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科普知识之新生儿黄疸

时间:2021-07-23 16:26:55 来源: 作者:

  新生(sheng)(sheng)儿黄疸是新生(sheng)(sheng)儿的一(yi)种常见病(bing),很多妈妈们(men)在生(sheng)(sheng)下宝宝第一(yi)时间里都会(hui)担心宝宝会(hui)不会(hui)得新生(sheng)(sheng)儿黄疸,那么新生(sheng)(sheng)儿黄疸到底是怎样一(yi)种病(bing)症呢?

  新生(sheng)(sheng)儿黄(huang)(huang)疸(dan)(别(bie)名:新生(sheng)(sheng)儿高胆(dan)红(hong)素血症(zheng)(zheng),胎黄(huang)(huang))是(shi)指新生(sheng)(sheng)儿期(qi)(自胎儿娩出脐带结扎至生(sheng)(sheng)后28天),由于胆(dan)红(hong)素在(zai)体内(nei)积(ji)聚(ju)而导致血中(zhong)胆(dan)红(hong)素水平升高而出现皮(pi)肤、黏膜及巩膜黄(huang)(huang)染为特征的病(bing)症(zheng)(zheng),本病(bing)分(fen)为生(sheng)(sheng)理性黄(huang)(huang)疸(dan)和病(bing)理性黄(huang)(huang)疸(dan)。

  胎龄12周时,羊水中已有(you)胆红素(su)(su)。这是由胎儿(er)(er)气管(guan)和(he)支气管(guan)树分泌到羊水中的未结合(he)胆红素(su)(su)。胎儿(er)(er)靠胎盘供应血和(he)氧气,但(dan)是体内为(wei)低氧环(huan)境,必(bi)须有(you)更多的红细胞(bao)携(xie)带氧气供给(ji)胎儿(er)(er),才能满足胎儿(er)(er)的需要。因此胎儿(er)(er)红细胞(bao)破(po)坏后产生的未结合(he)胆红素(su)(su),极大部分通过胎盘到母体循环(huan)中去清除,故(gu)新生儿(er)(er)刚(gang)出(chu)生时都无黄(huang)疸。

  出生(sheng)(sheng)(sheng)(sheng)(sheng)后,新(xin)生(sheng)(sheng)(sheng)(sheng)(sheng)儿必(bi)须用自己的(de)肺呼(hu)吸(xi)直(zhi)接(jie)获得氧气,体内的(de)低氧环境得到(dao)改(gai)变,红(hong)(hong)细胞的(de)需(xu)求(qiu)量减少(shao),于(yu)是大量的(de)红(hong)(hong)血(xue)球被(bei)破坏(huai),分解产(chan)生(sheng)(sheng)(sheng)(sheng)(sheng)未结合胆(dan)(dan)红(hong)(hong)素(su)。新(xin)生(sheng)(sheng)(sheng)(sheng)(sheng)儿必(bi)须自己处(chu)理(li)(li)血(xue)红(hong)(hong)蛋白的(de)代谢(xie)产(chan)物--未结合胆(dan)(dan)红(hong)(hong)素(su)。但这时(shi)新(xin)生(sheng)(sheng)(sheng)(sheng)(sheng)儿的(de)肝功能(neng)不(bu)(bu)完善,酶系统发(fa)育不(bu)(bu)成熟,葡萄糖醛(quan)酰(xian)转(zhuan)移(yi)酶在足月儿要(yao)3-5天、未成熟儿要(yao)5-7天才(cai)成熟,不(bu)(bu)能(neng)把过多的(de)胆(dan)(dan)红(hong)(hong)质处(chu)理(li)(li)后排(pai)出体外,只能(neng)堆积在血(xue)液中(zhong)。这种胆(dan)(dan)红(hong)(hong)质象黄(huang)色的(de)染料一(yi)样,随着血(xue)液的(de)流动,加诸各(ge)种新(xin)生(sheng)(sheng)(sheng)(sheng)(sheng)儿胆(dan)(dan)红(hong)(hong)素(su)代谢(xie)特点,把新(xin)生(sheng)(sheng)(sheng)(sheng)(sheng)儿的(de)皮肤和巩膜染成黄(huang)色,就发(fa)生(sheng)(sheng)(sheng)(sheng)(sheng)新(xin)生(sheng)(sheng)(sheng)(sheng)(sheng)儿生(sheng)(sheng)(sheng)(sheng)(sheng)理(li)(li)性黄(huang)疸。