Isifo senyongo esisandul 'ukuzalwa

I-jaundice esanda kuzalwa yenzeka xa umntwana enenqanaba eliphezulu le-bilirubin egazini. IBilirubin yinto etyheli eyenziwa ngumzimba xa ithatha indawo yeeseli ezibomvu ezindala zegazi. Isibindi sinceda ukwahlula into ukuze isuswe emzimbeni kwisitulo.

Inqanaba eliphezulu le-bilirubin lenza ulusu lomntwana kwaye abamhlophe bamehlo babonakala batyheli. Oku kubizwa ngokuba yi-jaundice.

Kuqhelekile kwinqanaba le-bilirubin yomntwana ukuba liphakame kancinci emva kokuzalwa.

Xa umntwana ekhula esibelekweni sikanina, i-placenta isusa i-bilirubin emzimbeni womntwana. Umkhaya ngumzimba okhula ngexesha lokukhulelwa ukondla umntwana. Emva kokuzalwa, isibindi somntwana siqala ukwenza lo msebenzi. Kungathatha ixesha ukuba isibindi somntwana sikwazi ukwenza oku ngokufanelekileyo.

Uninzi lweentsana ezisandul 'ukuzalwa lunomthubi wolusu, okanye ijundisi. Oku kubizwa ngokuba yi-jaundice yomzimba. Ihlala iqapheleka xa umntwana eneentsuku ezi-2 ukuya kwezi-4 ubudala. Amaxesha amaninzi, ayibangeli ngxaki kwaye iyahamba kwiiveki ezi-2.

Iindidi ezimbini ze-jaundice zinokwenzeka kwiintsana ezisandula ukuncanciswa. Zombini ezi ntlobo zihlala zingenabungozi.

• Ukuxiliswa kwe-jaundice kubonwa kwiintsana ezincancisayo ngeveki yokuqala yobomi. Kunokwenzeka ukuba kwenzeke xa iintsana zingancancisi kakuhle okanye ubisi lukanina lucotha ukuza, kukhokelela ekuphelelweni ngumzimba.
• Ubisi lwebele lwe-jaundice lunokubonakala kwezinye ezisempilweni, kwiintsana ezanyisayo emva komhla wesi-7 wobomi. Kungenzeka ukuba iphakame ngexesha leveki yesi-2 neye-3, kodwa inokuhlala kumanqanaba asezantsi inyanga okanye nangaphezulu. Ingxaki inokubangelwa yindlela izinto ezisebisini lobisi ezichaphazela ngayo ukwehla kwe-bilirubin esibindini. Ubisi lwebele lwe-jaundice luhlukile kunokuncancisa i-jaundice.

I-jaundice esandula ukuzalwa inokwenzeka ukuba umntwana unemeko eyonyusa inani leeseli ezibomvu zegazi ekufuneka zitshintshwe emzimbeni, ezinje:

• Ubume beeseli zegazi ezingaqhelekanga (ezinjengearheng cell anemia)
• Uhlobo lwegazi olungafaniyo phakathi kukamama nosana (ukungahambelani kweRh okanye ukungahambelani kweABO)
• Ukopha phantsi kwe-scalp (cephalohematoma) okubangelwa kukuhanjiswa okunzima
• Amanqanaba aphezulu eeseli ezibomvu zegazi, exhaphake kakhulu kubantwana abancinci-kubudala bokukhulelwa (SGA) kunye namawele
• Usulelo
• Ukungabikho kweeproteni ezithile ezibalulekileyo, ezibizwa ngokuba zii-enzymes

Izinto ezenza kube nzima kumzimba womntwana ukususa i-bilirubin kunokukhokelela kwi-jaundice ebaluleke ngakumbi, kubandakanya:

• Amayeza athile
• Usulelo lukhona ngexesha lokuzalwa, njenge-rubella, igcushuwa, kunye nezinye
• Izifo ezichaphazela isibindi okanye i-biliary tract, enjenge-cystic fibrosis okanye i-hepatitis
• Inqanaba leoksijini ephantsi (hypoxia)
• Usulelo (sepsis)
• Uninzi lweengxaki zofuzo okanye ilifa

Iintsana ezizalwe kwangoko kakhulu (ngaphambi kwexesha) zinethuba lokuphuhlisa i-jaundice kuneentsana ezisisigxina.

I-jaundice ibangela umbala otyheli wolusu. Ihlala iqala ebusweni ize ihle iye esifubeni, kwindawo yesisu, emilenzeni, nasezinyaweni zeenyawo.

Ngamanye amaxesha, iintsana ezine-jaundice ezinzima zinokudinwa kakhulu kwaye zondle kakubi.

