Yintoni iKernicterus? Ngaba umntwana wakho usemngciphekweni?

Ukuba ungumama okanye utata omtsha, ndiyazi ukuba ukhathazekile kangakanani ngomntwana wakho omncinci. Ngamanye amaxesha unokoyika ukubona ulusu lomntwana wakho lujika lube tyheli. Oku kubizwa ngokuba yi-jaundice. Uninzi lwexesha, akubi kakhulu, kodwa ngamanye amaxesha, ukuba le jaundice iba mandundu, inokubangela umonakalo engqondweni yomntwana. Yiloo nto sithetha ngayo namhlanje, ebizwa ngokuba yi-kernicterus.

Yintoni iKernicterus?

Ngamafutshane, iKernicterus yimeko engaqhelekanga eyenzeka xa igazi lomntwana wakho liqulethe into etyheli eninzi ebizwa ngokuba yi-bilirubin (esiyibiza ngokuba yi- hyperbilirubinemia), enokonakalisa ingqondo yomntwana.

Ngoku usenokuba uzibuza ukuba yintoni le bilirubin? Yinkunkuma etyheli eyenzeka xa iiseli ezibomvu zegazi emzimbeni wethu ziqhekeka. Ngokwesiqhelo, isibindi sethu sisusa le bilirubin emzimbeni. Kodwa ngamanye amaxesha, ingakumbi kwiintsana ezisandul’ ukuzalwa, isibindi asikwazi ukuyisusa ngokufanelekileyo. Emva koko i-bilirubin iqokelelana egazini, nto leyo ebangela ukuba ulusu lomntwana, amhlophe emehlweni, kwiintsini, kunye neenwebu ezingaphantsi kolwimi zibe tyheli. Yiloo nto siyibiza ngokuba yi-jaundice .

Iimpawu zeKernicterus zikhula kancinci kancinci. Ukongeza kwi-jaundice, iintsana ezisandul’ ukuzalwa zinokuba nokucaphuka, ukwala ukuncancisa, kunye nokuxhuzula. Ukuba imeko iba mandundu, umntwana usenokulahlekelwa kukuva kwaye usenokuchaphazeleka bubuchopho ngokusisigxina. Ngoko ke ukuba ubona naluphi na utshintsho kwindlela umntwana wakho osandul’ ukuzalwa aziphatha ngayo okanye abonakala ngayo, kufuneka ubone ugqirha ngoko nangoko.

Usenokuba ukhe weva ukuba ngamanye amaxesha oogqirha babiza le meko ngokuthi 'yiBilirubin Encephalopathy'.

Ixhaphake kangakanani iKernicterus?

I-jaundice ixhaphake kakhulu kwiintsana ezisandul’ ukuzalwa. Nangona kunjalo, oogqirha bahlala beqaphele ukuba i-jaundice isanda kuzalwa, nto leyo enciphisa umngcipheko wokuba ibe yi-kernicterus. Yiyo loo nto i-kernicterus yimeko engaqhelekanga.

Nangona oku kuchaphazela kakhulu iintsana ezisandul’ ukuzalwa, kunokwenzeka nakubantu abadala kwiimeko ezingaqhelekanga.

Ziziphi iimpawu zeKernicterus?

Uphawu lokuqala lwe-kernicterus yi-jaundice . Ukuba umntwana wakho une-jaundice, ezi ndawo zilandelayo ziya kubonakala zimthubi:

• Ulusu lomntwana.
• Inxalenye emhlophe yamehlo.
• Iinwebu ezithambileyo ngaphakathi emlonyeni (ezifana neentsini nangaphantsi kolwimi).

Oogqirha banokuyixilonga le meko kwiveki enye ukuya kwezintathu emva kokuba umntwana ezelwe.

Ukongeza kwi-jaundice, i-kernicterus inokuba nezi mpawu:

• Ukudinwa , ukozela.
• Ifiva.
• Ukuhlanza.
• Iintshukumo zemisipha ezizenzekelayo.

Ezi mpawu zinokwahluka ngokuxhomekeke kubukhali bemeko, oko kukuthi, amanqanaba ahlukeneyo e-kernicterus.

