Noj zaub mov nrog nce bilirubin > Mob ntshav qab zib muaj teeb meem

Kev piav qhia cuam tshuam rau 29.06.2017

Efficiency: kho tau zoo tom qab 21 hnub
Cov Hnub: los ntawm 3 lub hlis thiab ntau dua
Tus nqi khoom: 1300-1400 rubles toj ib as thiv

Cov kev cai dav dav

Bilirubin tsim los ntawm lwj hemoglobin hauv cov ntshav liabuas tau ua tiav lawv lub neej kev txom nyem (rhuav tshem tom qab 120 hnub). Nquag, 80-85% ntawm bilirubin yog tsim nyob rau hauv ib hnub. Plasma bilirubin yog khov kho ua ke rau albumin. Lub siab ua lub luag haujlwm tseem ceeb hauv kev hloov pauv ntxiv ntawm bile pigments. Nws ua rau lawv nqus thiab sib sau ua ke rau hauv lub cell, khi (lossis sib txuas thiab qhov no tiv thaiv tsis pub bilirubin rau hauv cov ntshav) thiab tshem nws mus rau hauv lub bile. Nws yog ntu kawg no uas cuam tshuam thaum lub siab ua rau lub siab puas - pob bilirubin nkag mus rau hauv lub bile hauv ib qho nyiaj me me thiab qhov tsis muaj txhij txhua bilirubin rov qab los ntawm lub siab hlwb mus rau cov hlab ntshav, qhov twg nws yog qhov muaj ntau ntxiv (hyperbilirubinemia).

Qhov pom pom ntawm hyperbilirubinemia yog dajntooCov. Muaj txog 50 syndromes thiab cov kab mob uas nrog los ntawm yellowness ntawm daim tawv nqaij thiab mucous daim nyias nyias. Hauv cov neeg laus, daim tawv muag tawv nqaij yog sau tseg ntawm theem bilirubin ntau dua 34 μmol / L. Nrog nce bilirubin, ntxiv rau cov tsos mob no, cov neeg mob tshwm sim mob taub haupauj kev chim siab tsaug zog, khaus tawv nqaij, qaug zog.

Cov laj thawj rau kev nce bilirubin yuav yog:

mob rau daim siab (mob thiab mob ntev kab mob siabrog tsis haum, intrahepatic cholestasis, mob ntswsautoimmune kab mob siab, cawv thiab tshuaj muaj muaj mob lom ua paug) thiab kua tsib lub raj,
hemolytic anemia,
mob caj dab
tej hauj lwm hyperbilirubinemia (tsev neeg muaj keeb Kriegler-Nayyar syndromes, Dabin Jones, Rotor, Gilbert).

Qhov kawg yog nyob rau hauv thawj qhov chaw hauv zaus ntawm kev muaj mob ua haujlwm bilirubinemia. Ntawm Gilbert's tus kab mob (kev muaj mob rau cov xim hepatosis) hauv cov neeg mob, theem ntawm bilirubin tsis muaj qhov siab yog qhov nce vim qhov tsis muaj peev xwm raug ntes los ntawm daim siab cell thiab khi ntawm glucuronic acid hauv nws (tom kawg yog piav qhia los ntawm tsis muaj enzyme). Kev tsis muaj qhov txhab bilirubin yog yooj yim soluble hauv cov rog, cuam tshuam nrog phospholipids ntawm lub puas ntawm cov hlwb hlwb, thiab yog li ntawd muaj cov nyhuv neurotoxic. Feem ntau cov neeg mob yws ntawm qhov tsis muaj zog, pw tsis tsaug zog, muaj kev ntxhov siab, cuam tshuam nrog.

Cov neeg mob tau ntev zuj zus pom qhov daj thiab tawv nqaij ntawm qhov sib txawv zuj zus. Qhov no yog qhov tshwj xeeb tshaj yog pom ntawm lub ntsej muag, nasolabial daim duab peb sab, ob txhais taw thiab ob txhais tes, axillary hollows. Tseem txhawj txog bradycardia thiab txoj leeg ntshav hypotension.

Jaundice muaj mob zuj zus nrog haus cawv, lub cev ntau dhau, tom qab phais tas, noj sulfonamidestshuaj tiv thaiv qhov ncauj salicylates thiab kis kab mob sib kis (qee zaus tus tsos mob tshwm sim thawj zaug nrog kab mob siab A) Qhov kev kuaj mob yog qhov muaj txiaj ntsig, txawm hais tias hyperbilirubinemia tseem mob rau lub neej. Siab rhiab heev ntawm cov neeg mob no rau cov mob hepatotoxic zoo (tshuaj, cawv, tshuaj).

Txhawm rau txhim kho qhov ua kom muaj kab mob (organic pathology lossis ua haujlwm), kev tshuaj xyuas thiab kev noj haus yog qhov tsim nyog. Kev noj zaub mov nrog bilirubin ntau ntxiv hauv cov ntshav yuav tsum tso lub siab thiab lwm yam kabmob ntawm cov hnyuv zom. Xws li yog Noj cov zaub mov naj npawb 5pom zoo rau ntau yam kab mob ntawm daim siab thiab tsib lub zais zis.

Nws muab rau nruab nrab sparing ntawm lub siab, txhim kho roj thiab xim metabolism, thiab tawm cov roj tawm. Nws muaj cov roj tsawg (vim tias cov roj refractory txo qis), cov ntsev ntsev, txwv tsis pub noj cov zaub mov muaj ntau hauv purines (tsiaj nplooj siab, nqaij ntses noog me me, haus luam yeeb, sardines, baker lub poov xab, tuna, tshuaj txau, herring, ntses salmon caviar, nceb ntawm cov kab mub nceb) , qav kaws).

Kev noj zaub mov nrog cov xyoob ntoo bilirubin yuav tsum muaj cov ntsiab lus siab pectin thiab fiber (zaub, berries, txiv hmab txiv ntoo). Txhawm rau ua kom muaj qhov ntws tawm ntawm cov kua tsib, cov khoom lag luam choleretic yog qhov muaj nyob hauv cov zaub mov noj: zaub roj, ceg, kua txiv (zaub qhwv, beetroot). Kev noj haus yog nplua nuj nyob hauv lipotropic tshuaj (nqaij nyug, cov ntses muaj roj tsawg, tsev cheese, taum pauv, whey, buckwheat), uas tiv thaiv daim siab los ntawm kev ua kom muaj roj thiab txo cov roj pob zeb. Muaj fiber ntau thiab polyunsaturated fatty acids (roj zaub yog nplua nuj nyob hauv lawv) kuj muaj cov nyhuv lipotropic.

Tshuaj lom neeg muaj lub siab txhawm rau muab lub tais ntxuav, muab hau lossis muab ci ua kom siav. Hauv kev noj zaub mov, kev siv cov khoom kib yog raug txwv tsis pub, tab sis cov tais diav tsis tuaj yeem ntxuav. Lub hauv paus ntsiab lus ntawm cov khoom noj muaj feem me me yog qhov tseem ceeb - qhov no tsis ua rau lub siab thiab lwm cov plab hnyuv plab zom mov, thiab tseem ua rau muaj qhov tawm ntawm cov kua tsib. Cov khoom tseem ceeb hauv zaub mov yog zaub thiab lawv muaj pes tsawg leeg yog ntau haiv neeg. Lawv, nrog rau txiv hmab txiv ntoo thiab txiv ntseej, tuaj yeem siv rau hauv ib daim ntawv.

Qhov kev xaiv ntawm nqaij kuj muaj ntau yam - nqaij nyuj, veal thiab nqaij npuas, thiab nqaij qaib thiab qaib cov txwv. Nws raug nquahu kom muab kev nyiam ua rau cov ntses muaj roj tsawg, uas yuav tsum tau noj 3 zaug hauv ib asthiv. Feem ntau, kev noj zaub mov kom muaj txhij txhua thiab muaj kev sib luag (cov protein muaj 100 g, carbohydrates - 400 g, rog - 80-90 g). Kev haus dej haus rau lub cev yuav tsum muaj ntau - txog li 2,5 litres ib hnub. Haus dej yuav tsum yog rooj dej tsis muaj roj, kua txiv hmab txiv ntoo, nodules, decoctions ntawm tshuaj ntsuab.

Tsis pub siv:

cov khoom lag luam nrog cov khoom txuag, dyes,
cov rog rog, kib zaub mov, nplooj siab, paj hlwb, cov zaub mov hauv kaus poom, nqaij nqaij, lub raum, cov quav (muaj cov khoom noj), cov hnyuv ntxwm, roj, ua noj ua haus,
fermentation txhim kho cov khoom lag luam (legumes, millet, qee zaum - cov zaub qhwv dawb, yog tias nws qhov siab kam tsis zoo),
lub plab zom mov yam muaj lub cev ua kom tawv nqaij (horseradish, vinegar, zaub, zaub tsib, txuj lom, nceb, nceb thiab salted zaub mov),
cov khoom lag luam nrog cov roj tseem ceeb (cov dos ntsuab, qij, turnips, txhua hom radishes, radishes),
cov kua zaub ntawm cov ntses, ntses, nceb, nqaij,
cream, rog qaub cream, rog tsev cheese,
txiv hmab txiv ntoo qaub (plums, cranberries, citrus txiv hmab txiv ntoo),
cocoa, roj haus, kasfes, chocolate, ka lee, qab zib confectionery.

Noj thaum twg Gilbert syndrome tsis txawv ntawm cov saum toj no, tab sis nrog tus kab mob no, zoo li tsis muaj lwm yam, nws yog qhov tseem ceeb heev uas tsis txhob cia lub sijhawm so ntev hauv kev noj zaub mov. Hauv cov neeg mob no, kev tshaib plab yog nrog los ntawm nce ntxiv hauv theem ntawm cov bilirubin uas tsis muaj kev txhim kho. Txhawm rau txhawm rau kuaj pom tus kab mob no, lawv txawm ua tiav qhov kev sim sai. Hauv 2 hnub, tus neeg mob tau txais cov zaub mov tsis muaj calorie ntau (400 kcal). Tom qab 2 hnub, bilirubin raug txiav txim siab thiab piv nrog cov ntsuas ua ntej pib kev kawm. Cov qauv yog txiav txim siab zoo yog tias qib bilirubin nce siab li 50-100%. Tsis tas li ntawd, cov neeg mob uas muaj cov tsos mob no yuav tsum tau soj ntsuam kev thauj dej, uas yog kev tiv thaiv kev ua kom tuab ntawm cov kua tsib. Microelements thiab cov roj-soluble vitamins nyob rau hauv daim ntawv ntawm cov tshuaj muaj ntxiv rau cov khoom noj.

