Iindidi zeJaundice

Umxholo

• Ziziphi iintlobo ezahlukeneyo ze-jaundice?
• Konke malunga ne-jaundice yangaphambi kwesibindi
• Konke malunga ne-jaundice ye-hepatic
• Konke malunga ne-jaundice post-hepatic
• Konke malunga ne-jaundice ye-neonatal
• Imbonakalo

Ziziphi iintlobo ezahlukeneyo ze-jaundice?

I-jaundice yenzeka xa i-bilirubin eninzi isakha egazini lakho. Oku kwenza ulusu lwakho kwaye abamhlophe bamehlo bakho bajonge ngokumthubi.

I-Bilirubin ngumbala omthubi owenziwe njenge hemoglobin - icandelo leeseli ezibomvu zegazi - eyaphukileyo.

Ngokwesiqhelo, i-bilirubin ihanjiswa ukusuka kwigazi ukuya kwisibindi sakho. Emva koko, idlula kwimibhobho ebizwa ngokuba yimibhobho yenyongo. Le mibhobho ithwala into ebizwa ngokuba yinyongo emathunjini akho amancinci. Ekugqibeleni, i-bilirubin idluliselwa emzimbeni wakho ngomchamo okanye isitulo.

Iindidi ze-jaundice zahlulwe ngokweendawo ezenzeka kuzo kwinkqubo yesibindi yokuthatha nokucoca i-bilirubin:

• kwangaphambili kwesibindi: phambi kwesibindi
• hepatic: esibindini
• emva kwesibindi: emva kwesibindi

Konke malunga ne-jaundice yangaphambi kwesibindi

I-jaundice yangaphambi kwesibindi ibangelwa ziimeko eziphakamisa inqanaba legazi lakho le-hemolysis. Le yinkqubo apho iiseli ezibomvu zegazi zehla, zikhuphe ihemoglobin kwaye ziguqulwe zibe yibilirubin.

Ngenxa yokuba isibindi sinokusebenza kuphela nge-bilirubin ngaxeshanye, i-bilirubin iyaphuphuma kwizicubu zomzimba.

I-jaundice yangaphambi kwesibindi yile:

• isifo seengcongconi, usulelo lwegazi olubangelwa sisidleleli
• I-sickle cell anemia, imeko yemfuza apho iiseli ezibomvu zegazi zimile okwecrescent kunesimo sediski esiqhelekileyo
• i-spherocytosis, imeko yemfuza yenwebu ebomvu yegazi ebangela ukuba babunjwe njenge-sphere kunokuba babe-disc
• i-thalassemia, imeko yemfuza ebangela ukuba umzimba wakho wenze uhlobo olungaqhelekanga lwehemoglobin ethintela inani leeseli ezibomvu ezisempilweni kwigazi lakho

Iimpawu eziqhelekileyo ze-jaundice yangaphambi kwesibindi zibandakanya:

• intlungu zesisu
• umkhuhlane, kubandakanya ukubanda okanye ukubila kubanda
• ukunciphisa umzimba ngokungaqhelekanga
• ukuziva urhawuzelele
• umchamo omnyama okanye isitulo esimthubi

Eminye yemingcipheko yolu hlobo lwe-jaundice ibandakanya:

• Ukusetyenziswa kweziyobisi
• ukuba nelungu losapho elinengxaki yegazi
• Ukuya kwimimandla eneengcongconi

Ukufumanisa i-jaundice yangaphambi kwesibindi, ugqirha wakho uya kuthi aodole ezi mvavanyo zilandelayo:

• Uvavanyo lokuchama ukulinganisa ubungakanani bezinto ezithile kumchamo wakho
• iimvavanyo zegazi, njengobalo olupheleleyo lwegazi (CBC) okanye uvavanyo lomsebenzi wesibindi ukulinganisa i-bilirubin kunye nezinye izinto egazini
• iimvavanyo zokucinga, njengeMRI okanye i-ultrasound, ukuvavanya isibindi sakho, i-gallbladder, kunye ne-bile ducts ukulawula ezinye iindlela ze-jaundice
• Iskena seHIDA ukunceda ukufumana iibhloksi okanye eminye imiba kwisibindi, i-gallbladder, i-bile ducts, kunye namathumbu amancinci

Ugqirha wakho uya kukufumanisa ene-jaundice yangaphambi kwesibindi ukuba akukho micimbi ine-bilirubin eqhutywa sisibindi sakho okanye ngaphakathi kwe-gallbladder kunye ne-biliary ducts.

