Neonatal daj ntseg nyob rau hauv cov me nyuam mos: ua, cov tsos mob thiab kev kho mob

Cov me nyuam yug ntawm tej yam khoom noj - nws yog ib tug zoo siab rau cov niam txiv. Tab sis tej zaum, tshwj xeeb tshaj yog thaum nws tawm los rau thawj-yug, nws muaj peev xwm yuav txom nyem vim hais tias ntawm cov xim hloov ntawm daim tawv nqaij thiab qog ua kua week ntawm tus me nyuam. Cov tshwm sim, lub npe hu ua neonatal daj ntseg, yog tsis yooj yim dua, yog li ntawd, rau cov neeg uas yuav sai sai no yuav yug los tus me nyuam yuav tsum kawm ntxiv txog nws.

yog vim li cas

Cov tshwm sim ntawm daj ntseg nyob rau hauv cov me nyuam mos - nws yog kiag li ib txwm. Xws li ib tug tshwm sim tshwm sim thaum cov ntshav noj vim cov hniav lwj ntawm cov ntshav liab bilirubin siab dua li ib txwm. Nws yuav tsum tau to taub hais tias nyob rau hauv tas li ntawd rau nws tus kheej cov ntshav, lub cev ntawm tus me nyuam mos muaj rau cov txheej txheem ntau thiab residual ntshav liab niam. Yog li, lub load yuav tseem ceeb, thiab nws thiaj li accumulates tshaj bilirubin, uas ua rau yus daj qhov muag sclera thiab tus me nyuam daim tawv nqaij. Nyob rau hauv cov ntaub ntawv no, tus me nyuam muaj tsis muaj lwm yam pathologies, nws yog pom tias yuav tau noj qab nyob zoo, thiab yuav tsis tau kev kho mob.

physiological daim ntawv

Feem ntau, cov kev hloov nyob rau hauv tus me nyuam lub cev zoo li muaj cai nyob rau ntawm lub 2-5 hnub tom qab yug tus me nyuam thiab ploj los ntawm 2 lub lim piam ntawm hnub nyoog. Nyob rau tib lub sij hawm ua rau kom lub hais disappearance ntawm cov tsos mob ntawm muaj sia zheltushki sai tau yog tias feem ntau muab tso rau crumbs mus rau lub mis. Qhov no yuav kom cov xaiv uas yog thawj quav - meconium, uas yog muab tshem tawm los ntawm lub cev tshaj bilirubin. Nyob rau hauv tas li ntawd, nws yog pom zoo kom ntau rau mus taug kev nrog tus me nyuam nyob rau hauv lub tshiab huab cua.

Physiological neonatal daj ntseg ntawm cov me nyuam mos: Ua

Raws li twb tau hais, lub ntuj xim ntawm daim tawv nqaij thiab qog ua kua week feem ntau zaug rau 10-14 hnub ntawm lub hnub nyoog. Txwv tsis pub mob neonatal daj ntseg. Nws yuav yog vim hais tias:

• ib tug ntxov ntxov tus me nyuam;
• bilirubin overproduction;
• enzymatic tsis paub qab hau mob hlwb;
• ib tug txo muaj peev xwm mus khi cov ntshav ntshiab bilirubin.
• pathological neonatal daj ntseg (ntev).

Tus kab mob muaj peev xwm yuav congenital los yog kis tau.

Nyob rau hauv thawj cov ntaub ntawv, neonatal daj ntseg tej zaum yuav vim:

• Pathology ntawm daim nyias nyias ntawm cov ntshav liab. Tus kab mob no tej zaum kuj tshwm twb nyob rau hauv lub neonatal lub sij hawm. Thaum lub sij hawm, nce po thiab lub siab, thiab tom qab ntawd anemia.
• Erythrocyte enzyme deficiency. Nyob rau hauv cov ntaub ntawv no, jaundice tshwm sim nyob rau hauv lub thib ob hnub ntawm lub neej. Ib tug hais yog cov zis darkening.
• Kho raws nyob rau hauv hemoglobin synthesis thiab cov qauv thiab heme. Nws zoo nkaus li ntawm 4-6 lub hlis ntawm tus me nyuam lub neej.

Nrhiav pathological neonatal daj ntseg yog ntawm peb hom:

• Hemolytic kab mob ntawm tus me nyuam mos, uas yog lub txiaj ntsim ntawm qhov teeb meem imuunologicheskogo me nyuam hauv plab ntshav los ntawm leej niam cov ntshav;
• hemorrhage nyob rau hauv lub hauv nruab nrog cev los yog cephalohematoma, uas tshwm sim thaum resorption ntawm cov ntshav cov khoom los ntawm kev nkag mus kawm rau lub neej puas hemoglobin;
• ib tug xov tooj ntawm lwm yam yog vim li cas, xws li qhov kev nce rau ntawm cov ntshav liab nyob rau hauv tus me nyuam cov ntshav, ib tug syndrome uas tsim nyob rau hauv kev sib cuag nrog cov ntshav thaum lub sij hawm yog tau me nyuam nyob rau hauv lub mob huam ntawm tus me nyuam mos, muaj cov nws niam tus mob immunopathological xwm, lam, thiab lwm yam hemolysis.

kev kho mob

Raws li nrog rau physiological daj ntseg, cov me nyuam mos feem ntau pom zoo kom pub niam mis thiab ua rau lub tshiab huab cua. Nyob rau hauv tas li ntawd, yog hais tias tus me nyuam txoj kev neonatal daj ntseg, Phototherapy txoj kev yog thov. Nws muaj irradiating tus yees duab teeb ib qho kuam me me. Nyob rau hauv nws cov rays nyob rau hauv nws lub cev yog ceev decomposition ntawm bilirubin, thiab ces nws yuav tas nyob hauv cov zis thiab feces.

