Ngezinye izikhathi lapho udokotela wethu esinika ukuhlolwa kwegazi, asikwazi ukuthola ukuthi kuyini. Elinye lamagama anjalo yi-'Coombs test'. Kumelwe ukuthi uke wezwa ngalolu vivinyo, ikakhulukazi uma ukhulelwe, umpontshelwe igazi, noma uma ingane yakho inesimo esifana ne-jaundice. Ngakho ake sibone ukuthi lolu vivinyo lufunani ngempela nokuthi kungani lubalulekile, ngendlela elula kakhulu.
Kalula nje, kuyini lokhu kuhlolwa kwe-Coombs?
Umzimba wethu unesimiso sokuzivikela, njengebutho elivikela izwe. Sibiza amasosha akhethekile kuleli butho ngokuthi ama-antibodies . Umsebenzi wawo oyinhloko ukusivikela ezifweni ngokulwa nezitha, njengamagciwane, amabhaktheriya, namagciwane, abizwa ngokuthi ama-antigen , angena emzimbeni evela ngaphandle.
Kodwa cabanga, kwenzekani uma ngezinye izikhathi la masosha okuzivikela enza iphutha futhi aqale ukuhlasela amangqamuzana ethu amahle, anempilo esikhundleni sokuwabona njengezitha zakwamanye amazwe? Yilokho okubi kakhulu. Ukuhlolwa kwe-Coombs ngokuyisisekelo kuhlola ukuthi ngabe kukhona yini ama-antibodies egazini lethu angahlasela amangqamuzana egazi abomvu, noma ukuthi asevele ewahlasela.
Kalula nje, lolu vivinyo lubheka ukuthi izivikelo zethu (ama-antibodies) ziyahlasela yini amangqamuzana ethu egazi abomvu.
Kunezinhlobo ezimbili zokuhlolwa kwe-Coombs.
Yebo, kunezinhlobo ezimbili eziyinhloko zalolu vivinyo lwe-Coombs. Udokotela uzokutshela ukuthi wenze enye yalezi ezimbili. Ake sibheke umehluko phakathi kwalezi ezimbili ngale ndlela.
| Uhlobo Lokuhlola | Ufunani kulokhu? | Yiziphi izikhathi ezivame kakhulu lapho isetshenziswa khona? |
|---|---|---|
| Ukuhlolwa kwe-Coombs okuqondile (Ukuhlolwa kwe-Direct Coombs) | Lokhu kuhlola ngqo ukubona ukuthi ama-antibodies anamathele yini ngaphandle kwamaseli akho abomvu egazi, okusho ukuthi anamathele kuwo. Uma sikhuluma iqiniso, kufana nokuhlola ukuthi ukulwa sekuqalile yini . | Thola izimo ezihlobene negazi njenge- autoimmune hemolytic anemia, okuyisimo lapho umzimba ubhubhisa khona amaseli awo abomvu egazi. |
| Ukuhlolwa Okungaqondile kwe-Coombs (Ukuhlolwa kwe-Coombs okungaqondile) | Lokhu kuhlola ukubona ukuthi kukhona yini ama-antibodies antanta ngokukhululeka ku-plasma yegazi lakho (uketshezi lwegazi) angahlasela amangqamuzana abomvu egazi. Kufana nokuhlola ukuthi usukulungele yini ukulwa . |
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Kungani ukuhlolwa kwe-Coombs kubaluleke kangaka ngesikhathi sokukhulelwa?
Ukuhlolwa kwe-Indirect Coombs, okwenziwa ngesikhathi sokukhulelwa, kuhlola ukuthi igazi likamama linawo yini ama-antibodies alwa ne-Rh factor. Manje ake sibone ukuthi iyini le Rh factor.
Cabanga nje, ngaphezu kwezinhlobo zethu zegazi (A, B, AB, O), kungase kube nenye iphrotheni ekhethekile, noma 'uphawu', kumaseli abomvu egazi. Lokhu kubizwa ngokuthi i-Rh factor .
- Uma lolu phawu lukhona, lolo hlobo lwegazi lune -Rh-positive (isib. O positive, A positive).
- Uma lolu phawu lungekho, lolo hlobo lwegazi luyi -Rh-negative (isib. O negative, A negative).
Manje cabanga ngalokhu: Kwenzekani uma uhlobo lwegazi lukamama lungenayo i-Rh (okusho ukuthi alunalo uphawu olukhethekile), kodwa umntwana osesiswini uzuze uhlobo lwegazi lukayise futhi une-Rh (okusho ukuthi igazi lomntwana linalolo phawu)?
Okungenzeka lapha ukuthi uma inani elincane legazi lomntwana lihlangana negazi likamama ngesikhathi esithile, njengasesikhathini sokubeletha, amasosha omzimba kamama ayaqaphela 'uphawu' olubizwa ngokuthi i-Rh factor egazini lomntwana njengesitha sangaphandle. Ngemuva kwalokho umzimba kamama uqala ukwenza ama-antibodies okulwa naleso sitha. Lokhu kubizwa ngokuthi i-Rh sensitization .
Ngokuvamile, ngesikhathi sokukhulelwa kokuqala, la ma-antibodies athatha isikhathi eside ukukhula, ngakho-ke umntwana wokuqala akathinteki kakhulu. Kodwa-ke, inkinga ifika ngesikhathi sokukhulelwa okulandelayo. Uma umama ekhulelwe umntwana one-Rh futhi, ama-antibodies enziwe ngaphambilini asuke esekulungele egazini likamama, awele i-placenta, bese eqala ukuhlasela nokubhubhisa amangqamuzana egazi abomvu engane.
