Blu-ray treatment of neonatal jaundice

Physiological jaundice is 24 hours after birth by the birth of serum bilirubin 17 ~ 51μmol / L (1 ~ 3mg/dl) gradually increased to 86μmol / L (5mg/dl) or more without other clinical jaundice symptoms subsided 1 to 2 weeks. Physiological jaundice of serum bilirubin in term children does not exceed 204μmol / L (12mg/dl) in premature children less than 255μmol / L (15mg/dl). However, individual serum bilirubin in premature children less than 204μmol / L (12mg/dl) bilirubin encephalopathy may also occur on the physiological jaundice due vigilance to prevent the pair of pathologic jaundice misdiagnosed.

Neonatal Jaundice:

(1) jaundice occurs early, within 24 hours after birth that the jaundice;

(2) jaundice was severe, golden brown or jaundice throughout the body, palms, plantar also obvious jaundice or serum bilirubin greater than 12 to 15 mg / dl;

(3) jaundice lasting 2-3 weeks after birth jaundice still persistent even better, or reduce the later deepened;

(4) accompanied by anemia or stool color fades;

(5) have abnormal body temperature, appetite is not Jia, vomiting performers.

pathologic jaundice should pay attention, because it is often a manifestation of the disease, should search for a cause. In addition, the concentration of unbound bilirubin up to a certain extent, it will damage brain cells through the blood-brain barrier (often called nuclear jaundice), causing death or cerebral palsy, mental retardation and other consequences. So once suspected of pathologic jaundice in children, seek medical attention immediately.

several common pathological neonatal jaundice

(1) hemolytic jaundice: The most common causes of hemolytic jaundice are ABO hemolysis, it is because the mother and fetus caused by blood group incompatibility , and to the mother blood type is 0, the fetal blood type is A or B were the most common cause of jaundice and heavier; other if the mother blood type is A, fetal blood group is B or AB; mothers blood type is B, fetal blood type is A or AB more rare, and jaundice caused by light. As a result, some parents would be very nervous, fearing the child will occur ABO hemolytic, in fact, point to note: Not all newborn ABO blood group incompatibility hemolysis occurs. It is reported that neonatal ABO blood group incompatibility hemolytic disease was 11.9%. Hemolytic jaundice after birth, characterized by jaundice within 24 hours, and gradually increased.

(2) infectious jaundice: jaundice due to infection or bacterial infection, viral infection causes major damage to the liver cell function and jaundice occurred. Virus infections as intrauterine infection, the cytomegalovirus and hepatitis B virus infection the most common, other rubella virus infection, EB virus, toxoplasmosis and so rare. Bacterial infection with sepsis the most common jaundice. Characterized by jaundice physiological jaundice physiological after persistent jaundice or persistent jaundice after.

(3) obstructive jaundice: Obstructive jaundice caused more by a congenital malformation of the bile duct to the more common congenital biliary atresia, which is characterized by jaundice after birth, another 1-2 weeks or 3-4 weeks jaundice, gradually deepened, the color gradually turned into light yellow stools, and even showed a white pottery earth tones.

(4) Breast Milk Jaundice: This is a special type of pathological jaundice. A small number of breast-feeding infants, the jaundice levels than normal physiological jaundice, because not very clear. The jaundice is characterized by: the physiological jaundice jaundice continues to increase after the peak, bilirubin up to 10-30mg/dl, such as continued breast-feeding, jaundice, high in the state continue to decline slowly after a period of time, such as the cessation of breast-feeding for 48 hours bilirubin decreased by 50%, if the re-feeding, the bilirubin rose again.

pathologic jaundice for whatever reason, can cause serious “nuclear jaundice”, its poor prognosis, in addition to causing damage to the nervous system, the severe cases can lead to death. Thus, neonatal pathological jaundice should focus on prevention, such as during pregnancy to prevent toxoplasmosis, rubella virus infection, especially in early pregnancy to prevent HIV infection; birth to prevent the occurrence of sepsis; neonatal hepatitis B vaccine at birth and so on. Parents should closely monitor the child's jaundice changes, such as found in the pathological signs of jaundice, should be sent to hospital for treatment.

clinical symptoms

1 physiological jaundice were limited to light yellow face and neck, or spread to the trunk, stained yellow sclera can also be dissipated after 2 to 3, to 5 6, skin color return to normal; severe cases, jaundice can be the same throughout the whole body spearhead hind, vomit, and cerebrospinal fluid, etc. can be stained yellow as long as 1 week or more, especially individual child sustainable to 4 weeks premature, their manure is still the yellow line no bilirubin in urine.

