Qee zaum thaum peb tus kws kho mob sau ntawv kom kuaj ntshav, peb tsis paub meej tias nws yog dab tsi. Ib lub npe zoo li no yog 'Coombs test'. Koj yuav tsum tau hnov txog qhov kev kuaj no, tshwj xeeb tshaj yog tias koj cev xeeb tub, muaj kev hloov ntshav, lossis yog tias koj tus menyuam muaj mob zoo li mob daj ntseg. Yog li cia peb saib seb qhov kev kuaj no nrhiav dab tsi tiag tiag thiab vim li cas nws thiaj li tseem ceeb, hauv txoj kev yooj yim heev.
Hais yooj yim xwb, qhov kev xeem Coombs no yog dab tsi?
Peb lub cev muaj ib lub cev tiv thaiv kab mob, zoo li ib pab tub rog uas tiv thaiv ib lub teb chaws. Peb hu cov tub rog tshwj xeeb hauv pab tub rog no ua cov tshuaj tiv thaiv kab mob . Lawv txoj haujlwm tseem ceeb yog tiv thaiv peb ntawm cov kab mob los ntawm kev tawm tsam cov yeeb ncuab, xws li cov kab mob me me, cov kab mob me me, thiab cov kab mob me me, hu ua antigens , uas nkag mus rau hauv lub cev los ntawm sab nraud.
Tiam sis xav txog seb, yuav ua li cas yog tias qee zaum cov tub rog tiv thaiv tus kheej no ua yuam kev thiab pib tawm tsam peb cov hlwb zoo, noj qab haus huv es tsis lees paub lawv ua yeeb ncuab txawv teb chaws? Qhov ntawd yog qhov phem tshaj plaws. Qhov kev xeem Coombs feem ntau xyuas seb puas muaj cov tshuaj tiv thaiv kab mob hauv peb cov ntshav uas tuaj yeem tawm tsam cov hlwb liab, lossis yog tias lawv twb tawm tsam lawv lawm.
Hais yooj yim xwb, qhov kev kuaj no saib seb peb tus kheej txoj kev tiv thaiv (antibodies) puas tab tom tawm tsam peb cov qe ntshav liab.
Muaj ob hom kev xeem Coombs.
Yog, muaj ob hom kev kuaj Coombs no. Tus kws kho mob yuav qhia koj kom ua ib qho ntawm ob qho no. Cia peb saib qhov txawv ntawm ob qho no li no.
| Hom Kev Ntsuas | Koj tab tom nrhiav dab tsi hauv qhov no? | Cov sijhawm twg feem ntau siv nws? |
|---|---|---|
| Kev Ntsuas Coombs Ncaj Qha (Kev sim Coombs ncaj qha) | Qhov no ncaj qha mus xyuas seb cov tshuaj tua kab mob puas tau txuas rau sab nraud ntawm koj cov qe ntshav liab, txhais tau tias lawv tau txuas rau lawv. Yog hais kom meej, nws zoo li xyuas seb qhov kev sib ntaus puas tau pib lawm . | Txheeb xyuas cov mob ntsig txog ntshav xws li autoimmune hemolytic anemia, uas yog ib qho mob uas lub cev rhuav tshem nws cov qe ntshav liab. |
| Kev Ntsuas Coombs Tsis Ncaj Qha (Kev sim Coombs tsis ncaj qha) | Qhov no kuaj xyuas seb puas muaj cov tshuaj tua kab mob uas ntab ywj pheej hauv koj cov ntshav plasma (cov kua ntshav) uas tuaj yeem tawm tsam cov qe ntshav liab. Nws zoo li kuaj xyuas seb koj puas npaj txhij rau kev sib ntaus . |
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Vim li cas qhov kev kuaj Coombs thiaj li tseem ceeb thaum cev xeeb tub?
Qhov Kev Ntsuas Coombs Tsis Ncaj Qha, uas ua thaum cev xeeb tub, xyuas seb cov ntshav ntawm leej niam puas muaj cov tshuaj tiv thaiv kab mob Rh. Tam sim no cia peb saib seb qhov Rh factor no yog dab tsi.
Xav txog, ntxiv rau peb cov hom ntshav (A, B, AB, O), tej zaum yuav muaj lwm cov protein tshwj xeeb, lossis 'cim', ntawm cov qe ntshav liab. Qhov no hu ua Rh factor .