Ababoneleli ngononophelo lwempilo baya kujonga iimpawu ze-jaundice esibhedlele. Emva kokuba usana olusandul 'ukuzalwa lugoduke, amalungu osapho ahlala eyibona i-jaundice.

Naluphi na usana olubonakala njenge-jaundiced kufuneka lube namanqanaba ebilirubin alinganiswe kwangoko. Oku kunokwenziwa kuvavanyo lwegazi.

Izibhedlele ezininzi zijonga amanqanaba onke e-bilirubin kubo bonke abantwana malunga neeyure ezingama-24 ubudala. Izibhedlele zisebenzisa iinkqubo ezinokuthi ziqikelele inqanaba le-bilirubin ngokuthinta ulusu. Ukufundwa okuphezulu kufuneka kuqinisekiswe kuvavanyo lwegazi.

Iimvavanyo ezinokuthi zenziwe zibandakanya:

• Gcwalisa ubalo lwegazi
• Uvavanyo lweCombombs
• Ukubala kweReticulocyte

Olunye uvavanyo lunokufuneka kwiintsana ezifuna unyango okanye inqanaba le-bilirubin elipheleleyo likhula ngokukhawuleza kunokuba bekulindelwe.

Unyango alufuneki amaxesha amaninzi.

Xa unyango lufuneka, uhlobo luya kuxhomekeka:

• Inqanaba lebilirubin yomntwana
• Ukukhawuleza kwenqanaba kuye kwenyuka
• Nokuba umntwana wazalwa kwangoko (abantwana abazelwe kwangoko kunokwenzeka ukuba baphathwe kumanqanaba asezantsi e-bilirubin)
• Umdala kangakanani umntwana

Umntwana uya kufuna unyango ukuba inqanaba le-bilirubin liphezulu kakhulu okanye likhula ngokukhawuleza.

Umntwana one-jaundice kufuneka athathe ulwelo oluninzi ngobisi lwebele okanye ifomula:

• Yondle umntwana rhoqo (ukuya kuthi ga kwali-12 ngemini) ukukhuthaza ukuhamba rhoqo kwamathumbu. Oku kunceda ukususa i-bilirubin kwizitulo. Buza umboneleli wakho ngaphambi kokunika umntwana wakho usana olongezelelekileyo ifomula eyongezelelweyo.
• Kwiimeko ezinqabileyo, umntwana unokufumana ulwelo olongezelelekileyo nge-IV.

Abanye abantwana abasandul 'ukuzalwa bafuna ukunyangwa ngaphambi kokuba baphume esibhedlele. Abanye banokufuna ukubuyela esibhedlele xa baneentsuku ezimbalwa ubudala. Unyango esibhedlele kuhlala iintsuku ezi-1 ukuya kwezi-2.

Ngamanye amaxesha, izibane ezizodwa eziluhlaza okwesibhakabhaka zisetyenziselwa iintsana ezinamanqanaba aphezulu kakhulu. Ezi zibane zisebenza ngokunceda ekwaphuleni i-bilirubin eluswini. Oku kubizwa ngokuba yi-phototherapy.

• Usana lubekwa phantsi kwezi zibane kwibhedi efudumeleyo, evaliweyo ukugcina ubushushu obungagungqiyo.
• Usana luya kunxiba kuphela ilweyile kunye neeleta ezikhethekileyo zokukhusela amehlo.
• Ukuncancisa kufuneka kuqhubeke ngexesha lokufota, ukuba kunokwenzeka.
• Kwiimeko ezinqabileyo, umntwana unokufuna umgca we-intravenous (IV) ukuhambisa ulwelo.

Ukuba inqanaba le-bilirubin alikho phezulu kakhulu okanye alinyuki ngokukhawuleza, ungenza i-phototherapy ekhaya ngengubo ye-fiberoptic, enezibane ezincinci kuyo. Unokusebenzisa ibhedi ekhanyisa ukukhanya kumatrasi.

• Kuya kufuneka ugcine unyango olukhanyayo kulusu lomntwana wakho kwaye wondle umntwana wakho rhoqo kwiiyure ezimbini ukuya kwezintathu (amaxesha ali-10 ukuya kwali-12 ngosuku).
• Umongikazi uza kuza ekhayeni lakho azokufundisa indlela yokusebenzisa ingubo okanye ibhedi, nokujonga umntwana wakho.
• Umongikazi uya kubuya mihla le ukujonga ubunzima bomntwana wakho, ukondliwa kwakhe, ulusu, kunye nenqanaba lebilirubin.
• Uya kucelwa ukuba ubale inani lamanabukeni amanzi namdaka.