High bilirubin nyob rau hauv cov ntshav hauv cov neeg laus: ua rau thiab kho

Cov ntshav muaj ntau yam sib txawv. Txhua ntawm lawv muaj nws tus kheej cov qauv ntsiab lus. Tshaj li cov cim tau tsim tseg qhia tias muaj qee cov kab pathologies lossis kev ntshawv siab. Ib ntawm cov tshuaj no yog bilirubin. Nws ua txoj haujlwm tseem ceeb thiab, thaum nws cov ntshav nce siab dhau heev lawm, kev ntsuas kho kom haum yuav tsum ua.

Bilirubin yog cov bile xim uas tau tsim vim los ntawm cov hemoglobin tawg

Hauv cov ntshav liab yog hemoglobin, uas nqa oxygen los ntawm lub ntsws mus rau txhua qhov nqaij ntawm lub cev. Tab sis thaum cov ntshav qog tsis tuaj yeem ua lawv lub luag haujlwm, lawv raug kev puas tsuaj hauv lub siab, tus po thiab pob txha pob txha. Hemoglobin raug tso tawm thiab hloov pauv mus rau bilirubin.

Video (nyem mus ua si).

Tab sis cov keeb tsim ua muaj kev phom sij rau lub cev thiab muaj qhov cuam tshuam tsis zoo rau lub paj hlwb. Tias yog vim li cas nws nkag mus rau hauv lub siab, qhov twg nws yog neutralized los ntawm ntau yam tshuaj yeeb dej caw. Yog li, ib hom kev tsis ncaj ncees tau txais, uas yog tom qab ua nrog nrog cov kua tsib, thiab tom qab ntawd tawm ntawm lub cev nrog rau cov zis.

Kev hloov pauv ntawm cov tshuaj yog ib txoj kev ua haujlwm uas muaj txheej txheem hauv lub cev.

Kev ua txhaum ntawm ntau theem ntawm kev hloov pauv ntawm hemoglobin mus rau bilirubin indirect ua rau muaj kev hloov pauv hauv nws qib ntawm cov ntsiab lus. Qhov ntsuas yog suav tias yog ib qho tseem ceeb hauv kev kuaj mob ntawm ntau yam kab mob.

Hauv tshuaj, tshuaj yeeb tshuaj feem ntau muab faib ua ob hom:

Indirect. Nws yog soluble tsuas yog hauv cov rog thiab yog tsim los ntawm tawg ntawm hemoglobin. Nws suav hais tias yog qhov txaus ntshai rau lub cev, vim nws yooj yim nkag rau hauv cov hlwb, cuam tshuam nrog kev ua haujlwm ntawm qee yam kabmob.
Ncaj qha. Nws yog synthesized hauv lub siab. Nws yog soluble hauv dej, thiab tsis suav tias yog kev phom sij rau lub cev. Nws yog tawm hauv ib txwm muaj nrog cov kua tsib.

Txoj kev ncaj qha hom bilirubin muaj kev nyab xeeb kiag rau lub cev, vim nws yog yav tas los ua kom tiav los ntawm daim siab enzymes. Cov tshuaj tsis yog cuam tshuam rau kev ua haujlwm ntawm ntau cov kab ke thiab cov kabmob, nws yog yooj yim tawm ntawm lub cev. Thaum kuaj pom, cov theem ntawm ob qho tib si thiab ncaj qha bilirubin raug txiav txim.

Txhawm rau txiav txim siab txog theem ntawm bilirubin, cov ntshav yuav tsum dhau mus rau kev tshuaj ntsuam biochemical

Bilirubin nyob rau hauv cov ntshav ntawm ib tus neeg. Yog vim li cas ntshav thiaj li coj los tsim qib ntawm nws cov ntsiab lus. Txhawm rau kom ntsuas qhov ntsuas tau ntseeg tau, tus neeg mob yuav tsum ua raws ntau txoj cai.

Ua ntej tshaj plaws, koj yuav tsum tso cov zaub mov tsawg kawg 12 teev ua ntej kev ua. Nws tseem yuav tsum ua kom tsis txhob dhau qhov xwm txheej ntxhov siab thiab kev ua haujlwm ntawm lub cev. Ob teev ua ntej noj ntshav rau kev soj ntsuam, nws tsis pom zoo haus luam yeeb.

Kev tsom xam pom peb yam ntsuas:

Qhov taw qhia dav dav. Nws yuav tsum tsis txhob qis dua 5.1 mmol / l, tab sis tsis siab tshaj 17 mmol / l.
Indirect. Cov kev txiav txim siab tau suav hais tias yog los ntawm 3.4 mus rau 12 mmol / l.
Ncaj qha. Qhov taw qhia tuaj yeem sib txawv ntawm 1.7 txog 5.1 mmol / L.

Qhov ntsuas ntawm cov khoom nyob rau hauv raws li poj niam txiv neej yog tsis siv tau thiab tsis hloov ntawm lub hnub nyoog ntawm 18 mus rau 60 xyoo.

Thaum kawm txog cov txiaj ntsig ntawm txoj kev tshawb no, cov kws tshwj xeeb tau saib xyuas tsis yog rau theem ntawm tag nrho bilirubin, tab sis kuj qhia ncaj qha thiab tsis ncaj qha.

Ib qho kev nce hauv cov nyiaj ntawm bilirubin ncaj qha tshwm sim vim qhov hloov pauv ntawm cov pa tawm, vim tias nws nkag mus rau hauv cov hlab ntsha thiab tsis pauv mus rau lub plab, tab sis yog thauj ua ke nrog ntshav.

Kev kuaj mob ntawm bilirubin tso cai rau koj los ntsuas tus mob thiab kev ua haujlwm ntawm daim siab

Cov laj thawj ntawm kev ua txhaum yog cov kab mob hauv qab no:

Cov mob voos voos voos yim, piv txwv li, kab mob siab A, B lossis kis mob mononucleosis.
Tus mob muaj kab mob.
Tshuaj muaj kab mob siab uas tshwm sim los ntawm kev siv tshuaj ntev ntawm ntau pawg (rau qog, mob ntsws lossis mob).
Tus mob muaj kab mob siab.
Kab mob siab kis los ntawm kev raug lom nrog lom lossis tshuaj lom nceb.
Cov kab mob Gallstone.
Cov qog nqaij hlav hauv lub siab, ntuav los yog zais zis.
Dabin-Johnson lossis Rotor Syndrome.

Hauv kev txheeb xyuas, kev nce nqi ntawm bilirubin ntawm kev tiv thaiv kuj tseem tuaj yeem pom. Tus mob no tuaj yeem tshwm sim los ntawm cov kab mob hauv qab no:

Kis tau tus mob txhab. Feem ntau pom tus mob no yog sepsis, typhoid fever thiab malaria.
Congenital hemolytic anemia. Cov kab mob zoo sib xws muaj xws li Markyafavi-Michele kab mob, tsis yog-spherocytic, thalassemia thiab lwm yam.
Syndromes ntawm Lucy-Driscola, Krigler-Nayyar, Gilbert.
Kev mob ntshav lom ua rau muaj kev lom los ntawm tus nab ua lom, lom nrog lom thiab ntau yam tshuaj lom, hlau ntau, txhuas, arsenic.
Tshuaj tiv thaiv kab mob cuam tshuam nrog kev siv tshuaj ntev ntev ntawm NSAIDs, insulin lossis tshuaj aspirin.

Qhov ua rau muaj kev nce qib hauv theem bilirubin nyob rau hauv cov ntshav tuaj yeem ua rau muaj kev txaus siab los ntawm qhov kev kis autoimmune hemolytic anemia, uas tshwm sim tawm tsam keeb kwm ntawm mob caj dab, mob ntshav tawm ntawm lub cev, thiab lwm yam kab mob.

Txhawb bilirubin nws muaj nws tus yam ntxwv tshwj xeeb, raws li qhov koj tuaj yeem xav tias muaj kev txhaum cai yam tsis muaj kev kuaj ntshav hauv tsev kuaj mob. Kev tsom xam tsuas yog pov thawj ntawm kev nce ntxiv hauv cov ntsiab lus ib txwm muaj ntawm cov khoom hauv cov ntshav.

Yellowness ntawm daim tawv nqaij thiab mucous daim nyias nyias yog cov cim ntawm nce bilirubin

Nrog rau theem tseem ceeb ntawm bilirubin, cov tsos mob tseem ceeb yog:

Dyspeptic mob, uas pom tias yog qhov tsis kaj siab tom qab lub qhov ncauj thiab xeev siab.
Mob taub hau.
Cov tsos hauv cov lus ntawm txho lossis dawb cov quav hniav. Nws muaj cov khov khov
Kiv taub hau
Cov tawv nqaij khaus.
Nkees
Yellowness ntawm cov qog ua kua ntawm lub qhov ncauj thiab tawv nqaij.
Cov quav tsis muaj kob.
Tsaus ntxoov ntxoo ntawm cov zis.

Muaj kuj tseem tshwm sim tsis xis nyob hauv txoj cai hypochondrium, uas tshwm sim los ntawm kev nce siab hauv daim siab. Tom qab noj cov rog thiab cov zaub mov hnyav, kub siab thiab tawv muag tshwm sim. Cov quav yuav tshwm sim. Nyob rau hauv rooj plaub uas qhov ua kom muaj qhov siab tshaj ntawm qhov kev coj ua ntawm bilirubin yog kis tus kab mob siab, muaj kev cuam tshuam tseem ceeb ntawm lub cev kub tau nce.

Kev nce qib ntau ntawm bilirubin vim niaj hnub kev ntawm kev kho tuaj yeem tsis muaj kev cuam tshuam rau lub cev. Tab sis thaum tsis muaj kev kho mob, tus mob no tuaj yeem ua rau muaj kev rau txim loj, uas yog li no:

Kev ua txhaum ntawm kev ua haujlwm ntawm txhua qhov system thiab kabmob.
Encephalopathy
Ntev daim ntawv ntawm cholecystitis.
Qhov tsim ntawm gallstones.
Daim ntawv kis tus kab mob siab.
Cov mob ua paug rau daim siab.

Tawm tsam keeb kwm yav dhau los ntawm kev muaj peev xwm siab dua li ib txwm bilirubin, kev txhim kho ntawm cov txheej txheem pathological uas tsis muaj kev cuam tshuam tau pom. Tus mob no tseem tuaj yeem ua rau lub cev tsis nco qab.

