Izinsana ezisanda kuzalwa
Izinsana eziningi ezisanda kuzalwa ziba yi-jaundiced-zithola ukuhlunga okwesibhakabhaka esikhumbeni sabo naselweni kusuka emazingeni aphezulu we-bilirubin (hyperbilirubinemia).
Ngokuvamile, izingane ezisanda kuzalwa ne-jaundice yemvelo ziyoba namazinga e-jaundice abuyela ejwayelekile ngaphandle kokwelashwa. Ngokuvamile bane-bilirubin eningi kakhulu ngoba isibindi sabo esingafaki sikwazi ukuyihlwitha ngokushesha, okuholela ezingeni elikhulayo ezinsukwini ezimbili nantathu nokuphakama ngosuku ngosuku lwamahlanu emva kokuzalwa.
Ngeshwa, ngoba ama-jaundice ngezinye izikhathi angafika emazingeni aphezulu ngokuyingozi, ngezinye izikhathi aholela ekernicterus kanye nokulimala kwengqondo, kubalulekile ukuthi i-jaundice inganakwa.
Izimpawu ze-Jaundice nezimpawu
Izingane zakha i-jaundice, ukuhlunga okuphuzi kwesikhumba sabo kanye nezingxenye ezimhlophe zamehlo abo, njengoba i-bilirubin yakha egazini nasesikhumba.
Izimpawu nezimpawu zokuxwayisa ukuthi i-jaundice yengane ingase ifike ezingeni eliphakeme eliyingozi ingafaka:
- ukuhlanza
- ubuqili
- hhayi ukudla kahle
- umkhuhlane
- ukukhala okukhulu
- umchamo omnyama noma izibani ezikhanyayo
Umlando womndeni we-jaundice obukhulu kufanele futhi ube yisixwayiso sokuthi ingane ingahlakulela amazinga aphezulu e-jaundice futhi.
Ukwelashwa kwe-Jaundice
Ukuze unqume izinga lomntwana we-jaundice, isamba se-serum bilirubin (TSB), ukuhlolwa kwegazi, noma izinga le-transcutaneous bilirubin (TcB) lingenziwa.
Ukumane nje ubheke ingane ukulinganisa izinga labo le-jaundice alikhuthazwa ngoba alikho kahle.
Izinga le-transcutaneous le-bilirubin liyingxenye enhle yokuhlolwa kwegazi uma kungenzeka, njengoba kuhilela ukucacisa izinga le-bilirubin esikhumbeni somntwana usebenzisa idivayisi efana nomshini we-BiliCheck.
Amazinga e-Bilirubin angahle ahlelwe ku-nomogram eyihora elilodwa ukusiza ukuthi unqume ukuthi ngabe ingane idinga ukwelashwa, okuvame ukubandakanya i-phototherapy evamile, ebizwa nangokuthi ukwelashwa okulula.
I-Phototherapy isebenzisa umthamo omncane wokukhanyisa okwesibhakabhaka ukusiza ingane ukuthi iguqule i-bilirubin ibe yizinhlobo ezingasetshenziswa emgqeni nasebheni. Ngaphandle kwe-phototherapy yasebhange ejwayelekile kabili eyenziwa esibhedlela, izinsana ze-jaundiced ngezinye izikhathi ziphathwa nge-biliblankets (i-fiberoptic pad) noma kwi-Bilibed. I-home phototherapy ibuye isetshenziswe ngezinye izikhathi kulabo bantwana abangekho engozini enkulu yokuthuthukisa i-jaundice engase ifinyelele emazingeni aphezulu ngokuyingozi.
Olunye ukwelashwa kwamazinga aphezulu kakhulu we-jaundice yi-transfusion yokushintshaniswa, lapho inani elinqunyelwe khona legazi lomntwana lisuswe futhi lifakwa esikhundleni segazi elizinikele.
Izincomo ze-Jaundice
Ukuze usize ukuvimbela amacala aqinile we-jaundice, i-AAP itusa ukuthi:
- Amantombazane ancelisayo ancelisa okungenani izikhathi eziyi-8 kuya kwezingu-12 ngosuku ngezinsuku ezimbalwa zokuqala ngemva kokuzalwa komntwana futhi agweme izithako ezivamile ngamanzi noma emashukela
- Izingane ezisanda kuzalwa zihlolwe njalo nge-jaundice ekliniki okungenani amahora angu-8 kuya kwangu-12
- izinga le-jaundice kufanele lihlolwe uma umntwana ebonakala e-jaundiced ngaphambi kokuba abe namahora angu-24 ubudala
- Izingane zinezinga le-bilirubin lihlolwe ngesikhathi sokukhishwa e-nursery ukuze ingane ihlolwe ngengozi yabo yokuthuthukisa i-jaundice enamandla
Okubaluleke kakhulu, zonke izingane kufanele zibonwe udokotela wezingane ezinsukwini ezimbalwa zokukhishwa ezikhungweni ukuze zibeke isisindo, amaphesenti ashintshe kusuka kwesisindo sokuzalwa, futhi ingozi yokuhlolwa kwe-jaundice ihlolwe. Ukuvakasha kokuqala kudokotela wezingane kubalulekile ukuze ukulahlekelwa kwesisindo ngokweqile namazinga aphezulu we-jaundice aphuthelwa.
