Kernicterus vacheche: zviratidzo, migumisiro uye kurapwa

Kernicterus kunoitika achangoberekwa ose rechitatu. Izvi zvemamiriro ezvinhu kunoitika icteric ganda nokuda kwazvo okuyerera zvakadai zvinhu sezvo bilirubin.

In inowanzotorwa neHurumende neonates muviri decays Chizenga uye bilirubin kugadzirwa, asi vangangokundikana umo chiropa haakwanisi ribude zvose kuumbwa bilirubin. Kuchikuvadza fuma anopinda muropa, bata zvakaipa pamusoro masero mumuviri uye tsinga. Bilirubin ndiye yenyukireya kwechirwere, ndokusaka chirwere zita rayo.

The pathogenesis uye etiology chirwere

The matambudziko bilirubin muuropi uye tsinga kunogona pakutsvaga wevasungwa ane fuma muropa. Panguva yakaoma pamwero 425 micromoles kuchimuka chirwere inonzi kernicterus vachangoberekwa. It rinongoshandisirwa renguva rokuti vacheche. Kana kuberekwa chamboitika izwi, ipapo exponential notation ipfupi. Muchiitiko chino, kuderedza padanho simba intrauterine hypoxia ari mudumbu uye zvirwere zvakasiyana-siyana.

Mukuwedzera, kusapindirana kweropa vomwana namai ndiwo unotokonya chinhu kukura kernicterus. Pane kupesana kusapindirana kweropa ropa zvinhu.

Nei muviri wemwana rinoungana bilirubin

Bilirubin - a fuma kuti inoonekwa somugumisiro kubudiswa Chizenga muviri wemwana. Pane mhando mbiri nyaya: soluble uye insoluble. Forms bilirubin vane mumwe reshiyo mumuviri, izvo vaiona kuipa, ndiko 1 kusvika 3. chiropa vatendeuka insolubilizing fuma iri soluble hwabviswa muviri dzinongoitika nzira chete weti uye mutsvina yadzo.

Vachangoberekwa chiropa simba, uye naizvozvo, kugadzira DZEMUNHU DZINODZORA. Somugumisiro, ruvara rwacho zvishoma nezvishoma rinoungana, asina kupatsanurwa, ipapo kernicterus. Migumisiro chirwere ichi vari kwazvo.

Term uye preterm Vana zvarinoita chitsama dzinonetsa pamwero wenyika bilirubin muropa. Musiyano zvakafanana 100 micromolar. Musiyano uyu imhaka mamiriro rusvava panyama - mune vakurumidze vana vane yakaderera nokuberekwa uremu havasi dzakabudirira zvomukati zvakazara, saka seiyi kubudiswa bilirubin. Muna 80% kuti zviitiko vakurumidze kuzvarwa vakacherechedza kernicterus.

zviratidzo

Iva chirwere mukati vhiki imwe. Kana hemolytic jaundice kwakasimbiswa mwana, chirwere kunooneka pacharo chitarisiko rimwe zuva pashure.

Kana nekukudziridza zvenyukireya neonatal jaundice, zviratidzo achivaratidza izvozvo, angava sezvinotevera:

• The unopinza kudzikira mune vakawanda mamiriro ezvinhu mwana.
• Mwana vakachengeta convulsive chinzvimbo kana kufema.
• Kwokunze kuongororwa kunoratidza kuvapo hyper tsandanyama.
• The kuzivikanwa kernicterus anongoerekana richiswedera shure musoro shure.
• With mberi nzira hosha asingabatwi mupfungwa underdevelopment.
• Clinical zviratidzo kernicterus anogona kupupura kuti musoro achangozvarwa pfungwa maronda.

The kwaita kernicterus: Zvinokonzera

The chikuru pezvikonzero chirwere zvinosanganisira:

• Kurwisana kusapindirana kweropa chinokonzera ropa mwana namai, kuti ndiro boka ropa haisi dzichienderana.
• Yokushomeka mumuviri achangoberekwa mavhitaminzi vakaita K, uyewo migumisiro iri mudumbu nedzimwe mishonga ufungisise mai panguva yepamuviri.
• Generic hematoma mune mwana.
• Kushaikwa okisijeni kuti mudumbu kana kururama muviri.
• Genetic kubatwa.
• Underdeveloped nhengo dzomukati.

Kana pamusoro-kugadzirwa bilirubin mu vacheche vakachengeta jaundice ruvara ganda. Zviratidzo kernicterus mune zvinenge zvose zvakafanana. Zvaringana kuongorora mwana kubudikidza Cramer kutonga: jaundice yemichindwe, tsoka uye dumbu vari kusaririra achangoberekwa tsvuku.

Migumisiro kernicterus

Migumisiro yacho chirwere angava akasiyana, vose nyaya nguva uye ingapedza nenguva kernicterus. Pangava pave encephalopathy, uye mune yepamusoro nyaya haasaruri kusanzwa uye upofu. Uyezve, pasina nenguva kurapa kunowedzera ngozi uropi, ndoupiko unonyanya zvikuru mugumisiro kernicterus.

Kukurirwa uropi vana chinovatadzisa vane simba, regai kupindura kuitika, uye kunyange inzwi vabereki.

Panoongororwa wokutanga zviratidzo jaundice kunofanira kugadziriswa pachishandiswa nenyanzvi, achakubatsira kusimbisa kana ndeyenhema zviratidzo.

unyanzvi hanya

Makore mashoma apfuura kuti kurapa kernicterus kushandiswa shuga uye zvimwe zvinodhaka isashande. In mushonga ano, kupfuura inowanzoshandiswa nzira phototherapy - nezvemidzimu pamusoro pomuviri achangoberekwa zvimwe radiations zvinobva rinokosha rambi. Kuburikidza nemwaranzi bilirubin iri shoma chepfu hwabviswa muviri sezvingatarisirwa, i.e. weti uye faeces.

Kuitira kudzivisa migumisiro yakaipa pamusoro kernicterus, pashure pokuberekwa ropa rinotorwa kuti ongororo. Research chiri kuitwa kuti kuziva uwandu bilirubin muropa mwana. Kana yakawandisa fuma vanotumirwa mishonga chaiyo, kuwedzera muitiro vachibvisa chepfu ruvara. Kana mwana ari pangozi yokuva, ipapo akaita chimwe-nguva sumo yomunyika plasma.

Kana kernicterus kunowedzera, plasma anogadzirwa donhwe aizomupa pachiimbwa phototherapy. Kana pasina kuvandudzika zvinokosha kushandisa zvizere ropa.

In pamberi kernicterus mwana ari pasi pokudzora chiremba wetsinga. It anoita ichi nyanzvi vapore kurapa kunobatsira kudzorera hwakakanganisika mabasa.