Neonatal jaundice hauv cov menyuam yug tshiab: ua rau, tsos mob thiab kho

2024 Tus sau: Priscilla Miln | [email protected]. Kawg hloov kho: 2024-02-18 01:45

Kev yug me nyuam yog kev zoo siab rau niam txiv. Txawm li cas los xij, qee zaum, tshwj xeeb tshaj yog thaum nws los txog rau tus menyuam yug tshiab, nws tuaj yeem cuam tshuam los ntawm kev hloov xim ntawm daim tawv nqaij thiab cov mucous membranes ntawm tus menyuam. Qhov tshwm sim, hu ua neonatal jaundice, yog ib qho txaus uas cov niam txiv yuav tsum kawm paub ntxiv txog nws.

Yog vim li cas

Cov tsos mob jaundice hauv cov menyuam yug tshiab yog qhov qub. Qhov tshwm sim no tau pom yog tias cov ntsiab lus ntawm bilirubin nyob rau hauv cov ntshav ntawm cov crumbs vim kev tawg ntawm cov qe ntshav liab ntau tshaj li cov qauv. Nws yuav tsum to taub tias, ntxiv rau lawv cov qe ntshav, lub cev ntawm tus menyuam yug tshiab kuj yuav tsum tau ua cov qe ntshav liab seem ntawm leej niam. Yog li, qhov hnyav dhau los ua qhov tseem ceeb, thiab vim li ntawd, ntau dhau ntawm bilirubin accumulates, uas ua rau yellowing ntawm lub qhov muag sclera thiab tawv nqaij ntawm tus menyuam. Nyob rau tib lub sijhawm, tus menyuam tsis muaj lwm yam kab mob, nws suav hais tias noj qab nyob zoo, thiab nws tsis tas yuav kho.

Physiological form

Feem ntau, kev hloov pauv ntawm tus menyuam pom nyob rau 2-5 hnub tom qab nws yug los thiab ploj mus ntawm 2 lub lis piam ntawm lub neej. Nyob rau tib lub sijhawm, nws muaj peev xwm ua tau los pab txhawb kom nrawm nrawm ntawm cov tsos mob ntawm lub cev jaundice, yog tias ntau zaus siv tus menyuam rau hauv siab. Qhov no yuav ua rau kom lub qhov tso tawm ntawm cov quav qub qub - meconium, uas ntau dhau bilirubin raug tshem tawm ntawm lub cev. Tsis tas li ntawd, nws raug nquahu kom taug kev ntau zaus nrog tus menyuam hauv huab cua ntshiab.

Lub cev nqaij daim tawv jaundice ntawm tus menyuam yug tshiab: ua rau

Raws li twb tau hais lawm, cov xim ntuj ntawm daim tawv nqaij thiab cov mucous membranes feem ntau rov qab los ntawm 10-14 hnub ntawm lub neej. Tsis tas li ntawd, cov kab mob jaundice tau kuaj pom. Nws tuaj yeem tshwm sim los ntawm:

• menyuam yau;
• bilirubin hyperproduction;
• enzymatic immaturity ntawm daim siab hlwb;
• txo peev xwm ntawm cov ntshav ntshav los khi bilirubin.
• pathological neonatal jaundice (ntev ntev).

Tus kab mob tuaj yeem yog los yog kis tau.

Nyob rau hauv thawj rooj plaub, neonatal jaundice yuav yog vim:

• Pathology ntawm erythrocyte membrane. Tej zaum tus kab mob no tshwm sim nyob rau hauv lub sij hawm neonatal. Sij hawm dhau mus, tus po thiab daim siab loj, thiab tom qab ntawd anemia tshwm sim.
• Erythrocyte enzyme deficiency. Hauv qhov no, jaundice tshwm sim rau hnub thib ob ntawm lub neej. Ib qho cim qhia yog zis tsaus.
• Tsis zoo hauv kev sib txuas thiab cov qauv ntawm hemoglobin thiab heme. Pom thaum 4-6 lub hlis ntawm tus menyuam lub neej.

Tau qhov txawv txav tsis zoo ntawm cov menyuam yaus jaundice yog peb hom:

• kab mob hemolytic ntawm tus menyuam mos, uas yog tshwm sim los ntawm kev tiv thaiv kab mob sib kis ntawm cov ntshav ntawm tus menyuam hauv plab thiab niam cov ntshav;
• hemorrhage rau hauv cov kabmob hauv nruab nrog cev, lossis cephalohematoma, thaum lub sijhawm resorption uas cov khoom tawg ntawm hemoglobin nkag mus rau hauv cov hlab ntsha;
• ntau yam ntawm cov laj thawj, xws li kev nce hauv cov ntsiab lus ntawm erythrocytes hauv cov ntshav ntawm tus menyuam, ib qho mob uas tshwm sim thaum cov ntshav nkag mus rau hauv plab hnyuv ntawm tus menyuam mos thaum yug me nyuam, muaj tus kab mob immunopathological nyob rau hauv. leej niam, tshuaj hemolysis, thiab lwm yam.

