Ke haki koke nei kou mau hunaola koko? E kamaʻilio kākou e pili ana i ka hemolysis!

Ke luhi nei ʻoe i kekahi manawa a puni ka poniuniu? A i ʻole ke manaʻo nei ʻoe i kekahi manawa he melemele iki kou ʻili, a he melemele nā ​​keʻokeʻo o kou mau maka? He mea pili paha kēia i kou mau hunaola koko ʻulaʻula, kekahi o nā ʻano hunaola koʻikoʻi loa i loko o kou koko. I kēia lā e kamaʻilio mākou e pili ana i kahi kūlana i kapa ʻia ʻo hemolysis , ʻo ia ka wā e haki ai nā hunaola koko ʻulaʻula a luku ʻia i ka wā mua. Mai hopohopo, he mea nui e makaʻala i kēia.

He aha maoli ka hemolysis?

I ka ʻōlelo maʻalahi, ʻo ka hemolysis ka luku ʻia ʻana o nā hunaola koko ʻulaʻula i loko o ko kākou kino . Ua ʻike ʻoe, ua like kēia mau hunaola koko ʻulaʻula me nā limahana liʻiliʻi i loko o ko kākou koko. ʻO lākou ka poʻe e lawe i ka oxygen mai nā māmā i ka wā e hanu ai kākou a hāʻawi iā ia i nā ʻāpana ʻē aʻe a me nā ʻiʻo i loko o ke kino. Ua like ia me ka lawe ʻana mai i kahi pahu kinoea i ka home. No laila, hoʻohana ko kākou kino i kēia oxygen e hana i ka ikehu e pono ai. Eia kekahi, kōkua kēia mau hunaola koko ʻulaʻula i ka lawe ʻana i ke kalapona ʻokikene i makemake ʻole ʻia e hōʻiliʻili ana i loko o ko kākou kino i nā māmā a hoʻokuʻu iā ia.

ʻO ka maʻamau, hoʻopau mau ko mākou kino i nā hunaola koko ʻulaʻula kahiko a nāwaliwali paha a hoʻololi iā lākou me nā hunaola koko ʻulaʻula olakino hou. Ua like kēia me ka hoʻopau ʻana i nā mea kahiko a loaʻa nā mea hou. ʻO kēia pōʻaiapuni o ka luku a me ka hana ʻana ke kumu e loaʻa mau ai iā mākou ka nui kūpono o nā hunaola koko ʻulaʻula i loko o ko mākou kino.

Eia nō naʻe, i kekahi manawa hoʻomaka kēia mau hunaola koko ʻulaʻula e haki i ka wā ʻōpiopio, ʻo ia hoʻi, wikiwiki loa . Hiki ke hana ʻia kēia ma mua o ka loaʻa ʻana o ka manawa o ko mākou kino e hana i nā hunaola hou e hoʻopiha i ka hakahaka. ʻO kēia luku wikiwiki ʻana o nā hunaola koko ʻulaʻula ua kapa ʻia ʻo hemolysis. Inā emi nui ka helu o nā hunaola koko ʻulaʻula i loko o ke kino ma muli o kēia hemolysis, kapa mākou i kēlā ʻano he anemia hemolytic , a i ʻole anemia.

No ke aha i luku ʻia ai nā hunaola koko ʻulaʻula ma kēia ʻano?

ʻO ka maʻamau, ola kahi hunaola koko ʻulaʻula no kahi o 120 mau lā. I ka hopena o kēia wā, ke ʻelemakule kēlā mau hunaola, hoʻokuʻu lākou i nā hōʻailona kūikawā. Hoʻoulu kēia mau hōʻailona i ka spleen (aia ma ka ʻaoʻao hema o ka ʻōpū) i loko o ko mākou kino e luku i kēia mau hunaola kahiko ma ke ʻano maʻamau. E like me kā mākou e hoʻolei aku ai i nā lako kahiko a haki i loko o ko mākou hale.

Hana ʻia nā hunaola koko ʻulaʻula hou i loko o kahi ʻāpana huʻahuʻa o ko kākou mau iwi i kapa ʻia he iwi ʻiʻo . A laila hoʻokuʻu ʻia nā hunaola koko ʻulaʻula hou i hana ʻia i loko o kēia iwi ʻiʻo i loko o ke koko.

