I-Bilirubin encephalopathy

I-Bilirubin encephalopathy yimeko enqabileyo yemithambo-luvo eyenzeka kwezinye iintsana ezine-jaundice eqatha.

I-Bilirubin encephalopathy (BE) ibangelwa ngamanqanaba aphezulu kakhulu e-bilirubin. I-Bilirubin ngumbala omthubi owenziwe njengoko umzimba ulahla iiseli ezibomvu zegazi ezindala. Amanqanaba aphezulu ebilirubin emzimbeni anokubangela ukuba ulusu lubukeke lutyheli (jaundice).

Ukuba inqanaba le-bilirubin liphezulu kakhulu okanye umntwana ugula kakhulu, loo nto iya kuphuma egazini ize iqokelele kwizicwili zobuchopho ukuba ayibophelelwanga kwi-albumin (protein) esegazini. Oku kunokukhokelela kwiingxaki ezinjengokwenzakala kwengqondo kunye nokulahleka kwendlebe. Igama elithi "kernicterus" libhekisele kwibala elityheli elibangelwa yi-bilirubin. Oku kubonakala kwiindawo zengqondo kwi-autopsy.

Le meko ihlala ikhula kwiveki yokuqala yobomi, kodwa inokubonwa kude kube yiveki yesithathu. Abanye abantwana abasandul 'ukuzalwa abane-Rh hemolytic isifo basengozini enkulu ye-jaundice enokubangela le meko. Rhoqo, i-BE inokukhula kwiintsana ezibonakala zisempilweni.

Iimpawu zixhomekeke kwinqanaba le-BE. Ayizizo zonke iintsana ezine-kernicterus kwi-autopsy ezineempawu ezithile.

Inqanaba lokuqala:

• I-jaundice egqithisileyo
• Isimanga sokucinga
• Ukungondli kakuhle okanye ukuncancisa
• Ubuthongo obukhulu (ubuthongo) kunye neethoni eziphantsi zemisipha (hypotonia)

Inqanaba eliphakathi:

• Isikhalo esiphakamileyo
• Ukucaphuka
• Usenokuba ubuyile umva ngentamo ixutywe ngasemva, ithoni ephezulu yemisipha (hypertonia)
• Ukutya okungalunganga

Inqanaba lokugqibela:

• Isiporho okanye isiqaqa
• Akukho kutya
• Shrill ukukhala
• Ukuqina kwemisipha, okuphawulwe ngokuqaqanjelwa ngumqolo ngentamo exutywe ngasemva
• Ukuxhuzula

Uvavanyo lwegazi luya kubonisa inqanaba eliphezulu le-bilirubin (ngaphezulu kwama-20 ukuya kuma-25 mg / dL). Nangona kunjalo, akukho khonkco lithe ngqo phakathi kwenqanaba le-bilirubin kunye nenqanaba lokulimala.

Amaxabiso esiqhelo ahluka kancinci phakathi kweelebhu ezahlukeneyo. Thetha nogqirha wakho malunga nentsingiselo yeziphumo zakho zovavanyo.

Unyango luxhomekeke ekubeni umntwana uneminyaka emingaphi (ngeyure) kwaye nokuba ingaba umntwana unazo naziphi na izinto ezinobungozi (njengokukhula ngaphambi kwexesha). Ingabandakanya:

• Unyango olukhanyayo (i-phototherapy)
• Utshintshiselwano lotofelo (ukususa igazi lomntwana kwaye endaweni yalo kufakwe igazi lomnikeli okanye iplasma)

I-BE yimeko embi. Uninzi lweentsana ezinesigaba sokugqibela seenkqubo zovalo ziyafa.

Iingxaki zinokubandakanya:

• Ukonakala okungapheliyo kwengqondo
• Ukuphulukana nokuva
• Ukufa

Fumana uncedo lwezonyango kwangoko ukuba umntwana wakho uneempawu zale meko.

Ukunyanga i-jaundice okanye iimeko ezinokukhokelela kuyo kunokunceda ukunqanda le ngxaki. Iintsana ezineempawu zokuqala ze-jaundice zinenqanaba le-bilirubin elinganiswa kwiiyure ezingama-24. Ukuba inqanaba liphezulu, usana kufuneka luhlolwe izifo ezibandakanya ukutshatyalaliswa kweeseli ezibomvu zegazi (hemolysis).

Bonke abantwana abasandul 'ukuzalwa banokuqeshwa emva kwentsuku ezimbini ukuya kwezintathu emva kokuba bemkile esibhedlele. Oku kubaluleke kakhulu ngaphambi kwexesha lokugqibela okanye kwiintsana zokuqala (ezizalwe ngaphezulu kweeveki ezi-2 ukuya kwezi-3 ngaphambi komhla wazo).

I-Bilirubin-indased neurologic dysfunction (BIND); IKernicterus

• Isifo senyongo esanda kuzalwa - ukubhobhoza

• IKernicterus

IHamati AI. Iingxaki ze-neurological zesifo se-systemic: abantwana. Ku: Daroff RB, Jankovic J, Mazziotta JC, Pomeroy SL, ii-eds. I-Neurology kaBradley kwiKlinikhi yokuziqhelanisa. Umhla wesi-7. IPhiladelphia, PA: Elsevier; Ngo-2016: isahluko 59.

IHensen TWR. IPathophysiology yekernicterus. Ku: Polin RA, Abman SH, Rowitch, DH, Benitz WE, Fox WW, ii-eds. I-Physology yoSana kunye neNzalo. Umhla we-5. IPhiladelphia, PA: Elsevier; Ngo-2017: isahluko 164.

UKaplan M, uWong RJ, uSibley E, uStevenson DK. Isifo se-jaundice kunye nesifo sesibindi. Ku: UMartin RJ, uFanaroff AA, uWalsh MC, ii-eds. UFanaroff kunye noMartin's Neonatal-Perinatal Medicine. Ngomhla we-10. IPhiladelphia, PA: Elsevier Saunders; 2015: isahluko 100.

UMarcdante KJ, uKliegman RM. Anemia kunye hyperbilirubinemia. Ku: UMarcdante KJ, uKliegman RM, ii-eds. UNelson oBalulekileyo kwiPediatrics. Ngomhla we-8. Elsevier; I-2019: isahluko 62.