Kev kho yog tsom mus rau tshem tawm qhov ua rau qhov teeb meem ua rau muaj xim ntau ntxiv

Txhawm rau kom rov qab cov nyiaj ib txwm ntawm bilirubin hauv cov ntshav, nws yog thawj zaug tsim nyog los tsim qhov ua rau muaj qhov hloov ntawm qhov ntsuas. Feem ntau siv Txoj kev lis ntshav kho, uas koom nrog kev tswj hwm cov kua nplaum thiab dej qab ntsev. Qhov no pab tshem tawm cov paib thiab tshem tawm cov khoom lag luam tawm hauv lub cev.

Hauv qee kis, kev kho mob duab ci kuj yog siv. Cov txheej txheem cuam tshuam nrog kev txhim kho nrog cov teeb tshwj xeeb. Nyob rau hauv kev cuam tshuam ntawm txoj sab ci, kev hloov pauv ntawm indil bilirubin rau hauv bilirubin ncaj qha raug pom, uas yog ces tawm los ntawm lub cev.

Tshuaj kho mob yog kho rau cov txheej txheem ib txwm ua ntawm lub zog tso tawm, nrog rau qhov uas bilirubin tseem raug ntaws. Txhais tau hais tias tseem siv tau los daws cov tsos mob ntawm intoxication. Feem ntau, cov neeg mob tau sau cov pa roj carbon activated.

Nyob rau hauv kis uas muaj ntau tshaj ntawm cov kev cai ntawm bilirubin hauv cov ntshav tau tiv thaiv los ntawm tus kab mob siab, ces txoj kev kho txhawm rau tshem tawm tus kabmob yog raug sau tseg.

Kev siv cov tshuaj tsom rau tiv thaiv lub siab kom tsis txhob muaj teeb meem thiab tiv thaiv qhov tshwm sim ntawm tus mob ntshav liab yog qhia. Thaum kuaj pom Gilbert's syndrome thiab lwm yam kev cuam tshuam, kev kho mob yuav tsum tsuas yog kws kho tshwj xeeb ua raws li tus neeg mob, hom, qauv thiab qib ntawm kev loj hlob ntawm tus kab mob.

Hepatoprotectors yog siv rau kev kho mob hauv daim siab. Immunomodulating, antibacterial thiab antiviral agents kuj sau tseg. Kev siv tshuaj ntsuab qhia txog kev noj tshuaj kom ua kom qhov theem ntawm bilirubin hauv cov ntshav yog txwv tsis pub.Qhov no yog vim muaj qhov tseeb tias tuaj yeem ua rau ntau yam ua rau tus mob no thiab kev kho tsis raug yuav ua rau muaj kev rau txim loj.

Cov khoom noj yuav tsum tau nquag (5-6 zaug hauv ib hnub) thiab fractional, yam tsis muaj overeating

Ib qhov siab bilirubin hauv cov ntshav kuj yuav tsum tau kho ntawm kev noj haus. Kev noj haus yuav pab ua kom lub nra hnyav. Cov neeg mob yuav tsum txo noj ntsev ntau. Lauj kaub tais diav yog pom zoo kom siav uas tsis muaj nws. Nws raug tso cai siv tsis pub ntau tshaj 10 gram nyob rau ib hnub.

Nws tseem yog ib qho tsim nyog yuav tsum tau tshem tawm qhov siv cov pickles, marinades, nqaij nqaij uas haus luam yeeb, nrog rau cov nqaij ntses thiab ntses. Cov neeg mob txwv tsis pub haus cov roj tsw qab, nceb, ntsuj plig, cov txiv ntoo qaub thiab txiv hmab txiv ntoo. Thaum ua noj, tsis txhob siv cov txuj lom.

Nrog nce bilirubin hauv cov zaub mov koj yuav tsum nkag mus:

Khoom noj siv mis nrog cov ntsiab lus tsis muaj roj tsawg.
Cov kua txiv qab zib.
Qab zib thiab zib ntab.
Cov nqaij ntshiv.
Porridge rau hauv dej.
Zaub roj.

Nws yog ib qho tseem ceeb kom soj ntsuam txoj cai haus cawv, thiab raug rau txhua yam khoom siv rau kev kho cua sov. Qhov taw qhia nce ntawm bilirubin nyob rau hauv cov ntshav yog tus cwj pwm los ntawm cov tsos mob hnyav, uas tso cai rau koj kom ncav sijhawm kom paub qhov ua txhaum. Nws yog ib qho tseem ceeb los tsim qhov ua kom muaj tus mob no thiab coj kev kho mob.

Cov lus qhia ntxiv txog bilirubin tuaj yeem pom hauv video:

Cov neeg mob yuav tsum tsis txhob noj cov tshuaj xwb, tab sis kuj ua raws noj zaub mov noj. Tsis muaj kev kho lossis kev kho kom tsis raug yuav ua rau muaj kev rau txim loj. Vim li no koj yuav tsum tsis txhob tso tawm mus cuag kws kho mob.

Kev piav qhia cuam tshuam rau 29.06.2017

Efficiency: kho tau zoo tom qab 21 hnub
Cov Hnub: los ntawm 3 lub hlis thiab ntau dua
Tus nqi khoom: 1300-1400 rubles toj ib as thiv

Cov laj thawj rau kev nce bilirubin yuav yog:

mob rau daim siab (mob thiab mob ntev kab mob siabrog tsis haum, intrahepatic cholestasis, mob ntswsautoimmune kab mob siab, cawv thiab tshuaj muaj muaj mob lom ua paug) thiab kua tsib lub raj,
hemolytic anemia,
mob caj dab
tej hauj lwm hyperbilirubinemia (tsev neeg muaj keeb Kriegler-Nayyar syndromes, Dabin Jones, Rotor, Gilbert).

Cov neeg mob tau ntev zuj zus pom qhov daj thiab tawv nqaij ntawm qhov sib txawv zuj zus. Qhov no yog qhov tshwj xeeb tshaj yog pom ntawm lub ntsej muag, nasolabial daim duab peb sab, ob txhais taw thiab ob txhais tes, axillary hollows. Tseem txhawj txog bradycardia thiab txoj leeg ntshav hypotension.

Tsis pub siv:

cov khoom lag luam nrog cov khoom txuag, dyes,
cov rog rog, kib zaub mov, nplooj siab, paj hlwb, cov zaub mov hauv kaus poom, nqaij nqaij, lub raum, cov quav (muaj cov khoom noj), cov hnyuv ntxwm, roj, ua noj ua haus,
fermentation txhim kho cov khoom lag luam (legumes, millet, qee zaum - cov zaub qhwv dawb, yog tias nws qhov siab kam tsis zoo),
lub plab zom mov yam muaj lub cev ua kom tawv nqaij (horseradish, vinegar, zaub, zaub tsib, txuj lom, nceb, nceb thiab salted zaub mov),
cov khoom lag luam nrog cov roj tseem ceeb (cov dos ntsuab, qij, turnips, txhua hom radishes, radishes),
cov kua zaub ntawm cov ntses, ntses, nceb, nqaij,
cream, rog qaub cream, rog tsev cheese,
txiv hmab txiv ntoo qaub (plums, cranberries, citrus txiv hmab txiv ntoo),
cocoa, roj haus, kasfes, chocolate, ka lee, qab zib confectionery.

Dab tsi ua kom siab bilirubin txhais tau: ua rau, kho thiab noj zaub mov ntawm cov laus

Bilirubin yog xim tshwj xeeb daj ntuj nrog lub teeb ntsuab zas. Nws yog tsim los ntawm kev tawg ntawm hemoglobin. Tib neeg lub cev muaj cov bilirubin hauv cov chaw ib puag ncig xws li ntshav thiab bile. Tswj cov tshuaj no kom tsis pub dhau qhov txiav txim siab qhov muaj txiaj ntsig zoo ntawm kev ua haujlwm ntawm lub siab. Txheej txheem metabolic ntawm enzyme nyob rau hauv nqe lus nug yog ib txoj haujlwm siv tshuaj lom neeg: nws tshwm sim txuas ntxiv hauv lub cev ntawm tus neeg noj qab haus huv. Kev ua txhaum ntawm txoj kev no thaum twg los tau ib qib twg yuav tshwm sim hauv cov qauv ntawm cov ntshav dej, tuaj yeem txiav txim siab yooj yim ua tsaug rau cov qauv kev tshawb fawb biochemical ntawm daim siab ua piv txwv.

Vim li cas tag nrho cov bilirubin nce rau hauv cov neeg laus?

Lub enzyme yog qhov ntsuas tseem ceeb ntawm kev ua haujlwm ntawm ntau lub cev ib txhij. Rau ib tus neeg laus, qhov taw qhia qub yog 5.2-17 mmol / L - tag nrho bilirubin, 3.5-12 mmol / L - tsis ncaj thiab 1.8-5.2 mmol / L - ncaj qha bilirubin.

Cov tshuaj no dhau los ntawm lub cev dhau los ntawm quav - nws yog daim siab enzyme uas muab cov quav tso quav.

Ib qho kev nce ntxiv hauv lub siab ua ke ntawm bilirubin hauv cov ntshav yog vim muaj qhov nce ntxiv hauv kev rhuav tshem cov qe ntshav liab. Kev puas tsuaj rau daim siab ua rau lub siab ua rau ua txhaum ntawm nws txoj kev ua haujlwm tsis ua haujlwm. Raws li qhov tshwm sim, qhov tawm ntawm cov kab mob bile tshwm sim hauv cov hnyuv, uas tau txais txiaj ntsig zoo rau kev tsim kho ntau yam kabmob.

Muaj tus lej ntawm cov kabmob thaum lub sijhawm hloov kho uas ib tus neeg tau nce siab daim siab enzymes hauv cov ntshav.

Muaj ntau lub hauv paus ua rau nce tag nrho bilirubin, thiab txij li lub spectrum yog dav, nws yog qhov yuav tsum tau txiav txim siab pib, uas tau txais kev pabcuam los ua lub hauv paus rau qhov xwm txheej no.

Xav tias kev nce qib ntawm bilirubin hauv tus neeg laus yog qhov yooj yim heev: qhov no tuaj yeem ua yam tsis muaj kev kuaj ntshav hauv chav kuaj, thiab qhov kev soj ntsuam tsuas yog lees paub qhov kev kuaj mob ua ntej.

Cov tsos mob tseem ceeb ntawm kev nce siab ua rau lub siab ua rau cov neeg laus yuav yog cov xwm txheej hauv qab no:

mob taub hau
dyspeptic mob (xeev siab, ua pa tsw phem hauv qhov ncauj, tshwj xeeb tshaj yog sawv ntxov),
txho xim dawb los sis pleev xim rau ntawm tus nplaig,
kiv taub hau
khaus ntawm daim tawv nqaij,
qaug zog,
loj yellowness ntawm daim tawv nqaij thiab mucous daim nyias nyias,
cov zis tsaus nti, cov quav tsis muaj kob,
kev tsis xis nyob hauv txoj cai hypochondrium vim qhov nce ntawm lub siab, rog thiab zaub mov hnyav ua rau tsis haum, tawg, qee zaum kub siab lossis mob plab.

