Kuyini i-Kernicterus? Ingabe ingane yakho isengozini?

Uma ungumama noma ubaba omusha, ngiyazi ukuthi ukhathazekile kangakanani ngengane yakho encane. Ngezinye izikhathi ungase wesabe ukubona isikhumba sengane yakho siphenduka siphuzi. Lokhu kubizwa ngokuthi i-jaundice. Esikhathini esiningi, akukubi kangako, kodwa ngezinye izikhathi, uma le jaundice iba yimbi kakhulu, ingabangela umonakalo ebuchosheni bengane. Yilokho esikhuluma ngakho namuhla, okubizwa ngokuthi i-kernicterus.

Kuyini i-Kernicterus?

Kalula nje, i-Kernicterus yisimo esingavamile esenzeka lapho igazi lomntwana wakho liqukethe into ephuzi eningi kakhulu ebizwa ngokuthi i-bilirubin (esiyibiza ngokuthi i -hyperbilirubinemia), engalimaza ubuchopho bomntwana.

Manje ungase uzibuze ukuthi iyini le bilirubin? Iwumkhiqizo ophuzi odaka okwakheka lapho amangqamuzana egazi abomvu emzimbeni wethu ewohloka. Ngokuvamile, isibindi sethu sisusa le bilirubin emzimbeni. Kodwa ngezinye izikhathi, ikakhulukazi ezinganeni ezisanda kuzalwa, isibindi asikwazi ukuyisusa kahle. Ngemuva kwalokho i-bilirubin iqoqana egazini, okwenza isikhumba somntwana, amhlophe amehlo, izinsini, kanye nolwelwesi lwamafinyila ngaphansi kolimi luphenduke oluphuzi. Yilokho esikubiza ngokuthi i-jaundice .

Izimpawu ze-kernicterus zikhula kancane kancane. Ngaphezu kwe-jaundice, izinsana ezisanda kuzalwa zingase zibe nokucasuka, ukwenqaba ukuncelisa, kanye nokuxhuzula. Uma isimo siba sibi kakhulu, ingane ingase ilahlekelwe ukuzwa futhi ingase ilimale ubuchopho unomphela. Ngakho-ke uma ubona noma yiziphi izinguquko ekuziphatheni noma ekubukekeni kwengane yakho, kufanele ubone udokotela ngokushesha.

Kungenzeka ukuthi uke wezwa ukuthi ngezinye izikhathi odokotela babiza lesi simo ngokuthi 'i-Bilirubin Encephalopathy'.

Ivame kangakanani i-Kernicterus?

I-jaundice ivame kakhulu ezinsaneni ezisanda kuzalwa. Kodwa-ke, odokotela bahlala beqaphile nge-jaundice esanda kuzalwa, okunciphisa ingozi yokuthi ibe yi-kernicterus. Yingakho i-kernicterus iyisimo esingavamile kakhulu.

Nakuba lokhu kuthinta kakhulu izinsana ezisanda kuzalwa, kungenzeka nakubantu abadala ezimweni ezingavamile kakhulu.

Ziyini izimpawu ze-Kernicterus?

Uphawu lokuqala lwe-kernicterus yi-jaundice . Uma ingane yakho ine-jaundice, lezi zindawo ezilandelayo zizobonakala ziphuzi:

• Isikhumba somntwana.
• Ingxenye emhlophe yamehlo.
• Ulwelwesi oluthambile ngaphakathi komlomo (njengezinsini nangaphansi kolimi).

Odokotela bangasithola lesi simo zingakapheli isonto elilodwa kuya kwamathathu umntwana ezelwe.

Ngaphezu kwe-jaundice, i-kernicterus ingaba nalezi zimpawu:

• Ukudinwa , ukozela.
• Imfiva.
• Ukuhlanza.
• Ukunyakaza kwemisipha okungahleliwe.

Lezi zimpawu zingase zihluke kuye ngokuthi isimo sibucayi kangakanani, okungukuthi, izigaba ezahlukene ze-kernicterus.

