1, physiological jaundice
Neonatal physiological jaundice is a unique phenomenon in neonatal period. Because the fetus is in an intrauterine hypoxia environment, there are too many red blood cells in the blood, which are immature and easy to be destroyed. After the fetus is born, it causes excessive bilirubin, which is about twice that of adults. On the other hand, neonatal liver function is immature, which limits bilirubin metabolism and other reasons, leading to neonatal jaundice for a period of time.
The physiological jaundice of full-term infants begins on the 2nd-3rd day, when the skin is pale yellow, the sclera (white eyes) is mainly blue and slightly yellow, and the urine is slightly yellow but does not touch diapers. It was the yellowest on the 4th to 5th day, and10-14th day full-term infants subsided. Check whether the liver function is normal and whether the serum free bilirubin is increased. Physiological jaundice in premature infants will appear earlier, higher and last longer, which can be delayed by 3 -4 weeks. Although there is jaundice, the child has no discomfort and the overall situation is good. Physiological jaundice is a normal physiological phenomenon and does not need treatment.
2, breast milk jaundice
Neonatal jaundice caused by breastfeeding is called breast milk jaundice, which is a special type of pathological jaundice. The degree of jaundice in a few breast-fed newborns exceeds normal physiological jaundice, and the reason is not very clear. Its jaundice is manifested as: jaundice continues to increase after the peak of physiological jaundice. If you continue breastfeeding, jaundice will gradually decrease after a period of high level. If you stop breastfeeding for 48 hours, jaundice will be significantly reduced. If you breastfeed repeatedly, jaundice will rise again. Because breast milk contains pregnanediol hormone, which can inhibit the activity of glucuronosyltransferase in newborn's liver, bilirubin in blood can't be metabolized and excreted in time, so the concentration of bilirubin in blood increases, resulting in yellow staining of newborn's skin and sclera.
Symptoms of neonatal jaundice
Neonatal jaundice can be divided into physiological jaundice and pathological jaundice. Neonatal jaundice has different symptoms according to different types.
Physiological neonatal jaundice symptoms are as follows:
Newborns appear yellow skin, white eyeball and yellow oral mucosa on the second to third day after birth, with varying degrees of severity. Generally, it is obvious on the face and chest, but the palms and soles are not yellow. It is most obvious on the 4th to 6th day. Full-term infants fade from 10 to 14 days after birth, and premature infants can last until the third week. During this period, the child is generally in good condition and has no other discomfort.
It is normal for newborns to have physiological jaundice, but parents should also pay close attention. Generally speaking, physiological jaundice is relatively light, and the concentration of bilirubin in the blood is low, which will not affect the intelligence of children.
Symptoms of pathological jaundice are as follows:
Jaundice in children can appear within 24 hours after birth, or last for a long time, or reappear after regression, or jaundice gradually increases.
Pathological neonatal jaundice can also cause manifestations of other diseases, such as nuclear jaundice. When it happened, the jaundice of the child was obviously aggravated, and symptoms such as drowsiness, inability to suck or choke milk, and low muscle tone began to appear. If the treatment is not timely, there may be serious symptoms such as groaning, screaming, convulsions and respiratory failure in the later stage. Some children died of respiratory failure, and the surviving children often have sequelae such as mental retardation and cerebral palsy.
The above is the introduction of neonatal jaundice symptoms. It should be noted that when newborns have jaundice, parents can feed glucose water to help jaundice. When jaundice is serious, the child should be sent to the hospital for treatment in time to prevent the occurrence of nuclear jaundice and avoid affecting the child's intellectual development.
Harm of neonatal jaundice
Neonatal physiological jaundice can be solved by itself, but pathological jaundice is a group of diseases composed of many reasons, which must be found and treated as soon as possible. Neonates with severe jaundice should be alert to the occurrence of nuclear jaundice, especially immature infants. The younger the month, the higher the incidence. Generally, symptoms such as listlessness, lethargy, weakness in sucking, decreased muscle tone, vomiting, and not feeding milk may occur within/0/2-48 hours after the occurrence of severe jaundice. At this time, if treated in time, it can be completely recovered.
