Zvizvarwa Zvitsva
Vana vakawanda vanozvarwa vacheche vanova jaundiced-kuwana kuchena kwechivara paganda ravo uye maziso kubva kumusoro kwebilirubin (hyperbilirubinemia).
Kakawanda kazhinji, vana vachangobva kuberekwa ne jaundice yepanyama vachave nejerice levels iyo inodzokera kune yakasarudzwa pasina mushonga. Vanowanzova ne-bilirubin yakawandisa nokuti chiropa chavo chisina simba hachikwanise kuchijekesa iyo nekukurumidza, zvichiita kuti kuwedzerwa kwemazuva maviri neatatu nepamusoro pezuva masikati kana mashanu shure kwekuzvarwa kwavo.
Zvinosuruvarisa, nokuti jaundice dzimwe nguva inogona kusvika pangozi yakakwirira, dzimwe nguva inotungamirira ku kernicterus uye zvichigona kukanganisa kwehuropi, zvinokosha kuti jaundice isingatariswi.
Jaundice Zviratidzo nezviratidzo
Vacheche vanokura jaundice, kuputika kwechivara kweganda ravo uye mutsvuku maziso avo, sezvo bilirubin inowedzera muropa neropa.
Zviratidzo nezviratidzo zvekuti jaundice yengwana inogona kunge iri kusvika kune imwe nzvimbo inokuvadza inogona kusanganisira:
- kurutsa
- lethargy
- kwete kudya zvakanaka
- fever
- kuva nenzwi rakakwirira
- rima mirefu kana zvigadziko
Mhuri yehutachiona hwehujaya hwakaoma inofanirawo kuva chiratidzo chekuyeuchidza kuti mwana angagona kukura marefu jaundice mazingawo.
Jaundice Mishonga
Kuti uone kuti chirwere chinonzi jaundice chikaita sei, serum bilirubin (TSB) yakazara, kuongororwa ropa, kana kuti inonzi transcutaneous bilirubin (TcB) level inogona kuitwa.
Kungotarisa mwana kuti ataridzire kuti jaundice yavo haina kukurudzirwa nokuti haina kururama.
A transcutaneous bilirubin level ndiyo imwe nzira yakanakisisa yekuongorora ropa apo iyo inogona kuitwa, sezvo inongosanganisira kuongorora bharizubin mucheche recheche uchishandisa chigadzirwa chakafanana neBiliCheck mishonga.
Bilirubin mazinga anogona kugadziriswa paawa-specific nomogram kuti ibatsire kuziva kana mwana achida kurapwa, izvo zvinowanzowanzobatanidza kupora kwepototherapy, zvakare inonzi inorapwa.
Phototherapy inoshandisa chidimbu chiduku chechiedza chebhuruu kubatsira mwana kuti atende bilirubin muzvigadzirwa zvinogona kuderedzwa mumugina uye bile. Mukuwedzera kune tsika yepamusoro yebhangi phototherapy iyo inowanzoitwa muchipatara, vana vejeriundi dzimwe nguva vanobatwa ne biliblankets (a fiberoptic pad) kana paBilibed. Pamba phototherapy dzimwe nguva inorondedzerwa kune avo vacheche vasati vava pangozi yekugadzira jaundice inogona kusvika pangozi yakakwirira.
Imwe mishonga yemakemikari akawandisa ejoundice ndiyo kuwedzerwa kwekushandura, iyo yakawanda yakatarwa yeropa remwana inobviswa uye yatsiviwa neropa rakapiwa.
Jaundice Zvinyorwa
Kuti ubatsire kudzivirira maitiro akaoma ejerice, AAP inokurudzira kuti:
- Vana vanoyamwisa vanoyamwisa vanokwana 8 kusvika 12 pazuva kwemazuva ekutanga mushure mekuberekwa kwecheche uye vachidzivisa zvipembenene zvemuviri nemvura kana shuga
- vana vachangoberekwa vanogara vachiongororwa kuti vawane jaundice muimba yekuchengeta vana maawa masere kusvika pa12
- chirwere chejerize chinofanira kuongororwa kana mwana achionekwa jaundiced vasati vakura maawa makumi maviri nemaviri
- vana vanove nemazinga avo ebhelirubin anoongororwa munguva yekusunungurwa kubva muimba yevana kuitira kuti mwana agone kuongororwa nekuda kwengozi yekuve nejerice yakanyanya
Chinonyanya kukosha, vana vose vanofanira kuonekwa nevana vavo mukati memazuva mashomanana ekubudiswa kubva muimba inochengetedza uremu hwavo, kubva muzana kubva pakuberekwa kwekuberekwa, uye panjodzi yejerice inotariswa. Uku kushanyirwa kwekutanga kune chiremba wevana kunokosha kuitira kuti kuwandisa kwekurema uye kukwirira kwejerice hakusipo.
