Nā ʻano o Jaundice

Anter

• He aha nā ʻano ʻokoʻa o ka jaundice?
• ʻO nā mea āpau e pili ana i ka jaundice pre-hepatic
• ʻO nā mea āpau e pili ana i ka jaundice hepatic
• ʻO nā mea āpau e pili ana i ka jaundice post-hepatic
• ʻO nā mea āpau e pili ana i ka jaundice neonatal
• ʻO ka nānā aku

He aha nā ʻano ʻokoʻa o ka jaundice?

Hana ʻo Jaundice ke kūkulu ka nui o bilirubin i kou koko. ʻO kēia e nānā ai i kou ʻili a me nā keʻokeʻo o kou mau maka e melemele.

ʻO Bilirubin kahi pigment melemele i hana ʻia ma ke ʻano he hemoglobin - kahi mahele o nā ʻulaʻula - ua haki.

ʻO ka maʻamau, hāʻawi ʻia ka bilirubin mai ke kahe o ke koko i loko o kou ake. A laila, hele i loko o nā paipu i kapa ʻia nā dole bile. Hāpai kēia mau aniani i kahi mea i kapa ʻia he bile i loko o kāu ʻōpū liʻiliʻi. ʻO ka hopena, ua hala ka bilirubin mai kou kino ma o ka mimi a i ʻole ka noho.

Hoʻokaʻawale ʻia nā ʻano jaundice e kahi e kū ai i loko o ke ake o ke ake o ka lawe ʻana a kānana ʻana i ka bilirubin:

• pre-hepatic: ma mua o ke akepaʻa
• hepatic: i ke akepaʻa
• post-hepatic: ma hope o ke akepaʻa

ʻO nā mea āpau e pili ana i ka jaundice pre-hepatic

Hoʻokumu ʻia ka jaundice pre-hepatic e nā kūlana e hoʻonui ai i ka nui o ke koko o ka hemolysis. ʻO kēia ke kaʻina e wāwahi ʻia ai nā hunaola ʻulaʻula, hoʻokuʻu i ka hemoglobin a lilo i bilirubin.

No ka hiki i ke akepaʻa ke hana i ka bilirubin nui i ka manawa hoʻokahi, holo ka bilirubin i loko o nā aʻa o ke kino.

ʻO nā jaundice pre-hepatic:

• malaria, he maʻi koko i hoʻokumu ʻia e kahi parasite
• anemia maʻi ʻaʻai, kahi ʻano kūpona kahi e lilo ai nā hunaola ʻulaʻula i ʻano crescent ma mua o ke ʻano o ka diski maʻamau
• spherocytosis, kahi ʻano kūʻauhau o ka membrane o ke koko ʻulaʻula e lilo ai i ʻano sphere ma mua o ka disc-shaped
• thalassemia, kahi ʻano kūlohelohe e kumu ai i kou kino e hana i kahi ʻano hemoglobin kūpono ʻole e kaupalena ana i ka helu o nā hunaola ʻulaʻula olakino i kou kahawai

ʻO nā ʻōuli maʻamau o ka jaundice pre-hepatic i:

• abdominal eha
• fiva, me nā haʻalulu a me nā hou anu
• ka pohō kaumaha
• ʻalalā
• mimi ʻeleʻele a i ʻole kahi noho pale

ʻO kekahi mau pilikia no kēia ʻano jaundice:

• hoʻohana lāʻau
• he lālā ʻohana me ka maʻi koko
• hele i nā wahi malaria-endemik

No ke kuhikuhi ʻana i ka jaundice pre-hepatic, e kauoha paha kāu kauka i nā hoʻokolohua aʻe:

• he urinalisis e ana i ka nui o kekahi mau mea i loko o kāu mimi
• hoʻāʻo koko, e like me ka helu piha o ke koko (CBC) a i ʻole nā ​​hoʻokolohua hana ate e ana i ka bilirubin a me nā mea ʻē aʻe i ke koko
• nā hoʻāʻo kiʻi, e like me kahi MRI a i ʻole ultrasound, e nānā i kou ake, kahe, a me nā aʻa o ka bile e kāpae i nā ʻano jaundice ʻē aʻe
• kahi nānā HIDA e kōkua i ka loaʻa ʻana o nā ālai a i ʻole nā ​​pilikia ʻē aʻe i ke akepaʻa, kahe o ke aʻa, nā aʻa aʻa, a me nā ʻōpū liʻiliʻi

E kuhi paha kāu kauka iā ʻoe me ka jaundice pre-hepatic inā ʻaʻohe pilikia me ka bilirubin e hana ʻia e kou ake a i ʻole ma loko o ke kahe o ka gallbladder a me nā biliary.

