Thaum muaj ntshav qab zib, tus neeg mob ntsib ntau yam teeb meem kev noj qab haus huv. Thiab yog tias koj tsis pib kev kho mob hauv lub sijhawm kom ua kom cov ntshav qab zib tsis txaus thiab tsis tshem tawm cov tsos mob ntawm tus kab mob, tus kab mob ntshav qab zib tuaj yeem tsim kab mob ntawm cov hlab plawv, ob lub raum lossis mob siab. Ib qho ntawm cov teeb meem uas cov ntshav qab zib tuaj yeem ua yog siab bilirubin ntau ntau.
Txhawb cov bilirubin hauv cov ntshav yog tsim los ntawm kev tawg ntawm cov qe ntshav liab. Ua ntej, bilirubin tsis ncaj qha yog tsim nyob rau hauv lub cev - khoom lom uas tsis tuaj yeem yaj nyob hauv dej.
Qhov no txhais tau hais tias nws tsis raug ntuav tawm, vim qhov ntawd, ua ke nrog ntshav, nws nkag mus rau hauv daim siab thiab hloov mus rau hauv bilirubin.
Cov khoom tsim, nyeg, tuaj yeem yaj tau yooj yim hauv cov kua thiab tawm ntawm tib neeg lub cev los ntawm kev tso zis thiab quav, muab cov kua qab daj.
Txhawm rau kom paub tag nrho bilirubin hauv ib tus neeg laus, koj yuav tsum tau kuaj ntshav tshwj xeeb. Tus nqi ib txwm ntawm ib yam khoom yog 3.4 µmol / litre rau ncaj qha thiab 17.1 µmol / liter rau tsis ncaj qha bilirubin.
Ua kom tag nrho bilirubin raug kuaj pom hauv cov neeg laus uas muaj tus lej ntau dua 4.6 thiab 15.4 μmol / litre, feem.
Cov tsos mob ntawm cov bilirubin ntau ntxiv
Yog tias theem ntawm tag nrho cov bilirubin hauv cov ntshav nce siab, tus neeg mob muaj daim tawv daj daj thiab tso zis dub. Qhov no qhia tau hais tias nce bilirubin txaij rau tib neeg cov ntaub so ntswg, staining lawv hauv cov xim grey-daj.
Tsis tas li, thaum qib bilirubin nce, tus neeg yuav hnov tsis xis nyob sab laug hypochondrium tom qab ua kev tawm dag zog, vim tias tus neeg mob yuav ntsib kev qaug zog, qaug zog thiab ua npaws.
Yog tias ib tus neeg muaj cov tsos mob no, nws txhais tau tias nws yuav tsum tau kho cov khoom hauv nruab nrog cev. Koj yuav tsum tam sim ntawd sab laj tus kws kho mob uas yuav ua kev kuaj ntshav kom txiav txim siab tag nrho cov bilirubin thiab kev kho mob kom kho. Yog tias theem thoob plaws hauv lub cev muaj ntau, qhov no qhia tau tias muaj qee qhov laj thawj ntawm kev loj hlob ntawm tus kabmob uas yuav tsum tau kho.
Muaj qee kis, qib tseem ceeb ntawm bilirubin tuaj yeem nce mus txog 300 units, uas yog txaus ntshai rau kev noj qab haus huv thiab xav tau kev kho mob sai. Raws li txoj cai, ntsuas ntawm 300 μmol / liter tuaj yeem pom hauv cov menyuam yaus, cov kws kho mob hu rau qhov tshwm sim no lub ntsej muag menyuam yaus daj, uas ploj tom qab ob peb hnub.
Tsom mus rau cov tsos mob, tus kws kho mob yuav sau ntawv kuaj ntshav los txiav txim theem bilirubin. Kev soj ntsuam rau tag nrho kom bilirubin feem ntau yog ua thaum sawv ntxov nyob rau ntawm lub plab khoob.
