ʻO ka hopena hemolytic transfusion

ʻO ka hopena hemolytic transfusion kahi pilikia koʻikoʻi i hiki ke hana ma hope o ke kaʻi ʻana o ke koko. Kū ka hopena i ka wā e luku ʻia nā hunaola ʻulaʻula i hāʻawi ʻia i ka wā o ke transfusion e ka ʻōnaehana pale o ke kanaka. Ke luku ʻia nā hunaola ʻulaʻula, kapa ʻia ke kaʻina hana he hemolysis.

Aia kekahi ʻano ʻē aʻe o nā hopena transfusion maʻi ʻaʻohe kumu hemolysis.

Hoʻokaʻawale ʻia ke koko i ʻehā mau ʻano like ʻole: A, B, AB, a me O.

ʻO kekahi ala e hoʻokaʻawale ʻia ai nā hunaola koko e Rh mau kumu. ʻO ka poʻe i loaʻa nā kumu Rh i ko lākou koko i kapa ʻia ʻo "Rh positive." ʻO nā poʻe me ka ʻole o kēia mau kumu i kapa ʻia ʻo "Rh maikaʻi ʻole." Hoʻokumu ka poʻe Rh maikaʻi i nā mea pale kūʻē e kūʻē iā Rh factor inā loaʻa iā lākou ke koko maikaʻi Rh.

Aia kekahi mau kumu ʻē aʻe e ʻike ai i nā hunaola koko, a ʻo ABO a me Rh.

Hiki i kāu ʻōnaehana pale pale ke haʻi maʻamau i nā hunaola ponoʻī o kēlā me kekahi kanaka ʻē aʻe. Inā loaʻa ʻoe i ke koko i kūlike ʻole me kou koko, hana i kou kino i nā mea ʻino e hōʻino ai i nā huna koko o ka mea hāʻawi. Mālama kēia hana i ka hopena transfusion. ʻO ke koko āu e loaʻa ai i kahi transfusion pono e kūlike me kou koko ponoʻī. ʻO ka manaʻo ʻole o kāu kino i nā mea pale kūʻē i ke koko āu e loaʻa ai.

ʻO ka hapa nui o ka manawa, ʻaʻole hoʻoili ke koko ma waena o nā hui kūlike (e like me O + a O +) i mea e pilikia ʻole ai. Hoʻopili ke koko ma waena o nā hui i kūlike ʻole (e like me A + a O-) ke kumu o ka pane pale ʻana. Hiki i kēia ke alakaʻi i kahi hopena transfusion koʻikoʻi. Hoʻouka ka ʻōnaehana pale i nā huna koko i hāʻawi ʻia, a hū iā lākou.

I kēia lā, nānā pono ʻia ke koko a pau. Kākaʻikahi ka hopena transfusion.

Pākuʻi ʻia paha nā ʻōuli i kekahi o kēia mau mea:

• ʻEha kua
• Mimi koko
• ʻO Chills
• Pāleʻaleʻa a luʻuluʻu paha
• Fiva
• ʻEha Flank
• Kahe ʻana o ka ʻili

Hōʻike pinepine ʻia nā ʻōuli o kahi hopena hemolytic transfusion i ka manawa a ma hope paha o ka hoʻolilo. I kekahi manawa, ulu paha lākou ma hope o kekahi mau lā (lohi ka hopena).

Hiki i kēia maʻi ke hoʻololi i nā hopena o kēia mau hoʻāʻo.

• CBC
• Hōʻike Coombs, kuhikuhi pololei
• Hōʻike Coombs, kuhikuhi ʻole
• Nā huahana hoʻohaʻahaʻa Fibrin
• ʻO Haptoglobin
• Manawa thromboplastin manawa
• Prothrombin manawa
• Serum bilirubin
• Serum creatinine
• Serum hemoglobin
• Urinalysis
• Hemoglobin mimi

Inā kū nā ʻōuli i ka wā o ka transfusion, pono e hoʻopau koke ʻia ke transfusion. Hiki ke hoʻāʻo ʻia nā hāpana koko mai ka mea loaʻa (ke loaʻa ka transfusion) a mai ka mea hāʻawi e haʻi inā paha e hoʻokumu ʻia nā hōʻailona e kahi hopena transfusion.

Hiki ke mālama ʻia nā ʻōuli akahai me:

• ʻO Acetaminophen, kahi mea hōʻemi ʻeha e hōʻemi i ke kuni a me ka hōʻoluʻolu ʻole
• Nā Fluids i hāʻawi ʻia ma o ke aa (intravenous) a me nā lāʻau ʻē aʻe e mālama a pale ai i ka hōʻino ʻana o ka puʻupaʻa a me ka haʻalulu

Aia ka hopena i ka nui o ka hopena. E nalo paha ka maʻi me ka pilikia ʻole. A i ʻole, paʻakikī paha ia a hoʻoweliweli i ke ola.

Komo pū nā pilikia:

• Hewa kōwi koʻikoʻi
• Anemia
• Nā pilikia o ka lepa
• Pāhaʻi

E haʻi i kāu mea mālama ola inā loaʻa iā ʻoe ke hoʻololi o ke koko a ua loaʻa iā ʻoe kahi hopena ma mua.

Hoʻokomo ʻia ke koko i hāʻawi ʻia i loko o nā hui ABO a me Rh e hoʻoliʻiliʻi i ka hopena o ka hopena transfusion.

Ma mua o kahi transfusion, hoʻāʻo ʻia ka mea loaʻa a me nā mea nāna e hāʻawi (e hoʻohālikelike ʻia) e ʻike inā pili pono lākou. Hoʻohui ʻia kahi liʻiliʻi o ke koko hāʻawi me ka hapa liʻiliʻi o ke koko loaʻa. Nānā ʻia ke kāwili ma lalo o ka microscope no nā hōʻailona o ka hopena antibody.

Ma mua o ka hoʻolilo ʻia ʻana, e nānā pinepine kāu mea e ʻike pono ana ke loaʻa nei ʻoe i ke koko kūpono.

ʻO ka hopena transfusion koko

• Nā proteins ʻili e hoʻopiʻi ai

Maikaʻi LT. Lapaʻau hoʻoliʻiliʻi. I: Goldman L, Schafer AI, eds. ʻO ka lāʻau lapaʻau Goldman-Cecil. 25th hua. Piladelapia, PA: Elsevier Saunders; 2016: chap 177.

Halelu JE. ʻAno Koko; hoʻoiho; ke kuʻi a me ka hoʻoliʻiliʻi ʻana o nā meaola I: Hall JE, hoʻoponopono. ʻO Guyton a me Hall Textbook of Medical Physiology. 13th ed. Piladelapia, PA: Elsevier; 2016: chap 36.

Savage W. Transfusion i nā hopena i ke koko a me nā huahana therapy cell. I: Hoffman R, Benz EJ, Silberstein LE, et al, eds. Hematology: Nā Kumumanaʻo a me ka Hoʻomeheu. ʻEpekema 7 Piladelapia, PA: Elsevier; 2018: chap 119.