Izvi zvinonyanya kukosha kune vacheche vane humwe huwandu hunokonzerwa nehuwandu hwehutachiona, kusanganisira vana vacheche, vana vacheche vane dambudziko rekudya, kushungurudzika kukuru kana cephalohematoma, kana rudzi rwemusiyano rwakasiyana kubva kuna amai vavo (ABO kana kuti Rh kusagadzikana).
Zvimwe Zvingagadziriswa zveJaundice
Dzimwe nzira dzokugadzirisa nayo jaundice dzinofanira kudziviswa.
Imwe mishonga yemusha yakagadzirwa ne jaundice iyo inofanira kudziviswa ndiyo kuisa mumwana wako muzuva. Mukuwedzera kune chiedza chebhuruu chinowanikwa muhutano hwephototherapy, zuva rinobudisawo mwana wako ku ultraviolet chiedza uye chiedza chinonzi infrared. Uye nguva shomanana iyo mwana wako angangobvumira kushivirira kwezuva iri haazoiti chinhu kumapundu ake ejeri.
Maererano neAAP, "zvinetso zvinobatanidzwa pakuvhura zvakachengeteka mucheche asina kupfeka zuva kana mukati kana kunze (uye kudzivirira kushandura kwezuva) zvinodzivisa kushandiswa kwezuva sechigadzirwa chechokwadi chekurapa."
Zvinokonzera Jaundice
Mukuwedzera kune utachiona hwehutano hwemucheche, mamwe marudzi e jaundice anosanganisira:
- Kuyamwisa jaundice - jaundice inonyanya kuipa nekuda kwehurombo husina kuwanikwa kana kupa mucheche usingawaniki muvhiki yekutanga yekutanga, zvichiita kuti mvura isakanganise uye kuwedzerwa kuora muviri.
- chifuva chema jaundice - kusiyana nekuyamwisa jaundice, vana ava vanoyamwisa uye vane mazoro ejerice anokwanisa kugara kwemwedzi miviri kana mitatu.
- Gilbert's syndrome - chimiro chinogona kukonzera zvinyoro zvishoma zvejerice zvinouya uye zvichienda mwana paanorwara, kunyange nezvirwere zvishoma, kushandisa zvinodhaka, kana pasi pemamwe marudzi ekutambudzika
- Chirwere cheNicgler-Nijjar - chisingawanzo chimiro chetachiona chinogona kukonzera matambudziko ehupenyu nejerice nekuda kwekusakwana kwakakwana kana kusarura kwe enzyme inoputsa bilirubin muropa
- chirwere chehemolytic - mamiriro ezvinhu anotungamirira kumasero matsvuku eropa achibvarura, achibudisa bilirubin yakawedzerwa, yakadai seropa rekusawirirana, sreditrophetosis, uye kushaya G6PD, nezvimwewo.
Uyezve, vana vaduku nevana vanogona kuwana jaundice kubva kune zvimwe zvinokonzera, kusanganisira hepatitis, kushandiswa kwemishonga, uye mono.
Sources:
American Academy of Pediatrics Policy Statement. Kutungamirirwa kweHyperbilirubinemia muMucheche Mucheche 35 kana Mamwe Mavhiki eGestation. Pediatrics 2004; 114: 1 297-316.
Burke, Bryan L. Trends mu Hospitalzations yeNeonatal Jaundice neKernicterus muUnited States, 1988-2005. Pediatrics February 2009; 123: 2 524-532.
Newman, Thomas B. Kuongorora uye Kuchengetedzwa kweJaundice muKuberekwa Kusingaperi: A Kinder, Gentler Approach. Pediatrics 1992; 89: 5 809-818.
Maisels, et al. Hyperbilirubinemia muchechecheche Mutsva ≥35 Mavhiki 'Gestation: Chirongwa Nekujekeswa. PEDIATRICS Bhuku 124, Nhamba 4, Gumiguru 2009