新生儿肝炎如何治疗(图）

时间 : 2009-11-28 02:47:37 来源：hbv.39.net

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新生儿肝炎如何治疗(图）,肝炎,甲肝,乙肝,丙肝,胆汁

新生儿肝炎如何治疗（图）www.39.net　　2007-06-28　　加拿大肝脏基金会　　

NeonatalHepatitis

Whatisneonatalhepatitis?

Neonatalhepatitisisaninflammationoftheliverthatoccursinearlyinfancy,usuallyonetotwomonthsafterbirth.About20percentofinfantswhodevelopneonatalhepatitiswereinfectedwithaviruscausinginflammationofthelivereitherbeforebirththroughtheirmother,orshortlyafterbirth.Viruseswhichcancauseneonatalhepatitisininfantsincludecytomegalovirus,rubella（measles）,andhepatitisA,BandC.Intheremaining80percentofaffectedinfants,nospecificcausecanbeidentified,butmanyexpertssuspectavirusistoblame.

Whatarethesymptomsofneonatalhepatitis?

Aninfantwithneonatalhepatitisusuallyhasjaundice（yelloweyesandskin）thatappearsatonetotwomonthsofage.Jaundiceoccurswhentheflowofbilefromtheliverisblockedduetoaninflammationorobstructionofthebileducts.Sincebileisessentialinthedigestionoffatsandabsorptionoffatsolublevitamins,achildwithneonatalhepatitismayfailtogainweightandgrownormally.Theinfantwillalsohaveanenlargedliverandspleen.

Howisneonatalhepatitisdiagnosed?

Thediagnosisofneonatalhepatitisisinitiallybasedonbloodtestsaimedatidentifyingpossibleviralinfectionsleadingtothedisease.Incaseswherenovirusisidentified,aliverbiopsyisperformed.Thisinvolvestheremovalofasmallpieceoftheliverusingaspecialsyringeforexaminationunderamicroscope.

Biopsyresultswilloftenshowthatgroupsoffourorfivelivercellshavejoinedtogethertoformlargercells.Althoughtheselargecellscontinuetofunction,theydosoatalesserratethannormallivercells.Thistypeofneonatalhepatitisissometimescalledgiantcellhepatitis.

Thesymptomsofneonatalhepatitisaresimilartothoseassociatedwithanotherinfantliverdiseasecalledbiliaryatresia.Ininfantswithbiliaryatresiahowever,bileductsareprogressivelydestroyedforreasonsthatarepoorlyunderstood.Althoughaninfantwithbiliaryatresiaisalsojaundicedwithanenlargedliver,thereisgenerallynormalgrowthandthespleenisnotinflamed.Inadditiontosymptoms,aliverbiopsyandbloodtestsareneededtodistinguishbiliaryatresiafromneonatalhepatitis.

Whatcomplicationsareassociatedwithneonatalhepatitis?

Infantswithneonatalhepatitiscausedbyrubellaorcytomegalovirusareatriskofdevelopinganinfectionofthebrainthatcouldleadtomentalretardationorcerebralpalsy.Manyoftheseinfantswillalsohavepermanentliverdiseaseduetothedestructionoflivercellsandtheresultingscarring（cirrhosis）.

Themajorityofinfantswithgiantcellhepatitiswillrecoverwithlittleornoscarringtotheliver.Theirgrowthpatternwillalsonormalizeasbileflowimproves.However,about20percentofaffectedinfantswillgoontodevelopchronic（ongoing）liverdiseaseandcirrhosis.Inthesechildren,theliverbecomesveryhardduetoscarring,andthejaundicedoesnotdissipatebysixmonthsofage.Infantswhoreachthispointinthediseaseeventuallyrequirealivertransplant.

Infantswithchronicneonatalhepatitiswillnotbeabletodigestfatsandabsorbfatsolublevitamins（A,D,EandK）asaresultofinsufficientbileflowandthedamagecausedtolivercells.ThelackofvitaminDwillleadtopoorboneandcartilagedevelopment（rickets）.AdeficiencyinvitaminAmayaffectnormalgrowthandvision.VitaminKdeficiencyisassociatedwitheasybruisingandatendencytobleed,whereasthelackofvitaminEresultsinpoorcoordination.Sincebileisresponsiblefortheeliminationofmanytoxinsinthebody,chronicneonatalhepatitiscanalsoleadtoabuildupoftoxinsinthebloodwhichinturnmayresultinitching,skineruptionsandirritability.

Howisneonatalhepatitistreated?

Thereisnospecifictreatmentforneonatalhepatitis.Vitaminsupplementsareusuallyprescribedandmanyinfantsaregivenmedicationswhichimprovebileflow.Formulascontainingfatsmoreeasilydigestedbythebodyarealsogiven.

Canneonatalhepatitisbespreadtoothers?

Infantswithneonatalhepatitiscausedbythecytomegalovirus,rubellaorviralhepatitismaytransmittheinfectiontootherswhocomeinclosecontactwiththem.Theseinfectedinfantsshouldnotcomeintocontactwithpregnantwomenbecauseofthepossibilitythatthewomancouldtransmitthevirustoherunbornchild.

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