I-Bilirubin encephalopathy

I-Bilirubin encephalopathy yisimo esingajwayelekile sezinzwa esenzeka kwezinye izingane ezisanda kuzalwa ezine-jaundice enamandla.

I-Bilirubin encephalopathy (BE) ibangelwa amazinga aphezulu kakhulu e-bilirubin. I-Bilirubin i-pigment ephuzi edalwa njengoba umzimba ususa amangqamuzana egazi abomvu amadala. Izinga eliphakeme le-bilirubin emzimbeni lingadala ukuthi isikhumba sibukeke siphuzi (i-jaundice).

Uma izinga le-bilirubin liphezulu kakhulu noma ingane igula kakhulu, into izophuma egazini iqoqele ezicutshini zobuchopho uma ingaboshelwe ku-albumin (protein) esegazini. Lokhu kungaholela ezinkingeni ezinjengokulimala kobuchopho nokulahleka kokuzwa. Igama elithi "kernicterus" lisho ukubala okuphuzi okubangelwa yi-bilirubin. Lokhu kubonakala ezingxenyeni zobuchopho ekuhlolweni kwesidumbu.

Lesi simo sivame ukukhula esontweni lokuqala lokuphila, kepha singabonakala kuze kube yisonto lesithathu. Ezinye izingane ezisanda kuzalwa ezinezifo ze-Rh hemolytic zisengozini enkulu ye-jaundice enzima engaholela kulesi simo. Imvamisa, i-BE ingakhula ezinganeni ezibonakala ziphilile.

Izimpawu zincike esigabeni se-BE. Akuzona zonke izingane ezine-kernicterus ku-autopsy eziye zaba nezimpawu ezithile.

Isigaba sokuqala:

• I-jaundice eyedlulele
• I-reflex yokwethuka engekho
• Ukungondli kahle noma ukuncela
• Ukulala ngokweqile (ukucobeka) nethoni yemisipha ephansi (hypotonia)

Isigaba esiphakathi:

• Ukukhala okuphezulu
• Ukuthukuthela
• Kungenzeka ukuthi ibuyele emuva ngentamo ehlanjululwe emuva entanyeni, ithoni ephezulu yemisipha (hypertonia)
• Ukudla okungafanele

Isigaba sekwephuzile:

• Isiphukuphuku noma ikhoma
• Akukho okuphakelayo
• Shrill ukukhala
• Ukuqina kwemisipha, kuphakanyiswe kakhulu emuva ngentamo okuxhunywe emuva ngentamo
• Ukuquleka

Ukuhlolwa kwegazi kuzobonisa izinga eliphakeme le-bilirubin (elingaphezu kuka-20 kuye ku-25 mg / dL). Kodwa-ke, akukho ukuxhumana okuqondile phakathi kwezinga le-bilirubin nezinga lokulimala.

Ububanzi bamanani ajwayelekile bungahluka kancane phakathi kwamalabhorethri ahlukene. Khuluma nodokotela wakho mayelana nencazelo yemiphumela yakho ethile yokuhlolwa.

Ukwelashwa kuya ngokuthi ingane ineminyaka emingaki (emahoreni) nokuthi ngabe ingane inezinto ezithile eziyingozi (njengokukhulelwa ngaphambi kwesikhathi). Kungabandakanya:

• Ukwelashwa okulula (phototherapy)
• Ukushintshaniswa kokumpontshelwa (ukususa igazi lengane bese ufaka igazi lomnikeli noma iplasma entsha)

I-BE yisimo esibi kakhulu. Izinsana eziningi ezinezinkinga zesistimu yezinzwa esekupheleni kwesikhathi ziyafa.

Izinkinga zingafaka:

• Ukulimala kwengqondo okungapheli
• Ukulahlekelwa ukuzwa
• Ukufa

Thola usizo lwezempilo ngokushesha uma ingane yakho inezimpawu zalesi simo.

Ukwelapha i-jaundice noma izimo ezingaholela kuyo kungasiza ukuvimbela le nkinga. Izinsana ezinezimpawu zokuqala ze-jaundice zinezinga le-bilirubin elinganiswa kungakapheli amahora angama-24. Uma izinga liphezulu, usana kufanele luhlolwe izifo ezibandakanya ukubhujiswa kwamaseli abomvu egazi (hemolysis).

Zonke izingane ezisanda kuzalwa zinesikhathi sokulandelwa zingakapheli izinsuku ezimbili kuya kwezingu-3 ziphumile esibhedlela. Lokhu kubaluleke kakhulu ezinganeni ezisanda kuqala noma sekwedlule isikhathi (ezizalwa ngaphezu kwamasonto amabili kuya kwamathathu ngaphambi kosuku lwazo lokuzalwa).

Ukungasebenzi kahle kwe-neurologic (BIND) kaBilirubin; I-Kernicterus

• I-jaundice esanda kuzalwa - ukukhipha

• I-Kernicterus

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I-Hansen TWR. I-Pathophysiology ye-kernicterus. Ku: Polin RA, Abman SH, Rowitch, DH, Benitz WE, Fox WW, ama-eds. I-Fetal ne-Neonatal Physiology. Umhlaka 5. IPhiladelphia, PA: Elsevier; I-2017: isahluko 164.

UKaplan M, Wong RJ, uSibley E, uStevenson DK. Isifo se-jaundice nesifo sesibindi. Ku: Martin RJ, Fanaroff AA, Walsh MC, ama-eds. UFanaroff kanye neMithi kaMartin's Neonatal-Perinatal Medicine. Umhlaka 10. IPhiladelphia, PA: Elsevier Saunders; 2015: isahluko 100.

UMarcdante KJ, uKliegman RM. I-anemia ne-hyperbilirubinemia. Ku: UMarcdante KJ, uKliegman RM, ama-eds. UNelson Essentials Pediatrics. Umhlaka 8. Elsevier; 2019: isahluko 62.