Izigaba zeKernicterus

Kunezigaba ezintathu eziyinhloko ze-kernicterus. Izimpawu ziyahlukahluka esigabeni ngasinye.

• Isigaba sokuqala: Ubunzima bokuncela nokumunca, ukozela, imisipha ephansi, ukwehla kokusabela kokushaqeka . Cabanga nje, umntwana umane nje akaphili.
• Isigaba esiphakathi: ukucasuka, ukuklabalasa okukhulu, ngezinye izikhathi ukukhala okukhulu, imisipha ephezulu. Ingane ibonakala ingaphumuli nje.
• Isigaba sokugcina: Ukuncelisa ubisi kuyayeka ngokuphelele, imisipha yomzimba iyaqina, umzimba ugobile emuva, intamo igobile emuva, bese kuba nokuxhuzula. Lesi yisigaba esiyingozi kakhulu nesisongela ukuphila .

Uma ingane yakho ine-jaundice nezinye izimpawu ezibalwe ngenhla, kufanele ubonane nodokotela ngokushesha.

Yiziphi izimbangela zeKernicterus?

Imbangela eyinhloko ye-kernicterus yi -hyperbilirubinemia , eyenzeka lapho isibindi sosana olusanda kuzalwa singakwazi ukususa i-bilirubin ngendlela efanele.

Kunezizathu eziningana zokuthi kungani i-bilirubin inganda ngale ndlela:

• I-Polycythemia: Lokhu kusho ukwanda okukhulu kwenani lamaseli abomvu egazi emzimbeni.
• I-Hemolysis: Lokhu ukubhujiswa kwamangqamuzana abomvu egazi. Lokhu kuvame ukwenzeka njengengxenye yomjikelezo wokuphila kweseli. Kodwa-ke, ngezinye izikhathi lawa maseli angabhujiswa ngokushesha kakhulu noma ngokweqile.
• Ukulimala ngesikhathi sokuzalwa: Lapho umntwana ezalwa, kungase kube nokuqoqwa kwegazi ngaphansi kwesikhumba sekhanda (cephalohematoma) , ukuphuma kwegazi phakathi kwesikhumba kanye nogebhezi (i-subgaleal hemorrhage) , noma ukuminyana.
• Isimo sezokwelapha esithinta amangqamuzana egazi lomntwana: Isibonelo , isifo se-Rh hemolytic , noma isimo esithinta isibindi somntwana, njenge- Crigler-Najjar syndrome .

Uma isibindi singakwazi ukukhipha i-bilirubin esitulweni, siyanqwabelana egazini bese siya ezicutshini zobuchopho. Uma i-bilirubin ifika ebuchosheni kanje, ingabangela izinkinga ezinkulu.

Yimiphi imiphumela yesikhathi eside kanye nezinkinga ze-Kernicterus?

Izinkinga ezibangelwa yi-kernicterus ngezinye izikhathi zingaba yingozi empilweni futhi zingaba nemiphumela yesikhathi eside. Zihlanganisa:

• Ukulahlekelwa ukuzwa.
• Ukukhubazeka kobuchophoIsimo.
• Izinkinga zokukhula kwengqondo.
• Ukulimala kobuchopho okungapheli.
• I-Coma.

Lezi izinto ezesabekayo ukuzizwa. Kodwa khumbula, lezi zimo ezibucayi zingavinjelwa uma zitholakala futhi zelashwa kusenesikhathi.

Ubani osengozini enkulu yokuthola i-Kernicterus?

Ingane yakho esanda kuzalwa ingase ibe sengozini enkulu yokuthola i-kernicterus uma:

• Uma umntwana osanda kuzalwa ene-jaundice.
• Uma umbala wesikhumba somntwana umnyama kancane, kungaba nzima ukubona ukuphuzi kwesikhumba (okuyisibonakaliso sokuqala salesi simo). Lokhu kuyinto okufanele uyiqaphele kakhulu.
• Ingane ezelwe ngaphambi kwamasonto angu-37 ibizwa ngokuthi ingane engakazalwa.
• Uma ungadli kahle, ngeke ukwazi ukuphuma endlini yangasese ngendlela efanele (i-bilirubin ikhishwa emzimbeni kanye nendle).
• Uma othile emndenini eke waba ne-jaundice ebuntwaneni (umlando womndeni wemvelo).