Amanqanaba eKernicterus

Kukho amanqanaba amathathu aphambili e-kernicterus. Iimpawu zahlukile kwinqanaba ngalinye.

• Inqanaba lokuqala: Ubunzima bokutya nokuncancisa, ukozela, imisipha ephantsi, ukuncipha kokusabela kokuthuka . Khawuthelekelele, umntwana akaphili.
• Inqanaba eliphakathi: ukucaphuka, ukukhwaza kakhulu, ngamanye amaxesha ukukhala kakhulu, imisipha ephezulu. Usana lubonakala lungazinzanga nje.
• Inqanaba lokugqibela: Ukuncancisa ubisi kuyayeka ngokupheleleyo, izihlunu zomzimba ziyaqina, umzimba ugobile umqolo, intamo igobile ngasemva, kwaye kubakho ukuxhuzula. Eli lelona nqanaba liyingozi kakhulu nelisongela ubomi .

Ukuba umntwana wakho une-jaundice kunye nezinye iimpawu ezichazwe apha ngasentla, kufuneka ubone ugqirha ngokukhawuleza.

Zithini izizathu zeKernicterus?

Eyona nto ibangela i-kernicterus yi -hyperbilirubinemia , eyenzeka xa isibindi sosana olusandul’ ukuzalwa singakwazi ukususa i-bilirubin ngokufanelekileyo.

Kukho izizathu ezininzi zokuba kutheni i-bilirubin inokwanda ngale ndlela:

• I-Polycythemia: Oku kuthetha ukwanda okugqithisileyo kwenani leeseli ezibomvu zegazi emzimbeni.
• I-Hemolysis: Oku kukutshatyalaliswa kweeseli ezibomvu zegazi. Oku kudla ngokwenzeka njengenxalenye yomjikelo wobomi beseli. Nangona kunjalo, ngamanye amaxesha ezi seli zinokutshatyalaliswa ngokukhawuleza okanye ngokugqithisileyo.
• Ukwenzakala ngexesha lokuzalwa: Xa umntwana ezalwa, kunokubakho ingqokelela yegazi phantsi kolusu lwentloko (cephalohematoma) , ukopha phakathi kolusu kunye nentloko (i-subgaleal hemorrhage) , okanye ukukrweleka.
• Imeko yezonyango echaphazela iiseli zegazi zomntwana: Umzekelo , isifo se-Rh hemolytic , okanye imeko echaphazela isibindi somntwana, njenge -Crigler-Najjar syndrome .

Xa isibindi singakwazi ukukhupha i-bilirubin esitulweni, iyaqokelelana egazini ize iye kwizicubu zobuchopho. Ukuba i-bilirubin ifika engqondweni ngolu hlobo, inokubangela iingxaki ezinkulu.

Zithini iziphumo kunye neengxaki zexesha elide zeKernicterus?

Iingxaki ezibangelwa yi-kernicterus ngamanye amaxesha zinokuba yingozi ebomini kwaye zinokuba nemiphumo yexesha elide. Ziquka:

• Ukulahlekelwa kukuva.
• Umvakalelo yokitazoImeko.
• Iingxaki zophuhliso lwengqondo.
• Ukonakala kwengqondo okungapheliyo.
• I-Coma.

Ezi zizinto ezoyikisayo ukuziva. Kodwa khumbula, ezi meko zinzima zinokuthintelwa ukuba zifunyaniswe kwaye zinyangwe kwangethuba.

Ngubani osengozini enkulu yokufumana iKernicterus?

Usana lwakho olusandul’ ukuzalwa lunokuba semngciphekweni omkhulu wokufumana i-kernicterus ukuba:

• Ukuba umntwana osandul’ ukuzalwa une-jaundice.
• Ukuba umbala wolusu lomntwana umnyama kancinci, kunokuba nzima ukubona ukuba ulusu lutyheli (oluphawu lokuqala lwale meko). Le yinto ekufuneka uyilumkele ngakumbi.
• Umntwana ozelwe ngaphambi kweeveki ezingama-37 ubizwa ngokuba ngumntwana ozelwe ngaphambi kwexesha.
• Ukuba awutyi kakuhle, awuyi kukwazi ukukhupha indle ngokufanelekileyo (i-bilirubin ikhutshwa emzimbeni kunye nendle).
• Ukuba kukho umntu kusapho lwakhe owakha waba nesifo senyongo ebuntwaneni (imbali yosapho lwebhayoloji).