Eia nō naʻe, i kekahi manawa hiki i kahi kīnā i ke ʻano a i ʻole ka haku mele ʻana o kahi ʻulaʻula ke hoʻopōkole i kona ola. A i ʻole, hiki ke hōʻino ʻia nā ʻulaʻula e nā kumu o waho a make ma mua o ka hiki ʻana o ke kino ke hana i nā ʻulaʻula hou.

He aha nā ʻano nui o ka hemolysis?

Hiki ke hoʻokaʻawale ʻia ka hemolysis i ʻelua ʻano nui. Pili kēia mau inoa i kahi i luku ʻia ai nā hunaola koko ʻulaʻula.

1. Hemolysis extravascular: ʻO kēia ka wā e luku ʻia ai nā hunaola koko ʻulaʻula ma waho o ko kākou mau kīʻaha koko (ʻo ia hoʻi, nā aʻa koko, nā aʻa, a me nā capillaries). ʻO ka hapa pinepine, hana ʻia kēia ma ka spleen . I ka hele ʻana o ke koko ma o ka spleen, ʻike kahi ʻano kūikawā o ke koko keʻokeʻo i kapa ʻia ʻo macrophages (ua like kēia me nā kiaʻi palekana o ko kākou kino) i nā hunaola koko ʻulaʻula kahiko a hōʻino ʻia a luku iā lākou.

2. Hemolysis intravascular: Ma kēia, ua luku ʻia nā hunaola koko ʻulaʻula i loko o nā kīʻaha koko. Ke luku ʻia lākou, hele nā ​​ʻāpana o kēlā mau hunaola ma ke kino holoʻokoʻa me ko mākou koko.

He aha nā kumu o ka hemolysis?

ʻAʻole hoʻokahi wale nō kumu o ka hemolysis, akā he nui nā kumu e hiki ke kōkua i ia. E nānā kākou iā ia me nā kikoʻī hou aku.

1. Nā kīnā i loko o nā hunaola koko ʻulaʻula ponoʻī

I kekahi manawa, inā he ʻano ʻē a kīnā paha i ke ʻano a i ʻole ka hoʻonohonoho ʻana o kahi hunaola koko ʻulaʻula, hiki ke luku koke ʻia kēlā hunaola. Hoʻokumu pinepine ʻia kēlā mau kīnā e kekahi mau maʻi hānau mua, a i ʻole nā ​​maʻi hoʻoilina .

• ʻO ka paʻa ʻole o ka hemoglobin: ʻO ka hemoglobin kahi protein e kōkua i ka lawe ʻana i ka oxygen i loko o nā hunaola koko ʻulaʻula. ʻO nā kūlana e hoʻoulu ai i kēia paʻa ʻole e komo pū me ka anemia cell sickle (kahi e lilo ai nā hunaola koko ʻulaʻula i ʻano sickle) a me ka thalassemia .
• Nā hemahema o ka enzyme: Hiki ke loaʻa kēia ʻano ke nele kekahi mau enzyme e pono ai no ka hana o nā hunaola koko ʻulaʻula. ʻO nā hiʻohiʻona e komo pū me ka hemahema o G6PD a me ka hemahema o pyruvate kinase .
• Nā kīnā o ka membrane: Nā kūlana kahi i loaʻa ai nā hemahema i ka uhi waho o nā hunaola koko ʻulaʻula, ʻo ia hoʻi ka membrane cell. ʻO nā laʻana e komo pū me ka hereditary spherocytosis ( lilo nā cell i poepoe) a me ka hereditary elliptocytosis (lilo nā cell i hoʻolōʻihi ʻia).

2. Nā maʻi e pili ana i ka ʻōnaehana pale

I kekahi manawa, hoʻomaka hewa ko kākou ʻōnaehana pale kino ponoʻī (ka ʻōnaehana e pale aku iā kākou mai ka maʻi) e hoʻouka i ko kākou mau hunaola koko ʻulaʻula ponoʻī. Ua kapa ʻia kēia he anemia hemolytic autoimmune (AIHA) . He maʻi laha ʻole kēia. Aia kekahi mau ʻano o kēia:

• ʻO ka maʻi agglutinin anu ( ʻoi aku ka ʻino o nā hōʻailona ke hōʻike ʻia i ke anu)
• Maʻi agglutinin mahana

ʻO kekahi mau maʻi ʻē aʻe e hiki ai ke hoʻoulu i ka AIHA e komo pū me ka Mycoplasma pneumonia , lymphoma , leukemia (he mau ʻano maʻi kanesa kēia), lupus, a me ka rheumatoid arthritis (he mau maʻi autoimmune kēia).