Lokhu kubaluleke kakhulu ezinganeni ezinengozi eyengeziwe yokuthuthukisa izinga eliphezulu le-jaundice, kubandakanya izinsana zokubeletha, izinsana ezinenkinga yokudla, ukulimala okukhulu noma i-cephalohematoma, noma uhlobo lwegazi oluhlukile kumama wabo (ABO noma i-Rh incompatibilities).
Ezinye izixazululo zokwelashwa
Ezinye izindlela zokwelapha ze-jaundice kufanele zigwenywe.
Ikhambi elijwayelekile lasekhaya le-jaundice okufanele ligwenywe lifaka ingane yakho ilanga. Ngaphezu kokukhanya okwesibhakabhaka okufakwe ku-phototherapy ejwayelekile, ukukhanya kwelanga kubonisa ingane yakho ekukhanyeni kwe-ultraviolet nokukhanya kwe-infrared. Futhi isikhathi esifushane ingane yakho engase sikwazi ukubekezelela ngayo ukukhanya kwelanga ngeke kwenzeke emazingeni akhe e-jaundice.
Ngokusho kwe-AAP, "izinkinga ezingokoqobo ezihilelekile ekudaluleni ngokuphepha umntwana osanda kuzalwa ngaphakathi noma ngaphandle (nokugwema ukushisa kwelanga) kungavimbela ukusetshenziswa kwelanga njengethuluzi lokuthenjelwa elithembekile."
Izimbangela zeJaundice
Ngaphezu kwe-jaundice yemvelo yengane, ezinye izinhlobo ze-jaundice zihlanganisa:
- Ukuncelisa i-jaundice - i-jaundice ehamba phambili ngenxa yokuhlinzeka ngesifuba esingenamsoco noma ukunakekelwa okunganele ngokwedlulele ngesonto lokuqala, okuholela ekudambisweni kwemvelo nokulahlekelwa ngokweqile kwesisindo.
- isisu se-jaundice - ngokungafani ne-jaundice yokuncelisa, lezi zinsana ziyayinakekela kahle futhi zibe namazinga omzimba we-jaundice ongahlala isikhathi ezinyangeni ezimbili noma ezintathu.
- I-Gilbert's syndrome - isimo sezakhi zofuzo ezingabangela amazinga omzimba we-jaundice oza nokuya lapho ingane igula, ngisho nezifo ezincane, ukuzivocavoca ngokweqile, noma ngaphansi kwezinye izinhlobo zokucindezeleka
- I-Crigler-Nijjar syndrome - isimo esingavamile sezakhi zofuzo ezingabangela izinkinga zokuphila nge-jaundice ngenxa yokuntula okuphelele noma okuncane kwe-enzyme ephula i-bilirubin esibindi
- izifo ze-hemolytic - izimo eziholela kumangqamuzana egazi abomvu aphule phansi, ukukhulula i-bilirubin eyengeziwe, njengokungalingani kwegazi, i-spherocytosis yefa, nokuntuleka kwe-G6PD, njll.
Futhi-ke, izinsana nezinsana ezindala zingathola i-jaundice kwezinye izimbangela, kuhlanganise nesifo sofuba, ukusabela kwezidakamizwa, kanye ne-mono.
Imithombo:
Isitatimende Somgomo Wezemfundo yase-American Academy. Ukuphathwa kwe-Hyperbilirubinemia ku-Infants 35 entsha noma amaviki amaningi okuGestation. I-Pediatrics 2004; 114: 1 297-316.
Burke, Bryan L. Amathrendi e-Hospitalizations for Jaonce neonatal ne-Kernicterus e-United States, 1988-2005. Izifo zengqondo ngoFebhuwari 2009; 123: 2 524-532.
U-Newman, Thomas B. Ukuhlola Nokuphathwa Kwe-Jaundice Kwisigodi Esisha: I-Kinder, Indlela Yokusebenzisa I-Gentler. Izingane zokwelapha 1992; 89: 5 809-818.
Maisels, et al. I-Hyperbilirubinemia Emntwaneni Osanda Kuzalwa • Ukugujwa Kwemaviki angu-35: Ukuvuselelwa Ngezingcaciso. I-PEDIATRICS Umqulu 124, Inombolo 4, Okthoba 2009