Mea Kākau: Monica Porter
Lā O Ka Hana: 21 Malaki 2021
HōʻAno Hou I Ka Lā: 23 Nowemapa 2024
Anonim
Jaundice - causes, treatment & pathology
Wikiō: Jaundice - causes, treatment & pathology

Anter

He aha ka hoʻokolohua koko bilirubin?

ʻO Bilirubin kahi pigment melemele i loko o ke koko a me ka pahu o kēlā me kēia. Hoʻoholo kahi hōʻike bilirubin i ke kiʻekiʻe o ka bilirubin i ke kino.

I kekahi manawa ʻaʻole hiki i ke akepaʻa ke hana i ka bilirubin i ke kino. Hiki i kēia ke kumu o ka nui o bilirubin, kahi ālai, a mumū paha o ke ake.

Ke loaʻa ka bilirubin i kou kino, e melemele kou ʻili a me nā keʻokeʻo o kou mau maka. Kapa ʻia kēia ʻano he jaundice.

E kōkua kahi hōʻoia bilirubin e hoʻoholo inā loaʻa kekahi o kēia mau ʻano.

Hana ʻia ʻo Bilirubin i loko o ke kino ke wāwahi ʻia ka protein hemoglobin i nā hunaola ʻulaʻula kahiko. ʻO ka haki ʻana o nā pūnaewele kahiko kahi hana olakino maʻamau.

Ma hope o ke kaapuni ʻana i kou koko, holo ka bilirubin i kou ake.

I ke akepaʻa, hana ʻia ka bilirubin, kāwili ʻia i loko o ka pā, a laila excreted i loko o nā aʻa aʻa a mālama ʻia i loko o kāu gallbladder.

ʻO ka hopena, hoʻokuʻu ʻia ka pā i loko o ka ʻōpū liʻiliʻi e kōkua i ka hoʻoulu ʻana i nā momona. Hoʻopau ʻia ia i loko o kāu pahu.


ʻO Bilirubin i hoʻopili ʻia e ke akepaʻa i ka waikawa glucuronic, kahi waikawa i loaʻa mai i ka glucose, i kapa ʻia ʻo bilirubin pololei. Kāhea ʻia ʻo Bilirubin pili ʻole i ka waikawa glucuronic i kapa ʻia a i ʻole pili ʻole, bilirubin. Kāhea ʻia ka bilirubin āpau i loko o kou koko.

E loaʻa i kahi hōʻoia bilirubin koko piha kahi helu pololei o nā pae bilirubin ʻekolu i loko o kou koko: pololei, pololei ʻole, a me ka huina.

I nā mākua a me nā keiki, hiki i nā ʻōuli e pili ana i ka bilirubin kiʻekiʻe ke hoʻopili i ka jaundice, kahi melemele o ka ʻili a i ʻole nā ​​maka, luhi, ʻili ʻili, mimi ʻeleʻele, a me ka ʻai haʻahaʻa.

Nā kumu maʻamau e hōʻoia no bilirubin

Inā pili ʻole ʻia ka bilirubin i ka waikawa i loaʻa mai i ka glucose (hoʻopili ʻia) i ke akepaʻa a i ʻole ka lawe ʻia ʻana mai ke koko, hiki ke manaʻo he hōʻino i kou ake.

ʻO ka hoʻāʻo ʻana no ka bilirubin i ke koko no laila he ala maikaʻi loa no ka hoʻāʻo ʻana no ka hōʻino o ke ake.

Ma muli o nā loli maʻamau o ka metabolism o bilirubin, a i ʻole he hōʻailona mua ia no ka pilikia olakino.


Inā kiʻekiʻe loa ka pae ma ka hānau ʻana, e hoʻāʻo ʻia ke koko o kahi pēpē i nā manawa he nui i nā lā mua o ko lākou ola e nānā i ka hana ate. Jaundice i loko o kahi hānau hou hiki ke koʻikoʻi a hoʻoweliweli ke ola inā haʻalele ʻole ʻia.

ʻO kekahi kumu o nā pae bilirubin kiʻekiʻe i hiki ke hoʻopau ʻia nā hunaola koko ʻulaʻula ma mua o ka maʻamau. Kapa ʻia kēia he hemolysis.

I kekahi manawa ana ʻia ka bilirubin ma ke ʻano he ʻāpana o kahi "panela" o nā hoʻokolohua. ʻO ka manawa pinepine, loiloi ʻia ke akepaʻa me kahi hui o nā hoʻokolohua pū pū kekahi:

  • alanine transaminase
  • aspartate aminotransferase
  • alkaline phosphatase
  • albumin
  • huina protein

Pehea e hana ai i ka hoʻokolohua koko bilirubin?