Neentsana ezisempilweni zinokuba ne-jaundice. Nangona kunjalo, ukuba i-jaundice iba nkulu, inokukhokelela kwi-kernicterus.

Ifunyanwa njani iKernicterus?

Ugqirha udla ngokugqiba ukuba umntwana une-kernicterus na ngokwenza uvavanyo lomzimba kunye novavanyo oluthile. Kwenziwa iimvavanyo ezimbini eziphambili:

• Uvavanyo lwemitha yokukhanya: Oku kuquka ukukhanyisa ulusu lomntwana wakho ngesixhobo esikhethekileyo. Indlela ukukhanya okuphuma ngayo kulusu lomntwana kubuyele kwisixhobo isetyenziselwa ukubala inqanaba le-bilirubin. Olu luvavanyo olungenabuhlungu nolulula.
• Uvavanyo lwegazi lwe-bilirubin: Ukuqinisekisa ukuxilongwa, ugqirha uza kuthatha isampuli yegazi elincinci esithendeni somntwana wakho, alithumele kwilebhu, aze alinganise ubungakanani be-bilirubin.

Ngamanye amaxesha, izinto ezifana ne- ultrasound scan yentloko, i -CT scan , okanye i- MRI scan zingenziwa. Kodwa azinyanzelekanga. Zenzelwe nje ukuqinisekisa ukuba akukho ezinye iimeko ezineempawu ezifanayo.

Lithini inqanaba le-bilirubin elibangela i-kernicterus?

Ugqirha uza kulinganisa inqanaba le- Total Serum Bilirubin (TSB) egazini lomntwana wakho ukuze ajonge i-kernicterus. Ngokwesiqhelo, amanqanaba e-TSB kufuneka abe phakathi kwe-0.1 kunye ne-1.2 mg/dL (ii-milligrams nge-deciliter nganye). Iimpawu ze-jaundice ziqala ukubonakala xa amanqanaba e-TSB efikelela malunga ne-2.0 mg/dL. Inqanaba le-TSB elingama-25 mg/dL nangaphezulu lithathwa njengeliphezulu kakhulu kwaye lithathwa njenge-kernicterus. Ukuba unenkxalabo malunga neziphumo zovavanyo, buza ugqirha wakho.

Iphathwa njani iKernicterus?

Kukho iindlela ezahlukeneyo zonyango lwe-kernicterus. Ugqirha uya kumisela unyango olufanelekileyo ngokusekelwe kwimeko yomntwana.

• Unyango ngeFoto: Oku kubandakanya ukukhanyisa izibane ze-ultraviolet ezikhanyayo eluswini lomntwana. Ezi zibane zikhuselekile ngokwezonyango kwaye azilimazi umntwana. Umntwana ubekwa ebhedini kwaye ukukhanya kujoliswe eluswini lomntwana. Amehlo omntwana agqunywe ngexesha lonyango. Olu kukhanya lutshintsha i-bilirubin ukuze ikwazi ukukhutshwa emzimbeni ngokulula.
• Ukutshintshwa kwegazi: Oku kuquka ukususwa kwegazi lomntwana aze alifake endaweni yalo igazi kunye/okanye iplasma evela kumntu onikelayo. Ugqirha ufaka ityhubhu encinci kumthambo osengalweni yomntwana okanye i-catheter kwisiqu sesisu. Oku kwenzelwa ukunciphisa ngokukhawuleza inani le-bilirubin egazini.
• Ii-Immunoglobulins Ezifakwa Emthanjeni (IVIG): Ukuba umntwana wakho unezinga eliphezulu le-bilirubin ngenxa yesifo esifana nesifo se-Rh, ugqirha unokunika i-IVIG. Olu lunyango lwe-antibody. Lunikwa njengesicombululo se-saline esingena emthanjeni osengalweni yomntwana wakho.

Olu nyango lusenokuvakala luyoyikisa kancinci, kodwa kubalulekile ukukhumbula ukuba lwenziwa ukuze kusindiswe umntwana kwimeko embi kakhulu.

