Ukungahambelani kwe-ABO

A, B, AB, no-O yizinhlobo ezine zegazi ezinkulu. Izinhlobo zisuselwa ezintweni ezincane (ama-molecule) ebusweni bamaseli egazi.

Lapho abantu abanohlobo olulodwa lwegazi bethola igazi kumuntu onohlobo lwegazi oluhlukile, kungadala ukuthi amasosha omzimba wabo asabele. Lokhu kubizwa ngokungahambelani kwe-ABO.

Ngenxa yamasu wokuhlola wanamuhla, le nkinga ayivelakancane.

Izinhlobo ezihlukene zegazi yilezi:

• Thayipha u-A
• Uhlobo B
• Thayipha AB
• Thayipha u-O

Abantu abanohlobo olulodwa lwegazi bangakha amaprotheni (amasosha omzimba) abangela ukuthi amasosha omzimba wabo asabele kolunye noma ngaphezulu kolunye uhlobo lwegazi.

Ukuvezwa kolunye uhlobo lwegazi kungadala ukusabela. Lokhu kubalulekile lapho othile edinga ukuthola igazi (ukumpontshelwa) noma ukufakelwa isitho somzimba. Izinhlobo zegazi kufanele zihambisane ukugwema ukusabela kokungahambelani kwe-ABO.

Ngokwesibonelo:

• Abantu abanegazi lohlobo A bazosabela kuhlobo B noma ngegazi le-AB.
• Abantu abanegazi lohlobo B bazosabela kuhlobo A noma ngegazi le-AB.
• Abantu abanegazi lohlobo O bazosabela kuhlobo A, uhlobo B, noma uhlobo lwegazi le-AB.
• Abantu abanegazi lohlobo AB ngeke basabele kuhlobo A, uhlobo B, uhlobo AB, noma uhlobo O lwegazi.

Uhlobo lwe-O lwegazi alubangeli ukusabela komzimba uma unikezwa abantu abanohlobo A, uhlobo B, noma uhlobo lwegazi le-AB. Yingakho amangqamuzana egazi ohlobo O anganikezwa abantu banoma yiluphi uhlobo lwegazi. Abantu abanegazi lohlobo O babizwa ngokuthi banikeli bendawo yonke. Kepha abantu abanohlobo O bangathola kuphela igazi lohlobo O.

Kokubili ukumpontshelwa igazi kanye ne-plasma kumele kufaniswe ukuze kugweme ukusabela komzimba. Ngaphambi kokuba noma ngubani athole igazi, igazi negazi nalo lihlolwa ngokucophelela ukugwema ukusabela. Imvamisa, ukusabela kwenzeka ngenxa yephutha lobufundisi elibangela ukuthi umuntu athole igazi elingahambelani.

Okulandelayo yizimpawu ze-ABO ezingahambelani nokumpontshelwa igazi:

• Ubuhlungu obuphansi emuva
• Igazi emchameni
• Amakhaza
• Ukuzizwa "ngembubhiso esondelayo"
• Imfiva
• Isicanucanu nokuhlanza
• Ukuphelelwa umoya
• Ukunyuka kwenhliziyo
• Ubuhlungu esizeni sokumnika
• Ubuhlungu besifuba
• Isiyezi
• I-Bronchospasm (i-spasm yemisipha efaka iphaphu; ibangela ukukhwehlela)
• Isikhumba esiphuzi nabamhlophe bamehlo (i-jaundice)
• Ukungasebenzi kahle kwezinso
• Umfutho wegazi ophansi
• Kusatshalaliswe i-coagulation ye-intravascular (DIC)

Umhlinzeki wezokunakekelwa kwempilo uzokwenza ukuhlolwa komzimba. Ukuhlolwa kwegazi kuvame ukukhombisa:

• Izinga le-bilirubin liphakeme
• Isibalo segazi esiphelele (CBC) sikhombisa ukulimala kwamangqamuzana abomvu egazi noma i-anemia
• Igazi lomamukeli nelomnikeli alihambelani
• I-lactate dehydrogenase ephakeme (LDH) ephakeme
• Igazi eliphakeme le-urea nitrogen (BUN) ne-creatinine; uma kwenzeka ukulimala kwezinso
• Isikhathi eside se-prothrombin noma isikhathi se-thromboplastin esinqunyiwe (okutholwe yi-DIC)
• Ukuhlolwa okuqondile okuqondile kwe-antiglobulin (DAT)

Ukuhlolwa komchamo kukhombisa ubukhona be-hemoglobin ngenxa yokonakala kwamaseli abomvu egazi.

Uma kunanoma yikuphi ukusabela, ukumpontshelwa kufanele kumiswe ngokushesha. Ukwelashwa kungafaka futhi:

• Imithi esetshenziselwa ukwelapha ukungezwani komzimba (ama-antihistamine)
• Imithi esetshenziselwa ukwelapha ukuvuvukala kanye nokungezwani komzimba (i-steroids)
• Uketshezi olunikezwa ngomthambo (ngemithambo yegazi)
• Imithi yokwenyusa umfutho wegazi uma yehla kakhulu

Ukungahambelani kwe-ABO kungaba yinkinga enkulu kakhulu engaholela ekufeni. Ngokulashwa okulungile nangesikhathi esifanele, ukululama okugcwele kulindeleke.

Izinkinga ezingaba nomphumela zifaka:

• Ukuhluleka kwezinso
• Umfutho wegazi ophansi odinga ukunakekelwa okujulile
• Ukufa

Xhumana nomhlinzeki wakho uma usanda kufakwa igazi noma ufakelwa futhi unezimpawu zokungahambelani kwe-ABO.

Ukuhlolwa ngokucophelela kwezinhlobo zegazi zabanikeli nabazitholayo ngaphambi kokumpontshelwa noma ukufakelwa kungavimbela le nkinga.

Ukusabela kokumpontshelwa kwegazi - i-hemolytic; Ukusabela okunamandla kokumpontshelwa kwe-hemolytic; AHTR; Ukungahambisani kwegazi - ABO

• Usana olunguJaundiced
• Amasosha omzimba

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Ukwelashwa kwengxenye yegazi kanye nokusabela kokumpontshelwa. Ku: Kellerman RD, Rakel DP, ama-eds. Ukwelashwa Kwamanje kukaConn 2020. IPhiladelphia, PA: Elsevier; 2020: 394-400.