Tus txheej txheem yog nqa tawm raws li nram no:

• tus me nyuam undress tag (yog hais tias nws yog ib tug me nyuam tub, lub genitals ntaub qhwv) thiab muab tso rau hauv ib tug tshwj xeeb lub thawv rau tus me nyuam mos;
• ob lub qhov muag kaw opaque daim npog qhov ncauj nrog ib tug elastic band;
• irradiation yog nqa tawm yam tsawg kawg yog 2-3 teev kev cuam tshuam ntawm noj;
• los ntawm lub sij hawm rau lub sij hawm tus me nyuam muab mus yees duab beam muaj kev nkag tau mus rau tag nrho cov qhov chaw ntawm daim tawv nqaij.

Nyob rau hauv tshwj xeeb yog yam uas txhaum loj, thaum theem siab ntawm bilirubin yog ib qho tseem ceeb, qhov kev sib kho yog nqa tawm tsis tu ncua. Nyob rau tib lub sij hawm txhua txhua teev coj ib tug mus kuaj ntshav. Tus txheej txheem yog haujlwm tsuas yog thaum tshawb fawb qhia ib tug fee tshwm sim ntawm bilirubin.

Contraindication mus ntxiv Phototherapy yog ib tug reddening ntawm daim tawv nqaij. Txawm li cas los, xws phenomena muaj cai heev tsis tshua muaj.

GOIC

Kev kho mob ntawm neonatal daj ntseg nyob rau hauv loj mob yuav tsum tau ua los ntawm cov lag luam sib pauv ntshav. Indications rau cov kev siv ntawm cov qauv no yog:

• unsatisfactory tau ntawm laboratory kev ntsuam xyuas ntawm bilirubin theem nyob rau hauv lub txoj hlab ntaws ntshav thaum lub sij hawm ntawm yug me nyuam thiab tas mus li txoj kev loj hlob, txawm tawm tsam lub backdrop ntawm Phototherapy, thiab lwm leej lwm tus;
• pov thawj sensitization ntawm leej niam thiab tej yam tshwm sim mob hemolytic kab mob ntawm cov me nyuam mos nyob rau hauv nws tus me nyuam;
• cov tsos ntawm cov khoom noj cov tsos mob bilirubin toxicity.

ntshav yam rau transfusion cov kws kho mob yog raug xaiv nruj me ntsis zuj zus rau txhua tus me nyuam thiab kev noj mus rau hauv tus account lub hom ntawm cov ntshav incompatibility ntawm leej niam thiab tus me nyuam. Tsis tas li ntawd, GOIC khiav lag luam tsuas yog tom qab kev vam meej crossmatch los ntawm ib tug catheter ntsia mus rau hauv txoj hlab leeg. Nyob rau tib lub sij hawm, yuav tsum paub hais tias txawm nrog qhov tseeb xaiv ntawm cov ntaub ntawv rau lub lag luam thiab nruj ua kevcai nco txog sterility yuav tsis raug tshem tawm ib tug ntau yam ntawm cov teeb meem. Piv txwv li, tej zaum yuav muaj ib tug huab cua embolism, ib tug ua txhaum ntawm lub plawv, kab mob, thrombosis, anaphylactic poob siab, thiab lwm leej lwm tus. Lawv feem ntau yog tshwm sim nyob rau hauv lub thawj 3 teev tom qab GOIC, li ntawd, tag nrho cov sij hawm no, kev kho mob cov neeg ua yuav tsum nruj me ntsis saib xyuas tus mob ntawm tus me nyuam.

lwm txoj kev

Cov kev kho mob muaj peev xwm kuj yuav tau siv tshuaj thiab Txoj kev lis ntshav txoj kev kho. Nyob rau hauv rooj plaub thawj yog muab "ziksorin" agar-agar "Karbolit" thiab "Cholestyramine" uas txhawb qhov kev tso tawm ntawm plab hnyuv bilirubin. cholagogue tshuaj kuj muab rau koj. Nrog rau kev hwm mus Txoj kev lis ntshav txoj kev kho, ces nws yog nqa tawm nrog daws ntawm sodium tshuaj dawb thiab piam thaj, thiab cov albumin tshuaj twb thov ntawm ib tug txo cov protein ntau theem.

kev tiv thaiv

Neonatal daj ntseg ua rau uas yog piav saum toj no, tsis yog yuav tshwm sim los yog nws cov tsos mob ploj mus sai tau hais tias yuav siv sij hawm li nram qab no ntsuas.

• tam sim ntawd tom qab yug tus me nyuam crumbs mus rau xa mus rau lub mis;
• undress tus me nyuam thiab tawm hauv lub so ntawm lub pawj liab qab mus rau ib nrab ib teev;
• pub niam mis rau kev thov;
• Los ntawm cov thawj hnub nrog rau cov me nyuam rau ib tug taug kev nyob rau hauv lub tshiab huab cua;
• pub tus me nyuam los ntawm txhua lub mis tsawg kawg yog 7-10 feeb;
• yog hais tias tus me nyuam tsis kam nqus cov niam cov kua mis yuav tsum tau qhia thiab muab nws ua ib rab diav.

Tam sim no uas koj paub tias dab tsi lub neonatal daj ntseg. Cov tsos mob ntawm ntau yam ntaub ntawv ntawm tus kab mob tau piav saum toj no, yog li ntawd, pom lawv tej yam tshwm sim, koj yuav tam sim ntawd qhia lub crumbs tus kws kho mob thiab tsis txhob poob nqi lub sij hawm.