I-jaundice esanda kuzalwa

I-jaundice esanda kuzalwa yenzeka lapho ingane inezinga eliphakeme le-bilirubin egazini. I-Bilirubin yinto ephuzi eyenziwe ngumzimba lapho ithatha indawo yamaseli abomvu egazi amadala. Isibindi sisiza ukudiliza into ukuze ikwazi ukususwa emzimbeni osesihlalweni.

Izinga eliphezulu le-bilirubin lenza isikhumba sengane futhi abamhlophe bamehlo babonakale bephuzi. Lokhu kubizwa nge-jaundice.

Kujwayelekile ukuthi izinga le-bilirubin lengane libe phezulu kancane ngemuva kokuzalwa.

Lapho ingane ikhula esibelethweni sikanina, i-placenta isusa i-bilirubin emzimbeni wengane. I-placenta isitho esikhula ngesikhathi sokukhulelwa ukondla ingane. Ngemuva kokuzalwa, isibindi sengane siqala ukwenza lo msebenzi. Kungathatha isikhathi ukuthi isibindi sengane sikwazi ukwenza lokhu kahle.

Iningi lezinsana ezisanda kuzalwa zinokuphuzi okuthile kwesikhumba, noma i-jaundice. Lokhu kubizwa ngokuthi yi-jaundice yomzimba. Imvamisa kuyabonakala lapho ingane inezinsuku ezimbili kuya kwezine ubudala. Isikhathi esiningi, ayizibangeli izinkinga futhi iyahamba kungakapheli amasonto ama-2.

Izinhlobo ezimbili ze-jaundice zingavela ezinganeni ezisanda kuzalwa ezinceliswa ibele. Zombili lezi zinhlobo ngokuvamile azinabungozi.

• I-jaundice yokuncelisa ibele ibonakala ezinganeni ezincela ibele phakathi nesonto lokuqala lokuphila. Kunamathuba amaningi okuthi kwenzeke lapho izingane zingancelisi kahle noma ubisi lukamama luphuza ukuza, okuholela ekuphelelweni amanzi emzimbeni.
• Ubisi lwebele lwe-jaundice lungavela kwezinye izingane ezinempilo, ezincelisayo emva kosuku lwesikhombisa lokuphila. Kungenzeka ikhuphuke phakathi kweviki 2 no-3, kepha ingahlala emazingeni aphansi inyanga noma ngaphezulu. Inkinga ingabangelwa ukuthi izinto ezisobisini lwebele zithinta kanjani ukuwohloka kwe-bilirubin esibindini. I-jaundice yobisi lwebele ihlukile kune-jaundice yokuncelisa ibele.

I-jaundice esanda kuzalwa ingenzeka uma ingane inesimo esandisa inani lamaseli abomvu egazi adinga ukushintshwa emzimbeni, njenge:

• Ukuma okungavamile kwamangqamuzana egazi (njenge-sickle cell anemia)
• Ukungafani kohlobo lwegazi phakathi kukamama nengane (ukungahambelani kwe-Rh noma ukungahambelani kwe-ABO)
• Ukopha ngaphansi kwesikhumba (cephalohematoma) okubangelwa ukulethwa okunzima
• Izinga eliphakeme lamaseli abomvu egazi, okuvame kakhulu ezinganeni ezincane zeminyaka yokukhulelwa (SGA) namanye amawele
• Ukutheleleka
• Ukuntuleka kwamaprotheni athile abalulekile, abizwa ngama-enzyme

Izinto ezenza kube nzima ukuthi umzimba wengane ususe i-bilirubin nazo zingaholela ku-jaundice ebucayi, kufaka phakathi:

• Imithi ethile
• Izifo ezikhona lapho kuzalwa, njenge-rubella, ugcunsula nezinye
• Izifo ezithinta isibindi noma i-biliary tract, njenge-cystic fibrosis noma i-hepatitis
• Izinga le-oxygen ephansi (hypoxia)
• Izifo (sepsis)
• Izinkinga eziningi ezahlukahlukene zofuzo noma zofuzo

Izingane ezizalwa zisencane kakhulu (ngaphambi kwesikhathi) zinamathuba amaningi okuba ne-jaundice kunezingane zesikhathi esigcwele.

I-jaundice idala umbala ophuzi wesikhumba. Imvamisa iqala ebusweni bese yehlela esifubeni, esiswini, emilenzeni, nasematheni ezinyawo.

Kwesinye isikhathi, izinsana ezine-jaundice enzima zingakhathala kakhulu futhi zondle kabi.

