Ukusabela kokumpontshelwa kwe-hemolytic

Ukusabela kokumpontshelwa kwe-hemolytic kuyinkinga enkulu engenzeka ngemuva kokumpontshelwa igazi. Ukusabela kwenzeka lapho amangqamuzana abomvu egazi anikezwe ngesikhathi sokumpontshelwa abhujiswa amasosha omzimba womuntu. Lapho amaseli abomvu egazi ebhujiswa, inqubo ibizwa ngokuthi yi-hemolysis.

Kukhona ezinye izinhlobo zokuphendula ngokungezwani kokumpontshelwa okungabangeli i-hemolysis.

Igazi lihlukaniswa libe yizinhlobo ezine ezihlukene: A, B, AB, no-O.

Enye indlela amaseli egazi angahlukaniswa ngayo yizici ze-Rh. Abantu abanezici ze-Rh egazini labo babizwa nge- "Rh positive." Abantu abangenazo lezi zinto babizwa nge- "Rh negative." Abantu abangenayo i-Rh bakha ama-antibodies ngokumelene ne-Rh factor uma bethola igazi eline-Rh.

Kukhona nezinye izici zokukhomba amangqamuzana egazi, ngaphezu kwe-ABO ne-Rh.

Amasosha akho omzimba ngokuvamile akwazi ukutshela amaseli awo egazi kulawo omunye umuntu. Uma uthola igazi elingahambisani negazi lakho, umzimba wakho ukhiqiza amasosha omzimba wokuqeda amaseli egazi lomnikeli. Le nqubo ibangela ukusabela kokumpontshelwa. Igazi olitholayo uma ufakwa igazi kufanele lihambisane negazi lakho. Lokhu kusho ukuthi umzimba wakho awunawo amasosha omzimba alwa negazi olitholayo.

Isikhathi esiningi, ukumpontshelwa igazi phakathi kwamaqembu ahambisanayo (njenge-O + kuya ku-O +) akubangeli inkinga. Ukumpontshelwa igazi phakathi kwamaqembu angahambisani (njenge-A + kuya ku-O-) kubangela ukusabela komzimba. Lokhu kungaholela ekuphendukelweni okungathi sína kokumpontshelwa igazi. Amasosha omzimba ahlasela amangqamuzana egazi anikelwe, abangele ukuthi aqhume.

Namuhla, lonke igazi lihlolwe ngokucophelela. Ukusabela kokumpontshelwa igazi akuvamile.

Izimpawu zingafaka noma yikuphi okulandelayo:

• Ukuhlungu obusemhlane
• Umchamo onegazi
• Amakhaza
• Ukuquleka noma isiyezi
• Imfiva
• Ubuhlungu beFlank
• Ukuqhuma kwesikhumba

Izimpawu zokuphendula ngokumpontshelwa kwe-hemolytic zivame ukuvela ngesikhathi noma ngemuva nje kokumpontshelwa. Kwesinye isikhathi, zingakhula ngemuva kwezinsuku ezimbalwa (ukubambezeleka kokuphendula).

Lesi sifo singashintsha imiphumela yalezi zivivinyo:

• I-CBC
• Coombs test, ngqo
• Ukuhlolwa kwama-Coombs, okungaqondile
• Imikhiqizo yokwehliswa kwe-Fibrin
• I-Haptoglobin
• Isikhathi esithile se-thromboplastin
• Isikhathi se-Prothrombin
• I-serum bilirubin
• I-serum creatinine
• I-hemoglobin yeseramu
• Ukuhlolwa komchamo
• Umchamo hemoglobin

Uma izimpawu zenzeka ngesikhathi sokumpontshelwa, ukumpontshelwa kufanele kumiswe ngokushesha. Amasampula egazi avela kumamukeli (umuntu otholwa ukumpontshelwa) nakumnikeli angahlolwa ukuze kutholakale ukuthi ngabe izimpawu zibangelwa ukusabela kokumpontshelwa.

Izimpawu ezincane zingaphathwa nge:

• I-Acetaminophen, isiqabu sobuhlungu sokunciphisa umkhuhlane nokungakhululeki
• Uketshezi olunikezwa ngomthambo (ngemithambo) neminye imithi yokwelapha noma yokuvimbela ukwehluleka kwezinso nokwethuka

Umphumela uncike ekutheni ukusabela kubucayi kangakanani. Lesi sifo singahle sinyamalale ngaphandle kwezinkinga. Noma, kungaba nzima futhi kusongele impilo.

Izinkinga zingafaka:

• Ukungasebenzi kahle kwezinso
• Ukushoda kwegazi
• Izinkinga zamaphaphu
• Ukushaqeka

Tshela umhlinzeki wakho wezempilo uma ngabe ufakwa igazi futhi uke waphendula ngaphambilini.

Igazi elinikelwayo lifakwa emaqenjini e-ABO nawakwaRh ukunciphisa ingozi yokuphendula ngokumpontshelwa.

Ngaphambi kokumpontshelwa, igazi lomamukeli nelomnikeli liyahlolwa (liqondaniswa ngakubili) ukubona ukuthi liyahambisana yini. Inani elincane legazi elinikelayo lixutshwe nenani elincane legazi elitholayo. Ingxube ihlolwa ngaphansi kwesibonakhulu ukuthola izimpawu zokuphendula ngama-antibody.

Ngaphambi kokumpontshelwa, umhlinzeki wakho uzohlola futhi ukuqinisekisa ukuthi uthola igazi elifanele.

Ukusabela kokumpontshelwa igazi

• Amaprotheni angaphezulu abangela ukwenqatshwa

IGoodnough LT. Umuthi wokumpontshelwa. Ku: IGoldman L, iSchafer AI, ama-eds. Imithi yeGoldman-Cecil. Umhla ka-25. IPhiladelphia, PA: Elsevier Saunders; 2016: isahluko 177.

IHholo JE. Izinhlobo zegazi; ukumpontshelwa; ukufakelwa izicubu nezitho zomzimba. Ku: IHholo JE, kuhleliwe. Incwadi kaGuyton neHholo yePhysical Physiology. Umhlaka 13. IPhiladelphia, PA: Elsevier; 2016: isahluko 36.

Savage W. Ukusabela kokumpontshelwa emikhiqizweni yokwelashwa kwegazi neyamaseli. Ku: Hoffman R, Benz EJ, Silberstein LE, et al, ama-eds. I-Hematology: Izimiso Eziyisisekelo Nokuzijwayeza. Umhla wesi-7. IPhiladelphia, PA: Elsevier; 2018: isahluko 119.