Ngisho nezingane eziphilile zingaba ne-jaundice. Kodwa-ke, uma i-jaundice iba nzima, ingaholela ku-kernicterus.

Itholakala kanjani i-Kernicterus?

Udokotela uvame ukunquma ukuthi ingane ine-kernicterus yini ngokwenza ukuhlolwa ngokomzimba kanye nokuhlolwa okuthile. Kuyenziwa izivivinyo ezimbili eziyinhloko:

• Ukuhlolwa kwemitha yokukhanya: Lokhu kuhilela ukukhanyisa isikhumba somntwana wakho ngedivayisi ekhethekile. Indlela ukukhanya okudlula ngayo esikhumbeni somntwana bese kubuyela kudivayisi isetshenziswa ukubala izinga le-bilirubin. Lokhu ukuhlolwa okungenabuhlungu futhi okulula.
• Ukuhlolwa kwegazi le-bilirubin: Ukuze kuqinisekiswe ukuxilongwa, udokotela uzothatha isampula yegazi elincane esithendeni somntwana wakho, alithumele elabhorethri, bese elinganisa inani le-bilirubin.

Ngezinye izikhathi, izinto ezifana nokuskena ikhanda nge-ultrasound , i -CT scan , noma i- MRI scan zingenziwa. Kodwa azidingeki. Zenzelwe nje ukuqinisekisa ukuthi azikho ezinye izimo ezinezimpawu ezifanayo.

Iyini izinga le-bilirubin elibangela i-kernicterus?

Udokotela uzolinganisa izinga le- Total Serum Bilirubin (TSB) egazini lengane yakho ukuze ahlole i-kernicterus. Ngokuvamile, amazinga e-TSB kufanele abe phakathi kuka-0.1 no-1.2 mg/dL (ama-milligram nge-deciliter ngayinye). Izimpawu ze-jaundice ziqala ukuvela lapho amazinga e-TSB efinyelela cishe ku-2.0 mg/dL. Izinga le-TSB elingu-25 mg/dL noma ngaphezulu libhekwa njengeliphezulu kakhulu futhi libhekwa njenge-kernicterus. Uma unenkinga ngemiphumela yokuhlolwa, buza udokotela wakho.

Iphathwa kanjani i-Kernicterus?

Kunezindlela eziningana zokwelapha i-kernicterus. Udokotela uzonquma ukwelashwa okufanele kakhulu ngokusekelwe esimweni somntwana.

• Ukwelashwa nge-Phototherapy: Lokhu kuhilela ukukhanyisa izibani ze-ultraviolet ezikhanyayo esikhumbeni somntwana. Lezi zibani ziphephile ngokwezokwelapha futhi azilimazi ingane. Ingane ibekwa embhedeni bese ukukhanya kuqondiswa esikhumbeni somntwana. Amehlo omntwana ambozwe ngesikhathi sokwelashwa. Lokhu kukhanya kushintsha i-bilirubin ukuze ikwazi ukukhishwa kalula emzimbeni.
• Ukushintshanisa igazi: Lokhu kuhilela ukukhipha igazi lomntwana bese kufakwa igazi kanye/noma i-plasma kumnikeli esikhundleni salo. Udokotela ufaka ithubhu elincane emthanjeni osengalweni yomntwana noma i-catheter esiqwini se-umbilical. Lokhu kwenzelwa ukunciphisa ngokushesha inani le-bilirubin egazini.
• Ama-Immunoglobulins Angena Emthanjeni (IVIG): Uma ingane yakho inamazinga aphezulu e-bilirubin ngenxa yesimo esifana nesifo se-Rh, udokotela angase ayinike i-IVIG. Lokhu kuyindlela yokwelapha ngama-antibody. Inikezwa njengesixazululo sikasawoti emthanjeni osengalweni yengane yakho.

