Bilirubin ndi mtundu wobiriwira wobiriwira womwe umapangidwa ndi chiwonongeko cha hemoglobini ndi mapuloteni ena a magazi ndipo ali mu plasma. Chizolowezi cha bilirubin m'magazi a munthu wamkulu ndi mwana wakhanda amasiyana. Kwa akuluakulu ndi ana oposa mwezi umodzi, zomwe zilipo zimasiyana pakati pa 8.5 ndi 20.5 μmol / l. Ana amakhanda, mlingo wa bilirubin ukhoza kuwonjezeka kufika 205 μmol / l kapena kuposa.
Mankhwala oterewa a bilirubin m'matangwana amamveka. Pamene mwanayo ali m'mimba, sapuma yekha. Oxygen imalowa m'magazi ake mothandizidwa ndi erythrocytes okhala ndi fetal hemoglobin (fetal hemoglobin). Atabadwa, hemoglobini iyi yawonongedwa, chifukwa sichifunikanso. Chifukwa chake, bilirubin yatsopano ikhoza kuwonetsedwa mwa khanda. Izi ndizodziwika (zaulere) bilirubin, zomwe sizingatheke, sizingathetsedwe ndi impso ndipo zidzayenda m'magazi a mwana mpaka mavitamini ake atseke. Patapita kanthawi, pamene ma khanda angayambe kugwira ntchito, bilirubin yosalunjika idzasinthidwa ndi kuchotsedwa mthupi.
Jaundice wa ana obadwa kumene
Kuwonjezeka kwa bilirubin pamwamba pa chizoloŵezi kumachititsa maonekedwe a jaundice mu makanda, omwe angakhale:
- chithandizo;
- pathological.
Chikhalidwe cha jaundice
Zimapezeka pafupifupi 70 peresenti ya ana onse, zimawoneka pa masiku 3-4 ndipo pamapeto pake zimasowa popanda tsatanetsatane popanda kuvulaza thupi. Kuwonjezeka kwa bilirubin m'magazi a makanda kumadalira kukula kwa msinkhu, komanso momwe mimba ndi mayi amachitira: kaya pali matenda kapena mavuto ena. Kawirikawiri zochitika za jaundice zimayambitsa intrauterine fetal hypoxia, asphyxia, shuga ya amayi a shuga.
Mathological icterus
Ndi kuwonjezeka kwakukulu kwa bilirubin m'magazi mwa ana omwe akubadwa kumene kumawopsa kupweteka kwapachipatala, zomwe zimayambitsa izi:
- kusagwirizana kwa amayi ndi mwana mwa magulu a magazi kapena Rh factor;
- chiwonongeko chotheratu cha erythrocyte;
- zilonda za chiwindi;
- chithunzi;
- matumbo a m'mimba;
- Gilbert's syndrome;
- matenda a hormoni, ndi zina zotero.
Monga momwe tikuonera, pali zifukwa zambiri, ndipo katswiri yekha amatha kumvetsa.
Njira yofunika yodziŵiratu ndiyo kuphunzira za kusanthula mwazi kwa ana obadwa kwa bilirubin ndi magawo ake. Pogwiritsa ntchito mayeso ndi mayeso ena, adokotala amadziwa kuti akuyenera kuchipatala.
Vuto lapamwamba kwambiri la bilirubin mu khanda ndiloti sizingatheke kutsekedwa ndi magazi alubinomu ndipo limalowa mu mitsempha ya mitsempha, kuwonetsa izo ku zotsatira zoopsa. Izi ndizoopsa kwa ubongo komanso malo okhudza ubongo. Matendawa amatchedwa "bilirubin (nuclear) encephalopathy" ndipo amadziwonetsera maola 24 oyambirira atabadwa monga zizindikiro zotsatirazi:
- kugona kwakukulu;
- kutsitsa reflex;
- kusokonezeka ndi nkhawa yamagalimoto;
- kuchepetsa kuthamanga kwa magazi;
- Kukulitsa chiwindi ndi nthata.
Ali ndi zaka zisanu ndi chimodzi, mwanayo amatha kumva kumva, kutaya mtima, kufooka. Choncho, chiŵerengero cha bilirubin m'mimba mwachinyama nthawi zonse chimafuna kuchipatala kwambiri, ndipo m'tsogolomu, kafukufuku wamaphunziro ochokera kwa katswiri wa zamaganizo.
Kodi mungatani kuti muchepetse bilirubin?
Ndi mankhwala a jaundice, njira yabwino kwambiri yochepetsera mkulu wa bilirubin ndi mankhwala ochepa (phototherapy). Pogwiritsa ntchito kuwala kosaoneka bwino, bilirubin imasandulika "lumirubin" yopanda poizoni ndipo imatulutsidwa mkati mwa maola 12 ndi nyansi ndi mkodzo. Koma chithunzicho chikhoza kupweteka: khungu loyang'anitsitsa, zotayirira, zomwe zimapita patatha mankhwala. Kupewa bwino ndi chithandizo chamankhwala a jaundice ndikumayambiriro koyambirira kumayamwitsa komanso kumadyetsa kawirikawiri. Mbalame yamakono imalimbikitsa mchere wa meconium (zinyama zoyambirira) pamodzi ndi bilirubin.
M'magazi a chifuwa chachikulu, kuphatikizapo kugwiritsira ntchito phototherapy ndi kumadyetsa kawirikawiri mkaka wa m'mawere, chithandizo n'chofunikira pakuganizira chifukwa cha matendawa. Mankhwalawa amaperekedwa kuchipatala cha ana ndi a neonatologists.
Musaiwale, mkulu wa bilirubin wa khanda nthawi zonse amamvetsera mwachidwi.