Kwiimeko ezinzima kakhulu ze-jaundice, ukutshintshwa kwegazi kuyadingeka. Kule nkqubo, igazi lomntwana lithathelwa indawo ligazi elitsha. Ukunika i-immunoglobulin efakwa ngaphakathi kwiintsana ezine-jaundice eqatha nako kunokusebenza ukunciphisa amanqanaba e-bilirubin.

I-jaundice esanda kuzalwa ayinabungozi kumaxesha amaninzi. Kwiintsana ezininzi, i-jaundice iya kuba bhetele ngaphandle konyango kwisithuba seeveki ezi-1 ukuya kwezi-2.

Inqanaba eliphezulu kakhulu le-bilirubin linokonakalisa ingqondo. Oku kubizwa ngokuba yi-kernicterus. Imeko iphantse yafunyanwa phambi kokuba inqanaba libe phezulu ngokwaneleyo ukwenza lo monakalo. Unyango luhlala lusebenza.

Rare, kodwa iingxaki ezinzulu ezivela kumanqanaba aphezulu e-bilirubin zibandakanya:

• Umvakalelo yokitazo
• Izithulu
• I-Kernicterus, eyonakalisa ingqondo kumanqanaba aphezulu kakhulu e-bilirubin

Zonke iintsana kufuneka zibonwe ngumboneleli kwiintsuku zokuqala ezintlanu zobomi ukujonga i-jaundice:

• Iintsana ezichitha ngaphantsi kweeyure ezingama-24 esibhedlele kufuneka zibonwe zineminyaka engama-72.
• Iintsana ezithunyelwa ekhaya phakathi kweeyure ezingama-24 ukuya kuma-48 kufuneka ziphinde zibonwe zineminyaka engama-96.
• Iintsana ezithunyelwa ekhaya phakathi kweeyure ezingama-48 nezingama-72 kufuneka ziphinde zibonwe zineminyaka engama-120.

I-jaundice ingxamisekileyo ukuba umntwana unefiva, uye wangabinalo uluhlu, okanye akatyi kakuhle. I-jaundice ingaba yingozi kwiintsana ezisengozini.

I-jaundice ngokubanzi ayisiyongo kwiintsana ezizelwe ixesha elipheleleyo kwaye zingenazo ezinye iingxaki zonyango. Tsalela umnikezeli wosana ukuba:

• IJaundice inzima (ulusu lukhanyayo mthubi)
• I-jaundice iyaqhubeka nokwanda emva kotyelelo olusandul 'ukuzalwa, ihlala ngaphezulu kweeveki ezi-2, okanye ezinye iimpawu zikhula
• Iinyawo, ngakumbi iinyawo, zilubhelu

Thetha nomboneleli wakho womntwana ukuba unemibuzo.

Kwiintsana ezisandul 'ukuzalwa, inqanaba elithile le-jaundice liqhelekileyo kwaye mhlawumbi alinakukhuselwa. Umngcipheko we-jaundice enzulu unokuhlala uncitshiswa ngokondla abantwana ubuncinci ama-8 ukuya kwali-12 amaxesha ngemini kwiintsuku zokuqala kunye nokuchonga ngononophelo iintsana ezisemngciphekweni omkhulu.

Bonke abasetyhini abakhulelweyo kufuneka bavavanyelwe uhlobo lwegazi kunye neentsholongwane ezingaqhelekanga. Ukuba umama uneRh negative, uvavanyo lokulandelela kwintambo yosana luyacetyiswa. Oku kungenziwa kwakhona ukuba uhlobo lwegazi lukamama liyi-O positive.

Ukubeka iliso ngononophelo kuzo zonke iintsana kwiintsuku ezintlanu zokuqala zobomi kunokuthintela uninzi lweengxaki ze-jaundice. Oku kubandakanya:

• Ukuqwalasela umngcipheko womntwana we-jaundice
• Ukujonga inqanaba le-bilirubin kusuku lokuqala okanye njalo
• Ukucwangcisa utyelelo lokulandelela kube kanye kwiveki yokuqala yobomi yeentsana ezithunyelwe ekhaya zivela esibhedlele kwiiyure ezingama-72

Ijusi yomntwana osandul 'ukuzalwa; Neonatal hyperbilirubinemia; Izibane zeBili - inyongo; Ulusu lweentsana - tyheli; Usana olusanda kuzalwa - ulusu olutyheli

• Isifo senyongo esanda kuzalwa - ukubhobhoza
• Isifo senyongo esisandul 'ukuzalwa - yintoni ongayibuza ugqirha wakho

• I-Erythroblastosis fetalis - ifotomicomic
• Usana olugqityiweyo
• Utshintshiselwano lotshintshiselwano- uthotho
• I-jaundice yabantwana

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