Mi pakhat chu kawngpui accident lian takah thisen a chhuak nasa hle tih han ngaihtuah teh. A nih loh leh surgery lian tak neih lai hian beisei loh takin thisen tam tak a bo thin. Chutiang hunah chuan kan taksaa thisen zam (natural blood clotting process) hian hna a thawk tha lo a nih chuan nunna atana hlauhawm tak a ni thei. Chutiang thil pawi tak takah chuan nunna chhanhim thei damdawi Fresh Frozen Plasma, a nih loh leh kan hriat vek FFP tih hi kan sawi thin. I doctor-in he hming a sawi hian tlem chuan hlauthawng leh hriat duhna i nei mai thei. Chuvangin vawiin hian he FFP hi eng nge a nih, tu hnenah nge pek a nih, engtin nge a pek, eng nge a hlawkna leh hlauhawmna tih hi awlsam tak leh friendly takin i sawi ang u.
A awlsam zawngin Fresh Frozen Plasma (FFP) hi eng nge ni?
Kan thisen hi thil pakhat chauh atanga siam a ni lo. Component engemaw zat a nei a. Fruit salad ang maiin han ngaihtuah teh. A chhungah thei chi hrang hrang a awm ang bawkin kan thisen hian thil pawimawh engemaw zat a nei bawk.
- Thisen sen (red blood cells): Hengte hi kan taksa pum puia oxygen phurtu an ni.
- White blood cells: Hengte hi kan sipai, natna thlentu hrik dotu an ni.
- Platelets: Cut i hmuh hian thisen chhuah tihtawp nan leh hliam tuamna tur a lo thleng hmasa ber a, plaster te tak te ang mai a ni.
- Plasma: Hei hi kan thawnthua mi langsar ber a ni. Plasma hi thisen a tui sen (yellow liquid) a ni. A chunga kan sawi tâk cell zawng zawng hi he ‘lui’ plasma an tih dungah hian an thlawk chhuak vek a ni.
He plasma hi tui chauh a ni lo. Kan nunna atana pawimawh protein, hormone leh salt tam tak a pai a ni. Chung zinga pawimawh ber chu "clotting or coagulation factors" an tih protein te hi an ni.
Heng clotting factors te hi engineer tenau team angin han ngaihtuah teh. Thisen kalna kawng a hliam emaw, a chhe emaw a nih chuan heng engineer-te hian a chunga kan sawi tak platelet te nen chuan rang takin chu hmun vel chu ‘dam’ ang maiin mesh an siam a, thisen chhuah chu a titawp vek a ni. Hetiang kalphung hian hna a thawk tha lo a nih chuan hliam tenau tak pawhin thisen a chhuah tam thei hle.
FFP chu mi pakhat thisen pek atanga cell dang zawng zawng paih chhuakin, he plasma hlu tak chauh hi a then a ni. Tichuan, chu ‘engineer’ hlu tak tak, chu chu clotting factors te humhalh nan thisen chu la in darkar 8 chhungin -18 degree Celsius emaw a aia hniam emaw ah deep-frozen a ni. Chuta tang chuan ‘Fresh Frozen’ tih hming hi a lo chhuak ta a ni.
FFP enkawlna hi tuin nge mamawh tak tak?
FFP hi thisen chhuak zawng zawng tan enkawlna a ni lo. Doctor-te’n thil engemaw zat bik, enkawlna dang a tawk loh laia an hman thin damdawi hlu tak a ni. Chu case te chu eng nge ni tih i en ang u.
| Enkawl a tul hunah | A awlsam zawnga sawifiah chuan... |
|---|---|
| Thisen chhuak nasa tak a chhuak (Thisen tam tak hloh) . | Car accident lian tak, sang tak atanga tlu emaw, operation buaithlak tak emaw ang hunah chuan taksa atangin thisen tam tak chu a chhuak nghal vek a ni. Hetih lai hian thisen zam (blood clotting factors) pawh nasa takin a tlahniam bawk. Chutih lai chuan chutiang tihtlem tawhte chu siam\hat leh thisen chhuahna control turin FFP pek a ni. |
| Thisen zam thei (blood clotting factors) tlakchhamna (Clotting Factor tlakchhamna) 1.1. | Mi thenkhat chuan pianpui natna an nei a. Entirna pakhat chu hemophilia hi a ni . Heng natnaah hian thisen zawrhna atana thil tul thenkhat chu taksaah siam chhuah a ni lo. Tin, he harsatna hi thin natna vei teah pawh a thleng thin . A chhan chu heng clotting factors te hi liver atanga siam a ni tlangpui. Chutiang mite thisen pek a nih chuan FFP hmangin chutiang tlakchhamna chu pek a ni. |
| Thisen tihthianghlimna damdawi Warfarin ang chi ei thinte tan | Warfarin hi thisen zam tur venna damdawi a ni a, lung natna ang chi natna atan pek thin a ni. He damdawi eitu mi pakhatin accident a tawk a, thisen a chhuah tan chuan tihtawp a harsa hle thei. Hemi atan hian vitamin K pek ni mah se, hna thawh nan hun a duh a ni. Chuvangin, solution rang tak angin FFP hi pek a ni a, chu chuan clotting factors mamawh chu direct-in a pe thei a ni. |
| TTP tih hming pu condition hmuh tur awm lo tak (Thrombotic Thrombocytopenic Purpura) (Trombotic Thrombocytopenic Purpura) te hi a tha hle a ni. | Hei hi natna hlauhawm tak leh hlauhawm tak a ni. Taksa thisen kalna kawng te teah thisen zam (blood clots) a siam thin. FFP pek hian taksain enzyme pakhat bo chu a siam tha leh thei a, natna chu a control thei bawk. |
FFP chi dang a awm em?