Lokhu kwelashwa kungase kuzwakale kuyesabisa kancane, kodwa kubalulekile ukukhumbula ukuthi kwenziwa ukuze kusindiswe umntwana esimweni esibucayi.

Kuthatha isikhathi esingakanani ukuthi umntwana alulame ngemva kokwelashwa?

Kungathatha amasonto amabili ukuthi ingane ilulame. Kodwa-ke, uma isimo sengane sisesigabeni sokugcina futhi ubuchopho bonakalisiwe, umonakalo ungase ungalungiseki. Uma lokho kwenzeka, kunezindlela zokwelapha nokusekela okutholakalayo ukusiza ingane ibhekane nalesi simo njengoba ikhula.

Ungasiza ingane yakho ukuthi ilulame ngokushesha ngokuyipha ukudla kahle. Ingane ene-kernicterus ingaba nobunzima bokuncelisa. Udokotela wakho uzokweluleka ngokuthi ungayinika kanjani ingane ukudla okunomsoco okudingekayo. Ingane yakho idinga ukondliwa kahle ukuze ikwazi ukuthulula kahle indle. Kungokukhipha indle lapho imfucuza efana ne-bilirubin isuswa khona emzimbeni.

Iyini ikusasa likaKernicterus?

Uma ingane yakho yelashwa ezigabeni zokuqala noma eziphakathi ze-kernicterus, ingalulama ngokuphelele. Kodwa-ke, izingane ezinezigaba zakamuva ze-kernicterus zingaba nezinkinga ezisongela ukuphila. Khuluma nodokotela wakho ukuze ufunde kabanzi ngesimo sengane yakho.

Esikhathini esiningi, odokotela bathola futhi belapha i-jaundice ezinganeni ezisanda kuzalwa ngaphambi kokuba ibe nzima futhi iphenduke i-kernicterus. Yingakho i-kernicterus iyisimo esingavamile kakhulu.

Ingabe ingane ingalulama ngokuphelele e-kernicterus?

Yebo,Uma itholakale futhi yelashwa kusenesikhathi, ingane ingalulama ngokuphelele ku-kernicterus. Kodwa-ke, izinga lokululama kwengane lincike esigabeni sesimo kanye nezici ezibangele lokho.

Ingabe i-Kernicterus ingavinjelwa?

Ayikho indlela yokuvimbela zonke izimbangela ze-kernicterus. Kodwa unganciphisa ingozi yengane yakho yokuthola i-kernicterus ngokwenza okulandelayo:

• Hlala uqaphele i-jaundice ngemva kokuzalwa kwengane yakho. Uma ubona noma yikuphi ukushintsha kombala ophuzi noma kuphi emzimbeni wengane yakho, bona udokotela ngokushesha.
• Ungaphuthelwa yizikhathi zokulandelela zosana lwakho. Lokhu kubaluleke kakhulu uma ingane yakho yazalwa ngaphambi kwesikhathi.
• Uma ingane yakho ine-jaundice, funa ukwelashwa ngaphansi kwesiqondiso sikadokotela. Udokotela uzokweluleka ngokwelashwa uma kudingeka.

Into ebaluleke kakhulu ukutshela udokotela uma ubona ngisho noshintsho oluncane ekubukekeni noma ekuziphatheni kwengane yakho, ngaphandle kokuyishaya indiva.

Kufanele ngiyise nini ingane yami kudokotela?

Uma isikhumba somntwana wakho osanda kuzalwa, okumhlophe kwamehlo akhe, noma ingaphakathi lomlomo wakhe libonakala liphuzi, kubalulekile ukubona udokotela phakathi namasonto ambalwa okuqala okuzalwa. I-jaundice ivame kakhulu ezinganeni ezisanda kuzalwa, kodwa amazinga aphezulu e-bilirubin angaba yingozi empilweni. Udokotela uzohlola ingane yakho futhi ahlole amazinga ayo e-bilirubin ukuqinisekisa ukuthi iphilile.

Kufanele ngiyise nini ingane yami egunjini lokwelashwa okuphuthumayo (ETU) ?