Nā kūlana ʻē aʻe ʻaʻole autoimmune:

• ʻO ka hemoglobinuria anu paroxysmal
• ʻO ka hemoglobinuria pō paroxysmal

3. Nā maʻi

Hiki i kekahi mau parasites, viruses, a me bacteria e komo i loko o ko kākou kino ke hōʻino i ko kākou mau cell koko ʻulaʻula, e luku ana iā lākou ma mua o ko lākou hiki ke hoʻololi ʻia. ʻO kahi laʻana maikaʻi o kēia ʻo ia ka malaria . Hoʻouka pololei ka parasite e hoʻoulu ai i ka malaria i nā cell koko ʻulaʻula.

Nā kumu ʻē aʻe o ka maʻi:

• ʻO Babesiosis
• Ka maʻi o Carrion
• kuni kiko o ka mauna pōhaku
• Haemophilus influenza
• ʻO ka maʻi pale ʻole kanaka (HIV)

4. Kekahi mau lāʻau lapaʻau

Hiki i kekahi mau lāʻau lapaʻau a mākou e lawe ai, ʻoiai he kakaikahi loa, ke hoʻoulu i kā mākou ʻōnaehana pale e hoʻouka i nā hunaola koko ʻulaʻula a luku koke iā lākou. Ua kapa ʻia kēia he anemia hemolytic immune induced drug-induced (DIHA) . He mea kakaikahi loa kēia.

ʻO kekahi mau lāʻau lapaʻau e hiki ke hoʻoulu i ka hemolysis:

• ʻAsetaminopena ( paracetamol)
• ʻO kekahi mau lāʻau antibiotic cephalosporin
• ʻO Clopidogrel
• ʻO Dapsone
• Heparin
• ʻO Levodopa
• ʻO Levofloxacin
• Methyldopa
• ʻO Nitrofurantoin
• Penicillin
• ʻO Phenazopyridine
• Kuinidina
• Kuina
• ʻO Rifampin
• ʻO kekahi mau sulfonamides

Mea nui: Mai hopohopo i kēia papa inoa o nā lāʻau lapaʻau. ʻAʻole pinepine kēia mau lāʻau lapaʻau i ka hemolysis. Inā ua kuhikuhi ke kauka i kēia mau lāʻau lapaʻau nāu, e hahai i kā lākou mau kuhikuhi. Inā he mau nīnau kāu, e kamaʻilio me kāu kauka.

5. Nā pilikia i ka wā hāpai

Hiki i kekahi mau pilikia i ka wā hāpai ke hoʻoulu i nā hunaola koko ʻulaʻula e haki koke.

• ʻO ka maʻi HELLP
• ʻO ka preeclampsia
• ʻEklampsia

Ma muli o kēia mau kūlana koʻikoʻi e hiki ke hana i ka wā hāpai, he mea nui e ʻimi koke i ke kōkua lapaʻau inā ʻike ʻia nā hōʻailona.

6. Nā lako lapaʻau a me nā lāʻau lapaʻau

He mea kākaʻikahi nō hoʻi kēia. Hiki ke hana ʻia ka hemolysis ke hoʻokomo ʻia kekahi mau mea lapaʻau i loko o ke kino, a i ʻole i ka wā o kekahi mau lāʻau lapaʻau, a hiki i ka wā e hoʻomaʻamaʻa ai ke kino iā lākou.

• Hemodialysis no nā maʻi puʻupaʻa
• Mīkini bypass puʻuwai-mahamaʻi (hoʻohana ʻia i nā ʻoki kino nui)
• Nā pani pani valve puʻuwai
• Nā mea hana ʻē aʻe i hoʻohana ʻia i nā kūlana e like me ka hāʻule ʻana o ka puʻuwai, no ka laʻana nā pamu balloon intra-aortic a me nā mea hana Impella .
• Nā hoʻoili koko (e like me ka wā e hāʻawi ʻia ai ke koko kūlike ʻole)

7. Nā mea make a me nā mea ʻawahia

Hiki i kekahi mau mea ʻawahia, ke ʻai ʻia, ke hōʻino i nā hunaola koko ʻulaʻula a hoʻoulu i ka hemolysis.