- Yog tias muaj lub cim no, ces hom ntshav ntawd yog Rh-positive (piv txwv li O positive, A positive).
- Yog tias tsis muaj lub cim no, ces hom ntshav ntawd yog Rh-negative (piv txwv li O negative, A negative).
Tam sim no xav txog qhov no: Yuav ua li cas yog tias leej niam cov ntshav yog Rh-negative (txhais tau tias nws tsis muaj lub cim tshwj xeeb ntawd), tab sis tus menyuam hauv plab tau txais hom ntshav ntawm leej txiv thiab yog Rh-positive (txhais tau tias tus menyuam cov ntshav muaj lub cim ntawd)?
Qhov uas yuav tshwm sim tau ntawm no yog tias yog tias muaj me ntsis ntshav ntawm tus menyuam sib xyaw nrog cov ntshav ntawm leej niam thaum lub sijhawm, xws li thaum yug menyuam, lub cev tiv thaiv kab mob ntawm leej niam paub txog 'cim' hu ua Rh factor hauv cov ntshav ntawm tus menyuam ua tus yeeb ncuab txawv teb chaws. Tom qab ntawd lub cev ntawm leej niam pib tsim cov tshuaj tiv thaiv kab mob los tawm tsam tus yeeb ncuab ntawd. Qhov no hu ua Rh sensitization .
Feem ntau, thaum cev xeeb tub thawj zaug, cov tshuaj tiv thaiv no siv sijhawm ntev dua los tsim, yog li tus menyuam thawj zaug tsis raug cuam tshuam ntau. Txawm li cas los xij, qhov teeb meem tshwm sim thaum cev xeeb tub tom ntej. Yog tias leej niam rov yug tus menyuam Rh-positive dua, cov tshuaj tiv thaiv uas tau ua yav dhau los yuav npaj txhij hauv cov ntshav ntawm leej niam, hla lub placenta, thiab pib tawm tsam thiab rhuav tshem cov qe ntshav liab ntawm tus menyuam.
Qhov no tuaj yeem ua rau muaj teeb meem kev noj qab haus huv loj rau tus menyuam, xws li ntshav tsis txaus thiab mob daj ntseg. Yog vim li ntawd nws thiaj li tseem ceeb heev uas yuav tsum ua qhov kev kuaj Coombs no thaum ntxov ntawm cev xeeb tub kom paub seb puas muaj kev pheej hmoo zoo li no thiab, yog tias tsim nyog, kho nws kom tiv thaiv nws.
Koj puas ua qhov kev xeem no rau cov menyuam mos tshiab thiab?
Yog. Qee zaum, yog tias tus menyuam mos muaj mob daj ntseg hnyav, cov kws kho mob yuav ua qhov kev kuaj Direct Coombs. Qhov kev kuaj no yog los saib seb cov tshuaj tua kab mob uas leej niam tsim thaum cev xeeb tub puas tau nkag mus rau hauv tus menyuam lub cev, txuas rau tus menyuam cov qe ntshav liab, thiab rhuav tshem lawv.
Puas muaj dab tsi uas kuv yuav tsum tau ua ua ntej kuv mus xeem?
Tsis yog. Tsis muaj dab tsi tshwj xeeb uas koj yuav tsum npaj ua ntej mus rau qhov kev xeem Coombs no. Koj tsis tas yuav yoo mov lossis tsum tsis txhob noj tshuaj dab tsi li.
Qhov no yog ib qho kev kuaj ntshav yooj yim heev. Muab ib rab koob me me ntxig rau hauv cov leeg ntawm koj txhais caj npab thiab coj cov ntshav mus kuaj. Koj tsuas yog yuav hnov ib qho me me xwb. Tom qab ntawd cov ntshav kuaj yuav raug xa mus rau chav kuaj mob kom kuaj. Cov txiaj ntsig feem ntau yuav muaj nyob rau hauv 24 teev.
Daim ntawv qhia txog kev xeem txhais li cas?
