Jaundice is a common symptom. Due to the increase in bilirubin, sclera, skin, mucous membranes, etc. are yellow stained due to bilirubin. One month after birth is 1.7 ~ 17.1 umol/L, the serum bilirubin reaches 34.2 umol/L to the naked eye to identify jaundice, but the severity of jaundice is incomplete as the level of serum bilirubin level parallel. So, what is the cure of jaundice diagnosis? How can we diagnose and treat jaundice in order and accurately? Considering the following problems, maybe the cause of jaundice will no longer be blurred.
1. Identify the true and false jaundice
The sclera, skin, and mucosal yellow stain caused by the increased serum bilirubin is called true jaundice; the skin and mucosa yellow stain caused by other reasons of low serum bilirubin is called pseudo -jaundice.
Pseudo -jaundice is common in a large number of carotes, pumpkin, pumpkin, tomatoes, spinach, oranges, etc., and yellow stains such as palms, foreheads, nose wings. The serum bilirubin is not high, the sclera has no yellow dye, and there are a lot of food with carotene -rich foods. It is not difficult to diagnose.
2. Direct bilirubin or indirect bilirubin increase?
No matter how big the child encounters jaundice, the level of bilirubin is rising, one of the questions we should answer first is: direct bilirubin elevation is the main or indirect bilirubin elevation?
The total bilirubin is divided into bilirubin and unbound bilirubin is a key step in assessing children with hyperbilotin ledin. Why do you say that? For example, if the child is mainly based on the increase of bilirubin, and the level of bilirubin accounted for a high level of total bilirubin, γ-GT is very high, then it should be highly doubtful whether there is a high risk factors in obstruction, such as biliary tract, such as biliary tract Tworals, due to poor prognosis of biliary tunnels, early diagnosis of early diagnosis is the key to subsequent intervention and improvement of prognosis.
Mainly, which is not combined with bilirubin, it is common in newborn jaundice and hemolysis, which may be an important signal of a medical emergency. This is because it is not combined with bilirubin as a fat -soluble. The “nuclear jaundice” (also known as bilirubin encephalopathy) that directly damage the brain, causing irreversible injury to the nervous system.
It is worth mentioning that sometimes use “direct” and “indirect” bilirubin instead of “combination” and “non -combined” bilirubin, which is related to the detection method, but the two are not completely equal. Measurement of direct bilirubin, not only bilirubin single glucosol acid and bilirubin bilircetal acid, but also Delta bilirubin -combined bilirubin with serum albumin.
Incidentally, when the older director often checks the room, he will ask: How to distinguish whether the naked eye is combined with bilirubin or non -combined bilirubin elevation? Those who are not combined with bilirubin, jaundice is lemon or pale yellow, and Chinese medicine is called “yang yellow”; those who combine bilirubin increased, jaundice is dark yellow or yellow -green, and itching is often obvious. Chinese medicine is called “Yin Yin Yin yellow”. In addition, itching often indicates that blood bile acid is elevated, and it is mainly prompted to combine bilirubin elevation.
3. Is jaundice accompanied by other abnormal physical examinations?
With the advancement of modern medical technology, doctors may rely more on various inspections than before, but it is worth reminding that any advanced auxiliary examination cannot completely replace the clinical status of physical examination. Special discovery of physical examination is often discovered by the diagnosis and treatment of diseases, and sometimes it plays a key role in the diagnosis and treatment of diseases. The following physical examination exception can provide important clues for the diagnosis of the disease:
★ Newborn’s significant high unblocked bilirubin ledmia. Pay attention to whether baby’s skull hematoma or extensive skin ecchymosis caused by birth injuries increases.
★ Torch infected newborns may have deformities in the palace, such as small head deformities, slow growth, hepatoplastomia, leverans retinitis or rash;
★ Niccd children’s face often shows the characteristics of “fat face”;
★ Hepatogenic cumulative disease can be manifested as “mud paste facial”;
★ Jaundice Children’s skin and mucosa are pale, spleen, and blood image indicates anemia. Pay attention to excluding hemolytic jaundice;
★ Jaundice is accompanied by fever, large liver, liver tenderness or pain, anorexia, diarrhea, hepatitis jaundice should be paid attention to;
★ The red blood cells of the children with a child syndrome are low and deformable;
★ Children in Alagille syndrome can often hear heart murmurs;
If the muscle tone of jaundice decreases and the corners are reversed, they should immediately think of whether there is acute bilirubin encephalopathy or nuclear jaundice.
4. Is there a family history or exposure history of jaundice?
When analyzing the cause of jaundice, you should pay attention to family genetic medical history, history of infectious disease contact, medicinal history, feeding history, history of pregnancy production, and jaundice, and jaundice, fluctuations and treatment reactions. Many diseases with jaundice are family hereditary. For example, Alagille syndrome is a common autosomal genetic disease; α1-anti-fascinase deficiency, Cigler-najjar syndrome I and type II, galactose, and tyrosine are a minority. Corporal hidden genetic diseases related to jaundice; G6PD deficiency is hidden inheritance of X chromosomes, but it is highly polymorphism. It should be considered that men and women are different.
Does jaundice continue to exist after birth, or do they appear after dietary changes?For example, if a child with hereditary fructose is not tolerated, jaundice may be induced after adding fructose -rich sugar; broad beans, sulfa drugs or camphor balls can induce jaundice in children with deficiency of G6PD, which can produce jaundice; children with NICCD can be in the NICCD children.Special milk powder gradually relieved after eating special milk powder.In addition, age is also closely related to the cause.Little babies are common in congenital anatomy, such as biliary locks, congenital genetic metabolic defects; and older children may be more obtained or secondary to liver diseases, such as cholelite, sclerosis bile tubeitis, etc.Essence