Kuthatha ixesha elingakanani ukuba umntwana aphile emva konyango?

Kungathatha ukuya kuthi ga kwiiveki ezimbini ukuba umntwana aphile. Nangona kunjalo, ukuba imeko yomntwana ikwinqanaba lokugqibela kwaye ingqondo yonakele, umonakalo usenokungabuyeki. Ukuba oko kuyenzeka, kukho unyango kunye nenkxaso ekhoyo yokunceda umntwana ukuba ajongane nale meko njengoko ekhula.

Ungamnceda umntwana wakho aphile ngokukhawuleza ngokumondla kakuhle. Umntwana one-kernicterus unokuba nobunzima bokuncancisa. Ugqirha wakho uza kukucebisa ngendlela yokubonelela umntwana ngesondlo esifunekayo. Umntwana wakho kufuneka ondliwe kakuhle ukuze akwazi ukulahlwa kakuhle. Kungokulahla inkunkuma apho inkunkuma efana ne-bilirubin isuswa khona emzimbeni.

Iyintoni imbono kaKernicterus?

Ukuba umntwana wakho unyangwa kwisigaba sokuqala okanye esiphakathi se-kernicterus, unokuphila ngokupheleleyo. Nangona kunjalo, abantwana abanezigaba zokugqibela ze-kernicterus banokuba neengxaki ezisongela ubomi. Thetha nogqirha wakho ukuze ufunde okungakumbi ngemeko yomntwana wakho.

Izihlandlo ezininzi, oogqirha bayayifumanisa baze bayinyange i-jaundice kwiintsana ezisandul’ ukuzalwa ngaphambi kokuba ibe nzima ize ibe yi-kernicterus. Yiyo loo nto i-kernicterus isisifo esingaqhelekanga.

Ngaba umntwana angaphila ngokupheleleyo kwi-kernicterus?

Ewe,Ukuba usana lufunyenwe kwaye lunyangwa kwangethuba, lunokuchacha ngokupheleleyo kwi-kernicterus. Nangona kunjalo, izinga lokuchacha kosana lixhomekeke kwinqanaba lemeko kunye nezinto ezibangele oko.

Ngaba iKernicterus ingathintelwa?

Akukho ndlela yokuthintela zonke izinto ezibangela i-kernicterus. Kodwa ungayinciphisa ingozi yomntwana wakho yokuba ne-kernicterus ngokwenza oku kulandelayo:

• Soloko ulumkele i-jaundice emva kokuba umntwana wakho ezelwe. Ukuba ubona naluphi na utshintsho olumthubi emzimbeni womntwana wakho, bonana nogqirha ngoko nangoko.
• Ungaphoswa ziintlanganiso zokulandelela zosana lwakho olusandul’ ukuzalwa. Ezi zibaluleke kakhulu ukuba umntwana wakho wazalwa ngaphambi kwexesha.
• Ukuba umntwana wakho une-jaundice, funa unyango phantsi kwesikhokelo sikagqirha. Ugqirha uya kukunika iingcebiso malunga nonyango ukuba kuyimfuneko.

Eyona nto ibalulekileyo kukuxelela ugqirha ukuba ubona notshintsho oluncinci kwinkangeleko okanye kwindlela umntwana wakho aziphethe ngayo, ngaphandle kokulibazisa.

Ndifanele ndimse nini umntwana wam kugqirha?

Ukuba ulusu losana lwakho olusandul’ ukuzalwa, amhlophe emehlweni alo, okanye ngaphakathi emlonyeni walo lubonakala lutyheli, kubalulekile ukubona ugqirha kwiiveki ezimbalwa zokuqala zokuzalwa. I-jaundice ixhaphakile kwiintsana ezisandul’ ukuzalwa, kodwa amanqanaba aphezulu e-bilirubin anokuba yingozi ebomini. Ugqirha uza kuhlola umntwana wakho aze ajonge amanqanaba akhe e-bilirubin ukuqinisekisa ukuba usempilweni.

Ndifanele ndimse nini umntwana wam kwiyunithi yonyango olungxamisekileyo (ETU) ?