Qhov tshwm sim ntawm qhov kev xeem no tuaj yeem los ua ob txoj hauv kev tseem ceeb: Zoo lossis Tsis Zoo.
| Qhov tshwm sim | Nws txhais li cas (Lub ntsiab lus) |
|---|---|
| Zoo (Zoo / Txawv Txawv) | Qhov no txhais tau hais tias muaj cov tshuaj tua kab mob hauv koj cov ntshav uas tab tom tawm tsam lossis muaj peev xwm tawm tsam koj cov qe ntshav liab. Qhov no tuaj yeem muaj ntau yam ua rau:
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| Tsis zoo (Tsis zoo / Ib txwm) | Nov yog xov xwm zoo! Qhov no txhais tau tias tsis pom muaj cov tshuaj tua kab mob uas tuaj yeem txuas lossis tawm tsam koj cov qe ntshav liab. Qhov no txhais tau tias:
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Txhais li cas yog tias koj tau txais qhov tshwm sim zoo?
- Yog tias koj kuaj pom tias muaj tus kab mob ua ntej pub ntshav: Qhov no txhais tau tias koj yuav tsum ceev faj heev thaum pub ntshav, thiab xaiv hom ntshav uas haum rau koj. Cov neeg uas tau txais ntshav ntau zaus tuaj yeem tsim cov tshuaj tiv thaiv no, yog li nws yuav nyuaj me ntsis los nrhiav hom ntshav sib xws.
- Yog tias koj kuaj pom tias muaj Rh-positive thaum cev xeeb tub: Qhov no txhais tau tias koj lub cev tau tsim cov tshuaj tiv thaiv kab mob tawm tsam tus menyuam Rh-positive. Tom qab ntawd koj yuav tsum nrhiav kev kho mob los tiv thaiv tus menyuam.
- Yog tias tus menyuam yaus daim ntawv qhia tias muaj: Feem ntau nws qhia tias tus menyuam muaj ntshav tsis txaus lossis mob daj ntseg. Tus kws kho mob yuav kuaj tus menyuam thiab pom zoo rau kev kho mob tsim nyog.
Kuv yuav tsum mus ntsib kws kho mob thaum twg?
Yog tias koj muaj cov tsos mob ntawm kev tsis muaj zog, xws li tawv nqaij lossis qhov muag daj (jaundice) , qaug zog thiab tsis muaj zog ntau zaus , kiv taub hau , lossis tsis meej pem , mus ntsib koj tus kws kho mob tam sim ntawd . Nws yuav kuaj koj thiab, yog tias tsim nyog, ua lwm yam kev kuaj mob, suav nrog Coombs test, los txiav txim siab seb koj tus mob yog dab tsi thiab kev kho mob zoo tshaj plaws rau nws.
Nco ntsoov, yog tias koj muaj cov tsos mob uas koj xav tias tsis zoo li qub, qhov zoo tshaj plaws uas yuav tsum ua yog tham nrog koj tus kws kho mob txog qhov ntawd.
Qhov kev kuaj Coombs tsuas yog ib qho kev kuaj uas qhia rau koj tus kws kho mob txog qhov teeb meem hauv koj lub cev xwb. Nws tsis qhia meej tias tus kab mob yog dab tsi. Yog li ntawd, yog tias koj tau txais qhov tshwm sim zoo, koj yuav tsum tau ua ntau qhov kev kuaj ntxiv kom paub tseeb tias yog dab tsi ua rau nws.
Cov Lus Qhia Txog Kev Coj Mus Tsev
- Qhov kev kuaj Coombs yog ib qho kev kuaj ntshav yooj yim uas kuaj xyuas cov tshuaj tiv thaiv kab mob uas tawm tsam peb cov qe ntshav liab.
- Muaj ob hom tseem ceeb ntawm qhov no: Kev Ntsuas Coombs Ncaj Qha (uas xyuas seb koj puas twb tawm tsam lawm) thiab Kev Ntsuas Coombs Tsis Ncaj Qha (uas xyuas seb koj puas npaj txhij tawm tsam).
- Qhov kev kuaj no tseem ceeb heev los xyuas seb puas muaj qhov tsis sib xws ntawm cov hom ntshav (Rh factor) ntawm leej niam cev xeeb tub thiab nws tus menyuam.
- Yog koj tau txais qhov tshwm sim zoo, tej zaum yuav muaj ntau yam ua rau nws. Yog li ntawd, tsis txhob ntshai, tsuas yog saib ntxiv thiab koj tus kws kho mob yuav pab tau koj.
- Nrog koj tus kws kho mob tham txog koj cov txiaj ntsig kuaj thiab kom nkag siab meej.
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Tsis muaj lus teb tau muab tso tawm. Ntxiv koj cov lus tawm ntawm no thawj zaug.
Ntxiv koj cov lus