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饮食养生:新生儿融血黄疸怎么办

经这种光线照射后,胆红素被光氧化变成无色物质,从尿和胆汁排出体外。

After being irradiated by this light, bilirubin is oxidized to colorless substance and excreted from urine and bile.

这种治疗简便易行,有一定疗效。

This treatment is simple and effective.

将宝宝置于保温箱中,除去衣服及尿布,用黑眼罩(纱布裹黑纸)遮盖双目。

Put baby in incubator, remove clothes and diapers, cover eyes with black eye mask (gauze wrapped with black paper).

将光源置于离体表33-35cm处,每小时改变一次体位以增加光照面积。

The light source was placed 33-35cm away from the body surface, and the body position was changed every hour to increase the light area.

光照时间大多为24-48小时,最长可达96小时。

The illumination time is mostly 24-48 hours, and the longest is 96 hours.

治疗过程中要注意液体补给(以防脱水)和护肝治疗。

During the treatment, we should pay attention to liquid supply (to prevent dehydration) and liver protection treatment.

经这种治疗,宝宝皮肤黄疸消退和血清胆红素下降均较快。

After this treatment, jaundice subsided and serum bilirubin decreased rapidly.

输血。

Blood transfusion.

血清间接胆红素如超过20mg/dl(342μmol/l),需采用换血输血。

If the serum indirect bilirubin is more than 20 mg/dl (342 μ mol/L), exchange transfusion is needed.

供血者须先作g6pd缺乏的过筛试验,必须没有g6pd缺乏方可供血,以免输血后加重和黄疸。

In order to avoid aggravation and jaundice after blood transfusion, blood donors should first perform screening test for G6PD deficiency.

避免亲属供血。

Avoid blood supply from relatives.

黄疸不严重者不需输血。

If jaundice is not serious, no blood transfusion is needed.

2、新生儿融血黄疸病因胆红素生成过多因过多的红细胞的破坏及肠肝循环增加,使血清未结合胆红素升高。

2. The cause of neonatal hemolytic jaundice is excessive bilirubin production. The serum unconjugated bilirubin is increased due to the destruction of excessive red blood cells and the increase of intestinal and hepatic circulation.

常见的病因有:红细胞增多症、血管外溶血、同族免疫性溶血、感染、肠肝循环增加、红细胞酶缺陷、红细胞形态异常、血红蛋白病、维生素e缺乏和低锌血症等。

The common causes are: polycythemia, extravascular hemolysis, homologous immune hemolysis, infection, increased intestinal and liver circulation, red blood cell enzyme deficiency, abnormal red blood cell morphology, hemoglobinopathy, vitamin E deficiency and hypozincemia.

肝脏胆红素代谢障碍由于肝细胞摄取和结合胆红素的功能低下,使血清未结合胆红素升高。

The disorder of liver bilirubin metabolism results in the increase of unconjugated bilirubin in serum due to the low function of hepatocyte uptake and conjugated bilirubin.

常见的病因有:缺氧和感染、crigler-najjar综合征(先天性尿苷二磷酸葡萄糖醛酸基转移酶缺乏)、gilbert综合征(先天性非溶血性未结合胆红素增高症)、lucey-driscoll综合征(家族性暂时性新生儿黄疸)、药物(如磺胺、水杨酸盐、吲哚美辛、毛花苷丙等)、先天性甲状腺功能低下、垂体功能低下、21-三体综合征等。

The common causes are: hypoxia and infection, crigler Najjar syndrome (congenital uridine diphosphate glucuronosyltransferase deficiency), Gilbert syndrome (congenital non hemolytic unconjugated bilirubin increase), Lucey Driscoll syndrome (familial temporary neonatal jaundice), drugs (such as sulfanilamide, salicylate, indomethacin, lanolin C), congenital hypothyroidism Hypopituitarism, trisomy 21 syndrome, etc.

3、新生儿融血黄疸并发症新生儿黄疸的严重并发症为胆红素脑病。

3. The serious complication of neonatal jaundice is bilirubin encephalopathy.

当血清胆红素重度升高或同时存在高危因素时,可使未结合胆红素透过血脑屏障入脑,导致胆红素脑病。

The unconjugated bilirubin can enter the brain through the blood-brain barrier and cause bilirubin encephalopathy when the serum bilirubin is seriously increased or there are high-risk factors at the same time.

多见于出生后1周内,最早可于出生后l~2天内出现神经系统症状。

Most of them were found within 1 week after birth, and the earliest symptom of nervous system appeared in 1-2 days after birth.