Ua ntej ua qhov kev txheeb xyuas, koj tsis tuaj yeem haus rau plaub teev. Yog tias tag nrho cov kev cai ua raws, cov kev tshawb fawb muaj tseeb yuav tau txais.
Cov Ua Rau Bilirubin Nce
Qhov ua kom nce bilirubin hauv cov ntshav tuaj yeem tshwm sim los ntawm tus kab mob ntawm daim siab thiab cov ntshav ncig. Muaj ntau txoj kev xaiv yog vim li cas muaj kev ua txhaum ntawm kev saib xyuas ntawm ib qho khoom hauv lub cev.
- Raws li qhov tshwm sim ntawm cov mob qog nqaij hlav ntshav yug me nyuam hauv plab los yog muaj ntshav liab hauv tib neeg lub cev, kev rhuav tshem cov qe ntshav liab hauv cov ntshav tau nrawm, uas ua rau muaj kev nce qib hauv bilirubin. Qhov kev cuam tshuam tshwm sim vim qhov nce ntxiv ntawm cov tshuaj no. Ntxiv mus, vim muaj ntshav khiav tawm, indil bilirubin ntawm lub nce.
- Lwm qhov laj thawj yog cuam tshuam nrog kev ua kom tsis muaj zog ntawm bilirubin ncaj qha rau hauv daim siab. Cov kab mob uas muaj koob npe xws li kab mob siab, mob ntsws, mob qog noj ntshav thiab lwm yam kabmob tuaj yeem ua rau muaj qhov no. Xws li cov laj thawj rau kev nce hauv bilirubin qib yuav raug raws caj ces. Piv txwv li, tus kab mob ntawm Gilbert syndrome ua rau kev ua txhaum ntawm kev tsim cov nplooj siab enzymes.
- Qhov thib peb yog vim li cas tej zaum yuav yog gallbladder teeb meem. Vim tias qhov ua txhaum ntawm outflow ntawm bile los ntawm choleretic zais zis, theem ntawm bilirubin hauv lub cev feem ntau nce.
- Xws li cov laj thawj yuav cuam tshuam nrog kev siv yeeb tshuaj. Qhov no txhais tau hais tias ua ntej pib kev kho mob, koj yuav tsum tau twv yuav raug koj tus kheej nrog cov contraindications uas tau sau tseg hauv cov lus qhia.
- Feem ntau, vim li cas rau kev nce bilirubin yog nyob rau hauv kev kis ntawm lub cev nrog helminths. Thaum kuaj pom tus kab mob helminthiasis, nws yog thawj zaug tsim nyog kom tau txais kev kho mob uas tsim nyog, tom qab ntawd dhau mus kuaj ntshav thiab rov kuaj bilirubin qhov tseem ceeb.
- Nrog lub cev tsis muaj vitamin B12, qib bilirubin kuj tseem tuaj yeem nce ntxiv. Qhov no txhais tau tias, ua ntej tau txais kev kho mob nrog tshuaj, koj yuav tsum tau ntxiv lub cev nrog cov tshuaj muaj txiaj ntsig uas ploj lawm.
Txo Nqi Bilirubin Qib Hauv Cov Ntshav
Ua ntej pib kho, nws yog ib qho tsim nyog yuav tsum tshawb pom qhov ua rau muaj tus kab mob. Cov hau kev muaj nyob rau hauv cov tshuaj niaj hnub tso cai rau koj los kho qhov ua txhaum ntawm qhov ntsuas ntawm qhov ntsuas pom. Vim li no, tsuas yog kws kho mob tuaj yeem sau ntawv txo qis bilirubin ntau ntau.
Nrog kev pab los ntawm infusion therapy, qabzib thiab detoxification tshuaj yog txhaj tshuaj ua ke.
Cov kev kho no tso cai rau koj ntxuav lub cev ntawm qhov nce ntxiv ntawm bilirubin. Siv cov qauv zoo sib xws yog tias tus neeg mob muaj mob hnyav.
