新生儿黄疸（Neonatal Jaundice）ppt课件.pptVIP

Neonatal Jaundice;Introduction;Introduction continued; ; ;;Bilirubin Metabolism:;The metabolic characteristics of bilirubin in newborns: ; 3. Bilirubin metabolism of hepatocyte a. Hepatic uptake of bilirubin b. Bilirubin conjugation: UDPGT (uridine diphosphate glucoronyl transferase) c. Defective bilirubin excretion ability to bile system 4. Enterohepatic circulation ;Bilirubin toxicity;Clinical Manifestations;Evaluation of jaundice : 1. By eyes: face, 5mg/dl ( 85μmol/L ); abdomen, 10-15mg/dl; feet, 15-20mg/dl ; 2. By transcutaneous measurement : used for screening 3. By serum levels : standard; Classification: Physiological Jaundice Pathological Jaundice ; Physiological jaundice : 1. General state is well 2. Appears 2-3days (24h of age) peaks 12.9mg/dl (full term infants) 15mg/dl (preterm infants) fades 2 week (term infants) 4 weeks (preterm infants) 3. Accumulates 5mg/dl/d 4. Direct bilirubin 2mg/dl; Pathological Jaundice 1. Appears earlier (first 24 hours of life) 2. Peaks 12.9mg/dl (full term infants) 15mg/dl (preterm infants) Fades 2 weeks (term infants) 4 weeks (preterm infants) 3. Accumulates 5mg/dl/d 4. Direct bilirubin 2mg/dl 5.Jaundice recurrent ;Common causes of pathological jaundice;2. Conjugated bilirubinemia: a. Neonatal hepatitis b. Biliary obstruction (cholestatic jaundice) biliary atresia, common bile duct stenosis c. Congenital metabolic diseases α-1 antitrypsin deficiency;Hemolytic disease of newborn;Hemolytic disease of newborn continued;Pathogenesis;Pathophysiology;Clinical Manifestations:;Complication;1. Blood type incompatibility 2. Hyperbilirubinemia : Unconjugated bilirubin level 3. Hemolytic tests 1). Hemoglobin level : low 2). Reticulocytes:10–15% 3).