Pono kahi liʻiliʻi o kou koko e hana i kēia hoʻokolohua. Loaʻa ka laʻana o ke koko ma o ka venipuncture: Hoʻokomo ʻia kahi nila i loko o kahi aa i loko o ka ʻili i kou lima a lima paha, a ʻohi ʻia kahi hapa liʻiliʻi o ke koko i kahi pahu hōʻike.

Pehea wau e hoʻomākaukau ai no ka hoʻokolohua koko bilirubin?

No kēia hoʻāʻo, ʻaʻole ʻoe e ʻai a inu i kekahi mea ʻē aʻe ma mua o ka wai no ʻehā mau hola ma mua o ka hoʻokō ʻia ʻana o ka hōʻike. Hiki iā ʻoe ke inu i kāu nui o ka wai ma mua o ka hele ʻana i ka hale hana a me ka pūnaewele hōʻiliʻili.


Hiki paha iā ʻoe ke kāpae i ka lawe ʻana i kekahi mau lāʻau i mua o ka hōʻike ʻia ʻana, akā inā ʻōlelo ʻia e kāu kauka e hana pēlā.

ʻO nā laʻana o nā lāʻau i hiki ke hoʻopili i nā pae bilirubin e komo pū me nā antibiotic e like me ka penicillin G, nā mea hoʻohiehie e like me phenobarbital, diuretics e like me furosemide (Lasix), a me nā lāʻau lapaʻau hānō e like me theophylline.

Nui nā lāʻau ʻē aʻe i hiki ke hoʻohuli i nā pae bilirubin. E kamaʻilio me kāu kauka ma mua o kāu hōʻoia e ʻike inā pono ʻoe e kū a hoʻomau i ka lawe ʻana i ka lāʻau.

He aha nā pilikia o ka hoʻokolohua koko bilirubin?

Ke hōʻiliʻili ʻia ke koko, ʻike paha ʻoe i kahi ʻeha kaulike a i ʻole ʻano ʻūlū. Ma hope o ka lawe ʻia ʻana o ke kui kuhi, ʻike paha ʻoe i kahi ʻano throbbing.

E kauoha ʻia ʻoe e noi i ka kaomi i ka pūnaewele kahi i komo ai ka nila i kou ʻili. E hoʻokau ʻia kahi bandage ma luna o ka pūnaewele. E hoʻomau i kēia kāʻei ma 10 a 20 mau minuke.

Pono ʻoe e hōʻalo i ka hoʻohana ʻana i kēlā lima no ka hāpai hāpai kaumaha no ke koena o ka lā.

Aia kekahi mau pilikia nui loa i ka lawe ʻana i kahi laʻana koko.

  • ʻālohilohi a maʻule paha
  • hematoma, he ʻeha kahi e hōʻiliʻili ai ke koko ma lalo o ka ʻili
  • maʻi, pale pinepine ʻia e ka ʻili i hoʻomaʻemaʻe ʻia ma mua o ka hoʻokomo ʻia ʻana o ka nila
  • ke kahe nui ʻana o ke kahe, a i ʻole ke kahe ʻana no kahi wā lōʻihi ma hope, kahi e hōʻike ai i kahi kūlana kahe o ke kahe nui a pono e hōʻike ʻia i kāu kauka

He aha ka hopena maʻamau no ka hoʻokolohua koko bilirubin?

I kahi keiki makua a makua paha, nā waiwai maʻamau o ka bilirubin pololei mai 0-0.4 milligrams no deciliter (mg / dL). ʻO nā kumukūʻai maʻamau o ka bilirubin huina mai 0.3-1.0 mg / dL.

ʻO ka pae bilirubin kūlike ʻole i ke kahena o ka huina bilirubin i hoʻemi ʻia i nā pae bilirubin pololei i ke kahe o ke koko. Hoʻohui ʻia, ʻokoʻa paha nā pae kuhikuhi maʻamau mai ka lab a lab.

I kahi hānau hou, maʻamau ka bilirubin kiʻekiʻe ma muli o ke koʻikoʻi o ka hānau ʻana. Aia ka bilirubin kūlohelohe maʻamau ma lalo o 5.2 mg / dL i loko o nā hola 24 mua o ka hānau ʻana. Akā he nui nā keiki hānau hou i loaʻa i kekahi ʻano jaundice a me nā pae bilirubin e piʻi aʻe ma luna o 5 mg / dL i loko o nā lā mua ma hope o ka hānau ʻana.