2 jaundice, pale color and light by color, weight are darker in color, but yellow in rosy red skin.

3 jaundice common in parts of the trunk, proximal limbs, sclera, and the general, but Zhou Xi.

4 newborns generally good, without anemia, enlarged liver and spleen are not normal liver function, not a nuclear jaundice.

5 children Jaundice in preterm children than the more common term can be slightly delayed 1 ~ 2d appeared more severe jaundice subsided too late, can be extended to 2 to 4 weeks causes of neonatal jaundice

often simply jaundice yellowing of the skin as that is, in fact, was only half right, yellow skin surface phenomenon only. Normal human blood contains a certain amount of pigment material, called bilirubin, as a result of physiological and pathological reasons why the blood of bilirubin, skin, whites of the eyes, etc. will be yellow.

those reasons can cause elevated bilirubin in the body do?

First, the red blood cell destruction of too much too soon. About 80% of bilirubin in vivo aging of red blood cells from destruction and formation. If the red blood cell destruction of too much too soon, bilirubin surge can cause jaundice. Mother, child blood group incompatibility hemolytic jaundice caused fall into this category, within 24 hours after birth on jaundice, and progress quickly, the skin showed golden brown. When the blood, and bilirubin over 20 mg%, the bilirubin into the brain cells may interfere with normal brain cell activity and function, causing nuclear jaundice, threatening the lives of newborns. Despite the current severe jaundice with good treatment, but to achieve the desired effect, it must be time before jaundice in the event of a nuclear emergency. Parents to observe the degree of jaundice, should be selected where sufficient natural light, and look up again and again has increased. Rapid progress on neonatal jaundice should consult a doctor immediately.

Second, liver cell uptake, binding and excretion of bilirubin occurring obstacles. Because hepatic inflammation or the lack of an enzyme in the liver cells, or that such activity is low, excretion of bilirubin can not be good, such as neonatal hepatitis or sepsis and other patients. Infants with neonatal produce physiological jaundice, liver enzyme activity is low due to this reason. Some babies eat breast milk can also cause this type of jaundice, because breast milk contains a kind of material with a fat content of progesterone. Infant feeding, the fat content of this lipase decompose quickly, releasing free fatty acids, which can increase the intestinal absorption of bilirubin caused by jaundice, but the baby is healthy. Above are called hepatocellular jaundice.

Third, bile duct obstruction, bilirubin can not be excreted into the small intestine to cholestasis or biliary cells in the liver caused by jaundice. We call it the obstructive jaundice, such as neonatal biliary atresia, bile viscosity and so on.

how to treat neonatal jaundice

can heal more than sugar water feeding jaundice can speed up regression without treatment. However, a more serious case of jaundice and phototherapy should be further checks to prevent the inclusion of pathological jaundice.

Damp-heat jaundice, yellow skin in children can be seen clearly, the color of a dry color, with see fever, irritability, crying, thirst, vomiting, dark urine, constipation and other symptoms, common capillaris, Gardenia, Rhubarb, Scutellaria baicalensis, Plantago, Jhuru, tangerine peel and other traditional Chinese medicine, with see high fever, irritability, breathlessness, or convulsions, or coma, and vomiting diarrhea and other gastrointestinal symptoms. This type – like serious condition, mostly nuclear jaundice patients. Chinese patent medicines can be fed Angong Niuhuang Wan, Zi Xuedan so decoction used buffalo horn, gypsum, stir Gardenia, Coptis, capillaris, iris, rhubarb, Ur and other drugs, water simmer in water. If the children had been unconscious when the Chinese irrigation does not go in, available capillaris, Gardenia, rhubarb, licorice Jiantang, retention enema, for once, or use of acupuncture, medicine and other emergency comprehensive treatment approach.

