medsovetМедицинский СоветMeditsinskiy sovet = Medical Council2079-701X2658-5790REMEDIUM GROUP Ltd.10.21518/2079-701X-2016-07-56-65medsovet-1253Research ArticleГАСТРОЭНТЕРОЛОГИЯGASTROENTEROLOGYДифференциальный диагноз желтух у детей раннего возрастаDifferential diagnosis of neonatal jaundiceЗахароваИ. Н.ZakharovaI. N.

д.м.н., профессор

MD, Prof.

ГоряйноваА. Н.GoryainovaA. N.

к.м.н.

PhD in medicine

ХолодоваИ. Н.KholodovaI. N.

д.м.н., профессор

MD, Prof.

МайковаИ. Д.МaikovaI. D.

к.м.н.

PhD in medicine

БеленовичЕ. В.BelenovichE. V.ТамбиеваЕ. В.TambievaE. V.

к.м.н.

PhD in medicine

БолбиковаЕ. В.BolbikovaE. V.МеленькинаА. Н.Melen'kinaA. N.ХудяковаА. А.KhudyakovA. A.Российская медицинская академия последипломного образования, МоскваРоссияДетская городская клиническая больница им. З.А. Башляевой, МоскваРоссия201630122016075665Copyright © Захарова И.Н., Горяйнова А.Н., Холодова И.Н., Майкова И.Д., Беленович Е.В., Тамбиева Е.В., Болбикова Е.В., Меленькина А.Н., Худякова А.А., 20162016Захарова И.Н., Горяйнова А.Н., Холодова И.Н., Майкова И.Д., Беленович Е.В., Тамбиева Е.В., Болбикова Е.В., Меленькина А.Н., Худякова А.А.Zakharova I.N., Goryainova A.N., Kholodova I.N., Мaikova I.D., Belenovich E.V., Tambieva E.V., Bolbikova E.V., Melen'kina A.N., Khudyakov A.A.This work is licensed under a Creative Commons Attribution 4.0 License.https://www.med-sovet.pro/jour/article/view/1253

Желтуха относится к наиболее частым симптомам неонатального периода и в подавляющем большинстве случаев у детей этой возрастной группы не связана с тяжелым заболеванием. Примером является желтуха «здоровых новорожденных», не влияющая на развитие ребенка. Тем не менее в 2% случаев требуется уточнение причины появления желтухи, особенно если она имеет затяжное течение и переходит границы неонатального периода. Недооценка анамнеза, позднее назначение обследования приводят к диагностическим ошибкам, исправить которые удается далеко не всегда. Особое внимание необходимо уделять прямой гипербилирубинемии, в основе которой могут лежать пороки развития билиарного тракта, другие врожденные и приобретенные заболевания гепатобилиарной системы, в терапии которых могут быть успешны желчегонные средства. Прогноз при аномалиях развития билиарного тракта напрямую связан с быстротой постановки диагноза и проведением оперативного лечения. Знание различий между прямой и непрямой гипербилирубинемиями у детей раннего возраста необходимо для своевременного обследования и лечения ребенка.

Jaundice is one of the most common symptoms of the neonatal period which in most cases is not associated with a serious illness. For example, jaundice in healthy newborns which does not affect the child's development. Nevertheless, in 2% of cases the causes of jaundice should be investigated, especially if it is long-term and extends beyond the neonatal period. Underestimating the history and late examination lead to diagnostic errors which sometimes cannot be corrected. The risk of direct hyperbilirubinemia should be taken into account which may be caused by malformations of the biliary tract development or other congenital and acquired diseases of the hepatobiliary system, for the treatment of which cholagogues can be successfully used. The prognosis for the biliary tract anomalies is directly related to the promptness of diagnosis and surgery. Understanding the difference between direct and indirect hyperbilirubinemia in infants is necessary for timely examination and treatment of the infant.

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The authors declare that there are no conflicts of interest present.