Ni e, FFP hi chi hrang hrang a awm a, a siam dan leh siam hun chhung pawh a inang lo deuh vek a ni. `PF24` emaw `Cryo-poor plasma` tih ang chi hming i hre tawh mai thei. Mahse heng hmingte hi i tan chuan a pawimawh tak tak lo. Hengte hi doctor leh lab staff te tan technical details pawimawh tak tak a ni. I dinhmun nena inmil chiah plasma chi chu an thlang ang. Chuvangin chutiang lam ngaihtuah a ngai lo.
Engtin nge FFP enkawlna hi pek thin? A hrehawm em?
FFP enkawlna hi damdawi inah tih a ni tlangpui. Surgery lian tak a ni lo. Procedure awlsam tak a ni a, saline solution pek ang chi a ni.
1. Inbuatsaihna: A hmasa berin FFP bag chu freezer atangin la la, taksa lumna a thlen thlengin tui lum bik bath-ah dah rawh. Hei hi microwave-ah dah theih a ni lo va, chutianga tih chuan a chhunga protein hlu tak takte chu a tichhe vek dawn a ni.
2. IV line dah: A dawtah chuan nurse emaw doctor emaw chuan i kut vein pakhatah cannula te tak te a dah ang. Hei hi saline pe turin needle dah tir nen a inang. Stinging sensation tlem tih loh chu natna langsar tak a awm lo.
3. Plasma pek: Tunah chuan diluted yellow plasma awmna bag chu IV line nen an inzawm ta a ni. Tichuan zawi zawiin i thisen kaltlangin i taksaah a lut ta a ni. FFP bag pakhatah hian millilitre 200-250 vel a awm a. I taksaa a luh theih nan minute 30 atanga 45 vel a ngai a ni. I dinhmun nasat dan azirin bag engzat nge pek tur che tih chu doctor chuan a rel ang.
4. Monitoring: He enkawlna chhung hian nurse pakhat chu i bulah a thu ang a, i thisen sang, heart rate, leh taksa lumna te a enfiah reng ang . Allergic reaction eng pawh an ngaihven hle. Chuvangin nangmah chauh i ni lo va, tu emaw chuan a lo en reng che a ni.
5. Test: FFP pek hma leh pek hnuah i thisen sample lak a ni a, thisen zam chakna enfiah nan ``PT/INR test`` leh ``PTT test`` ang chi test te tih a ni. Hei hian enkawlna a hlawhtlin zia an hmu thei a ni.
A pawimawh ber chu he thil tih lai hian i rilru hahna, i hrual, thawk harsatna i neih chuan nurse emaw doctor emaw hnenah hrilh nghal rawh.
FFP hi thisen chi hrang hrang hnenah pek theih a ni em?
Hei hi zawhna pawimawh tak a ni. Thisen pek dawnin thisen chi hrang hrang a inmil tur a ni tih kan hre tlangpui. Red blood cells kan pek hian type O thisen hi "universal donor" a ni tih kan hria a, tu hnenah pawh pek theih a ni.
Mahse plasma pek chungchang sawi dawn chuan he thawnthu hi a danglam vek!
Plasma-ah chuan thisen chi AB nei mi pakhat atanga plasma chu universal donor , thisen chi hrang hrang nei tan pek theih a ni.A thleng thin. Tin, type O thisen nei chuan type O plasma chauh a dawng thei bawk.
Mahse hei hi ngaihtuah buai suh. Emergency-ah chuan i thisen chi hrang hrang hriat a nih loh chuan doctor leh blood bank-a thawktute chuan mi zawng zawng tan plasma pek theihna tur kawng him ber an thlang ang. I thisen chi hrang hrang nena inmil plasma pek che an tum fo thin.
FFP enkawlna hian eng hlawkna leh hlauhawmna nge a neih?
