黃疸-09級一系-老年-麻醉-救援-心理-陶小紅(編輯修改稿)
2025-02-14 22:22 本頁面
【文章內(nèi)容簡介】 膽栓 ) formation. Cholestatic Jaundice mechanism ? Clinical Manifestation ? Skin dark yellow, yellow green. ? Skin itch (癢 ), bradycardia (心動過緩 ), dark yellow of urine, faecal light yellow or clay color. ? Courvoisier’s sign. ? Laboratory Examination ? Serum CB↑ ? Urine bilirubin (+) ? Urobilinogen , stercobilin(糞膽原 ) ↓or absence ? Serum alkaline phosphatase and Cholesterol(膽固醇 )↑ A. Hemolytic anemia excess hemolysis ? unconjugated bilirubin (in blood) ? conjugated bilirubin (released to bile duct) UB ? Urobilinogen B. Hepatitis ? unconjugated bilirubin (in blood) ? conjugated bilirubin (in blood) ? UB ? Urobilinogen C. Biliary duct stone ? unconjugated bilirubin (in blood) ? conjugated bilirubin (in blood) ? UB Urobilinogen 5. Geic Disorders of Bilirubin Metabolism Condition Defect Bilirubin Clinical Findings CriglerNajjar syndrome severely defective UDPglucuronyl transferase Unconjugated bilirubin ??? Profound jaundice Gilberts syndrome reduced activity of UDPglucuronyl transferase Unconjugated bilirubin ? Very mild jaundice during illnesses DubinJohnson syndrome abnormal transport of conjugated bilirubin into the biliary system Conjugated bilirubin ?? Moderate jaundice Rotors syndrome deficiency of uptaking UCB and excreting CB, CB↑ jaundice. CriglerNajjar syndrome Gilberts syndrome Three kinds of jaundice laborotory examination indentification Class Hemolytic Hepatocellular Cholestatic TB increased increased increased CB normal increased markedly increased CB/TB ＜ 15％一 20％ ＞ 30
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