Kev kho mob

Raws li lub cev nqaij daim tawv, cov menyuam yaus raug txhawb kom pub niam mis ntau zaus thiab coj lawv tawm mus rau hauv huab cua ntshiab. Tsis tas li ntawd, yog tias tus me nyuam muaj tus mob jaundice, ces siv phototherapy. Nws muaj nyob rau hauv irradiating lub crumbs nrog ib tug yees duab teeb. Nyob rau hauv nws cov rays, bilirubin nrawm hauv nws lub cev, thiab tom qab ntawd nws tawm hauv lub cev nrog cov zis thiab quav.

txheej txheem yog raws li hauv qab no:

• tus menyuam tsis hnav khaub ncaws (yog tias nws yog menyuam tub, daim ntaub qhwv rau ntawm qhov chaw mos) thiab muab tso rau hauv lub thawv tshwj xeeb rau cov menyuam mos;
• qhov muag raug kaw nrog lub ntsej muag opaque nrog cov hlua elastic;
• irradiation yog nqa tawm tsawg kawg 2-3 teev, cuam tshuam rau kev pub mis;
• tig tus menyuam ib ntus kom cov duab thaij duab nkag mus rau txhua qhov chaw ntawm daim tawv nqaij.

Nyob rau hauv cov xwm txheej hnyav, thaum theembilirubin yog qhov tseem ceeb heev, kev sib kho yog ua tsis tu ncua. Nyob rau tib lub sijhawm, ntshav raug coj los tshuaj xyuas txhua teev. Cov txheej txheem raug tso tseg tsuas yog thaum cov kev tshawb fawb pom tau tias muaj txiaj ntsig zoo rau bilirubin.

Contraindication mus ntxiv phototherapy yog daim tawv nqaij liab. Txawm li cas los xij, qhov tshwm sim no tsis tshua muaj heev.

ZPK

Kev kho tus mob jaundice hauv cov mob hnyav tuaj yeem ua tau los ntawm kev hloov pauv hloov pauv. Cov lus qhia rau txoj kev no yog:

• cov txiaj ntsig tsis txaus ntseeg ntawm kev kuaj sim ntawm qib bilirubin hauv cov ntshav qaum qaum thaum yug los thiab nws qhov nce tsis tu ncua txawm tias tawm tsam keeb kwm ntawm kev kho mob, thiab lwm yam;
• pov thawj rhiab heev rau leej niam thiab cov tsos mob ntawm tus mob hemolytic hnyav ntawm tus menyuam mos hauv nws tus menyuam;
• pom cov tsos mob ntawm bilirubin intoxication hauv crumbs.

Tshuaj xaiv cov ntshav rau kev txhaj tshuaj nruj me ntsis rau ib tus menyuam yaus thiab suav nrog hom ntshav tsis sib haum ntawm niam thiab menyuam. Tsis tas li ntawd, FRP tsuas yog ua tiav tom qab qhov kev sib tw ua tiav ntawm txoj hlab ntaws ntawm txoj hlab ntaws. Nyob rau tib lub sijhawm, koj yuav tsum paub tias txawm tias muaj cov khoom siv zoo rau kev ua haujlwm thiab kev coj ua nruj me ntsis, ntau yam teeb meem tsis suav nrog. Piv txwv li, huab cua embolism, plawv tsis ua hauj lwm, kab mob, thrombosis, anaphylactic shock, thiab lwm yam.cov neeg ua haujlwm kho mob yuav tsum saib xyuas tus menyuam mos.

Lwm txoj kev

Kev kho mob kuj tuaj yeem ua nrog cov tshuaj thiab kev kho mob infusion. Nyob rau hauv thawj rooj plaub, "Zixorin", agar-agar, "Carbolen" thiab "Cholestyramine" yog tshuaj, uas pab kom tshem tawm cov hnyuv los ntawm bilirubin. Cov tshuaj choleretic kuj tau sau tseg. Raws li kev kho infusion, nws yog ua los ntawm sodium chloride thiab qabzib cov ntsiab lus, thiab nrog txo cov protein ntau, cov tshuaj albumin yog siv.

Kev Tiv Thaiv

Neonatal jaundice, cov laj thawj uas tau piav qhia saum toj no, feem ntau yuav tsis tshwm sim lossis nws cov tsos mob yuav ploj mus sai dua yog tias ntsuas cov hauv qab no.

• tam sim tom qab yug me nyuam, muab tus menyuam tso rau niam lub mis;
• muag tus me nyuam thiab tso nws liab qab rau ntawm daim pawj ib nrab teev;
• pub mis rau ntawm kev thov;
• txij thawj hnub taug kev nrog tus menyuam hauv huab cua ntshiab;
• pub tus menyuam ntawm txhua lub mis tsawg kawg 7-10 feeb;
• yog tus menyuam tsis kam nqus, yuav tsum qhia niam mis thiab muab ib rab diav rau nws.

Tam sim no koj paub tias tus mob jaundice yog dab tsi. Cov tsos mob ntawm ntau hom kab mob no tau piav qhia saum toj no, yog li pom lawv cov tsos mob, koj tuaj yeem coj tus menyuam mus rau tus kws kho mob tam sim ntawd thiab tsis poob lub sijhawm muaj nuj nqis.