Uma ingane yakho ine-jaundice nezinye izimpawu ze-kernicterus, njengokuxhuzula, shayela u-911 ngokushesha noma uyise ingane yakho ekamelweni lezimo eziphuthumayo eliseduze. Ezinye izimpawu okufanele uziqaphele uma kunesimo esiphuthumayo zifaka:

• Uma ingane igoba umzimba wayo njengomnsalo, igoba ikhanda layo emuva, bese yenza isimo "C" ngomzimba wayo.
• Uma ukhala ungayeki, noma umemeza ngezwi eliphezulu.
• Uma ama-meatball eqinile ngendlela engavamile, noma uma ama-meatball ebonakala ebuthakathaka.

Ngezikhathi ezinjengalezi, kubalulekile ukuthatha isinyathelo ngokushesha futhi ungesabi.

Yimiphi imibuzo okufanele ngiyibuze udokotela wengane yami?

Ungesabi ukubuza udokotela wakho noma yini onayo engqondweni ngomntwana wakho. Nansi eminye imibuzo ongayibuza:

• Usana olusanda kuzalwa kufanele luhlolwe kangaki ngokwezokwelapha?
• Yisiphi isigaba se-kernicterus ingane yami enaso?
• Ingabe ikhona imiphumela emibi yokwelashwa?
• Umntwana wami udinga kangaki ukwelashwa nge-phototherapy?
• Ingabe i-Kernicterus ithinte ubuchopho bomntwana wami noma ibangele noma yiziphi izinkinga zesikhathi eside?

Njengomzali wengane esanda kuzalwa, kuyinto evamile ukuzizwa wesaba lapho isikhumba namehlo engane yakho ephenduka aphuzi. Kunzima futhi ukubona ingane yakho ibonisa izimpawu ongakwazi ukuzilawula noma ukuzilungisa. Nakuba i-jaundice ivame kakhulu, i-kernicterus - inkinga enkulu ye-jaundice ebangelwa yi-bilirubin eningi egazini lengane - ayivamile kangako. Uma uzizwa sengathi kukhona okungahambi kahle, bona udokotela wengane yakho futhi ukhulumele ingane yakho. Nakuba izinkinga zingase zenzeke ngemva kwe-kernicterus, kunezinsizakalo zokuphila konke ukusiza ingane yakho ikhule. Uma itholakale futhi yelashwa kusenesikhathi, ingane yakho esanda kuzalwa ingalulama.

Amaphuzu amafushane okufanele uwakhumbule

Kulungile, ake sibukeze izinto ezibaluleke kakhulu esikhulume ngazo ngoKernicterus.

• I-Kernicterus yisimo esingavamile kodwa esiyingozi esingabangela ukulimala kobuchopho lapho izinga le-bilirubin egazini lezingane ezisanda kuzalwa likhuphuka kakhulu.
• Isibonakaliso sokuqala salokhu yi-jaundice - ukuphuzi kwesikhumba namehlo.
• Ngaphezu kwe-jaundice, uma ingane yakho ilele, yenqaba ukuncelisa, ithukuthele kabi, inomzimba oqinile, noma inesithuthwane, bona udokotela ngokushesha.
• Uma kutholakale ukuthi unegciwane futhi welashwa kusenesikhathi (njengokwelashwa nge-phototherapy kanye nokumpontshelwa igazi), umntwana angelapheka ngokuphelele. Uma eshiywa sekwephuzile, kungenzeka umonakalo wobuchopho unomphela.
• Qaphela i-jaundice ngemva kokuzalwa komntwana. Landela imiyalelo kadokotela.
• Uma unemibuzo, ungalokothi unqikaze ukukhuluma nodokotela. Ungumvikeli wengane yakho ongcono kakhulu.

Ngiyethemba ukuthi lolu lwazi luwusizo kuwe. Sikufisela impilo enhle wena nomntwana wakho!

I- Kernicterus, i-Bilirubin, i-Jaundice, Izinsana Ezisanda Kuzalwa, Ukulimala Kobuchopho, i-Hyperbilirubinemia, Impilo Yengane