Jaundice conjugation: chirwere, zvinokonzera, kurapwa

Jaundice haisi yoga chirwere, ndiko chete chiratidzo zvimwe pathologies. Muzviitiko zvakawanda, kungava vasiri, ndiko chokuita chero chirwere (mu vacheche). Chikonzero ichi ndiko dzichiwedzera bilirubin, izvo zvinopa icteric coloring ganda, mucous membranes uye sclera.

Jaundice: Types

mamiriro iri zvakabatana chaizvo pamwe zviri bilirubin muropa. Zvisinei, rinoita kuwedzera kungava zvakasiyana. Mune zvimwe zviitiko, kuziva chikonzero yokurega vanofungidzirwa zvokurwara mumuviri, kunoda kurapwa pakarepo. Zvichienderana shanduro bilirubin muviri zvirwere marudzi anoverengeka jaundice:

1. Conjugation jaundice, inova migumisiro vasingadzoreki conjugation kuti bilirubin. Kuti richiwanika vachangoberekwa.
2. Parenchymal jaundice ikabuda zvinoverengeka chiropa pathologies. The kukundwa pamusoro parenchyma muviri (kufa masero dzichipfekeka - hepatocytes) haikwani kuti andobata bilirubin uye zvakare nahwo.
3. Obstructive jaundice, kunoitika muna kutyora water drainage pakati bile. Rinobatanidzwa nezvirwere kuti pave okupedzisa kana aienda pamusoro lumen yacho bile mutsinga dzinofamba nemukaka. Izvi zvinoitika muna cholelithiasis uye paumbwe bundu.
4. Hemolytic jaundice - zvokurwara chokuita disintegration masero matsvuku eropa. Bilirubin - ruvara kunoitika apo kuparara Chizenga, saka yakakwirira erythrocyte lysis kunotungamirira kuwedzera ayo mwero.
5. Kernicterus - akazvimirira uye chinonyanya ngozi mhando. It kumbowanikwa nyaya kana mudumbu hwakafumurwa kuti hypoxia panguva budiriro kana kuzvarwa asphyxia. Uyewo, chikonzero chingava chirwere vakadzi vane pamuviri. The ngozi ndechokuti ruvara rinoungana mumasero tsinga uropi, iyo inotungamirira kuupenyu siyana chetsinga zvinetso, uye vanogona kuva kuurayisa.

Conjugation jaundice vachangoberekwa

Jaundice kunoitika muna vacheche pane vasiri, sezvo isina chokuita munhu pathological kwacho. Inokudziridza, kazhinji mazuva 3-5 aberekwa. Kazhinji, masero matsvuku eropa kupesvedzera kugara kuvandudzwa, icho pamwe hemolysis - vaparadzwe. In vakuru, chiropa zvizere kuumbwa, saka bilirubin, izvo aburitswa kuora masero aya vane nguva yokukurukura uye asingauyi -wedzera muropa.

The kunotoda mune vacheche Rinobatanidzwa zvikuru kuvandudzwa masero matsvuku eropa uye hama chiropa kukundikana. muviri ichi haisati kuumbwa zvizere, kazhinji jaundice kwakadaro kunoitika muna rokusamhanyira vacheche. Bilirubin anotanga kuvaka muropa, uye ipapo rinoungana paganda uye mucous membranes, achivapa noruzhinji ruvara. Peaking rechitatu-reshanu. Zviratidzo izvi zvino apfuura kubvira kupanana bilirubin zvishoma nezvishoma kudzokera dzose.

Chii ichi?

Conjugation jaundice (ICD-10) oga munyika dzakawanda kupatsanura haisi dzinounzwa. Ane P59.0 yeEncoding vaviri neonatal jaundice, inova migumisiro vakurumidze delivery, uye hwakabatana hyperbilirubinemia. Chinotaura muitiro pamusoro apa.

Conjugation chimiro chirwere rinowanikwa kakawanda muvana. Izvi zvinopfuura jaundice vachangoberekwa, uyewo mamiriro kuti ikabuda vakurumidze vacheche uye vana vachibatwa asphyxia. Kazhinji zvinokonzera matambudziko enhaka uye kwemakemikari anobudiswa zvokurwara (semuenzaniso, syndromes Lyutseya-Driskopa uye Gilbert). boka iri zvinosanganisira zvinodhaka jaundice.

