Ukushintshaniswa kwegazi

Ukushintshaniswa kokushintshaniswa kuyindlela esindisa impilo eyenziwayo ukulwa nemiphumela ye-jaundice engathi sína noma ushintsho egazini ngenxa yezifo ezinjenge-sickle cell anemia.

Le nqubo ifaka phakathi ukukhipha igazi lomuntu kancane kancane bese ulifaka esikhundleni segazi elisha lomnikeli noma i-plasma.

Ukufakwa kokushintshaniswa kudinga ukuthi kususwe igazi lomuntu bese kufakwa elinye. Ezimweni eziningi, lokhu kufaka ukufaka ishubhu elilodwa noma ngaphezulu, abizwa ngokuthi ama-catheters, emthanjeni wegazi. Ukumpontshelwa kokushintshaniswa kwenziwa ngemijikelezo, ngakunye kuvame ukuhlala imizuzu embalwa.

Igazi lomuntu likhishwa kancane (imvamisa cishe ngama-5 kuya kuma-20 ml ngasikhathi, kuya ngosayizi womuntu nobukhulu bokugula). Inani elilinganayo legazi elisha, elifakwe kusengaphambili noma i-plasma lingena emzimbeni womuntu. Lo mjikelezo uyaphindwa kuze kube kufakwa ivolumu efanele yegazi.

Ngemuva kokumpontshelwa kokushintshaniswa, ama-catheters angashiywa endaweni uma inqubo idinga ukuphindwa.

Ezifweni ezinjenge-sickle cell anemia, igazi liyasuswa bese kufakwa igazi lomnikeli.

Ezimweni ezifana neonatal polycythemia, inani elithile legazi lengane liyasuswa bese kufakwa ikhambi elijwayelekile likasawoti, i-plasma (ingxenye ecwetshiwe yegazi), noma i-albumin (isixazululo samaprotheni egazi). Lokhu kunciphisa inani eliphelele lamaseli abomvu emzimbeni futhi kwenza kube lula ukuthi igazi ligeleze emzimbeni.

Ukumpontshelwa kokushintshaniswa kungadingeka ukwelapha lezi zimo ezilandelayo:

• Ukubalwa kwamaseli abomvu ngokuyingozi okuyingozi enganeni esanda kuzalwa (i-neonatal polycythemia)
• Isifo se-hemolytic esibangelwa i-Rh sosana olusanda kuzalwa
• Ukuphazamiseka okukhulu kumakhemikhali omzimba
• I-jaundice esanda kuzalwa engaphenduli ku-phototherapy ngamalambu e-bili
• Inkinga enkulu yeseli
• Imiphumela enobuthi yezidakamizwa ezithile

Izingozi ezijwayelekile ziyafana nanoma yikuphi ukumpontshelwa. Ezinye izinkinga ezingaba khona zifaka:

• Amahlule egazi
• Izinguquko kumakhemikhali egazi (i-potassium ephezulu noma ephansi, i-calcium ephansi, i-glucose ephansi, ushintsho kubhalansi ye-acid-base egazini)
• Izinkinga zenhliziyo namaphaphu
• Ukutheleleka (ingozi ephansi kakhulu ngenxa yokuhlolwa ngokucophelela kwegazi)
• Ukushaqeka uma kungenele igazi elanele kushintshwa

Isiguli singadinga ukuqashwa izinsuku eziningana esibhedlela ngemuva kokumpontshelwa. Ubude bendawo yokuhlala buxhomeke esimweni lapho ukufakwa kokushintshaniswa kwenziwa ukwelashwa.

Isifo se-hemolytic - ukushintshaniswa kwegazi

• I-jaundice esanda kuzalwa - ukukhipha

• Ukushintshaniswa kwegazi - uchungechunge

ICosta K. Hematology. Ku: Hughes HK, Kahl LK, eds. Isibhedlela iJohns Hopkins: IHarriet Lane Handbook. Umhlaka 21. IPhiladelphia, PA: Elsevier; 2018: isahluko 14.

UJosephson CD, uSloan SR. Imithi yokumpontshelwa kwabantwana. Ku: Hoffman R, Benz EJ, Silberstein LE, et al, ama-eds. I-Hematology: Izimiso Eziyisisekelo Nokuzijwayeza. Umhla wesi-7. IPhiladelphia, PA: Elsevier; 2018: isahluko 121.

IKliegman RM, iSt. Geme JW, iBlum NJ, i-Shah SS, iTasker RC, iWilson KM. Ukuphazamiseka kwegazi. Ku: Kliegman RM, St Geme JW, Blum NJ, Shah SS, Tasker RC, Wilson KM, eds. Incwadi kaNelson Yezingane. Umhlaka 21. IPhiladelphia, PA: Elsevier; 2020: isahluko 124.

I-Watchko JF. I-hyperbilirubinemia engaqondile neonernterterus engaqondile. Ku: Gleason CA, Juul SE, ama-eds. Izifo zika-Avery Zomntwana osanda kuzalwa. Umhlaka 10. IPhiladelphia, PA: Elsevier; 2018: isahluko 84.