Unyango lwe-jaundice yangaphambi kwesibindi inokubandakanya:

Isifo seengcongconi:

• amayeza okunceda ukutshabalalisa i-parasite kunye nokukhusela ama-parasites ekubuyiseleni isibindi sakho kwakhona

I-sickle cell anemia:

• utofelo-gazi oluvela kulowo unikele ngempilo
• ukuphinda ufake amanzi emzimbeni nge-intravenous (IV) fluid
• amayeza alo naluphi na usulelo olunokubangela ingxaki yeseli

Ispherocytosis:

• folic acid isongezelelo
• utofelo-gazi lwe-anemia
• utyando lokususa udakada ukunceda ukwandisa ubomi beseli ebomvu kunye nokunciphisa ithuba lamatye enyongo

I-thalassemia:

• utofelo-gazi
• Ukunyuka komongo wethambo
• udakada okanye utyando lokususa inyongo

Konke malunga ne-jaundice ye-hepatic

I-hepatic jaundice yenzeka xa izicwili zakho zesibindi zinqabile (ezaziwa njenge-cirrhosis), ezonakeleyo, okanye ezingasebenzi kakuhle. Oku kuyenza ukuba isebenze kancinci ekucoceni i-bilirubin egazini lakho.

Kuba ayinakuhluzwa kwinkqubo yakho yokwetyisa ukuze isuswe, i-bilirubin yakha yenyuka yaya kwinqanaba eliphezulu egazini.

I-hepatic jaundice yile:

• i-cirrhosis yesibindi, oku kuthetha ukuba izicubu zesibindi zinqabile kukuchaphazeleka ixesha elide kwizifo okanye kwityhefu, njengamanqanaba aphezulu otywala
• I-hepatitis yentsholongwane, ukudumba kwesibindi okubangelwa yenye yeentsholongwane ezininzi ezinokungena emzimbeni wakho ngokutya okusulelekileyo, amanzi, igazi, isitulo, okanye ukunxibelelana ngokwesondo.
• i-cirrhosis yokuqala, eyenzeka xa imibhobho yenyongo yonakele kwaye ingenakho ukuqhubekeka nenyongo, ibangele ukuba yakhe isibindi kunye nokonakalisa izicwili zesibindi
• ihepatitis enotywala, apho izicwili zakho zesibindi zonzakele kukusela okunxilisayo, ixesha elide kotywala
• i-leptospirosis, sisifo esosasazeka zizilwanyana ezosulelekileyo okanye umchamo wesilwanyana okanye ilindle elosulelekileyo
• umhlaza wesibindi, apho iiseli ezinomhlaza zikhula kwaye zanda ngaphakathi kwezicubu zesibindi

Iimpawu eziqhelekileyo ze-jaundice ye-hepatic zibandakanya:

• Ukuphelelwa ngumdla wokutya
• impumlo enegazi
• ukurhawuzelela ulusu
• ubuthathaka
• ukunciphisa umzimba ngokungaqhelekanga
• ukudumba kwesisu okanye imilenze yakho
• umchamo omnyama okanye isitulo esimthubi
• intlungu kwimisipha yakho okanye kumalungu
• isikhumba esimnyama
• ifiva
• ziva gula
• ukuphosa phezulu

Eminye yemingcipheko yolu hlobo lwe-jaundice ibandakanya:

• Ukusetyenziswa kweziyobisi
• ukusela kakhulu utywala ixesha elide
• ukusetyenziswa kwamayeza anokubangela ukonakala kwesibindi, njenge-acetaminophen okanye amayeza athile entliziyo
• usulelo lwangaphambili oluchaphazele isibindi sakho

Ukufumanisa i-jaundice ye-hepatic, ugqirha wakho uya kuyalela ezi mvavanyo zilandelayo:

• Uvavanyo lokuchama ukulinganisa amanqanaba ezinto kumchamo wakho ezinxulumene nokusebenza kwesibindi
• iimvavanyo zegazi, njengokubala okupheleleyo kwegazi (CBC) kunye novavanyo lwe-antibody, okanye uvavanyo lwesibindi ukusebenza ukulinganisa i-bilirubin egazini kunye namanqanaba ezinto ezibonisa ukuba isibindi sakho asinakuqhuba kakuhle nge-bilirubin
• iimvavanyo zokucinga, njengeMRI okanye i-ultrasound, ukujonga isibindi sakho ukuba asonakele okanye kukho iiseli ezinomhlaza
• i-endoscopy, okubandakanya ukufaka ityhubhu encinci, ekhanyisiweyo kwisithuba esincinci ukuze ujonge isibindi sakho kwaye uthathe isampulu yethishu (i-biopsy) xa kukho imfuneko yohlalutyo lomhlaza okanye ezinye iimeko.

