Hemolytic kab mob ntawm tus menyuam mos

Hemolytic kab mob kev kuaj mob ntawm tus menyuam mos liab (HDN) yog kev mob ntshav rau tus menyuam hauv plab lossis menyuam mos tshiab. Hauv qee tus menyuam mos, nws tuaj yeem ua rau tuag taus.

Feem ntau, cov ntshav liab (RBCs) kav ntev txog 120 hnub hauv lub cev. Hauv kev cuam tshuam no, RBCs hauv cov ntshav tau pov tseg sai thiab yog li tsis ntev li ntev tau.

Thaum cev xeeb tub, RBCs los ntawm tus me nyuam hauv plab tuaj yeem nkag mus rau hauv leej niam cov ntshav los ntawm lub tsev me nyuam. HDN tshwm sim thaum lub nruab zog tiv thaiv leej niam pom tus me nyuam RBCs li txawv teb chaws. Cov tshuaj tiv thaiv kab mob tom qab ntawd tawm tsam tus me nyuam RBCs. Cov tshuaj tiv thaiv ua rau RBCs nyob rau hauv tus menyuam cov ntshav thiab ua rau lawv tawg thaum ntxov.

HDN yuav tshwm sim thaum leej niam thiab nws tus menyuam hauv plab muaj ntau hom ntshav sib txawv. Cov hom yog ua raws cov tshuaj me me (antigens) nyob rau ntawm cov qe ntshav.

Muaj ntau dua ntau txoj hauv kev uas tus menyuam hauv plab cov ntshav tsis tuaj yeem txuam nrog niam.

• A, B, AB, thiab O yog 4 pawg ntshav loj tus neeg antigens lossis hom. Qhov no yog daim ntawv tshaj ntawm mismatch. Feem ntau, qhov no tsis yog mob hnyav.
• Rh yog luv rau cov "rhesus" antigen lossis ntshav hom. Cov tib neeg yog ob qho tib si zoo los sis tsis zoo rau qhov antigen no. Yog tias leej niam yog Rh-negative thiab tus menyuam nyob hauv lub tsev menyuam muaj cov keeb ntawm Rh-positive, nws cov tshuaj tiv thaiv rau tus kabmob Rh antigen tuaj yeem hla lub cev thiab ua rau tus menyuam muaj ntshav ntau heev. Nws tuaj yeem tiv thaiv tau tus mob feem ntau.
• Muaj lwm yam, ntau qhov tsis tshua pom, hom kev tsis sib xws ntawm cov ntshav me antigens. Qee qhov kuj tuaj yeem ua teeb meem loj.

HDN tuaj yeem rhuav tshem cov menyuam mos cov ntshav cov ntshav sai sai, uas tuaj yeem ua rau cov tsos mob xws li:

• Edema (o rau hauv qab ntawm daim tawv nqaij)
• Menyuam mos cov tawv nqaij uas tshwm sim sai dua thiab mob hnyav dua li ib txwm

Cov cim ntawm HDN suav nrog:

• Kev ntsuas ntshav lossis ntshav qis
• Tshab daim siab los yog hnoos qeev
• Cov dej ua kua (cov kua dej thoob hauv lub cev cov ntaub so ntswg, suav nrog rau qhov chaw muaj lub ntsws, lub siab, thiab lub plab), uas tuaj yeem ua rau lub plawv tsis ua pa lossis ua pa tsis ua haujlwm los ntawm cov kua dej ntau dhau

Qhov kev kuaj twg yog ua nyob ntawm cov pab pawg ntawm cov ntshav tsis sib xws thiab qhov mob hnyav npaum li cas, tab sis yuav suav nrog:

• Ua kom tiav cov ntshav thiab lub qe ntshav liab thaum tseem yau (reticulocyte) suav
• Bilirubin qib
• Ntshav hom ntshav

Cov menyuam mos liab uas muaj HDN yuav raug kho nrog:

• Pub mis ntau zaus thiab tau txais dej rau ntxiv.
• Kev kho lub teeb (kho duab ci) siv cov teeb xiav tshwj xeeb los hloov bilirubin rau hauv ib daim ntawv uas yooj yim dua rau menyuam lub cev kom hle tau.
• Tshuaj tua kab mob (txhaj tshuaj immunoglobulin, lossis IVIG) los pab tiv thaiv tus menyuam lub hlwb liab kom tsis raug kev puas tsuaj.
• Tshuaj kho mob txhawm rau nce ntshav siab yog tias nws poob qis.
• Thaum muaj mob hnyav, yuav tsum hloov ntshav hloov. Qhov no suav nrog kev tshem tawm ntau ntawm cov ntshav ntawm cov ntshav, thiab yog li ntxiv cov bilirubin thiab cov tshuaj tiv thaiv. Cov ntshav pub dawb yog infused.
• Kev hloov ntshav yoojyim (yam tsis pauv). Qhov no yuav tsum tau rov ua tom qab tus menyuam mus tsev los ntawm tsev khomob.

Qhov mob hnyav no kuj sib txawv. Qee tus menyuam yaus tsis muaj tsos mob. Hauv lwm qhov xwm txheej, teeb meem xws li hydrops tuaj yeem ua rau tus me nyuam tuag ua ntej, lossis tsis ntev tom qab, yug. Yuav muaj kev tiv thaiv HDN ua ntej yug los ntawm kev tso ntshav ntxiv ntshav.

Daim ntawv foos tshwj xeeb tshaj plaws ntawm tus kabmob no, uas yog tshwm sim los ntawm Rh tus kabmob tsis tuaj yeem tiv thaiv tau yog tias tus niam raug kuaj thaum cev xeeb tub. Yog tias xav tau, nws tau txhaj tshuaj uas hu ua RhoGAM qee lub sijhawm thiab tomqab nws cev xeeb tub. Yog tias koj muaj menyuam yaus nrog tus kabmob no, tham nrog koj tus kws saib xyuas kev noj qab haus huv yog tias koj npaj yuav muaj lwm tus menyuam yaus.

Hemolytic kab mob ntawm tus me nyuam hauv plab thiab cov menyuam yug tshiab (HDFN); Erythroblastosis fetalis; Tshuaj Mob Yuam Kev - HDN; Ntshav tsis sib haum - HDN; ABO tsis sib xws - HDN; Rh incompatibility - HDN

• Tso ntshav sib xyaw rau hauv
• Tshuaj tua kabmob

Josephson CD, Sloan SR. Tshuaj mob txhab ntshav. Hauv: Hoffman R, Benz EJ, Silberstein LE, li al, eds. Hematology: Qhov Ntsiab Cai thiab Kev Coj UaCov. 7 tus ed. Philadelphia, PA: Elsevier; 2018: chap 121.

Niss O, Ware RE. Ntshav tsis txaus. Hauv: Kliegman RM, St. Geme JW, Blum NJ, Shah SS, Tasker RC, Wilson KM, eds. Nelson Phau Ntawv ntawm PediatricsCov. 21st ed. Philadelphia, PA: Elsevier; 2020: chap 124.

Simmons PM, Magann EF. Kev tiv thaiv kab mob thiab tsis muaj tshuaj tiv thaiv kab mob plab fetalis. Hauv: Martin RJ, Fanaroff AA, Walsh MC, eds. Fanaroff thiab 's Tshuaj Neonatal-Perinatal: Cov Kab Mob Ntawm Tus Mob Fetus thiab Menyuam MosCov. 11th ed. Philadelphia, PA: Elsevier; 2020: chap 23.