• ʻArsenika
• Keleawe ( inā e ʻai nui ʻia)
• Ke alakaʻi
• ʻArsine ( kinoea make)
• ʻO Stibine ( kinoea make)
• ʻAwa ʻawaʻawa o ka nahesa

Eia kekahi, ʻo kekahi kūlana e hana nui ai ka spleen (hypersplenism) hiki ke hana i ka hemolysis. Pēlā nō, hiki i ke koko kiʻekiʻe loa ke kumu i ka haki ʻana o nā hunaola koko ʻulaʻula i ka neʻe wikiwiki ʻana o ke koko ma o nā kīʻaha koko.

He aha nā hōʻailona o ka hemolysis?

Pili nā hōʻailona i ka haʻahaʻa o ka helu o kāu mau cell koko ʻulaʻula. Inā ʻaʻole haʻahaʻa loa ka helu o kāu mau cell koko ʻulaʻula, ʻaʻole paha ʻoe e ʻike i kekahi mau hōʻailona. ʻO ka hapa nui o ka manawa, kū mai nā hōʻailona no ka mea ʻaʻole lawa ka oxygen i nā cell a me nā ʻiʻo o ke kino ma muli o ka haʻahaʻa o ka helu o nā cell koko ʻulaʻula.

Nā hōʻailona maʻamau:

• Luhi
• Pōʻino
• ʻIli keʻokeʻo
• Nā palpitations o ka puʻuwai / tachycardia
• Pōkole o ka hanu / dyspnea
• Melemele o ka ʻili a me nā keʻokeʻo o nā maka (Jaundice) (ʻO kēia ke kumu o ka hōʻiliʻili ʻana o ka bilirubin, kahi mea i hoʻokuʻu ʻia i ka wā e haki ai nā hunaola koko ʻulaʻula, i loko o ke koko)
• Ka nui o ka spleen / splenomegaly

Hiki ke ʻokoʻa kekahi mau hōʻailona ma muli o ke kūlana kikoʻī e hoʻoulu ai i ka hemolysis. No ka laʻana, hiki i kekahi me ka maʻi agglutinin anu ke ʻike i ka emi ʻana o ke kahe koko i nā manamana lima a me nā manamana wāwae, e lilo ai lākou i polū a mae (Raynaud's phenomenon) .

He aha nā hoʻokolohua e hana ʻia e hoʻoholo ai inā he mau pilikia e pili ana i ka hemolysis?

E lawe ke kauka i kahi hāpana o kou koko a holo i kekahi mau hoʻokolohua e ʻike ai inā ʻo kāu mau hunaola koko ʻulaʻula haʻahaʻa ma muli o ka hemolysis.

• Helu koko piha (CBC): Hiki i kēia ke haʻi iā ʻoe i nā mea he nui e pili ana i nā ʻano āpau o nā cell i loko o kou koko, ʻoiai kou mau cell koko ʻulaʻula. Hiki iā ia ke nānā i nā mea e like me kou pae hemoglobin a me ka nui o ka wahi e lawe ai kāu mau cell koko ʻulaʻula i loko o kou koko (hematocrit).
• Helu Reticulocyte: He ʻāpana kēia o ka hoʻāʻo CBC. ʻO nā reticulocytes he mau hunaola koko ʻulaʻula i hana hou ʻia ʻaʻole i oʻo piha. Ke loaʻa ka hemolysis, hiki ke piʻi ka helu reticulocyte i ka wā e wikiwiki ai ke kino i ka hana ʻana o nā hunaola hou e pani i nā mea i luku ʻia.
• ʻO ka palaki koko peripheral: Hiki i kēia hoʻāʻo ke nānā i nā ʻano ʻē i ke ʻano a me ka nui o kāu mau hunaola koko. ʻOi aku ka nui o ka luku ʻia ʻana o nā hunaola i ke ʻano ʻē.
• Lactate dehydrogenase (LDH): He enzyme ka LDH i loaʻa i loko o nā hunaola koko ʻulaʻula. Ke wāwahi ʻia nā hunaola koko ʻulaʻula ma mua o ka maʻamau, hiki ke piʻi aʻe nā pae LDH i loko o ke koko.
• Hoʻāʻo Haptoglobin: ʻO Haptoglobin kahi protein e pili ana me ka hemoglobin. Ke wāwahi ʻia nā hunaola koko ʻulaʻula (e like me ka hemolysis), hoʻokuʻu ʻia ka nui o ka hemoglobin i loko o ke koko. A laila emi nā pae Haptoglobin.
• Bilirubin i hoʻohui ʻole ʻia: Hoʻopuka ʻia ka bilirubin i ka wā e haki ai ka hemoglobin i loko o nā hunaola koko ʻulaʻula. ʻO ke kiʻekiʻe o ka bilirubin i loko o ke koko e hōʻike ana ua luku ʻia ka nui o nā hunaola koko ʻulaʻula (ʻo ia ke kumu o ka jaundice).
• Hoʻāʻo Coombs pololei: Hiki i kēia hoʻāʻo ke ʻike inā he mau antibodies kāu e hoʻopili ai i kāu mau ʻula koko ʻulaʻula a luku koke iā lākou (hiki i kēia ke kōkua i ka ʻike ʻana i nā kūlana e like me AIHA).

