho daim siab daim siab lossis hloov cov tshuaj hormone hauv hypothyroidism, piv txwv.

Txoj kev kho mob kom txo tau lub cev ntau dua bilirubin, tshwj xeeb tshaj yog kev kho kom zoo nkauj, yuav tsum tau ua sai sai tom qab kuaj pom qhov kev hloov pauv, vim tias bilirubin ntau hauv tus menyuam lub cev tuaj yeem ua rau muaj kev mob hnyav, xws li lub hlwb lom hu ua kernicterus, uas ua rau lag ntseg lag ntseg, qaug dab peg, coma thiab kev tuag.

Kev yees duab ua tiav li cas

Kev siv tshuaj pleev ib ce muaj xws li tawm ntawm tus menyuam mus rau ntawm lub teeb fluorescent, feem ntau xiav, li ob peb teev, txhua hnub, txog thaum txhim kho. Txhawm rau kev kho kom siv tau, tus menyuam cov tawv nqaij yuav tsum tau ua kom tiav lub teeb, tab sis ob lub qhov muag yuav tsum tsis raug tawm, yog li cov ntaub npog lossis cov tsom iav tshwj xeeb npog.

Lub teeb nkag rau ntawm daim tawv nqaij txhawb kev rhuav tshem thiab tshem tawm ntawm bilirubin los ntawm bile, ua rau lub ntsej muag daj thiab daj daj kom ploj me ntsis los ntawm me me.

Kawm paub ntau ntxiv seb nws ua tiav li cas thiab lwm yam kev taw qhia rau kev siv tshuaj pleev ib ce.