Ngesikhathi sikashukela, isiguli sibhekene nezinkinga eziningi zempilo. Futhi uma ungaqali ukwelashwa ngesikhathi ukuze uguqule ushukela wegazi futhi ungaziqedi izimpawu zesifo, abanesifo sikashukela bangaba nezifo zesifo senhliziyo, izinso noma isibindi. Enye yezinkinga ezingabangelwa yisifo sikashukela ngamazinga aphezulu we-bilirubin.
I-bilirubin ephakeme egazini yakhiwa ngenxa yokuqhekeka kwamangqamuzana abomvu egazi. Okokuqala, i-bilirubin engaqondile yakhiwa emzimbeni - into enobuthi engeke ichithwe emanzini.
Lokhu kusho ukuthi ayikhiswanga, ngenxa yalokho, kanye negazi, ingena esibindini futhi iguqulwa ibe yi-bilirubin.
Umuthi owakhiwe ungaphenduka kalula ku-ketshezi bese ukhishwa emzimbeni womuntu ngomchamo nangama-ndove, ubanikeze umbala onsundu.
Ukubona i-bilirubin ephelele kumuntu omdala, udinga ukwenza uhlolo lwegazi olukhethekile. Izinga elijwayelekile lezinto ngu-3.4 µmol / ilitha ngokuqondile ne-17.1 µmol / ilitha nge-bilirubin engaqondile.
Inani eliphelele le-bilirubin litholakala kubantu abadala abanamanani amakhulu kune-4.6 no-15.4 μmol / lit, ngokulandelana.
Izimpawu ze-bilirubin ezikhulayo
Uma izinga le-bilirubin esegazini likhuphuka kakhulu, isiguli sinomsindo wesikhumba ophuzi nomchamo omnyama. Lokhu kusikisela ukuthi inani elikhulile lama-bilirubin latheleleka izicubu zomuntu, lazigcina ngombala ophuzi.
Futhi, njengoba izinga le-bilirubin likhuphuka, umuntu angazizwa engakhululekile kwi-hypochondrium yangakwesobunxele ngemuva kokuzivocavoca umzimba, ngenxa yalokho isiguli singase sibhekane nobuthakathaka, ubuthi kanye nomkhuhlane.
Uma umuntu enezimpawu ezinjalo, kusho ukuthi kuyadingeka ukwelapha izitho zangaphakathi. Kufanele uthintane nodokotela ngokushesha ozokwenza isivivinyo segazi ukuthola inani eliphelele le-bilirubin futhi anikeze nokwelashwa. Uma izinga elijwayelekile lomuthi liphezulu kakhulu, lokhu kuphakamisa ukuthi kunezizathu ezithile zokwenza lesi sifo esidinga ukwelashwa.
Kwezinye izimo, izinga elibucayi le-bilirubin lingakhuphuka liye kumayunithi angama-300, okuyingozi empilweni futhi kudinga ukwelashwa ngokushesha. Njengomthetho, izinkomba ezingama-300 μmol / ilitha zingabonakala ezinganeni, odokotela babiza le nto yesifo se-jaundice yobuntwana, esinyamalala ngemuva kwezinsuku ezimbalwa.
Egxila kuzimpawu, udokotela uzonikeza ukuhlolwa kwegazi ukuthola ukuthi yi-bilirubin kangakanani. Ukuhlaziywa kwe-bilirubin ephelele ephakeme kuvame ukwenziwa ekuseni ngesisu esingenalutho.
Ngaphambi kokuhlaziya, awukwazi ukuphuza amahora amane. Uma yonke imithetho ilandelwa, kutholakala imiphumela yocwaningo olunembile.
Izimbangela Zokwanda KweBilirubin
Imbangela yokwanda kwe-bilirubin egazini ingabangelwa yisifo sesibindi nohlelo lokujikeleza kwegazi. Kunezindlela eziningi zokuthi kungani kunokuphulwa kokuhlakazwa kwento emzimbeni.
- Njengomphumela we-congenital noma ye-ethgenital anemia emzimbeni womuntu, ukubhujiswa kwamangqamuzana abomvu egazini kuyasheshiswa, okuholela ekwandeni kwezinga le-bilirubin. Ukuphazamiseka kukhula ngenxa yokuqongelela okuthe xaxa kwale nto. Ngaphezu kwalokho, ngenxa ye-anemia, i-bilirubin engaqondile ikhuphuka.
- Esinye isizathu sihambisana nokukhiqizwa okungafanele kwe-bilirubin eqondile esibindini. Izifo ezaziwa njenge-hepatitis, cirrhosis, umdlavuza kanye nezinye izinhlobo zezifo kungaholela kulokhu. Kubandakanya izizathu zokwenyuka kwamazinga we-bilirubin kungaba njengefa. Isibonelo, isifo se-Gilbert's syndrome kuholela ekwephulekeni kokukhiqizwa kwama-enzymes wesibindi.
- Isizathu sesithathu kungaba yizinkinga ze-gallbladder. Ngenxa yokwephula ukuphuma kwe-bile okuvela ku-choleretic bladder, izinga le-bilirubin emzimbeni livame ukwanda.
- Kubandakanya izizathu kungahlotshaniswa nokusetshenziswa kwezidakamizwa. Lokhu kusho ukuthi ngaphambi kokuqala ukwelashwa, kufanele uzijwayeze ngokuhlangana kwe-contraindication okunikezwe emiyalweni.