Hoʻomaopopo ʻia ka hana no ka jaundice pre-hepatic:

No ka malaria:

• nā lāʻau e kōkua ai i ka luku ʻana i ka parasite a pale aku i nā parasites mai ke hoʻopili hou ʻana i kou ake

No ka anemia maʻi paʻakai:

• ke hoʻololi i ke koko mai kahi mea hāʻawi ola
• rehydrating me ka wai hoʻouluulu (IV)
• nā lāʻau no kēlā me kēia maʻi i hiki ke hoʻopilikia i kahi pilikia o ka cell sickle

No ka spherocytosis:

• hua hoʻohui folic acid
• hoʻoliʻiliʻi koko no ka anemia
• ʻoki wehe spleen e kōkua hoʻonui i ke ola o ke koko ʻulaʻula a hoʻohaʻahaʻa i ka manawa o nā gallstones

No ka thalassemia:

• hoʻoliʻiliʻi koko
• hoʻoiho iwi
• ʻoki a me ka ʻoki lāʻau gallbladder

ʻO nā mea āpau e pili ana i ka jaundice hepatic

Hana ka jaundice Hepatic ke wili ʻia kāu aʻa ate (ʻike ʻia ʻo cirrhosis), ʻino, a hana ʻole paha. Hoʻemi iki kēia i ka kānana ʻana i ka bilirubin mai kou koko.

ʻOiai ʻaʻole hiki ke kānana ʻia i loko o kāu ʻōnaehana digestive no ka hemo ʻana, kūkulu ʻo bilirubin i nā kiʻekiʻe kiʻekiʻe i kou koko.

ʻO nā jaundice hepatic nā:

• ate cirrhosis, ʻo ia hoʻi ka makaʻu o nā akepaʻa ate e ka lōʻihi o ke kau ʻana i nā maʻi a i ʻole nā ​​mea ʻona, e like me nā kiʻekiʻe o ka wai ʻona.
• ʻo ka maʻi hepatitis viral, kahi hoʻāhu o ke akepaʻa i hoʻokumu ʻia e kekahi o nā maʻi ʻē aʻe i hiki ke komo i loko o kou kino ma o ka meaʻai, ka wai, ke koko, ka noho, a i ʻole ka pili kolohe.
• ʻO ka cirrhosis biliary mua, kahi e hana ʻia inā hōʻino ʻia nā aʻa o ka bile a ʻaʻole hiki ke hana i ka bile, e hana ana ia i loko o kou ake a hōʻino hoʻi i nā aʻa o ke ake.
• ʻo ka hepatitis ʻona, kahi i hōʻino ʻia kou mau akepaʻa e ka inu nui ʻana o ka wai ʻona i kahi wā lōʻihi
• leptospirosis, he maʻi koʻohune i hiki ke hoʻolaha ʻia e nā holoholona i pā ʻia a i ʻole ka mimi holoholona a i ʻole nā ​​feces
• maʻi ʻaʻai akepau, kahi e hoʻomohala a hoʻonui ai nā hunaola maʻi i loko o nā aʻa ate

ʻO nā ʻōuli maʻamau o ka jaundice hepatic e:

• nalo ʻai ʻole
• ihu koko
• ʻili ʻili
• nāwaliwali
• ka pohō kaumaha
• pehu o kou ʻōpū a mau wāwae paha
• mimi ʻeleʻele a i ʻole kahi noho pale
• ʻeha i kou mau mākala a i ʻole nā ​​ami
• ʻili ʻeleʻele
• fiva
• manaʻo maʻi
• hoʻolei ʻana i luna

ʻO kekahi mau pilikia no kēia ʻano jaundice:

• hoʻohana lāʻau
• inu i ka nui o ka waiʻona ma kahi lōʻihi o ka manawa
• hoʻohana i nā lāʻau i hiki ke hōʻeha i ka ate, e like me ka acetaminophen a i ʻole kekahi mau lāʻau puʻuwai
• nā maʻi mua i pili i kou ake

No ke kuhikuhi ʻana i ka jaundice hepatic, e kauoha paha kāu kauka i nā hoʻokolohua aʻe:

• he urinalisis e ana i nā pae o kāu mimi e pili ana i kāu hana ate
• hoʻāʻo koko, e like me ka helu piha o ke koko (CBC) a me nā hoʻokolohua antibody, a i ʻole nā ​​hoʻokolohua hana ate e ana i ka bilirubin i ke koko a me nā pae o nā mea e hōʻike ana ʻaʻole paha e hana pono kāu ate i ka bilirubin
• nā hoʻāʻo kiʻi, e like me kahi MRI a i ʻole ultrasound, e nānā i kou akepaʻa no ka hōʻino a i ʻole no ke kū ʻana o nā hunaola maʻi ʻea
• he endoscopy, e pili ana i ka hoʻokomo ʻana i kahi ʻōmole lahilahi, kukui i loko o kahi incision liʻiliʻi e nānā i kou ake a lawe i kahi mea kiko (biopsy) inā pono no ke kālailai ʻana no ka maʻi ʻaʻai a i ʻole nā ​​kūlana ʻē aʻe

E kuhi paha kāu kauka iā ʻoe me ka jaundice hepatic inā ʻike lākou i ka hōʻino o nā kiko o ke akepaʻa ma kahi hopena hōʻike kiʻi a ʻike paha i nā pae maʻamau o kekahi mau mea ate, e like me albumin, a i ʻole nā ​​antibodies no nā maʻi a me ka maʻi ʻaʻai.