Ugqirha wakho uya kukufumanisa ene-hepatic jaundice ukuba ubona umonakalo kwizicwili zesibindi kwiziphumo zovavanyo lokucinga okanye abone amanqanaba angaqhelekanga ezinto ezithile zesibindi, ezinje ngealbumin, okanye izilwa-buhlungu zesifo okanye umhlaza.

Unyango lwe-hepatic jaundice lunokubandakanya:

Isibindi sokuqina kwesibindi:

• ukuyeka ukusela
• beta-iibhlokhi
• intravenous (IV) amayeza okubulala iintsholongwane
• ukutya okuneprotein encinci

Kwi-hepatitis yentsholongwane:

• amayeza antiviral
• ugonyo hepatitis
• ukuphumla okuninzi kunye namanzi

Kwiprayimari ye-biliary cirrhosis:

• i-bile acids ukunceda ukwetyisa
• unyango lwe-bile
• i-antihistamines efana ne-diphenhydramine (Benadryl) yokurhawuzelela

Kwi-hepatitis yotywala:

• ukuyeka utywala
• izongezo zesondlo
• ukufakelwa kwesibindi, kwiimeko ezinzima

Ileptospirosis:

• Iintsholongwane zentsholongwane
• isixhobo sokuphefumla sengxaki yokuphefumla
• dialysis yomonakalo wezintso

Umhlaza wesibindi:

• ichemotherapy okanye imitha yokubulala iiseli zomhlaza
• ukuthengiswa kwesibindi ngokuthe ngqo
• Ukufakelwa kwesibindi

Konke malunga ne-jaundice post-hepatic

I-post-hepatic, okanye i-jaundice ephazamisayo, yenzeka xa i-bilirubin ingenakunkxwa ngokufanelekileyo kwimibhobho ye-bile okanye kwi-digestive tract ngenxa yokuvalelwa.

I-post-hepatic jaundice yile:

• iinyongo, iidiski ezinzima kwi-gallbladder enokuthintela imibhobho yenyongo
• Umhlaza wepancreatic, ukukhula kunye nokusasazeka kweeseli zomhlaza kwiipancreas, ilungu elinceda ukuvelisa izinto zokwetyisa
• Umhlaza we-bile duct, ukukhula kunye nokusasazeka kweeseli zomhlaza kwimibhobho yakho yenyongo
• i-pancreatitis, ukudumba okanye usulelo lwepancreas
• , imeko yemfuza apho unemibhobho emincinci okanye elahlekileyo yenyongo

Iimpawu eziqhelekileyo ze-jaundice post-hepatic zibandakanya:

• ziva gula
• ukuphosa phezulu
• umchamo omnyama okanye isitulo esimthubi
• intlungu zesisu
• urhudo
• ukunciphisa umzimba ngokungaqhelekanga
• ukurhawuzelela ulusu
• ukudumba kwesisu
• ifiva

Eminye yemingcipheko yolu hlobo lwe-jaundice ibandakanya:

• ukutyeba kakhulu
• ukutya ukutya okunamafutha aphezulu, ukutya okune-fiber encinci
• unesifo seswekile
• ukuba nembali yosapho yeenyongo
• ukuba ngumfazi
• ukwaluphala
• ukutshaya iimveliso zecuba
• ukusela kakhulu utywala
• ukuba nokudumba kwangaphambili okanye usuleleko
• ukuvezwa kwimichiza yemizi-mveliso

Ukufumanisa i-jaundice emva kwesibindi, ugqirha wakho uya kuthi aodole ezi mvavanyo zilandelayo:

• Uvavanyo lokuchama ukulinganisa amanqanaba ezinto kumchamo wakho
• iimvavanyo zegazi, ezinje ngokubala okupheleleyo kwegazi (CBC) kunye novavanyo lomzimba ngokuchasene nomhlaza, okanye iimvavanyo zomsebenzi wesibindi wokulawula i-jaundice ye-hepatic
• iimvavanyo zokucinga, njengeMRI okanye i-ultrasound, ukuvavanya isibindi sakho, i-gallbladder, kunye ne-bile ducts yezithintelo ezinjenge-gallstones okanye i-tumors
• i-endoscopy, okubandakanya ukufaka ityhubhu encinci, ekhanyisiweyo ezantsi komqala ukujonga isibindi sakho, i-gallbladder, okanye i-bile ducts kwaye uthathe isampulu yethishu ukuba kukho imfuneko yohlalutyo lomhlaza okanye ezinye iimeko.