Eia kekahi, hiki i ke kauka ke hana i kahi urinalysis e nānā i ke koko a me ka bilirubin i loko o kou mimi, hiki ke lilo i mau hōʻailona o kahi ʻano i kapa ʻia ʻo ka anemia hemolytic.

Pehea e mālama ʻia ai ka hemolysis?

E hilinaʻi kāu lāʻau lapaʻau i ke kumu o kou hemolysis a me ke koʻikoʻi o kou mau hōʻailona. Hiki i nā koho lapaʻau ke komo pū me nā huaora, nā lāʻau lapaʻau, ke ʻoki kino, a me nā hoʻoili koko.

ʻO ka mea nui loa, ʻo ia ke kamaʻilio me kāu kauka e pili ana i ka lāʻau lapaʻau kūpono loa iā ʻoe, ma muli o kāu hōʻailona.

Ke hoʻāʻo mau nei ko mākou kino e mālama i ka helu kūpono o nā hunaola koko ʻulaʻula. Eia nō naʻe, hiki i nā maʻi, nā maʻi hānau ʻia, a me nā mana o waho ke hoʻopilikia i kēia kaʻina hana a hoʻopau koke i nā hunaola koko ʻulaʻula. ʻO ka hopena, hiki ke emi iho nā hunaola koko ʻulaʻula, e alakaʻi ana i ka anemia hemolytic.

Eia nō naʻe, ʻo ka nūhou maikaʻi, hiki ke mālama ʻia nā kumu he nui o ka hemolysis. Ke hoʻoholo ke kauka i ke kumu o kou hemolysis, e kuhikuhi lākou i nā lāʻau lapaʻau e kōkua i ka hoʻihoʻi ʻana i kāu helu koko ʻulaʻula i ka maʻamau.

Nā mea nui e hoʻomanaʻo (Leka Lawe-Home)

• ʻO ka hemolysis ka luku ʻia ʻana o nā ʻāpana koko ʻulaʻula i ka wā ʻōpiopio.
• Hiki i kēia ke hana i nā hōʻailona e like me ka luhi nui, ka poniuniu, a me ka melemele o ka ʻili (jaundice) .
• Nui nā kumu; nā hemahema i loko o nā hunaola koko ʻulaʻula ponoʻī, nā pilikia o ka ʻōnaehana pale, nā maʻi, kekahi mau lāʻau lapaʻau, nā pilikia i ka wā hāpai, a me nā mea hou aku.
• Inā loaʻa iā ʻoe kēia mau hōʻailona, ​​​​e ʻimi pono i ke kōkua lapaʻau .
• Hiki i nā hoʻāʻo koko ke kōkua i ka hoʻoholo ʻana i ke kumu a hāʻawi i ka lāʻau kūpono.
• Hiki ke mālama ʻia nā kumu he nui e hoʻihoʻi i nā pae o nā hunaola koko ʻulaʻula. No laila he mea nui e pale aku i ka hopohopo a e ʻimi i ke alakaʻi lapaʻau kūpono.

Manaʻolana wau he mea pono kēia ʻike nou. E ola kino!

ʻO ka hemolysis, nā hunaola koko ʻulaʻula, anemia, spleen, iwi ʻiʻo, jaundice, nā hoʻāʻo koko