Hiki i ka mālama ʻana no ka jaundice hepatic ke komo pū:

No ka cirrhosis ate:

• pau ka inu ʻana
• beta-blockers
• intravenous (IV) antibiotics
• he papaʻai haʻahaʻa protein

No ka maʻi hepatitis viral:

• nā lāʻau antiviral
• lāʻau hoʻomaʻi hepatitis
• ka nui o ka hoʻomaha a me nā wai

No ka cirrhosis biliary mua:

• bile acid e kōkua me ka digestion
• lāʻau hoʻohaʻahaʻa bile
• antihistamines like diphenhydramine (Benadryl) no ka ʻili

No ka hepatitis ʻona:

• ka haʻalele ʻana i ka ʻalekohola
• nā mea hoʻopihaʻai pono
• ke kuʻi ate, i nā hihia koʻikoʻi

No ka leptospirosis:

• antibiotics no ka maʻi
• ventilator no ka hanu pilikia
• dialysis no ka hakuʻala hōʻino

No ka maʻi ʻaʻai ate:

• chemotherapy a radiation paha e pepehi i nā hunaola maʻi ʻaʻai
• ʻili hapa o ke ake
• hoʻoliʻiliʻi ate

ʻO nā mea āpau e pili ana i ka jaundice post-hepatic

Hana ʻia ka post-hepatic, a i ʻole ke keʻakeʻa jaundice ke hiki ʻole ke hoʻokahe pono ʻia ka bilirubin i loko o nā aʻa aʻa a i ʻole ka digestive tract ma muli o ka paʻa.

ʻO nā jaundice post-hepatic:

• nā pōhaku ʻaʻā, nā waihona calcium paʻakiki i ka gallbladder i hiki ke ālai i nā aʻa o ka bile
• ʻo ka maʻi ʻaʻai pancreatic, ka hoʻomohala ʻana a hoʻolaha ʻana o nā hunaola maʻi ʻaʻai i ka pancreas, kahi lālā e kōkua i ka hana ʻana i nā mea digestive
• ka maʻi ʻaʻai bile duct, ka hoʻomohala ʻana a hoʻolaha ʻana o nā hunaola maʻi ʻaʻai i loko o kāu mau aʻa
• pancreatitis, kahi mumū a maʻi paha o kāu pancreas
• , kahi ʻano kūlohelohe kahi e loaʻa ai nā kaha bile a hihi paha

ʻO nā ʻōuli maʻamau o ka jaundice post-hepatic i:

• manaʻo maʻi
• hoʻolei ʻana i luna
• mimi ʻeleʻele a i ʻole kahi noho pale
• abdominal eha
• pāhoehoe
• ka pohō kaumaha
• ʻili ʻili
• ʻōpū ʻōpū
• fiva

ʻO kekahi mau pilikia no kēia ʻano jaundice:

• ke kaumaha nui
• ʻai i ka momona momona, momona
• loaʻa ka maʻi diabetes
• ka loaʻa ʻana o ka moʻohelu ʻohana o nā pōhaku ʻeho
• he wahine
• ʻelemakule
• puhipaka nā huahana paka
• inu ʻona nui
• i loaʻa i kahi mumū pancreas ma mua a maʻi paha
• ke waiho ʻia nei i nā kemika ʻoihana

E hōʻoia i ka jaundice post-hepatic, e kauoha paha kāu kauka i nā hōʻike aʻe:

• he urinalisis e ana i nā pae o kāu mimi
• hoʻāʻo koko, e like me ka helu piha o ke koko (CBC) a me nā hoʻokolohua antibody no ka maʻi ʻaʻai, a i ʻole nā ​​hoʻokolohua hana ate e hōʻoki i ka jaundice hepatic
• nā hoʻāʻo kiʻi, e like me kahi MRI a i ʻole ultrasound, e nānā i kou ake, ka paepae, a me nā aʻa o ka bile no nā mea keakea e like me nā gallstones a me nā tumors
• he endoscopy, e pili ana i ka hoʻokomo ʻana i kahi ʻōmole lahilahi, kukui i lalo o ka esophagus e nānā i kou ake, gallbladder, a i ʻole nā ​​dile bile a lawe i kahi laʻana kikoʻī inā pono no ka loiloi no ka maʻi ʻaʻai a i ʻole nā ​​kūlana ʻē aʻe

Inā ʻike kāu kauka i kahi ālai ʻia ma kahi hopena hōʻike hōʻike kiʻi a ʻike paha i nā pae o kekahi mau mea ʻino e hōʻike paha i nā maʻi a i ʻole ka maʻi ʻaʻai, e hōʻoia paha lākou i kāu jaundice ma hope o ka hepatic.

