Hemolytic transfusion cov tshuaj tiv thaiv

Tus mob hemolytic transfusion yog ib qho kev mob nyhav heev uas tuaj yeem tshwm sim tom qab hloov ntshav. Cov tshuaj tiv thaiv tshwm sim thaum cov ntshav liab uas tau muab thaum muab ntshav hloov los ntawm tus neeg lub cev tsis muaj zog tiv thaiv kab mob. Thaum cov ntshav liab tau raug puas tsuaj, cov txheej txheem hu ua hemolysis.

Muaj lwm yam kev hloov pauv tsis haum uas tsis ua rau hemolysis.

Ntshav tau faib ua plaub yam sib txawv: A, B, AB, thiab O.

Lwm txoj hauv kev cov qe ntshav yuav raug cais tawm yog los ntawm Rh. Cov neeg uas muaj Rh yam nyob rau hauv lawv cov ntshav yog hu ua "Rh positive." Cov tib neeg tsis muaj lub ntsiab lus no hu ua "Rh negative." Rh cov neeg tsis zoo tsim cov tshuaj tiv thaiv Rh factor yog tias lawv tau txais Rh zoo ntshav.

Kuj tseem muaj lwm yam los txheeb xyuas cov ntshav ntawm ntshav, ntxiv rau ABO thiab Rh.

Koj lub cev tiv thaiv kab mob feem ntau tuaj yeem qhia nws cov qe ntshav los ntawm lwm tus neeg. Yog tias koj tau txais cov ntshav uas tsis sib haum nrog koj cov ntshav, koj lub cev tsim cov tshuaj tiv thaiv tua cov ntshav ntawm cov neeg pub ntshav. Txoj kev no ua rau cov ntshav sib hloov. Cov ntshav uas koj tau txais ntawm cov ntshav yuav tsum sib haum nrog koj tus kheej cov ntshav. Qhov no txhais tau tias koj lub cev tsis muaj cov tshuaj tiv thaiv tawm tsam cov ntshav uas koj tau txais.

Feem ntau, cov ntshav sib kis ntawm cov pab pawg sib xws (xws li O + rau O +) tsis ua teeb meem. Tso ntshav ntxiv ntawm cov pab pawg tsis sib xws (xws li A + rau O-) ua rau lub cev tsis muaj zog tiv thaiv kev ua txhaum. Qhov no tuaj yeem ua rau lub cev hloov ntshav hnyav ntxiv. Kev tiv thaiv kab mob hauv lub cev tiv thaiv cov ntshav pub ntshav, ua rau lawv tawg.

Niaj hnub no, kuaj ntshav txhua qhov ua tib zoo kuaj. Hloov ntshav tsis tshua muaj tshwm sim.

Cov tsos mob tuaj yeem suav nrog ib qho hauv qab no:

• Mob nraub qaum
• Ntshav cov zis
• Ua daus no
• Tsaus muag lossis kiv taub hau
• Ua npaws
• Flank mob
• Ua dej ntws ntawm daim tawv nqaij

Cov tsos mob ntawm cov ntshav tshwm sim hemolytic feem ntau tshwm sim thaum lossis tom qab hloov ntshav. Qee zaum, lawv yuav pib tom qab ob peb hnub (ncua kev tsis haum).

Kab mob no tuaj yeem pauv cov kev tshwm sim hauv cov kev sim no:

• CBC
• Coombs kuaj, ncaj qha
• Coombs kuaj, tsis ncaj qha
• Fibrin kev ua rau tsis zoo
• Haptoglobin
• Ib nrab thromboplastin lub sijhawm
• Lub sijhawm Prothrombin
• Ntshav dej bilirubin
• Ntshav dej creatinine
• Ntshav ntshav hemoglobin
• Mob Lub Hlaus
• Zis hemoglobin

Yog tias cov tsos mob tshwm sim thaum hloov ntshav, ntxiv ntshav yuav tsum nres tam sim ntawd. Kuaj ntshav los ntawm tus neeg txais (tus neeg tau txais ntshav) thiab los ntawm cov neeg pub ntshav yuav raug sim ua kom paub seb puas muaj tsos mob los ntawm qhov hloov ntshav.

Cov tsos mob me yuav tau kho nrog:

• Acetaminophen, tso tshuaj rau mob kom txo ua npaws thiab tsis xis nyob
• Cov kua ua kua los ntawm txoj hlab ntshav (leeg ntshav) thiab lwm yam tshuaj los kho lossis tiv thaiv lub raum tsis ua haujlwm thiab ceeb

Qhov tshwm sim yog nyob ntawm seb cov kev tawm tsam hnyav npaum li cas. Qhov teeb meem no yuav ploj mus yam tsis muaj teeb meem. Lossis, nws yuav hnyav thiab lub neej txaus ntshai.

Teeb meem yuav suav nrog:

• Mob raum tsis ua hauj lwm
• Mob Kev Plab
• Teeb meem ntsws
• Poob Siab

Qhia koj tus kws kho mob yog tias koj tau tso ntshav ntxiv thiab koj tau muaj qhov tshuaj tiv thaiv ua ntej.

Cov ntshav pub rau muab tso rau hauv pawg ABO thiab Rh txhawm rau txo qis kev pheej hmoo ntawm kev sib hloov ntshav.

Ua ntej tso ntshav, tus neeg txais thiab cov ntshav pub kuaj (ntsuas cov ntshav sib deev) xyuas seb lawv puas sib haum. Qhov ntshav me pub rau lwm tus tau koom nrog cov ntshav tau txais tsawg. Qhov sib xyaw yog tshawb xyuas hauv lub tshuab tsom rau cov cim ntawm cov tshuaj tiv thaiv.

Ua ntej hloov ntshav, koj tus kws kho mob yuav rov tshuaj xyuas dua kom paub tseeb tias koj tau txais cov ntshav txaus.

Kev hloov ntshav ntxiv

• Cov protein ntau ua rau kev tsis lees txais

Niag PojNtxoog LT. Transfusion tshuaj. Hauv: Goldman L, Schafer AI, eds. Goldman-Cecil TshuajCov. 25th ed. Philadelphia, PA: Elsevier Saunders; 2016: chap 177.

Hall JE. Hom ntshav; txhab ntshav; cov nqaij mos thiab hloov khoom nruab nrog cev. Hauv: Hall JE, ed. Guyton thiab Hall Phau Ntawv Qhia Txog Tshuaj Kho MobCov. 13th ed. Philadelphia, PA: Elsevier; 2016: cha 36.

Txhab W. Kev Hloov pauv hloov mus rau cov ntshav thiab cov khoom siv ntshav kho lub cev. 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 119.