Ukugcotshwa kwegazi

Ukuhlolwa kwegazi ukuhlolwa kwegazi okunikeza imininingwane ngenombolo nokuma kwamangqamuzana egazi. Kuvame ukwenziwa njengengxenye noma ngokuhambisana nokubalwa kwegazi okuphelele (i-CBC).

Kudingeka isampula yegazi.

Isampuli yegazi ithunyelwa elebhu. Lapho, uchwepheshe waselebhu uyibheka ngaphansi kwesibonakhulu. Noma, igazi lingahlolwa ngomshini ozisebenzelayo.

I-smear inikeza lolu lwazi:

• Inombolo nezinhlobo zamaseli amhlophe egazi (umehluko, noma iphesenti lohlobo ngalunye lweseli)
• Inombolo nezinhlobo zamaseli egazi abunjwe ngokungajwayelekile
• Isilinganiso esinzima samaseli egazi amhlophe kanye nokubalwa kweplatelet

Akukho ukulungiselela okukhethekile okudingekayo.

Lapho inaliti ifakwa ukudonsa igazi, abanye abantu bezwa ubuhlungu obulinganiselayo. Abanye bazizwa beshaywa noma betinyelwa kuphela. Ngemuva kwalokho, kungahle kube nokushaywa okuthile noma ukulimazeka okuncane. Lokhu maduzane kuyaphela.

Lokhu kuhlolwa kungenziwa njengengxenye yokuhlolwa kwezempilo okujwayelekile ukusiza ukuthola izifo eziningi. Noma, umhlinzeki wakho wezokunakekelwa kwempilo angancoma lokhu kuhlolwa uma unezimpawu ze:

• Noma yikuphi ukuphazamiseka kwegazi okwaziwayo noma okusolwayo
• Umdlavuza
• Umdlavuza wegazi

I-smear yegazi nayo ingenziwa ukuqapha imiphumela emibi yokwelashwa ngamakhemikhali noma ukusiza ukuxilonga ukutheleleka, okufana nomalaleveva.

Amaseli egazi abomvu (ama-RBC) ngokujwayelekile alingana nombala ofanayo futhi anombala okhanyayo enkabeni. I-smear yegazi ibhekwa njengejwayelekile uma kukhona:

• Ukubukeka okujwayelekile kwamaseli
• Ukwehluka okujwayelekile kwamangqamuzana egazi amhlophe

Ububanzi bamanani ajwayelekile bungahluka kancane phakathi kwamalabhorethri ahlukene. Amanye amalebhu asebenzisa izilinganiso ezahlukahlukene noma avivinye amasampula ahlukile. Khuluma nomhlinzeki wakho mayelana nencazelo yemiphumela yakho ethile yokuhlolwa.

Imiphumela engajwayelekile isho ukuthi usayizi, umumo, umbala, noma ukumbozwa kwama-RBC akujwayelekile.

Okunye okungajwayelekile kungabekwa esikalini samaphoyinti ama-4:

• I-1 + isho ukuthi ingxenye yesine yamaseli iyathinteka
• 2+ kusho ukuthi uhhafu wamaseli uthintekile
• I-3 + isho ukuthi izingxenye ezintathu zamaseli zithintekile
• I-4 + isho ukuthi wonke amaseli ayathinteka

Ukuba khona kwamaseli abizwa ngokuthi ama-target cell kungahle kube ngenxa ye:

• Ukushoda kwe-enzyme ebizwa nge-lecithin cholesterol acyl transferase
• I-hemoglobin engajwayelekile, iphrotheni kuma-RBC athwala umoya-mpilo (hemoglobinopathies)
• Ukushoda kwe-Iron
• Isifo sesibindi
• Ukususwa kobende

Ukuba khona kwamangqamuzana amise okwengxenye yomhlaba kungahle kube ngenxa:

• Inani eliphansi lama-RBC ngenxa yomzimba owabhubhisayo (immune hemolytic anemia)
• Inombolo ephansi yama-RBC ngenxa yama-RBC athile abunjwe njengezimbulunga (i-spherocytosis eyifa)
• Ukuwohloka okwengeziwe kwama-RBC

Ukuba khona kwama-RBCs anomumo ovundlile kungaba uphawu lwe-elliptocytosis noma ifa le-ovalocytosis. Lezi yizimo lapho ama-RBC abunjwe ngokungajwayelekile.

Ukuba khona kwamaseli ahlukanisiwe kungenzeka kungenxa yokuthi:

• I-valve yenhliziyo yokufakelwa
• Ukuphazamiseka lapho amaprotheni alawula ukujiya kwegazi eba ngokweqile (kusatshalaliswa i-intravascular coagulation)
• Ukutheleleka ohlelweni lokugaya ukudla kukhiqiza izinto ezinobuthi ezibhubhisa ama-RBC, kubangele ukulimala kwezinso (hemolytic uremic syndrome)
• Isifo segazi esidala ukuthi amahlule egazi akhe emithanjeni yegazi emincane emzimbeni futhi siholele ekubalweni kweplatelet ephansi (thrombotic thrombocytopenic purpura)

Ukuba khona kohlobo lwama-RBC angavuthiwe abizwa ngokuthi ama-normoblasts kungahle kube ngenxa:

