He aha ke kumu a pehea e mālama ai i ka hyperbilirubinemia neonatal

Anter

• Nā kumu nui
• 1. ʻO ka ʻōnaehana Physiological jaundice
• 2. Jaundice i ka waiū umauma
• 3. Nā maʻi koko
• 4. Nā maʻi akepaʻa
• Pehea e hana ai i ka phototherapy

ʻO ka Hyperbilirubinemia o ka hānau hou a neonatal paha kahi maʻi i hōʻike ʻia i nā lā mua o ke ola o ka pēpē, e ka hōʻiliʻili ʻia o bilirubin i ke koko, a melemele ka ʻili.

Hiki i kēlā me kēia keiki ke hoʻomohala i ka hyperbilirubinemia, ke kumu nui e hoʻololi ʻia i ke ʻano o ka hana ate, nā maʻi o ke koko, e like me ka hemolytic anemia, nā maʻi o ke akepaʻa, nā kumu o nā maʻi a me nā maʻi kūlohelohe, a i ʻole nā ​​hopena i ka hānai umauma ʻana. E nānā pū i nā kumu o ka bilirubin kiʻekiʻe a me ka jaundice i nā mākua.

ʻO ka mālama e hōʻemi i ka nui o ka bilirubin i ke koko e pono e hoʻomaka koke ʻia, a ʻo ka lapaʻau me ka phototherapy ka mea e hoʻohana nui ʻia. I kekahi mau hihia, pono paha ka hoʻohana ʻana i nā lāʻau a i ʻole ke kōpō ʻana o ke koko, a ua aʻo ʻia e ka pediatrician.

Nā kumu nui

Hana ʻo Jaundice ke hiki ʻole i ka pēpē ke hoʻopau pono i ka bilirubin, i hana ʻia e ka metabolism o ke koko, no ka mea, ma mua o ka hānau ʻana, hana ka placenta i kēia hana. ʻO nā kumu nui o ka hyperbilirubinemia hānau hou:

1. ʻO ka ʻōnaehana Physiological jaundice

Hana pinepine ia ma hope o 24 a 36 mau hola o ka hānau ʻana, ʻo ia ka ʻano maʻamau o ka jaundice, ʻoiai ke hoʻomohala maikaʻi ʻole ʻia nei ka ate o ka pēpē a loaʻa paha kekahi mau pilikia i ka hoʻololi ʻana a me ka hoʻopau ʻana i ka bilirubin mai ke koko ma o ka bile. Hoʻoholo maʻamau kēia hoʻololi i kekahi mau lā, me ka mālama ʻana me ka phototherapy a me ke kū ʻana i ka lā.

• Pehea e mālama ai: Phototherapy me ka malamalama fluorescent mea pono e hōʻemi i ka nui o ka bilirubin i loko o ke koko. I nā hihia maʻalahi, lawa paha ka hōʻike ʻana i ka lā, akā i nā hihia koʻikoʻi loa, pono ke koko a hoʻohana paha i nā lāʻau, e like me phenobarbital, e pono ai e loaʻa nā hopena maikaʻi aʻe. Maopopo ka ʻike ʻana pehea e mālama ʻia ai ka jaundice physiological o ke keiki hānau hou.

2. Jaundice i ka waiū umauma

Kēia ʻano o ka hoʻonui i ka bilirubin hiki ke hana ma kahi o 10 mau lā ma hope o ka hānau ʻana, i kekahi mau pēpē e hānai wale ana i ka hānai, ma muli o ka hoʻonui ʻana o nā hormones a i ʻole nā ​​mea i loko o ke koko e hoʻonui ai i ka resorption o bilirubin i loko o ka ʻōpū a kāohi i kona hoʻopau ʻana, ʻoiai ʻaʻole ke ʻike nei naʻe i ke ʻano kikoʻī.

• Pehea e mālama ai: i nā hihia ʻoi aku ka nui o ka jaundice nui, hiki ke hana i ka phototherapy e kāohi i nā pae o ke koko, akā ʻaʻole pono e hoʻōki ʻia ka hānai ʻana i ka waiū ke ʻole ke kuhikuhi ʻia e kahi kauka. E nalo maʻamau kēia jaundice ma kahi o ka lua a ʻekolu paha o ka malama o ka pēpē.

3. Nā maʻi koko

Hiki i kekahi mau maʻi ke hōʻiliʻili i ka pēpē bilirubin, e like me ka autoimmune a i ʻole nā ​​loli kūlohelohe, a hiki ke koʻikoʻi a kū i nā hola mua ma hope o ka hānau ʻana. ʻO kekahi mau maʻi he spherocytosis, thalassemia a i ʻole incompatibility me ke koko o ka makuahine, ʻo kahi laʻana, akā ʻo ka mea nui ka maʻi hemolytic o ka hānau hou, a ʻo ka erythroblastosis fetal kekahi.

• Pehea e mālama ai: i ka hoʻohui ʻana i ka phototherapy e kaohi i ka nui o ka bilirubin i ke koko, hana maʻamau ʻia me ka transfusion o ke koko a, i kekahi mau hihia, hiki i nā lāʻau ke hana i ka pale ʻana i ka pale.

4. Nā maʻi akepaʻa

Hiki ke hānau ʻia ke pēpē me nā loli o ka hana ate, ma muli o nā kumu he nui, e like me nā deformities bile duct, cystic fibrosis, rubella congenital, hypothyroidism kūpuna, nā maʻi e nā mea ʻino a me nā koʻohune, a i ʻole nā ​​syndrome genetika, e like me Crigler-Najjar syndrome, Gilber a me ka maʻi Gaucher, no ka laʻana.

• Pehea e mālama ai: e kaohi i ke koko hyperbilirubinemia, me phototherapy, lawe ʻia nā lāʻau e hoʻomaikaʻi i ka maʻi i kumu e hoʻonui ai ka bilirubin, e like me ka mālama ʻana i ka maʻi me nā lāʻau ʻalopika, ke ʻoki e hoʻoponopono ai i nā malformations o ke ake a i ʻole ka hoʻololi hormonone i ka hypothyroidism, no ka laʻana.

ʻO ka mālama ʻana e hōʻemi i ka bilirubin i hoʻonui nui ʻia o ke kino, ʻo ia hoʻi ka phototherapy, pono e hana koke ma hope o ka ʻike ʻana i ka loli, ʻoiai ʻo ka bilirubin nui i loko o ke kino o ka pēpē hiki ke hana i nā pilikia koʻikoʻi, e like me ka lāʻau ʻona i kapa ʻia ʻo kernicterus, ka mea e kuli ai, hopu ʻia, koma a make.

Pehea e hana ai i ka phototherapy

ʻO ka Phototherapy ka waiho ʻana o ka pēpē i ke kukui uila, polū maʻamau, no kekahi mau hola, i kēlā me kēia lā, a hiki i ka hoʻomaikaʻi ʻana. No ka hopena o ka lāʻau, pono e hōʻike piha i ka ʻili o ka pēpē i ka mālamalama, akā ʻaʻole pono e hōʻike i nā maka, no laila uhi ʻia kahi lole a aniani kūikawā paha.

Hoʻopili ke kukui i ka ʻili e hoʻonāukiuki i ka luku a me ka hoʻopau ʻana o ka bilirubin ma o ka bile, e nalo liʻiliʻi ana i ka jaundice a me ke kala melemele.

E aʻo hou e pili ana i ka hana ʻana a me nā hōʻailona ʻē aʻe no ka hoʻohana ʻana i ka phototherapy.