Yog tias nce bilirubin tshwm sim tawm tsam keeb kwm ntawm tus kab mob siab ntawm lub hauv paus chiv keeb, ib qho tshwm sim uas tsis tuaj yeem yog lub cev kub nce mus rau tus lej siab.

Txhawm rau txhim kho dab tsi yog vim li cas rau qhov tsis zoo ntawm lub dag zog, tus kws kho mob yuav tsum xub pib. Kev tshuaj xyuas tso cai rau koj txheeb xyuas qhov hloov pauv ntawm xim ntawm sclera thiab daim tawv nqaij, qhov pom ntawm txheej xim viscous ntawm tus nplaig, qhov nce ntawm lub siab, uas tuaj yeem ua rau palpated, txij li cov khoom hauv nrog o tau txhais kom meej meej txog cov contours.

Yog tias nws paub tseeb tias qhov teeb meem yog pom tseeb ua daim siab mob siab, tus neeg mob xa mus rau tus kws kho mob plab lossis kws kho mob tshwj xeeb. Yog tias thaum lub sijhawm ntawm kev kho mob nws twb paub txog tus txheej txheem hloov qog, tus oncologist tau koom nrog kev kho mob. Tso rau kev kuaj ntshav biochemical los txiav txim siab txog qib bilirubin ncaj qha thiab tsis ncaj qha, ntxiv rau AST thiab ALT (daim siab ua piv txwv).

Ib qho ultrasound ntxiv ntawm daim siab ua - qhov no yuav tso cai rau koj kom pom lub xeev ntawm parenchyma, kua tsib lub plab, hloov ncig thiab nws qhov chaw nyob.

Cov ncauj lus ntxaws ntxaws ntxaws ntshav tau tshuaj - nyob rau hauv txoj kev no tus kws kho mob yuav nkag siab qhov tseeb ntawm lub xeev ntawm lub cev: kab mob leukocytosis qhia tias muaj mob, thaum lub siab tsis zoo ntawm hemoglobin yuav qhia kev txhim kho ntshav liab. Ib txoj kev kho tau tuaj yeem npaj tsuas yog vim los ntawm keeb kwm kev kho mob zoo ntawm tus neeg mob thiab cov ntaub ntawv tshaj plaws tau los ntawm kev kuaj thiab pabcuam pab txhawb nqa.

Nws yog tsis yooj yim sua kom txo qis ntawm bilirubin yam tsis muaj kev tshem tawm tus kab mob hauv qab. Los ntawm kev txiav tu lub hauv paus, koj tuaj yeem rov qab qib ntawm cov ntshav enzyme. Tsuas yog ib tug kws kho mob lossis ib tus kws paub kis mob tshwj xeeb yuav tsum npaj kho kom zoo, nyob ntawm qhov mob qis. Txhua ntawm cov qauv ntawm kev kho mob muaj cim qhia, contraindications thiab muaj ntau cov kev phiv. Tus neeg uas tsis muaj kev kawm tsim nyog tuaj yeem tsim kev puas tsuaj rau nws tus kheej los ntawm kev sim tshuaj thiab cov txheej txheem. Cov hauv kev tseem ceeb los txo cov qib bilirubin yog raws li hauv qab no:

Tseem muaj qhov ntau ntawm cov tshuaj ib txwm muaj - kev ua kom zoo nkauj, infusions, tab sis kev tsim nyog thiab kev nyab xeeb ntawm kev siv lawv yuav tsum tau sab laj nrog koj tus kws kho mob. Qee cov tshuaj ntsuab thiab nroj tsuag muaj cov kev mob tshwm sim, suav nrog palpitations, xeev siab, ntuav, tsis hnov qab, tsis muaj zog, thiab tsaug zog. Ua ke nrog cov kab mob tseem ceeb, nws tsis yog ib txwm tsim nyog los coj cov tshuaj qhia tshuaj ntsuab - qhov no tuaj yeem ua qhov txawv txav ntawm cov duab hauv chaw kuaj mob tiag tiag.

Qhov ntim ntawm bilirubin hauv cov ntshav tau txiav txim siab los ntawm kev ua haujlwm kom tiav txhua ntu ntawm cov saw ntawm kev tsim khoom, cov metabolism thiab ua haujlwm ntawm bilirubin tawm hauv lub cev. Cov txheej txheem ntawm kev ua kom huv si los ntawm cov khoom tom kawg yuav tsum tshwm sim sib lawv liag, tsis nthawv ntaws, tsis ua tiav, tsis muaj qhov tsis ua tiav txhua ntu. Kuaj hauv tsev kawm yuav pab ntsuas qhov no. Txwv tsis pub, nws tsis yooj yim sua kom pom qhov nce ntawm lub siab ntawm daim siab enzyme, ua kev kuaj mob thiab pib kho. Nws tsis zoo yuav tsis quav ntsej txog cov cim ntawm cov ntsiab lus bilirubin ntau dhau: qhov yuav tsum tau nrhiav kev pab tsim nyog.

Tag nrho bilirubin hauv cov neeg laus yog tsa kom siab: nws txhais li cas, cov kab mob dab tsi tuaj yeem ua rau

Bilirubin yog cov txiv kab ntxwv-daj bile xim. Nws yog tsim thaum lub sij hawm muaj teeb meem ntawm cov ntshav liab (cov qe ntshav liab), tom qab ntawd nws tau tso rau hauv cov kab mob thiab tso tawm los ntawm cov quav. Bilirubin tuaj yeem muab cais ua qhov tsis ncaj (dawb, tsis ua haujlwm lossis tsis ncaj qha bilirubin), ib daim ntawv uas cov bile xim tsis yaj hauv dej, ncig hauv cov ntshav nws nkag mus rau hauv lub siab, qhov twg nws yuav siv daim ntawv soluble (ncaj qha bilirubin). Txhua txhua bilirubin ncig hauv cov hlab ntsha nrog rau cov kua liab tau raug hu ua tag nrho bilirubin.

Cov ncauj lus kom ntxaws bilirubin thiab cov txheej txheem muaj feem xyuam

Bilirubin hauv lub cev tshwm sim hauv cov txheej txheem thaum hemoglobin (ib qho kev xyaw ua hlau uas muaj cov protein) hauv cov qe ntshav liab ua kom tawg. Kev lwj lub hlwb qub yog txoj kev coj ua, noj qab nyob zoo. Tom qab cov ntshav ncig hauv cov ntshav, bilirubin xa mus rau daim siab. Hauv lub siab, bilirubin yog sib zog ua ke, sib xyaw nrog cov kua tsib thiab tso rau hauv cov kua tsib lub plab thiab nyob rau qee lub sijhawm hauv koj lub zais zis. Thaum kawg, bile tso tawm rau hauv txoj hnyuv me kom pab zom cov rog, tom qab ntawd nws tawm hauv lub cev rau hauv koj cov quav.

Ib theem siab ntxiv ntawm cov kab mob bile no yog hu ua hyperbilirubinemia (Gilbert syndrome).Tsis yog txhua tus paub tias tus kabmob no kis tau los ntawm leej niam thiab leej niam mus rau menyuam, hmoov tsis muaj kev mob nkeeg, qib tseem nyob thoob plaws tus neeg lub neej.

Uniljugated bilirubin tuaj yeem tsim kev puas tsuaj rau kev loj hlob ntawm lub paj hlwb ntawm tus menyuam mos (txog 2-4 lub lis piam), nws tsis ua rau muaj kev phom sij rau cov hluas thiab cov neeg laus. Hauv cov hluas thiab cov neeg laus, cov "ntshav-thaiv lub hlwb" ntau dua tsim thiab txwv tsis pub bilirubin nkag mus rau lub hlwb lub hlwb. Txawm li cas los xij, cov qib siab ntawm bilirubin qhia tau tias muaj cov txheej txheem lossis cov kabmob hauv lub cev uas xav kuaj thiab kho.

Bilirubin feem ntau tsis muaj nyob hauv cov zis. Txawm li cas los xij, kev sib xyaw ua ke (saib ncaj qha) yog dej-soluble thiab tuaj yeem tawm hauv lub cev los ntawm kev tso zis yog tias nws tsis nkag mus rau hauv cov kua tsib. Pom cov kua tsib daj tso zis hauv cov zis feem ntau qhia tau tias lub siab ua haujlwm tsis zoo rau lub siab lossis cov kua tsib lub plab, mob siab, lossis lwm yam txheej txheem pathological cuam tshuam nrog cov kab mob no thiab tuaj yeem kuaj tau thaum ntxov ntawm tus kab mob.

Cov kws kho mob kuaj mob tshuaj lom bilirubin ntau ntxiv nrog lwm cov kev sim tshuaj kuaj kab mob (alkaline phosphatase, aspartate aminotransferase (AST), alanine aminotransferase (ALT)) cuam tshuam nrog teeb meem daim siab. Kev kuaj mob ntawm bilirubin yog nqa nrog:

Jaundice (Ntawv Moo Zoo)
Thaum tus neeg mob qaug cawv lossis haus cawv ntau heev,
Yog koj xav tias noj cov tshuaj muaj yees thiab tshuaj lom,
Thaum ib tus neeg tau kis nrog tus kab mob siab.

Kev kuaj ntshav biochemical kuj tseem tuaj yeem ua yog muaj kev ua xyem xyav los ntawm kev mob ntshav qab zib (hemolytic anemia) uas yog qhov ua rau muaj ntshav tsis txaus (ib qho mob uas muaj ntshav tsawg los yog ntshav liab hauv cov ntshav). Hauv qhov xwm txheej no, kev tshawb fawb ntxiv feem ntau yog txhawm rau soj ntsuam hemolysis (suav cov ntshav dav dav, tshuaj xyuas rau reticulocytes, haptoglobin thiab lactate dehydrogenase (LDH)).

Dab tsi yuav cuam tshuam rau nws txoj haujlwm tsis raug:

Cov laj thawj uas vim li cas koj thiaj li tsis tuaj yeem twv kom dhau qhov kev xeem los sis vim li cas cov txiaj ntsig tsis tuaj yeem tsis suav nrog:

Haus kas fes los yog cov khoom uas muaj caffeine, uas tuaj yeem txo qib bile xim.
Tsis yoo mov los ntawm cov khoom noj rau lub sijhawm ntev (yoo mov), uas feem ntau nce qib ntawm tsis ncaj qha bilirubin.