Kev siv tshuaj pleev ntsej muag yog siv los txo cov qib bilirubin tsis yog rau cov laus xwb tab sis kuj yog rau menyuam yaus. Cov txheej txheem muaj nyob rau hauv irradiating tus neeg mob nrog kev pab los ntawm cov teeb tshwj xeeb, nyob rau hauv tus ntawm uas indirect bilirubin tau hloov mus rau hauv daim ntawv ncaj qha, tom qab uas nws tuaj yeem yooj yim tawm ntawm lub cev.
Yog tias qhov laj thawj ntawm kev nce bilirubin nyob hauv kev ua txhaum ntawm kev tshem tawm cov kua tsib los ntawm lub cev, tus kws kho mob tau sau ntawv kho kom tsim nyog nrog cov tshuaj tshwj xeeb. Ua ntej tshaj plaws, nws yog cov tshuaj choleretic nrog stagnation ntawm bile.
Kev noj tshuaj pab kom noj qab haus huv tseem yuav pab txo qis ntawm cov bilirubin hauv cov ntshav. Tsis tas li ntawd, kev kho yog nrog kev siv lub tshuab hluav ncaig hluav taws xob, tshuaj ntxuav kom huv thiab tshem tawm cov kua roj. Xws li cov rog, kib, ntsim tais diav thiab haus dej hauv cov pa roj carbon monoxide tsis suav nrog tus neeg mob noj zaub mov.
Yog tias tus neeg mob kuaj pom muaj tus kab mob siab, thawj qhov uas tus neeg mob tau sau yog kev kho mob ntawm tus kab mob no, uas ua rau txo qis bilirubin. Xws li tus kws kho mob sau ntawv yuav tshuaj los tiv thaiv daim siab.
Nrog Gilbert syndrome thiab qee cov kab mob siab, Phenobarbital yog tus muaj cai yuav tshuaj.
Txhawm rau zam kev nyuaj, kev kho thiab tshuaj yuav tsum yog tus kws kho mob sau tseg tom qab kuaj thiab tshuaj ntsuam.
Tus Kab Mob Siab Bilirubin
Direct bilirubin nce ntxiv yog tias muaj cov laj thawj hauv qab no:
- Nce bilirubin hauv cov ntshav;
- Kab mob siab hom A, B, mob siab nrog mob mononucleosis;
- Kab mob siab C, tus mob autoimmune;
- Kab mob siab Brucellosis thiab mob leptospirosis;
- Lom nrog lom lossis tshuaj tsw qab;
- Kev siv tshuaj tiv thaiv hormonal contraceptives, NSAIDs, tshuaj tiv thaiv kab mob ntsws thiab qog;
- Qhov muag daj thaum cev xeeb tub;
- Lub qog ntawm lub siab;
- Mob plab mob ib ce;
- Tus kab mob muaj pob txha caj qaum - Rotor syndrome, Dabin-Johnson.
Indirect bilirubin nce rau hauv cov ntshav vim muaj cov ntsiab lus hauv qab no:
- Congenital hemolytic anemia, suav nrog spherocytic, tsis-spherocytic, kab mob cell mob, thalassemia, Markyafa-Michele kab mob;
- Tau txais hemolytic anemia, uas tawm tsam keeb kwm ntawm cov kab mob lupus erythematosus, mob caj dab, mob caj dab, lymphocytic leukemia, lymphagranulomatosis.
- Sepsis, mob npaws, kub cev thiab lwm yam kab mob kis;
- Tshuaj tiv thaiv kab mob ntshav siab vim yog siv insulin, cephalosporins, tshuaj aspirin, NSAIDs, chloramphenicol, penicillin, levofloxacin;
- Tshuaj lom neeg mob ntshav qab zib lom los ntawm lom nrog lub cev lom, nceb, arsenic, tooj liab sulfate, tom ntawm cov kab lom.
- Syndromes ntawm Gilbert, Krigler-Nayyar, Lucy-Driscola.
