neonatal jaundice lwz英文课件

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1、NeonatalJaundiceIntroductionNeonatalJaundiceisknownasthevisibleclinicalmanifestationofdyingskinandsclerayellowduringtheneonatalperiod,resultingfromdepositionofbilirubinintheneonatalbodies.IntroductionJaundiceisobservedduringthe1stwkinapproximately60%oft

2、erminfantand80%ofpreterminfant.Hyperbilirubinemiacanbetoxic,withhighlevelsresultinginanencephalopathyknownaskerni-cterus.MetabolismofBilirubinIncreasedbilirubinproductionLesseffectivebindingandtransportationLessefficienthepaticconjugationEnhancedabsorpt

3、ionofbilirubinviatheenterohepaticcirculationClinicalManifestationJaundicemaybepresentatbirthoratanytimeduringtheneonatalperiod.Jaundiceusuallybeginsonthefaceand,astheserumlevelincreases,progressestothechestandabdomenandthenthefeet.Jaundiceresultingfromd

4、epositionofindirectbilirubinintheskintendstoappearbrightyellowororange;jaundiceoftheobstructivetype(directbilibrubin),agreenishormuddyyellow.MethodsofDiagnosisAcompletediagnosticevaluationDeterminationofdirectandindicrectbilirubinfractionsDeterminationo

5、fhemoglobinReticulocytecountBloodtypeCoombs’testExaminationoftheperipheralbloodsmearClassificationsDirect-reactinghyperbilirubinemiaHepatitisCholestasisInbornerrorsofmetabolismSepsisClassificationsIndirect-reactinghyperbilirubinemiaHemolysisReticulocyto

6、sisEvidencesofredbloodcelldestructionApositiveCoomb’stestBloodgroupincompatibilityPositiveresultsofspecificexaminationClassificationsDirectandindirect-reactinhyperbilirubinemiaHepatitisSepsisLiverdamagecomplicatedbyHemolysisClassificationsPhysiologicjau

7、ndiceClinicaljaundiceappearsat2-3days.Totalbilirubinrisesbylessthan5mg/dl(86umol/L)perday.Peakbilirubinoccursat3-5daysofage.PeakbilirubinconcentrationinFull-terminfant<12mg/dl(205.2umol/L)PeakbilirubinconcentrationinPrematureinfant<15mg/dl(257umol/L)Cli

8、nicaljaundiceisresolvedby2weeksintheterminfantby3-4weeksinthePreterminfant.ClassificationsPathologicjaundiceClinicaljaundiceappearsin24hoursofage.Totalbilirubinrisesbyhigherthan5mg/dl(86umol/L)perday.Peakconcentrationoftotalbilir