Ib qho kev sim ntshav sib luag ntawm bilirubin yuav qhia qhov tseeb ntawm tag nrho peb theem ntawm bilirubin hauv koj cov ntshav: ncaj qha, tsis ncaj thiab tsis tag nrho. Hauv qab no yog cov cai ntawm txhua peb qhov tseem ceeb rau cov laus:

Tus nqi ncaj qha bilirubin muaj nuj nqis txij li 1.8-5.2 mmol / L.
Cov txiaj ntsig ntawm kev coj ncaj qha bilirubin sib txawv ntawm qhov chaw ntawm 3.5-12 mmol / L.
Tag nrho bilirubin (ncaj qha thiab tsis ncaj) nws txawv ntawm qhov ntau ntawm 5.2-17 mmol / l.

Cov tsos mob ntawm tus siab bilirubin hauv cov neeg laus yog dab tsi?

Rau cov neeg laus, mob daj ntseg (ib tug kab mob nrog los ntawm daim tawv nqaij daj lossis khaus ntawm lub qhov muag) thiab khaus yog cov tsos mob tseem ceeb thiab cov tsos mob ntawm qib siab bilirubin hauv cov ntshav.

Hauv qab no yog qee qhov muaj peev xwm ua kom nce bilirubin thiab cov kab mob cuam tshuam thiab cov tsos mob (qhov no yog cov npe luv, tsis muaj npe tag nrho):

Cov tsos mob thiab tus cim qhia tias tus neeg mob ntshav tsis txaus (vim qhov ua kom muaj ntshav liab tsawg tsawg hauv lub cev) suav nrog:

Cov tsos mob thiab cov tsos mob ntawm tus mob siab muaj xws li:

Nkees
Ua npaws me me
Mob leeg
Xeev siab thiab ntuav
Vwm

Cov tsos mob thiab cov tsos mob ntawm tus mob huam biliary muaj xws li:

Lub rooj zaum lub teeb
Tsaus zis
Khaus
Mob hauv sab xis ntawm lub plab
Xeev siab, ntuav,
Yellowness ntawm daim tawv nqaij.

Cov cim ntawm kev kis tus kab mob (piv txwv, malaria):

Sib quas ntus sib ce / ua daus no,
Neeg tsis muaj zog.

Cov kab mob caj ces (e.g. sickle cell disease thiab kab mob viav vias) muaj cov tsos mob li nram no:

Mob plab
Txog siav
Nkees
Neeg tsis muaj zog
Cov ntshav liab yog cov tsis xwm yeem.

Cov cim thiab cov tsos mob ntawm daim siab ua haujlwm (ua rau muaj kab mob ua paug, mob qog noj ntshav, haus cawv, tshuaj, kis kab mob, Gilbert thiab Krigler-Najar syndromes):

Zais plab rau lub plab zom mov txawv txav.

Tsis tas li, cov tshuaj xws li sulfonamides thiab nitrofuemberin (ib yam tshuaj uas muaj lub zog tiv thaiv kabmob) tuaj yeem nce qib ntawm tag nrho cov bilirubin, nce rhuav tshem cov ntshav liab. Thiab tshuaj yeeb tshuaj zoo li atazanavir tsub kom tsis muaj kev txwv (tsis ncaj) bilirubin.

Raws li txoj cai, lub siab ntawm no bile pigment hauv cov txiv neej yog siab dua poj niam. Hauv cov neeg Asmeskas Asmeskas, cov ntsiab lus ntawm cov tshuaj no feem ntau yog qis dua. Tsis tas li, kev ua haujlwm hnyav lossis kev tawm dag zog tuaj yeem nce qib ntawm tag nrho bilirubin hauv cov ntshav.

Kev txhaj ntshav - Cov txiaj ntsig ntawm kev tshawb nrhiav thiab kev sim kho mob hauv Suav teb qhia tias hom no los txo bilirubin kom tsawg dua kev phiv yog ib txoj hauv kev zoo.

Cov Tshuaj Kho Mob - txhawm rau tshem tawm ntawm lub cev thiab txo bilirubin, koj tuaj yeem siv tshuaj xws li salicylates, furosemide, ampicillin thiab ceftriaxone, (qee cov tshuaj muaj kuab txaus ntshai heev, koj yuav tsum tau sab laj nrog kws kho mob).

Phototherapy (kev kho tshuab, kho lub teeb) - hyperbilirubinemia los ntawm kev daj ntseg tuaj yeem kho tau yooj yim yam tsis muaj lossis qhov tshwm sim tsawg kawg nkaus nrog kev pab ntawm phototherapy (kev kho mob nrog hnub ci lossis teeb ci cuav, duab ci). Qhov ua tau zoo ntawm phototherapy nyob ntawm ntau yam (cov ntaub ntawv qhia hauv qab no yuav pab tau zoo thaum tham nrog tus kws kho mob):

Lub cev nqaij npog rau thaj chaw
Lub teeb ci qhov chaw pom: feem ntau rau kev kho kom zoo, qhov tshwj xeeb xiav cov leeg nrog lub cim F20T12 / BB es tsis yog F20T12 / B tau siv, thaum irradiation lossis lub zog tawm tuaj yeem nce ntxiv hauv chav ntsuas duab, txo qhov kev ncua deb rau tus neeg hauv kev dav ntawm 15-20 cm.
Kev niaj hnub ua kom pom kev zoo dua yuav zoo dua qhov kev thaij duab ib ntus.

Kev sib txuas lus lossis fiber ntau hauv cov duab thaij ua haujlwm tuaj yeem siv, muab tias qhov nqaij daj tsis yog hemolytic lossis nws qhov kev loj hlob tau qeeb.

Nyob rau hauv cov xwm txheej ntawm hemolytic jaundice, kev nce nrawm dua ntawm bilirubin lossis qhov tsis muaj txiaj ntsig ntawm ib qho kev thaiv yooj yim, kev siv tshuaj pleev plhaws yuav yog qhov tseeb.

Cov hom bilir rau hauv thiab nws lub ntsiab lus

Bilirubin yog cov bile xim uas tau tsim vim los ntawm cov hemoglobin tawg

Kev hloov pauv ntawm cov tshuaj yog ib txoj kev ua haujlwm uas muaj txheej txheem hauv lub cev.

Hauv tshuaj, tshuaj yeeb tshuaj feem ntau muab faib ua ob hom:

Indirect. Nws yog soluble tsuas yog hauv cov rog thiab yog tsim los ntawm tawg ntawm hemoglobin. Nws suav hais tias yog qhov txaus ntshai rau lub cev, vim nws yooj yim nkag rau hauv cov hlwb, cuam tshuam nrog kev ua haujlwm ntawm qee yam kabmob.
Ncaj qha. Nws yog synthesized hauv lub siab. Nws yog soluble hauv dej, thiab tsis suav tias yog kev phom sij rau lub cev. Nws yog tawm hauv ib txwm muaj nrog cov kua tsib.

Kev kuaj mob thiab cov cai

Txhawm rau txiav txim siab txog theem ntawm bilirubin, cov ntshav yuav tsum dhau mus rau kev tshuaj ntsuam biochemical

Kev tsom xam pom peb yam ntsuas:

Qhov taw qhia dav dav. Nws yuav tsum tsis txhob qis dua 5.1 mmol / l, tab sis tsis siab tshaj 17 mmol / l.
Indirect. Cov kev txiav txim siab tau suav hais tias yog los ntawm 3.4 mus rau 12 mmol / l.
Ncaj qha. Qhov taw qhia tuaj yeem sib txawv ntawm 1.7 txog 5.1 mmol / L.

Qhov ntsuas ntawm cov khoom nyob rau hauv raws li poj niam txiv neej yog tsis siv tau thiab tsis hloov ntawm lub hnub nyoog ntawm 18 mus rau 60 xyoo.

Cov Ua Rau Txhawb Nqa Bilirubin

Thaum kawm txog cov txiaj ntsig ntawm txoj kev tshawb no, cov kws tshwj xeeb tau saib xyuas tsis yog rau theem ntawm tag nrho bilirubin, tab sis kuj qhia ncaj qha thiab tsis ncaj qha.

Kev kuaj mob ntawm bilirubin tso cai rau koj los ntsuas tus mob thiab kev ua haujlwm ntawm daim siab

Cov laj thawj ntawm kev ua txhaum yog cov kab mob hauv qab no:

Cov mob voos voos voos yim, piv txwv li, kab mob siab A, B lossis kis mob mononucleosis.
Tus mob muaj kab mob.
Tshuaj muaj kab mob siab uas tshwm sim los ntawm kev siv tshuaj ntev ntawm ntau pawg (rau qog, mob ntsws lossis mob).
Tus mob muaj kab mob siab.
Kab mob siab kis los ntawm kev raug lom nrog lom lossis tshuaj lom nceb.
Cov kab mob Gallstone.
Cov qog nqaij hlav hauv lub siab, ntuav los yog zais zis.
Dabin-Johnson lossis Rotor Syndrome.

Hauv kev txheeb xyuas, kev nce nqi ntawm bilirubin ntawm kev tiv thaiv kuj tseem tuaj yeem pom. Tus mob no tuaj yeem tshwm sim los ntawm cov kab mob hauv qab no:

Kis tau tus mob txhab. Feem ntau pom tus mob no yog sepsis, typhoid fever thiab malaria.
Congenital hemolytic anemia. Cov kab mob zoo sib xws muaj xws li Markyafavi-Michele kab mob, tsis yog-spherocytic, thalassemia thiab lwm yam.
Syndromes ntawm Lucy-Driscola, Krigler-Nayyar, Gilbert.
Kev mob ntshav lom ua rau muaj kev lom los ntawm tus nab ua lom, lom nrog lom thiab ntau yam tshuaj lom, hlau ntau, txhuas, arsenic.
Tshuaj tiv thaiv kab mob cuam tshuam nrog kev siv tshuaj ntev ntev ntawm NSAIDs, insulin lossis tshuaj aspirin.

Cov tsos mob txuam nrog

Yellowness ntawm daim tawv nqaij thiab mucous daim nyias nyias yog cov cim ntawm nce bilirubin

Nrog rau theem tseem ceeb ntawm bilirubin, cov tsos mob tseem ceeb yog:

Dyspeptic mob, uas pom tias yog qhov tsis kaj siab tom qab lub qhov ncauj thiab xeev siab.
Mob taub hau.
Cov tsos hauv cov lus ntawm txho lossis dawb cov quav hniav. Nws muaj cov khov khov
Kiv taub hau
Cov tawv nqaij khaus.
Nkees
Yellowness ntawm cov qog ua kua ntawm lub qhov ncauj thiab tawv nqaij.
Cov quav tsis muaj kob.
Tsaus ntxoov ntxoo ntawm cov zis.

