Nā hōʻailona o ka jaundice

Ma waho aʻe o kona hopena aesthetic, ʻaʻohe hopena pathological ka hoʻololi ʻana i ke kala o nā integuments (ʻili a me nā mucous membranes). Ma muli o nā kumu o ka jaundice, hiki ke pili i nā hōʻailona ʻē aʻe, e hiki ai ke kuhikuhi i ka maʻi: ʻeha ʻōpū, kuni, ʻili, luhi, ʻeha hui, etc.

ʻO ka bilirubin manuahi, no laila ʻaʻole i "conjugated" i loko o ke ake, he mea ʻawaʻawa i ka lolo. I nā keiki hānau hou, ʻo kona hōʻiliʻili ʻana i ka nui he mea pōʻino loa ia no ka lolo a pono e mālama koke.

He aha nā kumu?

Ma waho aʻe o ka ʻona o ka bilirubin manuahi no ka lolo (neurotoxicity), i ka hapa nui o nā hihia, ʻo nā kumu o ka jaundice e hoʻoholo i ka prognosis, benign a koʻikoʻi paha ma muli o ka hihia. Pēlā nō, ʻokoʻa ka mālama ʻana ma muli o ke kumu o ka jaundice. No laila, pono ka ʻike pololei. No ka hana ʻana i kēia maʻi, hoʻohana nā kauka i ka hoʻokolohua lapaʻau mua, kahi hoʻāʻo koko a me ka ultrasound o ka ʻōpū. Pono paha nā ʻimi ʻē aʻe: CT scan, MRI, cholangiography, endoscopy, biopsy, etc.

No ka mea he hōʻailona ka jaundice a ʻaʻole he maʻi, ʻaʻole ia e lele.

ʻO ka maʻamau, ʻelua ʻano ʻano jaundice:

• ʻO ia paha ka hoʻonui ʻana o ka bilirubin manuahi
• A i ʻole hiki ke hoʻohui ʻia ka bilirubin.

I ka hihia mua, i ka wā o ka hoʻonui ʻana i ka bilirubin manuahi, pili paha ka nui i ka luku nui ʻana o nā ʻulaʻula ʻulaʻula (hemolysis) a i ʻole ka conjugation maikaʻi ʻole o ka bilirubin i loko o ke ake. ʻO ke kūlana mua e hoʻoulu pinepine ai i ka anemia (hoʻemi i ka pae hemoglobin) a hiki ke hōʻike i kahi maʻi koko, a i ʻole kahi maʻi, kahi kumu lāʻau, pōʻino immunological, etc.

I ka hihia o ka jaundice ma muli o ka piʻi ʻana o ka bilirubin conjugated, pili pinepine ka jaundice i kahi maʻi genetic (maʻi ʻo Gilbert) me ka lawa ʻole o ka conjugation o bilirubin. ʻO kēia maʻi o Gilbert a i ʻole Gilbert's Syndrome he maʻi ma ka hapa nui o nā hihia.

ʻO ka lua o ka hihia, inā ʻoi aku ka nui o ka bilirubin conjugated, hoʻonui ʻia ka hoʻopau ʻana i loko o ka mimi e lawe ana i kahi kala ʻeleʻele e pili ana i ka wehe ʻana o ka ʻōpū. Hiki ke kānalua ʻia nā ʻano kumu ʻelua. ʻO ka mea mua, ka pōʻino o ke ake (hepatitis, cirrhosis, parasitosis, etc.) a i ʻole kahi keʻakeʻa ma nā aʻa bile maanei  ka pale ʻana i ka hoʻopau ʻana i ka bilirubin. I kēia hihia hope loa, ke ʻimi nei mākou i ka helu ʻana, ke kāohi ʻana i ke ala, no kahi maʻi maʻi kūloko e hoʻopiʻi ana i nā auwai bile…

ʻO ka hihia kūikawā o ka jaundice i nā pēpē

I loko o ke keiki hānau hou, aia kekahi mau kumu o ka jaundice e pili ana i kēia wā o ke ola.