Lokhu kungabangela izinkinga ezinkulu zempilo enganeni, njenge-anemia kanye ne-jaundice. Yingakho kubaluleke kakhulu ukwenza lokhu kuhlolwa kwe-Coombs ekuqaleni kokukhulelwa ukuze kutholakale ukuthi ikhona yini ingozi enjalo, futhi uma kudingeka, ukuyiphatha ukuze uyivimbele.
Ingabe nawe uyalwenza lolu vivinyo lwezingane ezisanda kuzalwa?
Yebo. Ngezinye izikhathi, uma umntwana osanda kuzalwa ene-jaundice enzima, odokotela bangenza i-Direct Coombs Test. Lokhu kuhlola ukubona ukuthi ama-antibodies akhiqizwa ngumama ngesikhathi sokukhulelwa angene yini emzimbeni womntwana, anamathele kumaseli egazi abomvu omntwana, futhi awabhubhise.
Ingabe kukhona okudingeka ngikwenze ngaphambi kokwenza isivivinyo?
Cha. Akukho okukhethekile okudingeka ukulungiselele ngaphambi kokuya kulolu vivinyo lweCoombs. Akudingeki uzile ukudla noma uyeke ukuthatha noma yimiphi imithi.
Lokhu ukuhlolwa kwegazi okulula kakhulu. Inaliti encane ifakwa emthanjeni ongalweni yakho bese kuthathwa isampula yegazi. Uzozwa ukugwazwa okuncane kuphela. Isampula yegazi bese ithunyelwa elabhorethri ukuze ihlolwe. Imiphumela ivame ukutholakala zingakapheli amahora angama-24.
Usho ukuthini umbiko wokuhlolwa?
Umphumela walolu vivinyo ungafika ngezindlela ezimbili eziyinhloko: Okuhle noma Okubi.
| Umphumela | Kusho ukuthini (Incazelo) |
|---|---|
| Okuhle (Okuhle / Okungajwayelekile) | Lokhu kusho ukuthi kunezinhlayiya zamasosha omzimba egazini lakho ezihlasela noma ezikwazi ukuhlasela amaseli akho abomvu egazi. Lokhu kungaba nezimbangela eziningana:
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| Okubi (Okungekuhle / Okuvamile) | Lezi yizindaba ezinhle! Lokhu kusho ukuthi awekho ama-antibodies atholakale anganamathela noma ahlasele amaseli akho abomvu egazi. Lokhu kusho ukuthi:
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Kusho ukuthini uma uthola umphumela omuhle?
- Uma uhlolwe watholakala unegciwane ngaphambi kokunikela ngegazi: Lokhu kusho ukuthi udinga ukuqaphela kakhulu lapho unikela ngegazi, bese ukhetha uhlobo lwegazi olufanele wena. Abantu abathola igazi izikhathi eziningi bangaba nala ma-antibodies, ngakho kungaba nzima ukuthola uhlobo lwegazi oluhambisanayo.
- Uma uhlolwe ukuthi unegciwane ngesikhathi sokukhulelwa: Lokhu kusho ukuthi umzimba wakho usungule amasosha omzimba ngokumelene nomntwana one-Rh-positive. Uzodinga-ke ukuthola ukwelashwa ukuze uvikele umntwana.
- Uma umbiko womntwana ubonisa ukuthi une-anemia noma i-jaundice: Ngokuvamile kubonisa ukuthi umntwana une-anemia noma i-jaundice. Udokotela uzomhlola umntwana futhi ancome ukwelashwa okudingekayo.
Kufanele ngimbone nini udokotela?
Uma uba nezimpawu ze-anemia, njengokuphuzi kwesikhumba noma amehlo (i-jaundice) , ukukhathala nobuthakathaka obuvamile , isiyezi , noma ukudideka , bona udokotela wakho ngokushesha . Uzokuhlola futhi, uma kudingeka, enze ezinye izivivinyo, okuhlanganisa nokuhlolwa kwe-Coombs, ukuze anqume ukuthi isimo sakho siyini kanye nokwelashwa okungcono kakhulu kwaso.
Khumbula, uma unezimpawu ocabanga ukuthi azivamile, into engcono kakhulu ongayenza ukukhuluma nodokotela wakho ngazo.
Ukuhlolwa kwe-Coombs kuwukuhlolwa okunikeza udokotela wakho umbono ngenkinga emzimbeni wakho. Akukutsheli kahle ukuthi siyini lesi sifo. Ngakho-ke, uma uthola umphumela omuhle, kungadingeka wenze izivivinyo ezengeziwe ukuze uthole ukuthi yini ngempela ebangela lesi sifo.
Umlayezo Wokuya Nawe Ekhaya
- Ukuhlolwa kwe-Coombs ukuhlolwa kwegazi okulula okuhlola ama-antibodies ahlasela amangqamuzana ethu egazi abomvu.
- Kunezinhlobo ezimbili eziyinhloko zalokhu: Ukuhlolwa Okuqondile Kwe-Coombs (okuhlola ukuthi usuvele uhlasela) kanye Nokuhlolwa Okungaqondile Kwe-Coombs (okuhlola ukuthi usukulungele yini ukuhlasela).
- Lokhu kuhlolwa kubaluleke kakhulu ukuhlola noma yikuphi ukungahambisani phakathi kwezinhlobo zegazi (i-Rh factor) zomama okhulelwe kanye nomntwana wakhe.
- Uma uthola umphumela omuhle, kungaba nezizathu eziningana zalokho. Ngakho ungesabi, vele ubheke kabanzi futhi udokotela wakho uzokwazi ukukusiza.
- Khuluma nodokotela wakho njalo ngemiphumela yokuhlolwa kwakho bese uthola ukuqonda okucacile.
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