ʻO ka mālama ʻana no ka jaundice post-hepatic e hoʻoponopono i ke kumu. Pākuʻi ʻia kēia:

No nā pōhaku

• ke hoʻololi nei i kāu papaʻai e hoʻōki i ka hana ʻana i nā gallstones
• ka hemo ʻana o nā gallstones a i ʻole kāu gallbladder āpau
• lawe i nā lāʻau a i ʻole nā ​​lāʻau e hoʻonā i nā gallstones

No ka maʻi ʻaʻai pancreatic:

• ʻoki e wehe i nā aʻa maʻi ʻaʻai a i ʻole kāu pancreas holoʻokoʻa
• radiation a chemotherapy e hōʻino ai i nā hunaola maʻi ʻaʻai

No ka maʻi ʻaʻai bile:

• ʻoki e wehe i nā aʻa aʻa a me nā ʻāpana o kou ake a me nā pancreas
• radiation a chemotherapy e hōʻino ai i nā hunaola maʻi ʻaʻai
• hoʻoliʻiliʻi ate

No ka pancreatitis:

• hoʻomaha
• intravenous (IV) fluids a i ʻole ka lāʻau ʻeha
• ʻoki kino e hemo i kekahi kumu o ka lī (e like me nā gallstones)

No ka biliary atresia:

• ke kaʻina hana Kasai e hemo a hoʻololi i nā aʻa
• hoʻoliʻiliʻi ate

ʻO nā mea āpau e pili ana i ka jaundice neonatal

ʻO ka jaundice neonatal kahi ʻano maʻamau o ka jaundice i hiki i nā pēpē hānau hou.

Hānau ʻia ka hapa nui o nā pēpē me ka nui o nā hunaola ʻulaʻula, a no ka hoʻomohala ʻole ʻole ʻia o ke ake, ʻaʻole hiki ke hana koke ʻia ka bilirubin. ʻO ka hopena, loaʻa paha i kāu keiki nā ʻōuli o ka jaundice i kekahi mau lā ma hope o ka hānau ʻia ʻana.

Nā ʻano o ka jaundice neonatal pū me:

• Pilikino. Hana kēia no ka mea ʻaʻole i hoʻokumu ʻia ke akepaʻa i kēia manawa.
• Prematurity. ʻO kēia nā hopena mai ka hānau ʻia ʻana o kahi pēpē a kakahiaka a hiki ʻole i ka poop pololei ʻana i ka bilirubin.
• Hānai umauma. Hana ʻia ka jaundice waiū umauma mai kahi pēpē e pilikia nei i ka hānai ʻana a me ka lawa ʻole o ka waiū waiū.
• Kūlike ʻole ke ʻano koko. ʻO kēia nā hopena mai ka pēpē a me ka makuahine i loaʻa i nā ʻano koko ʻokoʻa, ka mea hiki ke hana i ka makuahine e hana i nā mea ʻino e wāwahi i nā hunaola ʻulaʻula o kāna pēpē.

ʻAʻole pinepine ka jaundice neonatal i kumu no ka hopohopo. Akā inā kūkulu ʻo bilirubin i nā kiʻekiʻe kiʻekiʻe loa, hiki i kāu keiki ke hōʻeha i ka lolo (ʻike ʻia ʻo kernicterus) mai ka bilirubin e komo ana i ka lolo.

E ʻimi i ka lāʻau olakino pōpilikia inā ʻike ʻoe i kekahi o nā hōʻailona ma hope o kāu keiki:

• wā lōʻihi o ka uē kiʻekiʻe ʻana
• hoʻopaʻa ʻana o ko lākou ʻāʻī a me kā lākou kua
• fiva
• hoʻolei ʻana i luna
• pilikia i ka hānai ʻana

ʻO ka nānā aku

ʻO ka manaʻo o Jaundice he nui loa ka bilirubin i loko o kou koko, akā hiki ke loli ke kumu kumu.

E ʻike koke i kāu kauka inā ʻike ʻoe i ka melemele ʻana o kou ʻili a i ʻole ke keʻokeʻo o kou mau maka. Hiki ke mālama ʻia kekahi mau kumu me ka loli o kāu papaʻai a i ʻole ka nohona ʻana, akā pono paha kekahi i kahi ʻoki koke a me ka lāʻau lōʻihi.