Dab tsi yog qhov phom sij ntawm qhov siab bilirubin?

Kev ua txhaum ntawm kev ua haujlwm ntawm txhua qhov system thiab kabmob.
Encephalopathy
Ntev daim ntawv ntawm cholecystitis.
Qhov tsim ntawm gallstones.
Daim ntawv kis tus kab mob siab.
Cov mob ua paug rau daim siab.

Yuav ua li cas rau normalize bilirubin qib?

Kev kho yog tsom mus rau tshem tawm qhov ua rau qhov teeb meem ua rau muaj xim ntau ntxiv

Nyob rau hauv kis uas muaj ntau tshaj ntawm cov kev cai ntawm bilirubin hauv cov ntshav tau tiv thaiv los ntawm tus kab mob siab, ces txoj kev kho txhawm rau tshem tawm tus kabmob yog raug sau tseg.

Hepatoprotectors yog siv rau kev kho mob hauv daim siab. Immunomodulating, antibacterial thiab antiviral agents kuj sau tseg. Kev siv tshuaj ntsuab qhia txog kev noj tshuaj kom ua kom qhov theem ntawm bilirubin hauv cov ntshav yog txwv tsis pub. Qhov no yog vim muaj qhov tseeb tias tuaj yeem ua rau ntau yam ua rau tus mob no thiab kev kho tsis raug yuav ua rau muaj kev rau txim loj.

Cov lus pom zoo khoom noj khoom haus

Cov khoom noj yuav tsum tau nquag (5-6 zaug hauv ib hnub) thiab fractional, yam tsis muaj overeating

Nrog nce bilirubin hauv cov zaub mov koj yuav tsum nkag mus:

Khoom noj siv mis nrog cov ntsiab lus tsis muaj roj tsawg.
Cov kua txiv qab zib.
Qab zib thiab zib ntab.
Cov nqaij ntshiv.
Porridge rau hauv dej.
Zaub roj.

Cov lus qhia ntxiv txog bilirubin tuaj yeem pom hauv video:

Koj puas pom muaj qhov yuam kev? Xaiv nws thiab nias Ctrl + Saulos qhia rau peb paub.

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 ntaug rau hauv tib neeg cov ntaub so ntswg, staining lawv hauv cov xim grey-daj.

Tsis tas li ntawd, thaum cov 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 tsis muaj zog, qaug zog thiab ua npaws.

Yog tias ib tus neeg muaj cov tsos mob no, qhov no txhais tau hais tias nws yuav tsum tau kho 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 / litre tuaj yeem pom nyob rau ntawm cov menyuam mos, 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 kis los ntawm tib neeg lub cev, cov txheej txheem ntawm kev rhuav tshem cov qe ntshav liab hauv cov ntshav tau nrawm, uas ua rau muaj qhov nce ntawm theem bilirubin. Qhov kev cuam tshuam tshwm sim vim qhov kev nthuav dav ntxiv ntawm cov khoom 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 teeb meem gallbladder. 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 tias ua ntej pib kev kho mob, koj yuav tsum 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 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 Theem Bilirubin 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 ib tus 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 rau menyuam mos. 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 ntawd 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 tseg kev kho mob tsim nyog nrog cov tshuaj tshwj xeeb. Ua ntej tshaj plaws, nws yog choleretic tshuaj 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 cov dej haus hauv lub cev tsis pub cais tawm ntawm tus neeg mob noj 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 nyob rau hauv cov ntshav,
Kab mob siab hom A, B, mob siab nrog mob mononucleosis,
Kab mob siab C, tus kab mob siab autoimmune,
Kab mob siab Brucellosis thiab mob leptospirosis,
Kev lom los ntawm cov tshuaj lom lossis fungi,
Kev siv tshuaj tiv thaiv hormonal contraceptives, NSAIDs, tshuaj tiv thaiv kab mob ntsws thiab qog,
Qhov muag daj thaum cev xeeb tub
Mob siab mob qog
Mob leeg nqaij 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, typhoid fever, malaria thiab lwm yam kev sib kis,
Tshuaj tiv thaiv kab mob ntshav siab vim los ntawm kev noj 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.

Dab tsi yog bilirubin, thiab nws los qhov twg los?

Vim li cas thiaj paub tus neeg laus paub tias muaj tus mob bilirubin ntau dua, thiab qhov no txhais li cas? Hemoglobin yog pom nyob hauv cov ntshav liab - cov ntshav liab ntawm tus neeg, nws nqa cov pa oxygen rau lub cev cov ntaub so ntswg los ntawm lub ntsws. Kev puas tsuaj thiab muaj ntshav liab tsawg hauv cov pob txha taub hau, nplooj siab thiab pob txha pob txha. Hauv qhov no, hemoglobin raug tso tawm thiab hloov mus rau hauv bilirubin.

Tus tsim tshiab bilirubin yog tsis ncaj, lom rau tib neeg lub cev, tshwj xeeb tshaj yog ua rau cov hlab ntsha hauv nruab nrab. Yog li ntawd, daim siab yog kho kom zoo los ntawm lwm yam tshuaj yeeb dej caw. Cuam tshuam - ncaj qha bilirubin yog tawm nrog rau cov kua tsib lub siab thiab tawm ntawm lub cev ib txwm muaj. Qhov xim tsaus nti ntawm cov quav ntau zaus qhia txog cov kev hloov pauv ntawm bilirubin.

Kev faib tawm

Bilirubin metabolism yog cov txheej txheem tshuaj lom neeg nyuaj uas niaj hnub tshwm sim hauv peb lub cev, yog tias nws tau ntxhov siab nyob rau txhua ntu, kev hloov pauv ntawm cov theem ntawm cov tshuaj no hauv cov ntshav cov ntshav tau tshwm sim. Yog li no, bilirubin yog qhov ntsuas tseem ceeb ntawm kev ua haujlwm ntawm ntau lub cev.

Ua raws li hom, bilirubin ncaj qha thiab tsis ncaj qha cais.

Indirect - ib qho uas tsim los ntawm kev tawg ntawm hemoglobin. Nws yog soluble tsuas yog hauv cov rog, yog li ntawd nws tau suav tias yog lom heev. Nws muaj peev xwm nkag mus rau hauv lub hlwb yooj yim, yog li ua txhaum lawv cov haujlwm.
Direct yog tus uas tsim tawm hauv lub siab. Nws yog soluble hauv dej, yog li ntawd, nws yog suav tias yog tshuaj lom tsawg. Direct bilirubin yog tawm hauv lub cev nrog rau cov kua tsib.

Direct bilirubin muaj kev nyab xeeb rau lub cev, txij li nws tau ua tiav los ntawm daim siab enzymes. Cov khoom zoo li no ua rau lub cev tawm ntawm lub cev mus thiab tsis ua teeb meem ntau. Indirect bilirubin yog lom lom, nws tau tsis ntev los no tsim los ntawm hemoglobin thiab tsis khi los ntawm daim siab enzymes.

Cov cai ntawm bilirubin hauv cov ntshav

Rau ib tus neeg laus hnub nyoog 60 xyoo rov hauv, kev tshwm sim ib txwm muaj ntawm kev sim bilirubin yuav yog:

5.1-17 mmol / l - tag nrho bilirubin,
3.4-12 mmol / l - tsis ncaj,
1.7-5.1 mmol / L - ncaj qha.

Cov theem ntawm cov qib bilirubin hauv cov ntshav rau ob leeg kuj yuav luag sib npaug. Txawm li cas los xij, cov kws tshawb fawb tau tshaj tawm tias txiv neej yog 10 npaug feem ntau yuav muaj Gilbert's syndrome li poj niam.

Nce bilirubin hauv cov menyuam mos

Tag nrho bilirubin yog nce - qhov no txhais li cas rau cov neeg laus?

Vim li cas rau cov neeg laus, cov bilirubin ntau hauv cov ntshav nce ntxiv, thiab qhov no txhais tau li cas? Dab tsi ua rau muaj qhov no?

Hauv cov laus, ntau qhov laj thawj tseem ceeb:

accelerated lwj ntshav liab,
thawj biliary mob kas cees,
mob gallstone
lwm yam mob uas ua rau muaj kev ua txhaum ntawm outflow ntawm bile,
helminthiases thiab cab hauv lub cev,
mob siab cholestasis,
cev xeeb tub jaundice
mob qog
kev cuam tshuam hauv kev tsim cov enzymes lub luag haujlwm rau kev tsim cov bilirubin ncaj qha,
viral, kab mob, lom, tshuaj, kab mob autoimmune thiab mob rau daim siab ntev - thaum lub siab ua tsis tau dabtsi bilirubin.

Ua raws li cov txheej txheem twg yog ua txhaum, ib qho kev nce ntxiv hauv ib qho ntawm cov feem ntawm bilirubin tuaj yeem pom hauv cov ntshav. Yog tias nce ntxiv ntawm bilirubin nrog txoj kev faib ntawm cov tsis xws luag yog nrhiav tau, ces qhov no feem ntau yog kab mob siab.

Cov Ua Rau Txhawb Nqa Ncaj Nraim Bilirubin

Qib ntawm cov bilirubin ncaj qha nyob rau hauv cov ntshav nce siab vim yog kev ua txhaum ntawm kev tawm ntawm cov kua tsib. Raws li qhov ua tau, bile xa rau cov ntshav, thiab tsis ua rau lub plab. Cov laj thawj rau qhov no feem ntau yog cov hauv qab pathologies:

Kab mob siab kis mob siab (mob siab A, B, nrog rau mob mononucleosis),
mob siab ntawm kab mob etiology (leptospirosis, brucellosis),
kab mob siab
Kab mob siab autoimmune,
tshuaj tiv thaiv kab mob siab (los ntawm kev kho nrog tshuaj hormones, tshuaj tsis-steroidal anti-inflammatory, antitumor thiab anti-tuberculosis tshuaj),
mob rau daim siab mob (lom nrog lom poov xab, muaj tshuaj lom lom),
mob qog noj ntshav, qog noj ntshav
mob gallstone
biliary mob kas cees,
syndromes ntawm Rotor, Dabin-Johnson.

Kev nce siab tshaj nyob hauv bilirubin ncaj qha. Lub hauv paus yog qhov ua txhaum ntawm outflow ntawm bile.

