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Nui nā mākua i ʻike i ka jaundice neonatal. He ʻoiaʻiʻo loa kēia no nā pēpē i hānau ʻole ʻia, e ulu ana ma mua o 80 pakeneka. Akā i loko o nā pēpē i hānau ʻia i ka wā pōkole, he mea maʻamau kēia - aia ma 50-60 pakeneka o nā hihia.
Hoʻomaka ka Jaundice i nā lā mua ma hope o ka hānau ʻana o ka pēpē, a ʻike pinepine ʻia ka hoʻololi ʻana o ka ʻili i ka lā 3-4, i ka manawa e hoʻi mai ai ka makuahine a me ke pēpē mai ka haukapila.
No ke aha kēia hana? E pili ana i ka bilirubin. I kēlā me kēia kanaka, hoʻokumu ʻia ia i ka wā o ka haki ʻana o nā ʻulaʻula ʻulaʻula (nā ʻāpana koko ke kuleana no ka lawe ʻana i ka oxygen) i ke ola a maʻalahi ke hoʻokuʻu ʻia mai ke kino me ke kōkua o ke ake. Akā, i loko o kahi hānau hou, ʻaʻole ia e like me nā ʻōnaehana kino ʻē aʻe, ʻaʻole i oʻo loa, no laila ʻaʻole lawa nā enzymes i ke ake o ke pēpē e wāwahi a hoʻokuʻu iā ia. A he kiʻekiʻe loa ka pae o ka hemoglobin i loko o ke koko o kahi pēpē hānau hou. ʻO ka hopena, hoʻonui ka bilirubin i loko o ke koko, a huli melemele ka ʻili o ke keiki hānau. Hiki ke hoʻopaʻa ʻia nā keʻokeʻo o nā maka.
I ka manawa like, maikaʻi ke keiki. ʻO kēia ka mea i kapa ʻia ʻo jaundice physiological o nā keiki hou, ʻaʻole pono e mālama a nalowale loa i ka hopena o ka mahina mua o ke ola. Akā aia pū kekahi jaundice pathological i nā keiki hou. He kūlana koʻikoʻi loa kēia i hiki ke loaʻa nā hopena maikaʻi ʻole no ke keiki. Pono kēlā jaundice i ka mālama pono.
Nā kumu o ka jaundice i nā keiki hānau hou
ʻAʻole like me ka physiological, hoʻomohala pinepine ka jaundice pathological i nā hola mua ma hope o ka hānau ʻana o ke pēpē. He ʻeleʻele ka mimi a me ka ʻeleʻele o nā feces, anemia, a me ka ʻili ʻeleʻele. I ka manawa like, kiʻekiʻe loa ke kiʻekiʻe o ka bilirubin - ma luna o 256 µmol i nā keiki i hānau ʻia i ka manawa, i nā pēpē premature - ma luna o 171 µmol.
"Hiki ke kumu o ka jaundice pathological e nā kumu he nui," wahi a ka pediatrician Anna Levadnaya, Candidate of Medical Sciences, mea kākau o kahi blog e pili ana i nā pediatrics. - ʻO ka mea maʻamau ka piʻi ʻana o ka hemoglobin ma muli o kahi paio Rhesus a i ʻole ka hakakā ʻano koko ma waena o ka makuahine a me ke keiki. Eia kekahi, ʻo ke kumu o ka jaundice he pathology o ke ake a i ʻole kahi pathology o ka excretion o ka bile i loko o ka ʻōpū. Eia kekahi, hiki i ka jaundice ke hōʻailona o kahi maʻi, hypothyroidism (ma muli o ka emi ʻana o ka hana thyroid), polycythemia (ka piʻi ʻana o ke kiʻekiʻe o ke koko ʻulaʻula i loko o ke koko), keakea ʻana o ka ʻōpū, a i ʻole pyloric stenosis (he hōʻemi kēia o ka congenital. ka ʻāpana o ka ʻōpū ma mua o ke komo ʻana i loko o ka ʻōpū, he mea paʻakikī ke hele ʻana i ka meaʻai). i loko). Hiki ke hana me kekahi mau lāʻau a no nā kumu ʻē aʻe.
Eia kekahi, aia ka jaundice i loko o nā keiki hānau hou mai ka waiū umauma, i ka wā e piʻi ai ke kiʻekiʻe o ka bilirubin i loko o ka pēpē ma muli o ka ʻai ʻana i kekahi mau hormones i loko o ka waiū o ka makuahine i loko o ke kino o ke keiki. Hiki i kēia jaundice ke mau a hiki i 6 pule. Inā, i ka wā i hoʻopau ʻia ai ka HB no 1-2 mau lā, hoʻomaka ka emi ʻana o ke kiʻekiʻe o ka bilirubin, a nalowale ka melemele, a laila hana ʻia kahi maʻi. Akā me ka dynamics maikaʻi, ʻaʻole koi ʻia ka hoʻopau ʻana i ka umauma, hoʻomaka ia ma hope o 1-2 mau lā. I ka wā hoʻomaha, pono ka makuahine e hōʻike iā ia iho i mea e mālama ai i ka lactation i ka pae i koi ʻia.