Nā kumu o nā hopena maʻamau

Makemake paha kāu kauka e hana hou i nā hoʻokolohua koko a i ʻole kahi ultrasound inā ʻike ʻia nā kiʻekiʻe o ka bilirubin i kou koko. I ke kanaka makua, pili ka bilirubin kiʻekiʻe ma muli o nā pilikia me ke ake, nā aʻa o ka bile, a me ka gallbladder. ʻO nā laʻana me:

  • nā maʻi ate, e like me ka maʻi hepa
  • ʻO Gilbert Syndrome, he maʻi maʻi
  • cirrhosis, ka ʻili o ke ake
  • biliary strure, kahi ʻāpana o ke aʻa o ka bile i hāiki loa e ʻae ai i ka wai e hele
  • Ka maʻi ʻaʻai o ka gallbladder a i ʻole pancreas
  • pōhaku ʻalā
  • lāʻau hoʻowahāwahā lāʻau

ʻO ka bilirubin kiʻekiʻe paha ma muli o nā pilikia i ke koko ma kahi o nā pilikia i ke ake. Hiki ke kumu ʻia nā hunaola koko e hōʻeha ʻia e:

  • Hemolytic anemia: Kū kēia ke luku ʻia nā keena koko he nui loa mai kahi maʻi autoimmune, kīnā genetika, lāʻauʻona lāʻau, a i ʻole maʻi, a ʻaʻole hiki i ke akepaʻa ke hoʻopili i ka nui o ka bilirubin kūloko ʻole i ke kino.
  • Ka hopena transfusion: Kū kēia i ka wā e hoʻouka ai kāu ʻōnaehana pale i ke koko i hāʻawi ʻia iā ʻoe ma o kahi transfusion.

ʻO ka jaundice pēpē

I kahi pēpē, hiki i ka bilirubin kiʻekiʻe a me ka jaundice ke weliweli loa a hiki ke kumu ʻia e nā kumu he nui. ʻEkolu ʻano maʻamau:

  • physiological jaundice: ma ʻelua a ʻehā mau lā ma hope o ka hānau ʻana, ma muli o ka lohi o ka hana ʻana o ke ake a ʻaʻole koʻikoʻi.
  • hānai umauma jaundice: i ka hebedoma mua o ke ola, i hoʻokumu ʻia e kahi pēpē i hānai ʻole ʻole a i ʻole ka waiū haʻahaʻa i ka makuahine
  • jaundice waiū umauma: ma hope o ʻelua a ʻekolu mau pule o ke ola, i hoʻokumu ʻia e ka hana ʻana i kekahi mau mea i ka waiū umauma

Hiki ke mālama maʻalahi ʻia i kēia mau mea āpau a ʻaʻole maʻa ʻole inā mālama ʻia. ʻO kekahi mau kūlana koʻikoʻi i kumu i ka bilirubin kiʻekiʻe a me ka jaundice i loko o kahi pēpē.

  • nā kinona kūlohelohe o ke koko, e like me ka anemia maʻi maʻi
  • kūlike ʻole ke ʻano koko ma waena o ka pēpē a me ka makuahine, e alakaʻi ana i ka haki nui o nā hunaola ʻulaʻula o ke pēpē, i kapa ʻia ʻo erythroblastosis fetalis
  • ka nele o kekahi mau proteins koʻikoʻi ma muli o nā kīnā kīnā
  • paopao ma muli o ka hāʻawi paʻakikī
  • nā pae kiʻekiʻe o nā hunaola ʻulaʻula ma muli o ka liʻiliʻi, prematurity
  • nā maʻi maʻi

He aha ka hana ma hope o kahi hoʻokolohua koko bilirubin

Inā hōʻike kāu hōʻike i kou koko i nā kiʻekiʻe kiʻekiʻe o ka bilirubin, kauoha paha kāu kauka i nā hoʻokolohua hou aku e hoʻoholo ai i ke kumu kumu.

I ka manawa i hoʻoholo ai kāu kauka i kahi kumu o nā pae bilirubin kiʻekiʻe, pono ʻoe e lawe hou i nā hoʻokolohua koko bilirubin e nānā i ka maikaʻi o kāu lapaʻau.

Inā manaʻo kāu kauka ʻaʻole hiki i kāu ake a i ʻole gallbladder ke hana pono, kauoha paha lākou i nā hoʻokolohua kiʻi ʻana e hōʻoia i ka loaʻa ʻole o nā hanana kūpono ʻole.

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