Cov Ua Kom Muaj Kev Tawm Indirect Bilirubin

Cov kab mob uas tsis ncaj qha ntawm bilirubin nce:

Syndromes ntawm Gilbert, Krigler-Nayyar, Lucy-Driscola.
Cov kab mob sib kis - typhoid fever, sepsis, malaria.
Congenital hemolytic anemia - spherocytic, tsis-spherocytic, sickle cell, thallasemia, Markyafavi-Michele kab mob.
Tshuaj lom neeg mob ntshav qab zib lom - lom los ntawm tshuaj lom, kab tom, nab, nceb lom, hmoov txhuas, arsenic, ntsev tooj liab (vitriol). Kev mob ntshav qab zib hemolytic - ua rau mob los ntawm noj cephalosporins, insulin, tshuaj aspirin, NSAIDs, chloramphenicol, penicillin, levofloxacin, thiab lwm yam.
Tau txais autoimmune hemolytic anemia - tiv thaiv keeb kwm ntawm cov kab mob lupus erythematosus (cov tsos mob, kev kho mob), mob rheumatoid kev mob caj dab, lymphocytic leukemia, lymphagranulomatosis (cov tsos mob, kho mob), thiab lwm yam.

Kev nce siab tshaj nyob hauv kev tsis ncaj qha bilirubin. Lub hauv paus yog kev rhuav tshem cov ntshav liab ntau heev.

Teeb meem mob siab

Lub siab yog qhov tseem ceeb tshaj plaws hauv cov txheej txheem bilirubin ntau lawm. Nrog pathologies ntawm no hloov, cov txheej txheem ib txwm ntawm neutralizing free bilirubin thiab nws txoj kev hloov mus rau ib lub xeev ncaj qha ua tsis yooj yim sua. Ntawm cov kab mob siab hauv kev mob plab bilirurin cuam tshuam, muaj kab mob siab, kab mob siab A, B, C, B thiab E, dej cawv thiab tshuaj muaj kab mob siab, thiab mob cancer.

Qib ntawm ob hom bilirubin nce, uas yog pom los ntawm cov tsos mob zoo li no:

tsis xis nyob thiab hnyav nyob rau sab xis vim yog mob siab,
faded quav thiab tsaus - zis,
lightheadedness, nraus tom qab noj mov, tshwj xeeb tshaj yog kev tsis xis nyob los ntawm cov rog thiab cov zaub mov hnyav,
poob ntawm lub zog, kiv taub hau, tsis nco qab,
qhov nce hauv lub cev kub (nrog rau daim siab muaj tus kab mob kis).

Tej zaum yuav qhia lwm yam ua kom muaj ntau ntau bilirubin. Cov no suav nrog qhov tsis muaj mob muaj keeb ntawm daim siab enzymes, tus kab mob no hu ua Gilbert syndrome. Hauv cov neeg mob, theem ntawm bilirubin hauv cov ntshav tau nce ntau dua, yog li cov tawv nqaij thiab qhov muag sclera feem ntau muaj qhov zas daj.

Ua txhaum ntawm outflow ntawm bile

Hauv cov kab mob ntawm cov txheej txheem biliary, piv txwv li, mob gallstone, tus neeg mob feem ntau muaj cov tsos mob li nram no:

yellowness ntawm daim tawv nqaij thiab sclera,
mob nyob rau hauv txoj cai hypochondrium (nrog hepatic colic yog qhov mob siab heev),
tsam plab, raws plab tsis haum (raws plab lossis quav tawv),
tshem tawm cov quav thiab tso zis dub,
khaus tawv.

Tsis zoo li ntshav thiab kab mob siab, hauv qhov xwm txheej no qhov nyiaj ntawm bilirubin ncaj qha, uas yog twb ua kom tiav los ntawm daim siab, nce ntxiv.

Suprahepatic ua rau

Kev txhim kho ntawm cov nqaij ntshiv suprahepatic yog vim muaj kev puas tsuaj ntau ntxiv ntawm cov ntshav liab. Hauv qhov no, feem ntau pub dawb feem ntau sawv. Ntawm cov kab mob qhia qhov txawv:

hemolytic thiab B12-tsis txaus noj tshuaj,
dav hematomas
cov nyhuv ntawm cov tshuaj lom rau cov ntshav hlwb,
cov tshuaj tiv thaiv kev hloov ntshav txawv teb chaws lossis hloov khoom nruab nrog cev,
thalassemia.

Nrog kev ua txhaum ntawm cov metabolism ntawm bilirubin, nws cov lus qhia ntau hauv cov ntshav yuav ua tau loj. Nws qhia los ntawm kev daj ntseg, lossis los ntawm staining cov leeg ntawm daim tawv nqaij thiab tawv nqaij ua daj.

Yog hais tias qhov kev txiav txim siab ntawm bile pigment hauv cov ntshav cov ntshav tau nce mus txog 85 micromol / l, tom qab ntawd lawv hais txog kev hloov me me.
Qhov muag daj nrog cov cim ntawm 86-169 mmol / L raug suav tias yog mob hnyav, hnyav - nrog cov lej siab tshaj 170 μmol / L.

Ua raws li hom jaundice, nws cov kev pom muaj qhov sib txawv. Cov tawv nqaij tuaj yeem siv lub teeb daj daj, ntsuab, lossis saffron daj zoo. Tsis tas li ntawd, nrog bilirubin ntau dua, cov zis tsaus nti yog sau tseg (nws dhau los ua xim ntawm cov npias tsaus nti), khaus heev ntawm daim tawv nqaij.

Lwm cov tsos mob tuaj yeem suav nrog:

iab hauv qhov ncauj
tsaus zis
dawb xim ntawm quav,
feem ntau tsis muaj zog
tsis nco qab thiab txawj ntse,
kev loj hlob ntawm daim siab nyob rau hauv qhov loj me thiab hnyav nyob rau hauv txoj cai hypochondrium.

Gilbert syndrome

Yuav ua li cas kho bilirubin kom ntshav hauv cov ntshav

Bilirubin tuaj yeem txo qis nkaus xwb tom qab tsim qhov ua rau ntawm nws nce. Qhov no txhais tau hais tias koj yuav tsum tau xeem kom paub txog kab mob siab, kis mob siab (txiav txim siab ast kev ua si, alkaline phosphatase, thiab lwm yam), yauv mus kuaj daim siab ultrasound thiab ntau cov kev tshawb fawb tshwj xeeb.

Hauv qhov no, kev kho mob hauv cov neeg laus yog qhov tseem ceeb etiotropic, uas yog, nws cuam tshuam rau cov kabmob ua rau mob. Piv txwv li, yog tias muaj kev ua txhaum ntawm daim tawv nqaij txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm, nws yuav tsum tau ua kom tshem lub pob zeb los yog qog, qee qhov xwm txheej stenting ntawm cov ducts tau txais txiaj ntsig.

Nrog rau kev loj hlob bilirubin vim yog hais tawm hemolysis ntawm cov ntshav liab, kev kho mob infusion nrog kev qhia ntawm qabzib, albumin, nrog rau plasmapheresis, yog qhia. Nrog jaundice ntawm cov menyuam yug tshiab, kev kho lub ntsej muag yog qhov ua tau zoo, nyob rau hauv uas ultraviolet irradiation ntawm daim tawv nqaij pab hloov cov tshuaj lom dawb bilirubin mus rau hauv qhov chaw khi, yooj yim tawm ntawm lub cev.

Vim li cas ho muaj bilirubin txaus ntshai?

Jaundice, lossis bilirubinemia, yog qhov kev ua haujlwm tsis zoo, qhov pom ntawm lub ntsej muag yog qhib lub ntsej muag daj (qhov muag pom, tus nplaig), nrog rau thaj chaw hauv ib cheeb tsam ntawm cov qog ntshav (axillae, xib teg).

Qhov laj thawj yog cov ntsiab lus nce ntawm bilirubin hauv cov ntshav, vim tias nws tau muab tso rau hauv lwm cov nqaij hauv lub cev, suav nrog cov qauv ntawm daim tawv nqaij. Cov tsos mob kuj tshwm sim mob taub hau, xeev siab, qaug zog, khaus tawv nqaij, hnov qhov ncauj ntawm lub qhov ncauj, lub siab.

Bilirubin yog kev txhais cov lus tseeb los ntawm Latin "liab tsib" (bilis - kua tsib thiab ruber - liab) - qhov tseem ceeb ntawm cov kua tsib hauv tib neeg thiab tsiaj. Qhov tseeb, nws yog cov khoom siv tshuaj lom neeg muaj ntau ntawm kev rhuav tshem ntawm lub tsev cov tshuaj (protein) uas tshwm sim hauv lub siab, nrog rau hauv cov hlwb ntawm cov pob txha pob txha, hnoos qeev, thiab cov qog ntshav. Cov khoom noj tom kawg yog txeem tawm ntawm lub cev uas siv cov txheej txheem biliary.

Tag nrho cov nyiaj xim yog ua los ntawm cov bilirubin dawb thiab khi. Qub rau cov poj niam laus thiab txiv neej qhov ntsuas no yuav tsum tsis pub tshaj 20,5 μmol ib liv ntawm cov ntshav, thaum txoj kev faib ua feem ntawm bilirubin ncaj qha yuav tsum tsis pub ntau tshaj 5 μmol.

Thaum muaj kev tsis txaus ntseeg, cov kab mob tseem ceeb xws li lub siab, tus po, lub paj hlwb muaj qhov pheej hmoo, thiab tsis quav ntsej qhov teeb meem thaum kawg tuaj yeem ua rau tuag taus. Kev mob qog nqaij tawv hauv cov menyuam mos yog qhov txheej txheem ib txwm muaj, uas feem ntau tsis tas yuav muaj kev kho mob thiab muaj sijhawm tom qab ob peb hnub nrog kev pub mis niam lossis pub mis nrog cov khoom sib xyaw zoo.

Cov ntsiab cai kev noj zaub mov zoo

Lub hom phiaj ntawm kev noj zaub mov tshwj xeeb nrog bilirubin ntau dua yog kom tshem tawm lub siab kom ntau li ntau tau, txhawb kev sib pauv ntawm cov xim thiab cov rog, kom zoo li lub sijhawm tawm ntawm cov kua tsib los ntawm lub cev. Cov khoom siv tseem ceeb rau kev noj zaub mov kom muaj kev noj qab nyob zoo nrog rau kev noj haus No. 5, uas tsis zoo ua rau cov neeg muaj kev txom nyem los ntawm kab mob siab thiab lub zais zis. Nws cov lus piav qhia muaj nyob rau hauv ib phau ntawv qhia txog kev kho mob ntawm kev noj haus.

Qhov tsis tau txais txiaj ntsig zoo ntawm cov khoom noj no yog qhov ntau ntawm cov khoom siv tau txais thiab qhov dav dav thoob plaws kev noj haus, yog li nws tuaj yeem suav hais tias yog kev noj zaub mov zoo rau kev noj qab haus huv zoo.