Damdawi dang ang bawkin FFP enkawlna hian hlawkna a nei a, hlauhawmna pawh a tlem hle.
A thatna ber chu:
Hei hi a thatna lian ber leh awm chhun chu nunna chhanhimtu a nih vang a ni. Thisen chhuah thunun theih loh a awm chuan FFP hian clotting factors mamawh a pe thei a, thisen chhuah chu a titawp thei a, damlo nunna a chhanhim thei bawk. Hei hi he enkawlnaah hian a hlu ber a ni.
Risk awm thei (Complications): 1.1.
Heng risk te hi a tlem hle tih hriat reng a pawimawh. Sri Lanka rama thisen banking service hi a sang ber a nih avangin heng hlauhawmnate hi tih tlem nan hmalak a ni.
| Tum chhin | Chu chu... |
|---|---|
| Allergy nei te pawh a awm (Allergic avanga thil thleng) . | A châng chuan taksain pawn lam aṭanga plasma a dawn chu a chhân lêt thei a ni. Hei hian symptom tenau te, hliam leh hnim hring te a thlen thei a ni. Chungte chu damdawi hmangin rang taka control theih a ni tlangpui. |
| Infection awm thei te (Natna hrik kai) . | Tunah chuan he risk hi a hniam hle hle. A chhan chu thisen petu zawng zawng hi HIV, Hepatitis B, leh C ang chi natna te uluk taka test vek an ni a, chuvangin he hlauhawmna hi hlauh lutuk a ngai lo. |
| TRALI (lung hliam na tak) 1.1. (Transfusion avanga lung hliam na tak) . | Hei hi a tlem hle a, mahse a pawi hle.Dinhmun. Plasma-a thil \henkhatin i taksa a thawh that loh chuan i lung chu tuiin a khat a, thawk a harsa \hin. Hei hi plasma an dawn atanga darkar 6 chhungin a thleng tlangpui. |
| TACO (fluid tam lutuk) 1.1. (Transfusion-a kaihhnawih Circulatory Overload) 1.1. | A bik takin lung natna nei emaw, kal natna nei tan chuan taksaah tui tam tak vawi khata inject a nih chuan thinlungin a tuar thei lo mai thei. Hei hian thisen sang a tisang thei a, thawk harsatna a thlen thei bawk. Doctor-te chuan hei hi an hre chiang a, plasma pek dan rate pawh an control a ni. |
Engtikah nge doctor nen inbiakna neih a ngaih? ETU ah i kal a ngai em?
I him tawk tih finfiah a nih hnuah chauh damdawi in atanga chhuahtir i ni ang. Mahse, in lama i haw hnuah side effect thenkhat a awm thei.
Heng symptoms te hi i neih chuan doctor hnenah hrilh rawh:
In i haw hnua hetiang thil i hriat chuan tihkhawtlai lova enkawltu damdawi in kha phone la, a nih loh leh i doctor hnenah hrilh rawh.
- Khawsik leh khawsik i neih chuan
- I taksaah itch, rash, blister i neih chuan
- Nausea leh luak chhuak a reh chuan
- I luak chhuak emaw, i lu a hah emaw tih i hriat chuan
- I hnungzang na i neih chuan
Heng symptoms te hi i neih chuan ETU ah kal nghal rawh!
A hnuaia symptoms te hi medical emergency a ni . A chunga kan sawi tak TRALI emaw TACO emaw dinhmun khirh tak chhinchhiahna an ni thei. Plasma an dawn atanga darkar 6 chhungin an rawn lang thei.
- Thâwk harsa
- Lung na tak tak
- Khawsik
Heng symptoms te hi i neih chuan nghak lovin damdawi in hnai ber Emergency Department (ETU) ah kal nghal mai tur a ni.
Take-Home Thuchah a ni
- FFP hi thisen pek chhuah atanga liquid portion a ni a, thisen zam chhuahna atana protein mamawh tamna a ni.
- Thisen chhuah tam lutuk control nan leh thisen zam lama harsatna nei te enkawlna atan hman a ni ber.
- Hei hi nunna chhanhim thei tur enkawlna hlu tak a ni.
- Enkawlna hi damdawi inah, damdawi lam enkawlna hnuaiah, awlsam takin, saline solution pek ang maiin pek a ni.
- Enkawlna zawng zawng ang bawkin hlauhawmna tlemte a awm a, mahse doctor-te chuan a hlawkna leh hlauhawmna an ngaihtuah hnuah he damdawi hi an pe ang. Side effect na tak tak a awm hi a tlem hle.
- Inenkawl hnua thawk harsatna, thinlung na chak tak, khawsik i neih chuan emergency-ah ngai la, damdawi in Emergency Department (ETU) pan nghal rawh.
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