Ukuba umntwana wakho une-jaundice kunye nezinye iimpawu ze-kernicterus, ezifana nokuxhuzula, fowunela u-911 ngoko nangoko okanye umse umntwana wakho kwigumbi likaxakeka elikufutshane. Ezinye iimpawu ekufuneka uziqaphele xa kukho imeko kaxakeka ziquka:

• Ukuba umntwana ugoba umzimba wakhe njengesaphetha, ugoba intloko yakhe ngasemva, aze enze imo "C" ngomzimba wakhe.
• Ukuba ukhala ungayeki, okanye ukhwaza ngelizwi eliphezulu.
• Ukuba iibhola zenyama ziqinile ngendlela engaqhelekanga, okanye ukuba iibhola zenyama zibonakala zibuthathaka.

Ngamaxesha anje, kubalulekile ukwenza izinto ngokukhawuleza kwaye ungoyiki.

Yeyiphi imibuzo endifanele ndiyibuze ugqirha womntwana wam?

Ungaze woyike ukubuza ugqirha wakho nantoni na ocinga ngayo ngomntwana wakho. Nazi ezinye zemibuzo onokuyibuza:

• Usana olusandul’ ukuzalwa lufanele luye kuhlolwa kangaphi ngonyango?
• Umntwana wam unaliphi inqanaba le-kernicterus?
• Ngaba kukho naziphi na iziphumo ebezingalindelekanga zonyango?
• Umntwana wam udinga kangaphi i-phototherapy?
• Ingaba iKernicterus iyichaphazele ingqondo yomntwana wam okanye ibangele naziphi na iingxaki ezihlala ixesha elide?

Njengomzali wosana olusandul’ ukuzalwa, kuyinto eqhelekileyo ukuziva usoyika xa ulusu namehlo omntwana wakho ejika abe tyheli. Kunzima nokubukela umntwana wakho ebonisa iimpawu ongakwaziyo ukuzilawula okanye ukuzilungisa. Nangona i-jaundice ixhaphake kakhulu, i-kernicterus – ingxaki enkulu ye-jaundice ebangelwa yi-bilirubin eninzi egazini lomntwana – ayixhaphakanga kangako. Ukuba uvakalelwa kukuba kukho into engalunganga, bona ugqirha womntwana wakho kwaye uthethe egameni lomntwana wakho. Nangona iingxaki zinokwenzeka emva kwe-kernicterus, kukho inkxaso yobomi bonke yokunceda umntwana wakho akhule. Ukuba ufunyaniswe kwaye unyangwa kwangethuba, umntwana wakho osandul’ ukuzalwa unokuphila.

Amanqaku amafutshane ekufuneka uwakhumbule

Kulungile, masiphinde sijonge ezona zinto zibalulekileyo esithethe ngazo ngoKernicterus.

• I-Kernicterus yimeko engaqhelekanga kodwa eyingozi enokubangela umonakalo engqondweni xa inqanaba le-bilirubin egazini leentsana ezisandul’ ukuzalwa linyuka kakhulu.
• Uphawu oluphambili lwale nto yi-jaundice - ukutyheli kolusu namehlo.
• Ukongeza kwi-jaundice, ukuba umntwana wakho ulele, akafuni ukuncancisa, uyacaphuka, unomzimba oqinileyo, okanye unesifo sokuxhuzula, bonana nogqirha ngokukhawuleza.
• Ukuba ufunyaniswe kwaye wanyangwa kwangethuba (njengonyango lwe-phototherapy kunye nokutshintshwa kwegazi), umntwana unokuphiliswa ngokupheleleyo. Ukuba ushiywe emva kwexesha, unokonakala kwengqondo ngonaphakade.
• Lumka malunga ne-jaundice emva kokuba umntwana ezelwe. Landela imiyalelo kagqirha.
• Ukuba unamathandabuzo, ungaze unqikaze ukuthetha nogqirha. Ungumkhuseli ongcono womntwana wakho.

Ndiyathemba ukuba olu lwazi luluncedo kuwe. Sikunqwenelela impilo entle wena nomntwana wakho omncinci!

I- Kernicterus, iBilirubin, iJaundice, iintsana ezisandul' ukuzalwa, Umonakalo wobuchopho, i-Hyperbilirubinemia, Impilo yosana