Qhov nruab nrab, qhov xav tau faib tawm ntawm cov khoom siv tshuaj yuav tsum muaj raws li hauv qab no:

100 g protein
400 g carbohydrates
80-90 g rog

Kev saib xyuas tshwj xeeb yuav tsum tau them rau cov kua hauv cov khoom noj, uas yuav tsum txog li 2.5 litres ib hnub. Nws yog cov dej cov lus tsis muaj roj cua thiab dyes. Compotes los ntawm qab zib ntau yam txiv hmab txiv ntoo thiab berries, decoctions thiab infusions ntawm tshuaj ntsuab, tshuaj yej tsis muaj zog, ntsuab yuav pab tau zoo heev.

Cov kev txwv tseem ceeb yog nyob ntawm khoom ntsev thiab ntsev - lawv suav nrog hauv seem txwv kiag li. Daim ntawv teev cov cawv nrog rau cawv, nrog rau cov dej hauv cov cawv. Tag nrho cov dej qab zib - thiab cov poov xab uas muaj khoom, nrog rau cov uas muaj nplua nuj hauv purines, muaj nplua nuj nyob rau hauv cov roj lossis muaj tshuaj fiber ntau, yuav raug rau cov tsis zoo.

Lub ntsiab tseem ceeb ntawm kev noj zaub mov kom zoo yog txhua yam uas muaj kev pabcuam nquag los txo cov theem ntawm cov xim hauv cov ntshav thiab cov roj metabolism, tiv thaiv lub siab ua kom tsis muaj paug, ntxuav cov hlab ntshav, txo qhov kev pheej hmoo ntawm kev tsim cov roj cholesterol, thiab tseem yuav tshem tawm cov kua tsib los ntawm lub cev.

Yog li, nws tseem ceeb heev uas yuav tsum muaj nyob hauv daim ntawv teev npe txhua hnub ntawm cov khoom noj muaj fiber ntau, pectins thiab lipotropic tebchaw. Qhov no hais txog yuav luag txhua cov zaub ntsuab (tshwj tsis suav nrog ntsim, iab thiab muaj oxalic acid), txiv hmab txiv ntoo (nrog rau kev zam ntawm cov kua qaub rau cov txiv hmab txiv ntoo) thiab cov txiv qab zib. Lub hauv paus ntawm kev noj zaub mov yog carbohydrate, txawm li cas los xij, qhov muaj cov txiaj ntsig protein thiab polyunsaturated rog zoo nyob hauv nws ua rau nws txaus siab los soj ntsuam ntev ntev.

Lwm qhov tseem ceeb ntxiv rau kev noj zaub mov yog cov fractional noj hauv feem me meCov. Qhov no yuav pab txhawb kom tsis tu ncua ntawm cov kua tsib los ntawm lub cev, nrog rau kev tiv thaiv kev hnyav ntawm daim siab, uas tshwm sim thaum noj ntau dhau. Tso cai rau hom kev kho cua sov: ua noj, muab cub thiab ci.

Kev hais tawm yuav tsis pom zoo., vim tias qhov no tshwm sim hauv lub siab ntawm cov khoom siv rho tawm muaj teeb meem rau daim siab. Qhov kub ntawm cov tais diav ua tiav tas li yuav tsum tau sov, thiab tsis muaj lub sijhawm txias, yog li kom tsis txhob thaiv txoj kev taug ntawm txoj hauv kev.

Qhov nruab nrab txhua hnub caloric kom tsawg yog li 2500 kcal. Lub xeem zoo kov nyob rau hauv dej siab ntawm cov khoom noj yog nws cov txheeb ze pheej yig. Yog li, yog tias koj lo rau kwv yees zaub mov muab rau hauv peb tsab xov xwm, cov nuj nqis txhua lub lim tiam yuav tsis pub tshaj 1,500 rubles rau ib tus neeg.

20 txwv tsis pub cov khoom noj

cawv
haus dej haus
cov khoom noj ntsev thiab salted, marinades, qaub zaub,
muab tshuaj tsw qab, ntses tuaj, tuna, sprats, herring, salmon caviar, cws, qwj nplais,
nceb, tshwj xeeb tshaj yog ceps
poov xab cov khoom, pastries, qhob cij tshiab ntawm thawj, tshwj xeeb tshaj yog los ntawm hmoov nplej ntawm thawj qib,
muaj cov rog rog, tshwj xeeb tshaj yog pom cov khaubncaws sab nraud povtseg rog, nplooj siab, lub hlwb, cov nqaij kaus poom, raum, cov menyuam noog cov nqaij, tsiaj thiab ua rog.
qe daj
haus yeeb, nqaij hnyuv ntxwm, hnyuv ntxwm, lard,
nyuaj, qab ntsev, ntse thiab iab Cov dag,
tag nrho muaj cov kua tshuaj thiab cov khoom ua si,
mustard, ntsim txuj lom, horseradish, marinades, mayonnaise,
sorrel, spinach, radishes thiab turnips, chives, qej,
cov roj nyeem (ua ntej),
cov kua txob kev lag luam, vinegar,
qaub txiv hmab txiv ntoo, berries thiab txiv qaub txiv hmab txiv ntoo,
cov zaub mov kib, nrog rau sauteing rau kua zaub (stews kuj tsis pom zoo),
legumes, millet, raws li zoo li txhua yam zaub qhwv, nrog tsis zoo tiv thaiv tsis zoo ntawm tom kawg,
cov khoom noj muaj roj: rog tsev cheese, qaub cream, butter,
kas fes, cocoa, chocolate, ice cream, pastry cream.

Cov ntawv qhia zaub mov rau lub lim tiam

Ua nruj me ntsis rau cov ntawv qhia saum toj no tsis tas yuav txhua. Koj tuaj yeem koj tus kheej hloov cov tais diav nrog cov uas zoo sib xws hauv lawv cov tshuaj lom neeg. Qhov loj tshaj plaws yog los tsim kom muaj lub cev sib npaug, nrog kev tsim nyog txhua hnub kom muaj cov carbohydrates, protein, thiab cov rog. Nws yog qhov tsim nyog tiag tiag kom tsis suav cov khoom noj uas txwv tsis pub noj nrog txoj kev noj haus, nrog rau kev ua noj ua haus.

Cov ntawv qhia ua zaub mov yog dav, thiab kev noj qab haus huv feem ntau yog tias muaj ntau npaum li cas ntawm cov kab mob bile. Txawm li cas los xij, qee cov kab mob, cov tsos mob uas yog daj ntseg, yuav tsum tau kho tshwj xeeb ntxiv rau hauv kev noj zaub mov noj, thiab qee kis muaj kev tiv thaiv tag nrho kev siv cov khoom raws li cov txheej txheem dav dav. Yog li, nco ntsoov sab laj nrog koj tus kws kho mob ua ntej pib noj zaub mov.

Lwm txoj hauv kev muaj pov thawj

Tsoos tshuaj ntsuab paub txoj hauv kev kom tshem tau cov jaundice. Tseem ceeb tshaj, ua ntej xaiv ib qho ntawm lawv, koj yuav tsum tau sab laj nrog kws kho mob, kuaj kev txheeb xyuas kom paub qhov ua rau ntawm cov ntsiab lus cov xim ntxiv, nrog rau kev sib txuas ntxiv ntawm kev noj haus.

Cov kua txiv Beetroot. Cov cuab yeej no muaj peev xwm ua kom muaj ntshav muaj zog nrog hemoglobin thiab ntxuav lub cev ntawm co toxins, pab txhawb kev tshem tawm sai sai ntawm cov kab tsib. Koj tuaj yeem ua kua txiv rau yav tsaus ntuj. Ua li no, tev tawm thiab luv luv so beets yuav tsum tau so ntawm yas grater, thiab qhov loj yuav tsum tau ntim cov piam thaj (ib khob - ob dia). Thaum sawv ntxov, cov kua txiv-muab cov dej loj yuav tsum tau nyem thiab muab nyob rau hauv ib feem peb ntawm lub khob ntawm lub plab khoob.
Pob kws stigmas. Ib qho zoo heev diuretic thiab choleretic anti-inflammatory tus neeg sawv cev. Ob dia ntawm pob kws stigmas yog nchuav nrog dej npau npau thiab hais kom noj ua ntej yuav mus pw (koob - ib nrab ib khob).
Infusions ntawm choleretic tshuaj ntsuab. John lub wort, chamomile, mint muaj cov nyhuv tshuaj uas tsim nyog kho. Cov nqi them tshuaj tshwj xeeb yuav tsum siv. Txoj kev pom zoo los npaj cov decoction yog dej da dej. Qhov kev xaiv sib dua yog lub hom phiaj tshuaj ntsuab, uas tseem yuav tsum tau yuav ntawm chaw muag tshuaj. Haus ib nrab ib khob ntawm Txoj kev lis ntshav ob zaug ib hnub. Cov txiaj ntsig yuav tshwm sim hauv ob rau peb lub lis piam.
Birch nplooj. Cov dej sib tov qhuav yog hliv nrog dej npau npau thiab coj tuaj rau kev npaj txhij hauv hauv dej da dej. Siv ib nrab ib khob ua ntej yuav mus pw.

Xaus

Ob qho tib si tau piav qhia txog kev noj zaub mov noj thiab tshuaj ntsuab pej xeem yuav tsum tsuas yog ntxiv rau cov tshuaj noj uas kws kho mob tau hais tseg, yog tias tsim nyog. Muaj ntau tshaj 50 qhov laj thawj rau kev nce qib ntawm bilirubin, thiab yog li ntawd muaj ntau qhov kev kho tau uas tsuas yog txiav txim los ntawm tus kws kho mob tom qab kev kuaj mob tshwj xeeb rau biochemistry, nrog rau quav thiab tso zis.

Txawm li cas los xij, nws paub tseeb tias yog koj nyob ntawm cov neeg mob uas muaj qhov tsis zoo no, koj yuav zam tsis dhau tag nrho cov kev txwv kev noj haus tau teev saum toj no kom rov zoo dua. Ua siab ntev, kawm ntau yam zaub mov txawv rau cov zaub mov noj uas siv cov khoom xyaw uas tau tso cai, vim tias cov khoom noj yuav tau ua raws ntau lub hlis.

Yog tias koj ua raws li tag nrho cov kev cai thiab tsis txhob tawv ncauj ntawm txoj kev tsis tiv thaiv, tom qab ntawd koj yuav yeej txaus siab tsis yog nrog kev txheeb xyuas zoo, tab sis kuj poob ceeb thawj thiab ua rau txhua leej txhua tus nrog koj tus hluas saib. Peb xav koj txoj kev vam meej thiab kev noj qab nyob zoo!