Ka mālama ʻana i ka jaundice i nā keiki hānau hou
ʻO ka jaundice physiological o nā keiki hou, e like me kā mākou i ʻōlelo ai, ʻaʻole pono e mālama. I kekahi manawa ʻōlelo nā pediatricians e hoʻohui i kēlā mau keiki me ka wai, akā inā hoʻokumu ʻia ka lactation a me ka hoʻohana ʻana i kahi puna, ʻaʻole i ka hue.
No ka jaundice pathological o kahi keiki hānau hou, pono ia i ka mālama pono, i kuhikuhi ʻia e ke kauka.
ʻO ka lāʻau lapaʻau maikaʻi loa no kēia maʻi i kēia lā he phototherapy. No ka hana ʻana i kēia, e hoʻohana i kahi kukui kūikawā me ke kukui "uliuli": ma lalo o ka mana o ka radiation ultraviolet, ua haki ka bilirubin a hoʻokuʻu ʻia mai ke kino o ke keiki hou me ka mimi a me nā feces. ʻO ka ikaika a me ka lōʻihi o ka phototherapy e pili ana i ke kaumaha o ke kino o ke pēpē i ka hānau ʻana a me ke kiʻekiʻe o ka bilirubin, e nānā mau ʻia. E like me ke kānāwai, ʻekolu mau hola ma lalo o ke kukui i kuhikuhi ʻia me ka hoʻomaha o 2-3 mau hola. Pono e wehe ʻia ke keiki hānau hou, akā pono e pale ʻia nā maka, loaʻa i nā keikikāne nā ʻuhane.
I nā hihia koʻikoʻi o ka jaundice neonatal, i ka wā e pilikia ai ke ola o ke keiki, hiki ke kuhikuhi ʻia ke kahe koko.
- He mea nui e hoʻomaopopo i kēia manawa ua ʻae ka hapa nui o ka poʻe loea i ke koho ʻana i nā sorbents, nā lāʻau lapaʻau e like me phenobarbital, Essentiale, LIV-52, ka hoʻopau ʻana i ka umauma, UV (hoʻonui koko ultraviolet), electrophoresis a i ʻole infusion therapy no ka jaundice ʻaʻole pono ( a no ka phenobarbital a ʻaʻole palekana) - wahi a Anna Levadnaya.
Nā hopena o ka jaundice i nā keiki hānau hou
ʻO ka jaundice physiological o nā keiki hānau hou, e like me kā mākou i ʻike mua ai, maʻa wale ia a ʻaʻole e lawe i nā hopena maikaʻi ʻole no ke olakino o ka pēpē. Akā ʻo nā hopena o ka jaundice pathological i kahi keiki hou hiki ke koʻikoʻi loa, ʻoiai inā ʻaʻole hoʻomaka ka mālama ʻana i ka manawa.
- ʻO ke kiʻekiʻe kiʻekiʻe o ka piʻi ʻana o ka bilirubin i loko o ke koko hiki ke alakaʻi i ka pōʻino lolo, - wahi a Anna Levadnaya. - E like me ke kānāwai, hiki kēia i nā keiki me ka maʻi hemolytic e like me ka Rh factor, me ka piʻi ʻana o ka pae bilirubin ma luna o 298-342 μmol / l. A ʻoi aku ka kiʻekiʻe o ka bilirubin, ʻoi aku ka kiʻekiʻe o ka hopena o ka encephalopathy.
Kāohi i ka jaundice i nā keiki hānau hou
ʻO ka pale maikaʻi loa o ka jaundice neonatal he ola olakino no ka makuahine i ka wā hāpai, haʻalele i nā hana maikaʻi ʻole, ka meaʻai maikaʻi.
He mea nui nō hoʻi ka hānai ʻana. ʻO ka waiū o ka makuahine ka meaʻai maikaʻi loa no kahi keiki hānau hou, maʻalahi loa ia e ʻeli, hoʻoulu ʻia ka ʻōpū me ka wikiwiki, hoʻopiha ʻia me ka microflora pono, a hana ʻia nā enzymes pono. ʻO kēia mau mea a pau e kōkua i ke kino o ke keiki hou e hoʻokō i ka jaundice me ka wikiwiki a me ka maikaʻi.