stasis visible face and body type of jaundice yellow, yellow, deep and dark, and gradually increase the body weight loss, food intake, loose stools thin, and accompanied by bleeding in the skin and see ecchymosis petechiae so, the Chinese believe that this is evil in-depth heat, causing injuries to the spleen and stomach, stasis of blood points, so that treatment to blood circulation, Liver and spleen, herbal medicine for Bupleurum, red peony, white peony root, angelica, peach kernel, safflower, Chuan Xiong, bergamot, tangerine peel, Poria, Chinese yam, Millettla other drugs.

spleen wet yellow skin Jaundice in children, lack of hard back and the color of dull, pale minimalist, body weight loss, fatigue pay less, loose stools soft, limb due to temperature, the treatment available Jianpihuashitang , and in the law, Chinese medicine can capillaris, Atractylodes, Ginger, Codonopsis, Chinese yam, Poria, bergamot, iris, turmeric, hawthorn and other coke, Chinese patent medicines available Spleen Pill and Yan mixture so.

the prevention of neonatal jaundice and nursing care should pay attention to the following points

(1) maternal fetal yellow, because they suffered heat attacks and involved the fetus, causing fetal birth after birth Huang, Therefore, during pregnancy, maternal diet should be noted that section, but the food cold, but the hungry fed, and Ji Jiu and Xin heat of the goods, to prevent stomach damage.

(2) women who have given birth to a baby in the fetal and yellow, and then should be the prevention of pregnancy, taking medicine on time.

(3) to observe the infant closely after scleral jaundice and found that treatment of jaundice as early as possible, and observe the color changes in order to understand jaundice, jaundice of the advance and retreat.

(4) to observe the fetal systemic symptoms of yellow baby, whether or listlessness, drowsiness, difficulty in sucking milk, shocked Ti unrest, with two strabismus, limbs, rigidity or convulsions embolism, for patients with severe early detection and timely treatment.

(5) close observation of heart rate, heart sounds, the degree of anemia and changes in liver size, early prevention and treatment of heart failure.

(6) to protect baby skin, navel and buttocks clean and prevent damage infection.

(7) in need of blood transfusion therapy should be wards of air disinfection in a timely manner, get ready blood and various drugs, goods, strict operational procedures.

mild protective effect on neonatal jaundice

recent study suggests that after birth the skin and eyes, jaundice has a protective effect on the body can make it from free radicals damage.

all infants and adults are the body's protective mechanism against free radicals, the latest research suggests that babies of their body has a protective effect of bilirubin, this pigment is an antioxidant, so that the performance of newborn mild jaundice. Mild neonatal jaundice is physiological, but the high level of bilirubin after birth must be given body, pay attention to whether there are pathological happen.

bilirubin is due to aging of red blood cells contain hemoglobin and body composition of disintegration caused by the accumulation of bilirubin in the blood when the liver to the intestine than excreted, that is jaundice. As we all know, too much bilirubin in infants is harmful, it increased slightly after birth because bilirubin is not clear, healthy babies born after 1 week of blood bilirubin levels can rise 15-20mg/dl, but severe jaundice (bilirubin> 25-30mg/dl) if not treated will lead to brain damage. The treatment of severe jaundice include light therapy, blue light can easily from bilirubin into a compound in urine.

order to understand the bilirubin increased slightly after birth, the reason, Snyder and colleagues using in vitro enzyme block the production of bilirubin, and the cells exposed to free radical environment The results showed that the cells did not bilirubin damage and death, and bilirubin can produce free radicals under the action of the cells can survive in, and passage. Bilirubin circulating in the body can produce, can be a good fight against free radicals. As to why the baby's bilirubin level higher than the adult, the newborn may need to adapt to the changed greatly concerned. Previous studies also suggested that an appropriate level of bilirubin can reduce stroke, cancer and the risk of myocardial infarction, perhaps one day may improve the health of bilirubin as the application of drugs.

prevention measures for high-risk children jaundice

of low birth weight children, choking child, maternal and child blood group incompatibility and other vulnerable persons at high risk neonatal hyperbilirubinemia, should be early in the postnatal serum bilirubin monitoring, if necessary, immediately upon the light therapy. This is a maternity home neonatal medicine, nursing personnel must be a good first pass, the short duration of the hospitalization of newborns discharged early there should also be accountable to the families of rapid progression of severe jaundice or take early visits. Abroad in order to avoid maternal and child separately, and some families in high-risk children for preventive light therapy 5 to 7 days.