Hemolytic chirwere chechechecheche chirwere chinowanikwa apo ropa raamai ne fetus harina kufanana. Izvi zvinogona kuitika kana fetus inobata ropa antigens kubva kuna baba, uye muropa raamai hakuna maantigen akadaro. Kazhinji kacho, chirwere ichi chinowedzera apo Rhesus antigen haikwanisi, asi inogonawo kuva mugumisiro wekusagamuchirwa nemamwe marudzi emaantijeni.
Mechanism of development disease
Mukupindura kwemigumisiro ye fetal antigens pamuviri waamai, zvirwere zvemaantigi aya anobudiswa muropa rake. Inopinda nepakati pencental barrier muropa remwana, zvirwere zvinokonzera hemolysis (kuparadzwa) kweyerythrocytes, iyo inokonzera kukanganiswa kwebilirubin metabolism. Mamiriro ezvinhu anowedzera nekusava nekuchenesa kwechiropa chechiropa chechiropa mu fetus, chisati chakwanisa kutamisa chinokonzera chakashata bilirubin kune chisina chepfu chakasvibiswa, chakanyanyiswa kuburikidza neitsvo. Madzimai emadzimai anokwanisa kupinda mukati meparcenta panguva yekudzivirira uye panguva yebasa.
Kuoma kwehosha ye hemolytic ye fetus uye mwana achangoberekwa kunobva maitiro akawanda emasikirwo akagamuchirwa kubva kuna amai muropa remwana, uyewo pamusoro pemikana yekubhadhara yeiyo yekupedzisira. Kazhinji chirwere ichi chinogona kukura panguva yekudzivirira kwekutanga. Mikana yezviitiko zvayo inowedzera nemubereki mumwe nomumwe anotevera, tk. kune huwandu hwezvirwere zvinoputika muropa raamai.
Mafomu ehemolytic chirwere chemangwana
Kana mwana wacho asingafi muUtero, zvino anoberekwa ane imwe yemhando dzechirwere ichi:
- anemic;
- edematous;
- icteric.
Zviratidzo zvinowanzoenderana nehutoriyamu zvirwere zve fetus nechechecheche: normochromic anemia nekuvapo kwevana vaduku erythrocytes muropa uye hyperplasia (kuwedzerwa) mune chirwere uye chiropa.
Anemic form
Izvo zviri nyore pane zvitatu zvechirwere chinowanikwa munyaya yekanguva shomanana kudarika nhamba shomanana yezvirwere zvekuberekwa kusvika kumucheche. Kuparadzwa erythrocyte kunotorwa kuburikidza neparcenta. Mumwana mucheche unogona kuona kupera kweganda, jaundice haipo. Anemia inozviratidza pakuguma kwevhiki yekutanga yehupenyu.
Edema fomu
Chirwere chakaoma kwazvo chehemolytic yechechecheche, inoda kurapwa mumasekondi ekutanga mushure mokuberekwa. Inoitika apo amai vanorwisa zvirwere pamwana vanoramba kwenguva yakareba. MuUtero, fetus inopona, nokuti zvigadzirwa zvekudhakwa zvinodhevedzwa kuburikidza nekuwedzera zvakanyanya muparcenta. Iyo fetus inotenderera kune mamiriro ezvinhu uye inowedzera foci ye hematopoiesis. Endocrine glands, chiropa uye chirwere chinowedzera zvikuru. Chirongwa cheprotein-forming basa rechiropa, chinoderedza kuwanda kwemapuroteni muropa, kune hupfumi hukuru hwehutachiona hwemafuta, huwandu hwemvura inowanikwa mumuviri. Migumisiro yemhando iyi yehemolytic chirwere chemucheche inouraya mwana. Vanenge vose vana vanoberekwa vari vapenyu vanopera mukati memaawa mashomanana kana maawa mashomanana.
Jaundice fomu
Inoitika pasi pesimba remadzimai ekurwisana nawo pamucheche, uyo atova wakakwana. Mwana anoberekwa nenguva uye aine muviri wepanyama. Hemolytic chirwere chinokura muzuva rokutanga. Zuva rakatevera kune jaundice, iri kukurumidza kukura. Nhengo dzemukati dzinowedzera muhukuru. Pane kuwedzera kwakanyanya kwehuwandu hwebilirubin, pane zviratidzo zvebilirubin kudhakwa nekuvhiringidzika kwepakati yenheyo yehurumende: huwandu hwekufungidzika hunovhuniwa, kurutsa uye kushungurudzika kunooneka, uye zvichida nekugadzirwa kwebilirubin infarct yeitsvo. Pasina nguva yakakodzera uye yakakodzera kurapwa kwekicteric maitiro ehemolytic chirwere chemucheche, mwana angafa pazuva rechipiri mushure mokuberekwa. Kuponesa vana kwakasara kure kumashure kwekuvandudza mupfungwa.
Kurapa kwehemolytic chirwere chemangwana
Kurapa kwehemolytic chirwere chemucheche kunofanira kuva yakakwana uye yakakodzera, kusanganisira:
- kubvisa kudhakwa munguva inopfupika inogoneka;
- kubviswa kwezvirwere kubva mumuviri wemwana, izvo zvinobatsira pakuwedzera hemolysis yemasero matsvuku eropa;
- kubudirira kwehutano huno huri nhengo dzakasiyana-siyana uye maitiro, kunyanya tsvete uye chiropa.
Nzira yakanakisisa yekurapa ndiyo kuwedzerwa ropa kuwedzerwa panguva yekutanga.
Hemolytic chirwere chevana vachangoberekwa zviri nani kusabata, asi kuti vanyevere. Sezvo prophylaxis, kutungamirirwa kwe antiresus gamma-immunoglobulin kumukadzi pakarepo mushure mekuberekwa kwemwana wekutanga, kukanganisa kuburikidza nekudzorerazve ganda kubva kune murume, kubviswa kwekubvisa pamuviri, kunyanya panguva yekubata pamuviri, kunoshandiswa. Vana vokutanga vanowanzoberekwa vakagwinya.