Bilirubin - chii?

zita iri akapiwa ruvara, iro inogadzirwa nokuputsika hemoglobin. Zvimwe kuwanda Chinokonzera coloring ganda uye mucous membranes. Bilirubin - anokosha chirwere chokuratidza, sezvo michero yayo kunoratidza pathological kwacho uye kutanga kurapwa. Huwandu ruvara inoratidza mamiriro chiropa uye biliary turakiti.

Mumuviri, asi bilirubin unowanika maviri siyana - zvakananga uye zvisina kunanga. Origin makabuda wechipiri kutendeuka chigadzirwa. Kunanga bilirubin chepfu uye kunyura kwemafuta. Haana yabudiswa kubva mumuviri. Metabolic zvinetso, chimiro ichi inogona vaunganidza, ichipa ane muchetura zvainoita muviri. Kazhinji, zvinonzi dzikwanise zvakananga bilirubin iri hakuna zvinokuvadza. Conjugation jaundice kunoitika nokuda kutyorwa ayo muviri.

Exchange bilirubin

Panobva ruvara iri Chizenga - chikuru chezvinonhuwira masero matsvuku eropa. Ari kuora dzvuku eropa Chizenga asunungurwa uye vakafumura cleavage. Izvi zviri kuitwa kushandiswa macrophages nhengo (mwongo, chiropa uye chirwatata). Somugumisiro yacho cleavage kuumbwa heme uye globin. Wekutanga kuva biliverdin - the mugadzi pane kunanga bilirubin. inotungamirwa yayo biliverdin chokuita basa chaizvo makemikari, pakati pavo - the cytochrome P-450, heme oxygenase. Uyezve kunanga bilirubin runotungamirirwa mu chiropa mumasero uko anosunga kuti glucuronic acid. Saka kuumbwa yakananga bilirubin, iyo anochengeterwa nduru dundira uye vakafumura excretion kupinda duodenum. Intestinal microflora chinowedzera rutapudzo kwahwo urobilinogen. Chikamu chiri pasi Absorção de Água, residues vari dzikwanise sterkobilinogena uye yabudiswa muna faeces, achichipa anozivikanwa ruvara.

Laboratory miedzo inogona kuratidza kuti bilirubin rakakwirira. Zvinorevei? Kuwedzera zvayo mwero inogona chokuita chero chirwere, rinoda kuita chirwere kuongorora. Vasiri kuwedzera bilirubin aona vachangoberekwa.

zvekuchipatara mufananidzo

Pasinei chokwadi kuti nokuda achangoberekwa dzinoratidzwa wakawedzera bilirubin, kurapwa anokuzviratidza ndee kwete zvachose. Chiratidzo kupiwa Hurumende - ruvara chitarisiko icteric. It haangoratidzi chete ganda asiwo mucous membranes. Physiologic jaundice conjugation rinopfuura kucherechedzwa, asi kana asina, anofanira vakafungira zvokurwara.

Diagnostics

Jaundice kunogona kwete chete vasiri mamiriro, asiwo chiratidzo ane chirwere. Kana mwana ane chaicho Ruvara ganda uye mucous membranes, zvinoda kuramba zvichiongororwa pedyo wevana. Uyewo pane nyaya dzakadaro vanofanira kudzora padanho bilirubin. Kazhinji, mumazuva nhamba yacho upenyu mangwanani rinosvika 60 mmol / L, asi hapana zvimwe. Uyezve, ichi pamwero kunowandawo (maawa 3-7).

Kazhinji, vakawedzera bilirubin yakachengeteka uye hakuna hunokachidza zvazvinoita muviri mwana Zvisinei, zvakadini haafaniri kupfuudza vanonzi pamuganhu kukosha - 205 pmol / l. Bilirubin akawedzera - zvinoreva kuchinja kwakadaro? Jaundice chinhu pathological uye kunoda nechimbichimbi kurapwa. Kana mufananidzo uyu zvechokwadi, asi jaundice hunoramba kwenguva refu, yava kunzi conjugation, ndiko kuti, rinova mhaka umbishi chiropa enzayemu hurongwa.

