Ukuhlolwa kwama-Coombs

-Delile

• Kungani ukuhlolwa kweCoombs kwenziwa?
• Kwenziwa kanjani ukuhlolwa kweCoombs?
• Ngisilungiselela kanjani isivivinyo seCoombs?
• Ziyini izingozi zokuhlolwa kweCoombs?
• Iyini imiphumela yokuhlolwa kweCoombs?
• Imiphumela ejwayelekile
• Imiphumela engavamile ekuhlolweni okuqondile kweCoombs
• Imiphumela engavamile ekuhlolweni okungaqondile kweCoombs

Kuyini ukuhlolwa kweCoombs?

Uma ubuzizwa ukhathele, uphefumula kanzima, izandla nezinyawo ezibandayo, nesikhumba esiphaphathekile impela, ungaba nenani elinganele lamaseli abomvu egazi. Lesi simo sibizwa ngokuthi yi-anemia, futhi sinezimbangela eziningi.

Uma udokotela wakho eqinisekisa ukuthi unesibalo esiphansi segazi elibomvu, ukuhlolwa kweCoombs kungenye yezivivinyo zegazi udokotela wakho angaku-oda ukusiza ukuthola ukuthi unaluphi uhlobo lwe-anemia.

Kungani ukuhlolwa kweCoombs kwenziwa?

Ukuhlolwa kweCoombs kuhlola igazi ukubona ukuthi liqukethe yini amasosha omzimba athile. Ama-antibody amaprotheni enziwa amasosha akho omzimba lapho ethola ukuthi okuthile kungaba yingozi empilweni yakho.

La masosha omzimba azobhubhisa umhlaseli oyingozi. Uma ukutholwa kwamasosha omzimba kungalungile, kwesinye isikhathi kungenza amasosha omzimba abheke kumaseli akho. Lokhu kungadala izinhlobo eziningi zezinkinga zempilo.

Ukuhlolwa kwe-Coombs kuzosiza udokotela wakho ukuthi anqume ukuthi unawo yini ama-antibody egazini lakho abangela ukuthi amasosha omzimba wakho ahlasele futhi aqede amaseli akho abomvu egazi. Uma amaseli akho abomvu egazi ecekelwa phansi, lokhu kungaholela esimweni esibizwa ngokuthi yi-hemolytic anemia.

Kunezinhlobo ezimbili zokuhlolwa kweCoombs: ukuhlolwa okuqondile kweCoombs kanye nokuhlolwa okungaqondile kweCoombs. Ukuhlolwa okuqondile kuvame kakhulu futhi kubhekwa amasosha omzimba anamathiselwe ebusweni bamaseli akho abomvu egazi.

Ukuhlolwa okungaqondile kuhlola amasosha omzimba angaxhumekile ezintanta egazini. Iphinde iphathwe ukunquma ukuthi ngabe kube khona ukusabela okungaba kubi ekumpontshelweni igazi.

Kwenziwa kanjani ukuhlolwa kweCoombs?

Kuzodingeka isampula legazi lakho ukwenza ukuhlolwa. Igazi lihlolwe ngamakhompiyutha azosabela ngama-antibody egazini lakho.

Isampuli yegazi itholakala nge-venipuncture, lapho kufakwa khona inaliti emthanjeni engalweni noma esandleni sakho. Inaliti idonsela inani elincane legazi kushubhu. Isampula ligcinwa kushubhu yokuhlola.

Lokhu kuhlolwa kuvame ukwenziwa ezinganeni ezingaba nama-antibody egazini lazo ngoba umama wazo unegazi elihlukile. Ukwenza lokhu kuhlolwa enganeni, isikhumba sihlatshwa ngenaliti encane ebukhali ebizwa nge-lancet, imvamisa esithendeni sonyawo. Igazi liqoqelwa kushubhu encane yengilazi, kusilayidi sengilazi, noma kumugqa wokuhlola.

Ngisilungiselela kanjani isivivinyo seCoombs?

Akukho ukulungiselela okukhethekile okudingekayo. Udokotela wakho uzokuphuza inani elijwayelekile lamanzi ngaphambi kokuya endaweni yokucwaninga noma lapho kuqoqwa khona.

Kungadingeka uyeke ukuthatha imishanguzo ethile ngaphambi kokuba kwenziwe ukuhlolwa, kodwa kuphela uma udokotela wakho ekutshela ukuthi wenze kanjalo.

Ziyini izingozi zokuhlolwa kweCoombs?

Lapho igazi liqoqwa, ungazizwa ubuhlungu obulinganiselayo noma ukuzwa okuncane kokuncinza. Kodwa-ke, lokhu kuvame ukuba yisikhathi esifushane kakhulu futhi kuncane kakhulu. Ngemuva kokuthi inaliti isusiwe, ungazizwa uthintekile. Uzokwaziswa ukuthi usebenzise ingcindezi kusayithi inaliti efake kuyo isikhumba sakho.