Pathological jaundice, no matter what the cause, will be caused in severe cases. Nuclear jaundice? Its prognosis is poor, which can not only cause nervous system damage, but also lead to death in severe cases. Therefore, neonatal pathological jaundice should be mainly prevented, such as preventing toxoplasmosis and rubella virus infection during pregnancy, especially in the first trimester; Prevention of septicemia after birth; Newborns are vaccinated against hepatitis B at birth. Parents should closely observe the changes of children's jaundice. If signs of pathological jaundice are found, they should be sent to the hospital for treatment in time.
Prevention of neonatal jaundice
1. Fetal jaundice often affects the fetus due to the invasion of damp heat by pregnant mothers, leading to jaundice after birth. Therefore, during pregnancy, pregnant mothers should pay attention to moderate diet, but eat cold food, but not too hungry, and avoid alcohol and irritating products to prevent damage to the spleen and stomach.
2. If a woman has given birth to a baby with fetal jaundice, she should take preventive measures when she is pregnant again and take Chinese medicine on time.
3. After the baby is born, closely observe its scleral jaundice and find that jaundice should be treated as soon as possible, and observe the color change of jaundice to understand the advance and retreat of jaundice.
4. Pay attention to the general symptoms of Huang Baobao, whether there are symptoms such as listlessness, lethargy, difficulty in sucking milk, panic, strabismus, stiff limbs or convulsions, so as to find and deal with severely ill children as soon as possible.
5. Closely observe the changes of heart rate, heart sound, anemia degree and liver size, and prevent and treat heart failure at an early stage.
6, pay attention to protect the baby's skin, navel and buttocks clean, to prevent damage and infection.
7, need to change blood treatment, should be timely disinfection ward air, ready to blood and all kinds of drugs, articles, strict operating procedures.
Treatment of neonatal jaundice
Physiological jaundice of newborn: it was previously thought that no treatment was needed. In view of the promotion of prenatal and postnatal care and the improvement of population quality, we should pay special attention to the following points:
1. Start milk early to accelerate meconium discharge.
2, hunger, hypoxia, constipation, dehydration, acidosis, skull hematoma, etc. Regenerative jaundice can be added and should be treated.
Hypercholesterolemia: The main harm is nuclear jaundice. In the study of nuclear jaundice, it used to be thought that indirect bilirubin is fat-soluble, lipophilic and free, and has affinity with brain cells rich in cephalin, which is easy to damage the nucleus through the blood-brain barrier and cause nuclear jaundice.
Treatment: Traditional methods include:
1, phototherapy: suitable for any indirect bilirubin, bilirubin >; 205? Mol/L, blue light (cold light source) with wavelength of 420 ~ 460 mm can be continuously or indirectly irradiated for 24 ~ 48 hours. Phototherapy has been used to treat neonatal jaundice for more than 40 years. Can effectively reduce the serum bilirubin level, is convenient to use and has few adverse reactions. It has been widely used in clinic and is still used to treat neonatal jaundice. Standard? Treatment. In order to maximize the therapeutic effect of phototherapy, the effects of different light sources were compared in clinical use. At present, the new phototherapy proposes to use gallium nitride light emitting diode, which is a high-energy and durable light source and can emit blue-green light with high intensity and narrow spectrum. The spectral range of blue-green light overlaps with the absorption spectral range of bilirubin. The effect of this light source on bilirubin degradation is better than that of the traditional blue light cold light source, and bilirubin rebound is very small after phototherapy.
2. A new viewpoint of drug therapy for jaundice: application of tin porphyrin, code name (SnMP). It is the only heme analog approved for clinical use by the US Food and Drug Administration (FDA). Heme oxygenase (HO) is the rate-limiting enzyme for heme metabolism to produce bilirubin. Inhibition of HO activity can reduce bilirubin production. Therefore, it is more reasonable to use this medicine when the therapeutic function of neonatal liver bilirubin is immature. Porphyrin in tin does not enter brain tissue, with a wide safe dose range, does not degrade in vivo, and does not affect the combination and excretion of free bilirubin and glucuronic acid in liver. Heme that is blocked by SnMP and cannot be degraded will not accumulate in tissues. ...