• Umdlavuza osudlulele emnkantsheni wethambo
• Isifo segazi esibizwa nge-erythroblastosis fetalis esithinta umbungu noma usana olusanda kuzalwa
• Isifo sofuba esisabalale sisuka emaphashini saya kwezinye izingxenye zomzimba ngegazi (isifo sofuba esiyisibungu).
• Ukuphazamiseka komnkantsha lapho umnkantsha ubuyiselwa khona yizicubu ezibomvu (i-myelofibrosis)
• Ukususwa kobende
• Ukuwohloka okukhulu kwama-RBC (hemolysis)
• Ukuphazamiseka lapho kukhona ukonakala ngokweqile kwe-hemoglobin (thalassemia)

Ukuba khona kwamaseli abizwa ngama-burr cells kungakhombisa:

• Izinga eliphakeme ngokungajwayelekile lemikhiqizo kadoti we-nitrogen egazini (uremia)

Ukuba khona kwamaseli abizwa ngokuthi ama-spur cell kungakhombisa:

• Ukwehluleka ukumunca ngokugcwele amafutha okudla ngokusebenzisa amathumbu (abetalipoproteinemia)
• Isifo esibi sesibindi

Ukuba khona kwamangqamuzana amise okwezinyembezi kungakhombisa:

• I-Myelofibrosis
• Ukushoda kakhulu kwensimbi
• I-Thalassemia enkulu
• Umdlavuza emnkantsheni wethambo
• I-anemia ebangelwa umongo wethambo ongakhiqizi amaseli egazi ajwayelekile ngenxa yobuthi noma amaseli wesimila (inqubo ye-myelophthisic)

Ukuba khona kwezidumbu zeHowell-Jolly (uhlobo lwegranule) kungakhombisa:

• Umnkantsha wethambo awakhiqizi amaseli wegazi anele (myelodysplasia)
• Ubende lususiwe
• I-sickle cell anemia

Ukuba khona kwemizimba ye-Heinz (izingcezu ze-hemoglobin eshintshiwe) kungakhombisa:

• I-Alpha thalassemia
• I-anemia ye-hemolytic engokwemvelo
• Ukuphazamiseka lapho ama-RBC ehla khona lapho umzimba uvezwa yimithi ethile noma ucindezelekile ngenxa yokutheleleka (ukushoda kwe-G6PD)
• Uhlobo olungazinzile lwe-hemoglobin

Ukuba khona kwama-RBC angavuthiwe kungakhombisa:

• I-anemia ngokululama komnkantsha
• I-hemolytic anemia
• Ukopha

Ukuba khona kwe-basophilic stippling (ukubukeka okubonakalayo) kungakhombisa:

• Ubuthi bomthofu
• Ukuphazamiseka komnkantsha lapho umnkantsha ubuyiselwa khona yizicubu ezibomvu (i-myelofibrosis)

Ukuba khona kwamaseli esikela kungakhombisa i-sickle cell anemia.

Kunobungozi obuncane obubandakanyekile ekuthatheni igazi lakho.Imithambo yegazi nemithambo yegazi iyehluka ngosayizi kusuka kwesiguli kuya kwesinye nokusuka kolunye uhlangothi lomzimba kuye kolunye. Ukuthola isampula yegazi kwabanye abantu kungaba nzima kakhulu ukwedlula kwabanye.

Ezinye izingozi ezihambisana nokudonswa igazi zincane, kepha zingafaka:

• Ukopha ngokweqile
• Ukuquleka noma uzizwe unekhanda elincane
• Ukubhoboza okuningi ukuthola imithambo
• I-hematoma (i-blood buildup ngaphansi kwesikhumba)
• Ukutheleleka (ingozi encane noma kunini lapho isikhumba siphukile)

I-peripheral smear; Ukubala okuphelele kwegazi - okuphathelene nomngcele; CBC - okuphathelene nomngcele

• Amaseli abomvu egazi, iseli lesikela
• Amaseli abomvu egazi, umumo wezinyembezi
• Amaseli abomvu egazi - ejwayelekile
• Amaseli abomvu egazi - i-elliptocytosis
• Amaseli abomvu egazi - i-spherocytosis
• I-acute lymphocytic leukemia - i-photomicrograph
• Amaseli abomvu egazi - amaseli amaningi amasikela
• Umalaleveva, ukubuka okuncane kakhulu kwama-parasites amaselula
• Umalaleveva, i-photomicrograph yama-parasites amaselula
• Amaseli abomvu egazi - amangqamuzana amasikela
• Amaseli abomvu egazi - isikela nePappenheimer
• Amaseli abomvu egazi, ama-target cell
• Izakhi ezakhiwe zegazi

I-Bain BJ. I-peripheral blood smear. Ku: IGoldman L, iSchafer AI, ama-eds. Imithi yeGoldman-Cecil. Umhla ka-26. IPhiladelphia, PA: Elsevier; 2020: isahluko 148.

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.

IMerguerian MD, iGallagher PG. I-elliptocytosis eyifa, ifa le-pyropoikilocytosis, kanye nokuphazamiseka okuhlobene nako. 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 486.

UNatelson EA, uChughtai-Harvey I, uRabi S. Hematology. Ku: Rakel RE, Rakel DP, ama-eds. Incwadi Yezokwelapha Yomndeni. Umhlaka 9. IPhiladelphia, PA: Elsevier; 2016: isahluko 39.

I-Warner EA, uHerold AH. Ukuhumusha izivivinyo zaselebhu. Ku: Rakel RE, Rakel DP, ama-eds. Incwadi Yezokwelapha Yomndeni. Umhlaka 9. IPhiladelphia, PA: Elsevier; 2016: isahluko 14.