Kuzofakwa ibhandishi. Kuzodingeka ukuthi ihlale endaweni uqobo imizuzu eyi-10 kuye kwengu-20. Kufanele ugweme ukusebenzisa leyongalo ukuphakamisa okunzima usuku lonke.

Izingozi ezingavamile kakhulu zifaka:

• ubuhlanya noma ukuquleka
• i-hematoma, isikhwama segazi ngaphansi kwesikhumba esifana nomhuzuko
• ukutheleleka, kuvame ukuvikelwa lapho isikhumba sihlanzwa ngaphambi kokuba kufakwe inaliti
• ukopha ngokweqile (ukopha isikhathi eside ngemuva kokuhlolwa kungakhombisa isimo sokopha kakhulu futhi kufanele ubikwe kudokotela wakho)

Iyini imiphumela yokuhlolwa kweCoombs?

Imiphumela ejwayelekile

Imiphumela ibhekwa njengejwayelekile uma kungekho ukuhlangana kwamaseli abomvu egazi.

Imiphumela engavamile ekuhlolweni okuqondile kweCoombs

Ukuhlangana kwamaseli abomvu egazini ngesikhathi sokuhlolwa kukhombisa umphumela ongajwayelekile. Ukuhlanganiswa (ukugoqana) kwamaseli akho egazi ngesikhathi sokuhlolwa okuqondile kweCoombs kusho ukuthi unamasosha omzimba kumaseli abomvu egazi nokuthi ungaba nesimo esidala ukubhujiswa kwamangqamuzana egazi abomvu amasosha akho omzimba, abizwa ngokuthi yi-hemolysis.

Izimo ezingadala ukuthi ube nama-antibody kumaseli abomvu egazi yilezi:

• i-autoimmune hemolytic anemia, lapho amasosha akho omzimba ephendula kumaseli akho abomvu egazi
• ukusabela kokumpontshelwa, lapho amasosha akho omzimba ehlasela igazi elinikelwe
• i-erythroblastosis fetalis, noma izinhlobo ezehlukene zegazi phakathi kukamama nosana
• i-lymphocytic leukemia engapheli namanye ama-leukemias
• i-systemic lupus erythematosus, isifo esizimele kanye nohlobo oluvame kakhulu lwe-lupus
• mononucleosis
• ukutheleleka nge-mycoplasma, uhlobo lwama-bacteria ama-antibiotic amaningi angakwazi ukuwabulala
• ugcunsula

Ubuthi bezidakamizwa bungesinye isimo esingahle sidale ukuthi ube nama-antibody kumaseli abomvu egazi. Izidakamizwa ezingaholela kulokhu zibandakanya:

• cephalosporins, isibulala-magciwane
• i-levodopa, yesifo sika-Parkinson
• i-dapsone, i-antibacterial
• i-nitrofurantoin (Macrobid, Macrodantin, Furadantin), isibulala-magciwane
• ama-anti-inflammatories ama-nonsteroidal (ama-NSAID) afana ne-ibuprofen (Advil, Motrin IB)
• i-quinidine, umuthi wenhliziyo

Kwesinye isikhathi, ikakhulukazi kubantu abadala asebekhulile, ukuhlolwa kweCoombs kuzoba nomphumela ongajwayelekile ngaphandle kwesinye isifo noma izinto ezinobungozi.

Imiphumela engavamile ekuhlolweni okungaqondile kweCoombs

Umphumela ongajwayelekile ekuhlolweni kweCoombs engaqondile kusho ukuthi unamasosha omzimba ajikeleza egazini lakho angadala ukuthi amasosha omzimba wakho asabele kunoma yimaphi amangqamuzana abomvu egazi athathwa njengangahambisani nomzimba - ikakhulukazi lawo angaba khona ngesikhathi sokumpontshelwa igazi.

Ngokuya ngeminyaka nezimo, lokhu kungasho ukuthi i-erythroblastosis fetalis, umdlalo wegazi ongahambelani wokumpontshelwa igazi, noma i-hemolytic anemia ngenxa yokusabela okuzenzakalelayo noma ubuthi bezidakamizwa.

Izinsana ezine-erythroblastosis fetalis zingaba namazinga aphezulu kakhulu e-bilirubin egazini lazo, okuholela ku-jaundice. Lokhu kusabela kwenzeka lapho usana nomama benezinhlobo ezahlukahlukene zegazi, njenge-Rh factor emihle noma emibi noma umehluko wohlobo lwe-ABO. Amasosha omama ahlasela igazi lomntwana ngesikhathi sokubeletha.

Lesi simo kufanele sibhekwe ngokucophelela. Kungaphumela ekufeni kukamama nengane. Owesifazane okhulelwe uvame ukunikezwa ukuhlolwa okungaqondile kweCoombs ukuhlola ama-antibodies ngaphambi kokubeletha ngesikhathi sokunakekelwa kokubeletha.