Ukuba ugqirha wakho ubona isithintelo kwisiphumo sovavanyo lokucinga okanye ufumana amanqanaba ezinto ezithile ezinokubonisa ukosuleleka okanye umhlaza, baya kuyifumana i-jaundice yakho njenge-post-hepatic.

Unyango lwe-jaundice yasemva kwesibindi iya kulungisa unobangela. Oku kubandakanya:

Amatye enyongo:

• Ukutshintsha indlela otya ngayo ukuze uyeke ukuvelisa iinyongo
• ukususa i-gallstones okanye i-gallbladder yakho ngokupheleleyo
• ukuthatha amayeza okanye unyango ukunyibilikisa inyongo

Umhlaza wepancreatic:

• utyando lokususa izicwili ezinomhlaza okanye ipancreas yakho iphela
• i-radiation okanye i-chemotherapy ukutshabalalisa iiseli zomhlaza

Ngomhlaza wenyongo:

• utyando lokususa imibhobho yenyongo kunye neendawo zesibindi sakho kunye nepancreas
• i-radiation okanye i-chemotherapy ukutshabalalisa iiseli zomhlaza
• Ukufakelwa kwesibindi

Ipancreatitis:

• phumla
• ulwelo olufakwa ngaphakathi (IV) ulwelo okanye iintlungu
• utyando lokususa naziphi na izizathu ezibangela ukudumba (njengamatye enyongo)

Kwi-biliary atresia:

• Inkqubo yeKasai yokususa nokubuyisela imibhobho endaweni yayo
• Ukufakelwa kwesibindi

Konke malunga ne-jaundice ye-neonatal

I-jaundice ye-neonatal luhlobo oluqhelekileyo lwe-jaundice eyenzeka kwiintsana ezisandul 'ukuzalwa.

Uninzi lweentsana luzalwa luneeseli ezibomvu zegazi, kwaye ngenxa yokuba isibindi singekakhuli ngokupheleleyo, i-bilirubin ayinakucutshungulwa ngokukhawuleza. Ngenxa yoko, umntwana wakho unokuba neempawu ze-jaundice kwiintsuku ezimbalwa emva kokuba bezelwe.

Iindidi ze-neundatal jaundice zibandakanya:

• Zomzimba. Oku kwenzeka ngenxa yokuba isibindi singekaqulunqwa ngokupheleleyo.
• Ubungqambi. Oku kubangela ukuba umntwana azalwe kwangoko kakhulu kwaye angabinakho ukukhupha i-bilirubin ngokufanelekileyo.
• Ukuncancisa. Ubisi lwebele lwe-jaundice lwenzeka kusana olunengxaki yokuncancisa okanye ukungafumani bisi lwebele lwaneleyo.
• Uhlobo lwegazi olungahambelaniyo. Oku kubangela ukuba umntwana nomama babe neentlobo ezahlukeneyo zegazi, ezinokubangela ukuba umama enze izilwa-buhlungu ezonakalisa iiseli ezibomvu zegazi lomntwana wakhe.

I-jaundice ye-Neonatal ayisoloko ibangela inkxalabo. Kodwa ukuba i-bilirubin iyakha iye kumanqanaba aphezulu kakhulu, umntwana wakho unokufumana ukonakala kwengqondo (okwaziwa ngokuba yi-kernicterus) ukusuka kwi-bilirubin engena kwizicwili zobuchopho.

Funa unyango lwengxamiseko ukuba uphawula ukuba umntwana wakho unazo ezi mpawu:

• ixesha elide lokukhala okuphezulu
• ukugoba kwentamo yabo kunye nomqolo
• ifiva
• ukuphosa phezulu
• unengxaki yokondla

Imbonakalo

I-jaundice ngokucacileyo ithetha ukuba kukho i-bilirubin eninzi egazini lakho, kodwa oyena nobangela uyahluka kakhulu.

Yiya kugqirha wakho ngoko nangoko xa ubona ukuba tyheli kolusu lwakho okanye abamhlophe bamehlo akho. Ezinye izizathu zinokunyangwa ngenguqu kwindlela otya ngayo okanye kwindlela ophila ngayo, kodwa abanye banokufuna unyango olukhawulezileyo okanye unyango lwexesha elide.