Abahlinzeki bezempilo bazobheka izimpawu ze-jaundice esibhedlela. Ngemuva kokuthi usana luzelwe luye ekhaya, amalungu omndeni ajwayele ukubona i-jaundice.

Noma yiluphi usana olubonakala lubanjwe i-jaundiced kufanele lube namazinga we-bilirubin alinganiswe ngaso leso sikhathi. Lokhu kungenziwa ngokuhlolwa kwegazi.

Izibhedlela eziningi zihlola amazinga e-bilirubin esewonke ezinganeni ezineminyaka engaba ngu-24 ubudala. Izibhedlela zisebenzisa ama-probes angalinganisa izinga le-bilirubin ngokuthinta isikhumba. Ukufundwa okuphezulu kudinga ukuqinisekiswa ngokuhlolwa kwegazi.

Ukuhlolwa okungenzeka kwenziwe kufaka:

• Qedela ukubalwa kwegazi
• Ukuhlolwa kwama-Coombs
• Ukubalwa kwe-Reticulocyte

Ukuhlolwa okuqhubekayo kungadingeka ezinganeni ezidinga ukwelashwa noma ezinenani eliphelele le-bilirubin lenyuka ngokushesha okukhulu kunokulindelekile.

Ukwelashwa akudingeki isikhathi esiningi.

Lapho kudingeka ukwelashwa, uhlobo luzoya ngokuthi:

• Izinga le-bilirubin yengane
• Izinga belikhuphuka ngokushesha kangakanani
• Ukuthi ingane izalwe kusenesikhathi (izingane ezizalwe kusenesikhathi maningi amathuba okuthi ziphathwe emazingeni aphansi e-bilirubin)
• Ingakanani ingane

Ingane izodinga ukwelashwa uma izinga le-bilirubin liphakeme kakhulu noma likhuphuka ngokushesha okukhulu.

Ingane ene-jaundice idinga ukuthatha uketshezi oluningi ngobisi lwebele noma ifomula:

• Yondle ingane kaningi (kuze kube izikhathi eziyi-12 ngosuku) ukukhuthaza ukunyakaza kwamathumbu kaningi. Lokhu kusiza ukususa i-bilirubin ngokusebenzisa indle. Buza umhlinzeki wakho ngaphambi kokunikeza ingane yakho ifomula eyengeziwe esanda kuzalwa.
• Ezimweni ezingavamile, ingane ingathola uketshezi olwengeziwe nge-IV.

Ezinye izingane ezisanda kuzalwa zidinga ukwelashwa ngaphambi kokuba ziphume esibhedlela. Abanye bangadinga ukubuyela esibhedlela lapho banezinsuku ezimbalwa ubudala. Ukwelashwa esibhedlela kuvame ukuthatha usuku olungu-1 kuya kwezi-2.

Kwesinye isikhathi, kusetshenziswa amalambu akhethekile aluhlaza ezinganeni ezinamazinga aphezulu kakhulu. Lezi zibani zisebenza ngokusiza ukudiliza i-bilirubin esikhunjeni. Lokhu kubizwa ngokuthi yi-phototherapy.

• Usana lubekwa ngaphansi kwalezi zibani embhedeni ofudumele, ovalekile ukuze kugcinwe izinga lokushisa njalo.
• Ingane izogqoka inabukeni kuphela nezingubo zamehlo ezikhethekile ukuvikela amehlo.
• Ukuncelisa ingane ibele kufanele kuqhubeke ngesikhathi se-phototherapy, uma kungenzeka.
• Ezimweni ezingavamile, ingane ingadinga ulayini we-intravenous (IV) ukuletha uketshezi.

Uma izinga le-bilirubin lingaphakeme kakhulu noma lingakhuphuki ngokushesha, ungenza i-phototherapy ekhaya ngengubo ye-fiberoptic, enamalambu amancane akhanyayo kuyo. Ungasebenzisa futhi umbhede okhanyisa ukukhanya kusuka kumatilasi.

• Kufanele ugcine ukwelashwa okulula esikhumbeni sengane yakho bese wondla ingane yakho njalo emahoreni ama-2 kuye kwayi-3 (izikhathi eziyi-10 kuye kwezingu-12 ngosuku).
• Umhlengikazi uzofika ekhaya lakho azokufundisa ukuthi uyisebenzisa kanjani ingubo noma umbhede, nokuhlola ingane yakho.
• Umhlengikazi uzobuya nsuku zonke azohlola isisindo sengane yakho, ukuphakelwa kwayo, isikhumba, nezinga le-bilirubin.
• Uzocelwa ukuthi ubale inani lamanabukeni amanzi nongcolile.