- Imvamisa, isizathu sokwanda kwe-bilirubin ekuthelelekeni komzimba ngama-helminths. Lapho kutholwa i-helminthiasis, okokuqala kudingekile ukuthola ukwelashwa okudingekayo, bese uphumelela ukuhlolwa kwegazi uphinde uhlole amanani we-bilirubin.
- Ngokushoda kwe-vithamini B12, amazinga we-bilirubin nawo angakhuphuka. Lokhu kusho ukuthi, ngaphambi kokulashwa ngemithi, udinga ukubuyisa umzimba ngezinto ezingekho usizo.
Ukwehlisa Amazinga weBilirubin eGazini
Ngaphambi kokuqala ukwelashwa, kuyadingeka ukuthola imbangela yalesi sifo. Izindlela ezitholakala emithini yesimanje zikuvumela ukuthi welaphe ukwephulwa ngesisekelo sezinkomba ezibekiwe. Ngalesi sizathu, udokotela kuphela ongabeka ukwehla kwamazinga we-bilirubin.
Ngosizo lwe-infusion therapy, izidakamizwa ze-glucose kanye ne-detoxification zifakwa ngaphakathi emzimbeni.
Lokhu kwelashwa kukuvumela ukuthi uhlanze umzimba ngenani elikhulile le-bilirubin. Indlela efanayo isetshenziswa uma isiguli sinesimo esibi.
I-Phototherapy isetshenziselwa ukunciphisa amazinga we-bilirubin hhayi kuphela kubantu abadala kepha nasezinganeni. Le ndlela iqukethe ukufudumeza isiguli ngosizo lwamalambu akhethekile, ngaphansi kwethonya lapho i-bilirubin engaqondile iguqulwa ifomu eliqondile, ngemuva kwalokho lingashiya umzimba kalula.
Uma isizathu sokwanda kwe-bilirubin silele kokuphulwa kwe-extretion ye-bile emzimbeni, udokotela unikeza ukwelashwa okufanele ngezidakamizwa ezikhethekile. Okokuqala, izidakamizwa ze-choleretic nge-stagnation ye-bile.
Ukudla okwelaphayo kusiza ukwehlisa ukugcwala kwe-bilirubin egazini. Ngaphezu kwalokho, ukwelashwa kuhambisana nokusetshenziswa kwamalahle ocushiwe, umuthi wokuhlanza kanye nama-gels okususa ubuthi. Kubandakanya ukudla okunamafutha, okuthosiwe, okunezipayisi kanye neziphuzo zekhabhoni akufakiwe ekudleni kweziguli.
Uma isiguli sitholakala sine-hepatitis, into yokuqala isiguli esinqunyelwe ukwelashwa kwalesi sifo, okubuye kunciphise i-bilirubin. Kubandakanya udokotela unquma izidakamizwa ukuvikela isibindi.
Ngesifo sikaGilbert kanye nezinye izifo zesibindi, kubekwa iPhenobarbital.
Ukugwema ubunzima, ukwelashwa nemithi kufanele inikezwe ngudokotela ngemuva kokuhlolwa nokuhlaziywa.
Isifo Esiphezulu seBilirubin
Ama-bilirubin aqondile akhuphuka uma kunezizathu ezilandelayo:
- Ukunyuka kwe-bilirubin egazini;
- I-acute hepatitis A, B, i-hepatitis ene-mononucleosis ethelelekayo;
- I-hepatitis C engapheli, i-autoimmune hepatitis;
- I-Brucellosis ne-leptospirosis bacterius hepatitis;
- Ukunobuthi ngezinto ezinobuthi noma isikhunta;
- Ukusetshenziswa kwemithi yokuvimbela inzalo yama-hormonal, ama-NSAIDs, izidakamizwa ezilwa nesifo sofuba kanye namaqhubu;
- Jaundice ngesikhathi sokukhulelwa;
- I-tumor yesibindi;
- I-Biliary cirrhosis;
- I-Hereditary jaundice - Isifo iRotor, uDabin-Johnson.
Ama-bilirubin aqondile akhuphuka egazini ngenxa yalezi zinto ezilandelayo:
- I-Congenital hemolytic anemia, kufaka phakathi i-spherocytic, i-non-spherocytic, isifo se-sickle cell, i-thalassemia, isifo sikaMarkyafa-Michele;
- I-anemia etholakele ye-hemolytic, ekhula ngokumelene nesizinda se-systemic lupus erythematosus, i-rheumatoid arthritis, i-lymphocytic leukemia, i-lymphagranulomatosis.
- I-Sepsis, umkhuhlane we typhoid, umalaleveva kanye nezinye izifo ezithathelwanayo;
- I-anemia ye-hemolytic anemia ebangelwa ukuthatha i-insulin, i-cephalosporins, i-aspirin, ama-NSAIDs, i-chloramphenicol, i-penicillin, i-levofloxacin;
- I-anemia enobuthi ye-hemolytic ebangelwa ubuthi ngento enobuthi, amakhowe, i-arsenic, i-sulfate yethusi, ukuluma kwezinambuzane ezinobuthi.
- AmaSyndromes kaGilbert, uKrigler-Nayyar, uLucy-Driscola.