溶血性黄疸出现较早,多发生于出生后3~5天。

Hemolytic jaundice appeared earlier, mostly occurred in 3-5 days after birth.

早产儿或其他原因所致者大多见于出生后6~10天。

Premature infants or other causes are mostly found in 6-10 days after birth.

当存在早产、窒息、呼吸困难或缺氧,严重感染、低白蛋白血症、低血糖、低体温、酸中毒或体重低于1.5kg等高危因素时,血清胆红素低于临界值亦可发生胆红素脑病。

When there are high risk factors such as premature delivery, asphyxia, dyspnea or hypoxia, severe infection, hypoalbuminemia, hypoglycemia, hypothermia, acidosis or body weight lower than 1.5kg, bilirubin encephalopathy may occur when serum bilirubin is lower than the critical value.

一般可于重度黄疸高峰后12~48小时出现症状。

Symptoms usually appear in 12-48 hours after the peak of severe jaundice.

新生儿黄疸如何护理1、判断黄疸的程度。

Neonatal jaundice how to care for 1, judge the degree of jaundice.

爸妈可以在自然光线下,观察新生儿皮肤黄染的程度,如果仅仅是面部黄染,为轻度黄疸;躯干部皮肤黄染,为中度黄疸;如果四肢和手足心也出现黄染,为重度黄疸。

Parents can observe the degree of jaundice of newborn skin under natural light. If it is only facial jaundice, it is mild jaundice; if the skin of trunk is yellow, it is moderate jaundice; if the limbs and hands and feet are also yellow, it is severe jaundice.

2、观察大便颜色。

2. Observe stool color.

如果大便成陶土色,应考虑病理性黄疸,多由先天性胆道畸形所致。

If the stool is clay colored, pathological jaundice should be considered, which is mostly caused by congenital biliary malformation.

如果黄疸程度较重、出现伴随症状或大便颜色异常应及时去医院就诊,以免耽误治疗。

If the degree of jaundice is severe, accompanied by symptoms or abnormal stool color, timely go to the hospital to avoid delay in treatment.

3、尽早使胎便尽早排出。

3. Let the fetus out as soon as possible.

因为胎便里含有很多胆红素,如果胎便不排干净,胆红素就会经过新生儿特殊的肝肠循环重新吸收到血液里,使黄疸增高。

Because fetal feces contain a lot of bilirubin, if the fetus is not discharged clean, bilirubin will be absorbed into the blood through the special liver and intestinal circulation of the newborn, so that jaundice increases.

4、给新生儿充足的水分,小便过少不利于胆红素的排泄。

4. To the newborn adequate water, urine too little is not conducive to the excretion of bilirubin.

5、在黄疽期间要注意给予足够的糖水及热力,并保护好肝脏。

5. During the period of jaundice, we should give enough sugar water and heat, and protect the liver.

新生儿黄疸的危害新生儿的生理性黄疸是可以自行消退的,但是病理性黄疸是由许多原因组成的一组疾病,必须尽早发现,尽早治疗。

The harm of neonatal jaundice the physiological jaundice of newborn can subside by itself, but pathological jaundice is a group of diseases composed of many reasons, which must be found and treated as soon as possible.

有严重黄疸的新生儿应警惕核黄疸的发生,特别是未成熟儿,月龄越小发病率越高,一般可于重黄疸发生后12-48小时之内出现精神萎靡、嗜睡、吮奶无力、肌张力减低、呕吐、不吃奶等症状,此时如及时治疗,可以完全恢复。

Neonates with severe jaundice should be alert to the occurrence of nuclear jaundice, especially the immature infants. The higher the incidence of the disease, the higher the incidence of the disease. The incidence rate of mental malaise, lethargy, sucking milk weakness, muscle tension reduction, vomiting and no feeding can be seen within 12-48 hours after the occurrence of severe jaundice.

病理性黄疸不论何种原因,严重时均可引起“核黄疸”,其预后差,除可造成神经系统损害外,严重的可引起死亡。

Pathological jaundice can cause "nuclear jaundice" no matter what the cause is. Its prognosis is poor. In addition to nervous system damage, serious jaundice can cause death.

因此,新生儿病理性黄疸应重在预防,如孕期防止弓形体、风疹病毒的感染,尤其是在孕早期防止病毒感染;出生后防止败血症的发生;新生儿出生时接种乙肝疫苗等。

Therefore, the prevention of neonatal pathological jaundice should be focused on, such as prevention of Toxoplasma and rubella virus infection during pregnancy, especially in the early pregnancy; prevention of septicemia after birth; hepatitis B vaccination at birth.

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