Ezimweni ezinzima kakhulu ze-jaundice, ukumpontshelwa kokushintshaniswa kuyadingeka. Kule nqubo, igazi lengane lithathelwa indawo ngegazi elisha. Ukunikezela ngemithambo yegazi ezinganeni ezine-jaundice enamandla nakho kungasebenza ekwehliseni amazinga e-bilirubin.

I-jaundice esanda kuzalwa ayilimazi isikhathi esiningi. Ezinganeni eziningi, i-jaundice izoba ngcono ngaphandle kokwelashwa kungakapheli amasonto amabili kuya kwamabili.

Izinga eliphakeme kakhulu le-bilirubin lingalimaza ubuchopho. Lokhu kubizwa ngokuthi yi-kernicterus. Isimo sihlale sitholakala ngaphambi kokuba izinga likhuphuke ngokwanele ukudala lo monakalo. Ukwelashwa kuvame ukusebenza.

Okuvamile, kepha izinkinga ezinkulu ezivela emazingeni aphezulu e-bilirubin zifaka:

• Ukukhubazeka kobuchopho
• Izithulu
• I-Kernicterus, okungukulimala kobuchopho kusuka emazingeni aphezulu kakhulu e-bilirubin

Zonke izingane kufanele zibonwe ngumhlinzeki ezinsukwini zokuqala ezinhlanu zokuphila ukuze zihlole i-jaundice:

• Izinsana ezichitha amahora angaphansi kwama-24 esibhedlela kufanele zibonwe zineminyaka engama-72.
• Izinsana ezithunyelwa ekhaya phakathi kwamahora angama-24 kuya kwangu-48 kufanele ziphinde zibonwe ngamahora angama-96.
• Izinsana ezithunyelwa ekhaya phakathi kwamahora angama-48 no-72 kufanele ziphinde zibonwe ngamahora angama-120 aneminyaka yobudala.

I-jaundice iyisimo esiphuthumayo uma ingane inemfiva, iba nohlu olungenalutho, noma ingondli kahle. I-jaundice ingaba yingozi ezinganeni ezisanda kuzalwa ezisengozini enkulu.

I-jaundice ngokuvamile ayiyona ingozi ezinganeni ezizalwe isikhathi esigcwele futhi ezingenazo ezinye izinkinga zezokwelapha. Shayela umhlinzeki wosana uma:

• I-jaundice inzima (isikhumba siphuzi ngokugqamile)
• I-jaundice iyaqhubeka nokwanda ngemuva kokuvakashelwa okusanda kuzalwa, ihlala isikhathi eside kunamasonto ama-2, noma ezinye izimpawu ziyakhula
• Izinyawo, ikakhulukazi amathe, aphuzi

Khuluma nomhlinzeki wengane yakho uma unemibuzo.

Ezinganeni ezisanda kuzalwa, izinga elithile le-jaundice lijwayelekile futhi mhlawumbe alinakuvinjelwa. Ingozi ye-jaundice engathi sína ingahle yehliswe ngokunika izingane ukudla okungenani ama-8 kuye kwayi-12 ngosuku ezinsukwini ezimbalwa zokuqala nangokukhomba ngokucophelela izinsana ezisengozini enkulu.

Bonke abesifazane abakhulelwe kufanele bahlolwe uhlobo lwegazi namasosha omzimba angajwayelekile. Uma umama ene-Rh negative, kunconywa ukuhlolwa kokulandela intambo yosana. Lokhu kungenziwa futhi uma uhlobo lwegazi lomama luthi O positive.

Ukuqapha ngokucophelela zonke izingane phakathi nezinsuku ezinhlanu zokuqala zokuphila kungavimbela izinkinga eziningi ze-jaundice. Lokhu kufaka:

• Ukucabangela ingozi yengane ye-jaundice
• Ukuhlola izinga le-bilirubin osukwini lokuqala noma kunjalo
• Ukuhlela okungenani ukuvakasha okukodwa kokulandelela isonto lokuqala lokuphila lezingane ezithunyelwe ekhaya zivela esibhedlela ngamahora angama-72

I-jaundice yengane esanda kuzalwa; I-hyperbilirubinemia engakazalwa; Izibani zeBili - i-jaundice; Isana - isikhumba esiphuzi; Usana olusanda kuzalwa - isikhumba esiphuzi

• I-jaundice esanda kuzalwa - ukukhipha
• I-jaundice esanda kuzalwa - okufanele ubuze udokotela wakho

• I-Erythroblastosis fetalis - i-photomicrograph
• Usana olunguJaundiced
• Ukushintshaniswa kwegazi - uchungechunge
• I-jaundice yezinsana

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