ʻAʻole lawa ke akepaʻa i kekahi manawa e hoʻohui i ka bilirubin. Eia nō naʻe, piʻi nui ka mea hope no ka mea pono ke "hoʻololi" i kāna hemoglobin fetal no ke ʻano makua, kahi e hoʻopau ai i nā ʻāpana koko ʻulaʻula he nui i ka manawa pōkole, kahi mea hiki ke kumu o ka jaundice.

Hiki ke ʻike ʻia ka jaundice ma ka waiu makuahine i nā pēpē hānai umauma.

ʻO ka hiki ʻole o ke koko ma waena o ka fetus a me kona makuahine ke kuleana no ka luku ʻana i nā ʻulaʻula ʻulaʻula a no laila no ka hōʻiliʻili ikaika o ka bilirubin. ʻO kēia ka hihia inā he Rh negative ka makuahine a he Rh maikaʻi kāna keiki. A laila, pale ka makuahine i ka Rhesus factor i loko o kāna pēpē a hana i nā antibodies e hele i loko o ka placenta e hoʻopau i nā ʻāpana koko ʻulaʻula o ka pēpē. I ka wā ʻaʻole i hānau ʻia ke keiki, hoʻopau ʻia ka bilirubin e ka placenta, akā, ma hope o ka hānau ʻana, hoʻoulu ʻia ka jaundice.

Ma waho aʻe o nā kumu ʻē aʻe e pili ana i nā maʻi congenital, ʻo nā hematomas koʻikoʻi e hiki ke hana i ka wā hānau keiki hiki ke hoʻokuʻu i ka nui o ka hemoglobin a no laila. i ka hopena bilirubin.

Nā lāʻau no ka jaundice

ʻAʻole hiki ke pale i ka jaundice i nā hihia āpau. Eia naʻe, ʻae ka mālama ʻana i kekahi mau kumu e kaupalena ʻia.

Eia nā hana e pale ai i ka hoʻomaka ʻana o nā maʻi e hiki ai i ka jaundice. 

• ʻO ka inu waiʻona haʻahaʻa,
• Kiʻi ʻia i ka maʻi hepa B a i ʻole A,
• E moe kolohe,
• E mālama i nā lula maʻemaʻe i nā ʻāina i ka pilikia o ka hoʻouna ʻana by Food,
• E hōʻalo i ka hoʻokē ʻai a i ʻole ka wai maloʻo inā loaʻa iā ʻoe ka maʻi maʻi o Gilbert.

ʻO ka mālama ʻana i ka jaundice ʻo ia ke kumu: 

• I kekahi manawa ʻaʻole pono ka mālama ʻana: ʻo ia ka hihia i ka maʻi hoʻoilina o Gilbert, hiki ke hoʻoulu i ka jaundice maʻamau ʻaʻole koʻikoʻi, ʻoi aku hoʻi i ka wā o ka hoʻokē ʻai a i ʻole dehydration.
• I nā kūlana ʻē aʻe, ʻo ka hopena o ke kumu e alakaʻi ai i ka jaundice (hepatitis, resorption of hematomas, etc.).
• I ka jaundice waiu o ka makuahine, me ka hoʻomehana ʻana i ka hopena i 60 ° C, a i ʻole ke hoʻololi ʻana i ke ʻano, hoʻoholo maʻamau i ke kūlana.
• I ka jaundice "physiological" o ke keiki hānau hou, ʻo ka ʻike ʻana i ke kukui uliuli e hoʻomaʻamaʻa i ka hoʻopau ʻana i ka bilirubin. I kekahi manawa ʻaʻole lawa kēia ana a, hāʻawi ʻia i ka pilikia neurological, pono ia e hana i kahi exsanguino-transfusion (ua hoʻololi ʻia ke koko o ke pēpē a hoʻololi ʻia me ka transfusion). - I nā hihia ʻē aʻe, koi ʻia ke ʻoki (nā pōhaku, nā ʻōpū), a i ʻole ka lawelawe ʻana i nā lāʻau lapaʻau kūikawā (nā maʻi, nā maʻi koko, ka maʻi kanesa).