Bilirubin yog xim daj-xim daj uas yog tsim los ntawm kev puas tsuaj ntawm hemoglobin thiab lwm cov ntshav thiab cov ntshav muaj nyob hauv plasma. Tus qauv ntawm bilirubin nyob rau hauv cov ntshav ntawm ib tus laus thiab ib tus me nyuam mos txawv. Hauv cov laus thiab menyuam yaus loj tshaj 1 lub hlis, nws cov lus sib txawv ntawm 8.5 thiab 20.5 μmol / l. Hauv cov me nyuam yug, qib bilirubin yuav nce mus rau 205 μmol / l lossis ntau dua.
Cov nqi siab ntawm bilirubin hauv cov me nyuam mos yog to taub. Thaum tus me nyuam nyob hauv plab, nws tsis ua pa ntawm nws tus kheej. Oxygen nkag nws cov ntaub so ntswg nrog kev pab ntawm erythrocytes uas muaj fetal hemoglobin (fetal hemoglobin). Tom qab yug, qhov no hemoglobin puas lawm, vim nws tsis tau ntxiv. Yog li ntawd, tus kws kho mob tshiab yuav ua tau cai rau tus menyuam mos. Qhov no yog dawb (dawb) bilirubin, uas yog insoluble, tsis muaj peev xwm raug tso tawm los ntawm ob lub raum thiab yuav circulate nyob rau hauv tus me nyuam cov ntshav kom txog rau thaum nws cov enzyme systems tag nrho ripen. Tom qab ib ntus, thaum cov kab nyuam no nyob hauv cov me nyuam mos tau muaj peev xwm ua hauj lwm, cov kis indirir bilinubin yuav raug xa mus thiab muab tshem tawm ntawm lub cev.
Jaundice ntawm cov menyuam mos
Ua kom paub bilirubin saum tus qauv ua rau pom kev daj ntseg hauv cov me nyuam mos, uas tuaj yeem:
- physiological;
- pathological.
Cev nqaij daim tawv xuab zeb
Nws tshwm sim rau li ntawm 70% ntawm tag nrho cov me nyuam mos, tshwm nyob rau 3-4 hnub thiab nws thiaj li tsis muaj kab uas tsis muaj mob rau lub cev. Qib zis nce siab hauv bilirubin nyob rau hauv cov ntshav ntawm cov me nyuam yug tshiab nyob ntawm qhov kawm tiav ntawm qhov fetus, nrog rau txoj kev xeeb tub nrog leej niam: seb puas muaj kab mob los yog lwm yam teeb meem. Feem ntau tshwm sim ntawm jaundice provokes intrauterine fetal hypoxia, asphyxia, ntshav qab zib ntshav qab zib ntshav qab zib.
Pathological icterus
Nrog ib qho tseem ceeb hauv bilirubin nyob rau hauv cov ntshav hauv cov me nyuam mos muaj cov kev sib daj nuv ntses, qhov uas ua rau:
- incompatibility ntawm leej niam thiab tus me nyuam los ntawm ntshav pawg lossis Rh Factor;
- txhob txwm txiav txim kev rhuav tshem ntawm erythrocytes;
- kis mob rau lub siab;
- mechanical jaundice;
- plab hnyuv txhuam;
- Gilbert's syndrome (kev cai lij choj hepatic dysfunction);
- hormonal ntshawv siab, thiab lwm yam.
Raws li peb pom, muaj ntau ntau yam, thiab tsuas yog ib tus kws kho mob tuaj yeem nkag siab txog lawv xwb.
Ib qho tseem ceeb ntawm txoj kev kuaj mob yog kawm txog ntshav tsom hauv cov me nyuam yug rau bilirubin thiab nws cov zauv. Raws li qhov no thiab lwm yam kev ntsuam xyuas thiab kev ntsuam xyuas, tus kws kho mob yuav kuaj xyuas thiab sau cov kev kho mob uas tsim nyog.
Qhov txaus ntshai ntawm ib theem siab ntawm bilirubin nyob rau hauv ib tug me nyuam mos yog tias nws tsis tuaj yeem cuam tshuam los ntawm cov ntshav albumin thiab nkag mus rau hauv lub hlwb, raug rau nws cov kev mob toxic. Qhov no yog qhov txaus ntshai rau lub hlwb thiab cov hlab ntsha tseem ceeb. Qhov mob no hu ua "bilirubin (nuclear) encephalopathy" thiab ua rau nws tus kheej pib hauv thawj 24 xuab moos tom qab yug me nyuam raws li cov tsos mob nram qab no:
- kev tsaug zog heev;
- txo qhov nqus dej ua kom zoo;
- convulsions thiab motor ntxhov siab;
- txo cov ntshav siab;
- kev loj hlob ntawm daim siab thiab tus po.
Thaum muaj hnub nyoog rau rau lub hlis, tus menyuam yuav hnov pob ntseg, hlwb ruamqauj, tuag tes tuag taw. Yog li, qhov siab tshaj ntawm bilirubin rau cov me nyuam mos yuav tsum tau muaj kev kho mob loj, thiab yav tom ntej, kev soj ntsuam xyuas los ntawm ib tug kws kho paj hlwb.
Yuav ua li cas kom txo tau cov bilirubin hauv ib tus menyuam mos?
Nrog cev nqaij daim tawv xuab moos, qhov zoo tshaj plaws ntawm kev txo cov bilirubin siab yog kev kho lub teeb (fais fab). Nyob hauv qee yam ntawm lub teeb ci, cov kis kabmob hu ua "lumirubin" thiab ua rau tsis pub dhau 12 teev nrog cov quav thiab zis. Tab sis phototherapy yuav muab cov kev mob tshwm sim: tawv nqaij tawv, tso quav, uas kis tau tom qab txoj kev kho mob. Kev tiv thaiv zoo thiab kev kho mob ntawm cev nqaij daim tawv yog ib daim ntawv thov rau lub mis thiab nquag noj mis. Colostrum txhawb nqa lub pob qij txha (thawj quav) ua ke nrog bilirubin.
Hauv cov nqaij daj daj ntseg, ntxiv nrog rau cov kws kho mob thiab ntau zaus pub nrog mis niam, kev kho mob yuav tsum tau siv los kho tus kab mob. Qhov kev kho no yog ua tiav hauv cov menyuam yaus lub tsev kho mob los ntawm neonatologists.
Tsis txhob hnov qab, tus bilirubin siab hauv ib tus menyuam mos yog ib txwm muaj kev kawm txog kev ua tib zoo mloog thiab kev saib xyuas qhov muag.