Bilirubin encephalopathy

Bilirubin encephalopathy wani yanayi ne mai ɗauke da jijiyoyin jiki da ke faruwa a cikin wasu jarirai masu fama da cutar youndice.

Bilirubin encephalopathy (BE) yana faruwa ne sanadiyar matakan Bilirubin sosai. Bilirubin launi ne mai launin rawaya wanda aka halitta yayin da jiki ke kawar da tsoffin ƙwayoyin jini. Yawan bilirubin a jiki na iya sa fata ta zama rawaya (jaundice).

Idan matakin bilirubin yayi yawa ko kuma jariri bashi da lafiya, abun zai tashi daga cikin jini ya tattara a cikin kwakwalwar idan ba a daure shi da albumin (protein) a cikin jini ba. Wannan na iya haifar da matsaloli kamar lalacewar kwakwalwa da rashin ji. Kalmar "kernicterus" tana nufin launin rawaya da bilirubin ya haifar. Ana ganin wannan a cikin sassan kwakwalwa akan autopsy.

Wannan yanayin yakan fi girma a cikin makon farko na rayuwa, amma ana iya ganin shi har zuwa mako na uku. Wasu jarirai da ke fama da cutar Rh hemolytic suna cikin haɗari ga mummunan jaundice wanda zai iya haifar da wannan yanayin. Da wuya, BE na iya haɓaka cikin yara masu lafiya.

Alamun cutar sun dogara da matakin BE. Ba duk jariran da ke da cutar sankara a jikin autopsy ba ne ke da tabbatattun alamu.

Mataki na farko:

• Matsanancin jaundice
• Rashin amsawa mai ban mamaki
• Rashin ciyarwa ko tsotsa
• Matsanancin bacci (rashin natsuwa) da ƙananan ƙwayar tsoka (hypotonia)

Matsakaici na tsakiya:

• Babban kuka
• Rashin fushi
• Mayila za su iya yin baya tare da wuyansa a baya baya, sautin tsoka (hypertonia)
• Rashin ciyarwa

Mataki na ƙarshe:

• Stupor ko coma
• Babu ciyarwa
• Kuka takeyi
• Idityarfin ƙarfin tsoka, wanda aka ja da baya baya tare da wuyansa a baya zuwa baya
• Kamawa

Gwajin jini zai nuna babban matakin bilirubin (mafi girma sama da 20 zuwa 25 mg / dL). Koyaya, babu hanyar haɗi kai tsaye tsakanin matakin bilirubin da matakin rauni.

Jeri na darajar yau da kullun na iya ɗan bambanta kaɗan tsakanin ɗakunan gwaje-gwaje daban-daban. Yi magana da likitanka game da ma'anar takamaiman sakamakon gwajin ku.

Maganin ya dogara da shekarun jaririn (a cikin awanni) da kuma ko jaririn yana da wasu abubuwan haɗari (kamar lokacin tsufa). Yana iya haɗawa da:

• Haske mai haske (phototherapy)
• Yin musayar jini (cire jinin yaron da maye gurbin shi da sabon jinin mai bayarwa ko jini)

BE yanayi ne mai tsanani. Yaran da yawa da ke fama da rikice-rikicen tsarin ƙarshen lokaci suna mutuwa.

Matsaloli na iya haɗawa da:

• Lalacewa ta dindindin
• Rashin ji
• Mutuwa

Nemi taimakon likita yanzunnan idan jaririn yana da alamun wannan matsalar.

Yin jinyar jaundice ko yanayin da zai iya haifar da shi na iya taimakawa hana wannan matsalar. Yaran da ke da alamun farko na cutar jaundice suna da matakin bilirubin a cikin awoyi 24. Idan matakin ya yi yawa, ya kamata a binciki jaririn kan cututtukan da suka shafi lalata jajayen ƙwayoyin jini (hemolysis).

Duk jariran da aka haifa suna da alƙawari na gaba tsakanin kwanaki 2 zuwa 3 bayan barin asibiti. Wannan yana da mahimmanci ga ƙarshen lokacin haihuwa ko jariran da suka fara haihuwa (waɗanda aka haifa sama da makonni 2 zuwa 3 kafin ranar haihuwarsu).

Bilirubin da ke haifar da matsalar rashin lafiyar jiki (BIND); Kernicterus

• Sabon jaundice - fitarwa

• Kernicterus

Hamati AI. Matsalolin ilimin jijiyoyin jiki na cututtukan tsari: yara. A cikin: Daroff RB, Jankovic J, Mazziotta JC, Pomeroy SL, eds. Bradley's Neurology a cikin Clinical Practice. 7th ed. Philadelphia, PA: Elsevier; 2016: babi na 59.

Hansen TWR. Pathophysiology na kernicterus. A cikin: Polin RA, Abman SH, Rowitch, DH, Benitz WE, Fox WW, eds. Haihuwar Jiki da Jikin Jarirai. 5th ed. Philadelphia, PA: Elsevier; 2017: babi na 164.

Kaplan M, Wong RJ, Sibley E, Stevenson DK. Ciwon jariri da cutar hanta. A cikin: Martin RJ, Fanaroff AA, Walsh MC, eds. Fanaroff da Martin's Neonatal-Perinatal Medicine. 10 ed. Philadelphia, PA: Elsevier Saunders; 2015: babi na 100.

Marcdante KJ, Kliegman RM. Anemia da hyperbilirubinemia. A cikin: Marcdante KJ, Kliegman RM, eds. Nelson Mahimman Bayanan Ilimin Yara. 8th ed. Elsevier; 2019: babi na 62.