Treatment conjugation jaundice

Pashure pokuongororwa zvikaonekwa jaundice vasiri kana pathological. Wokutanga hakurevi kurapwa uye inoguma voga uye pasina zvikasawanirwa. Mazhinji jaundice (conjugation) kunosvika pacharo apo enzayemu mamiriro chiropa pakupedzisira akura zvakare. Zvisinei, kana nhamba kwazvo yakaoma bilirubin pamwero anofanira ringazivikanwa zvokurwara. Zvinogona kuva nemavhairasi chiropa, bile mutsinga dzinofamba nemukaka mhingaidzo, kana hemolytic jaundice.

nemavhairasi chiropa

zvokurwara Izvi zvinogona apfuura kubva mwana utachiona kuna mai. Somugumisiro, mwana anozvarwa nehepatitis nemavhairasi hunhu. Zvazvakaita kweutachiwana pakutanga zvokukura fetus kunogona kukonzera mberi chaiko abnormalities. A chepfungwa chirwere, kusiyana nehepatitis B nedzevakuru, ndiyo yakanyanya kosi. Zvokurwara kungazviratidza kunyange asati kutanga jaundice. Kazhinji pane kuwedzera tembiricha, Kuipa kudya uye zvishoma catarrhal zvakavapo. Mune zvimwe zviitiko preicteric nguva vacheche asymptomatic.

Chifungidziro kuvapo nehepatitis B kunogona kuva kuburikidza Detective zvachinja ruvara weti uye mutsvina yadzo. Complete ropa kuongorora inozivikanwa nokuda kuderera kwakaita leucocyte uye erythrocyte sedimentation unodiwa. Monocytes vakanga kwakawedzera zvishoma. Kana icteric chimiro yave kuwedzera bilirubin, uye thymol. Nokuti mangwanani chirwere chirwere rinoitwa kudzidza chiropa makemikari. On giravhiti muitiro akati unopinza kuderera pamusoro prothrombin uye kuwedzera amoniya.

Treatment vana rinoitwa, kazhinji muchipatara. The kurapa anosanganisa mishonga antiviral gepatoprotektory, mavhitaminzi, uyewo cholagogue. Zvinokurudzirwa kuti munhu detoxification mishonga. Pakati asiri chinodhaka nzira kuti mukwanisi pharmacotherapy vanoda mubhedha zororo uye akanyarara.

hemolytic jaundice

zvokurwara iri chokuita hemolysis masero matsvuku eropa, kune ngozi chaizvo. Chikonzero kuenderana nepakudiwa kusapindirana kweropa chikonzero uye amai mwana, kuti ndiye kusapindirana kweropa-kunetsana. Zvokurwara kazhinji kunotungamirira kurufu - rufu mwero iri 60-80%. Uyezve, kuvapo kusapindirana kweropa kunetsana kungaita kuti vaingoerekana pamuviri.

dziviriro

Anobatsira kudzivirira jaundice nemazvo pamuviri uye achiyamwa vanodawo kugara uchiongororwa wevana. Kana jaundice vakurumidze asi kutanga, kunoda nguva richiona nezvezvabuda padanho bilirubin muropa.

Varwere jaundice dzinoratidzwa dzakasiyana ganda ruvara uye mucous membranes. chiratidzo ichi zvingaratidza pamberi chirwere kana kuti kuratidza vasiri kuchinja mumuviri (zvinopfuura neonatal jaundice).

mhedziso

Pamusoro kuziva miedzo jaundice zvinoitwa nokukurumidza kuona padanho bilirubin uye zvimwe zviratidzo. Conjugation jaundice vachangoberekwa inopfuura kunopfuura zvinopfuura, asi kuri ngozi. Mazvikokota kunofanira kusimbisa vabereki uye kugadza kuongorora. Kazhinji, hapana matambudziko akanga kuchengetwa.