Kūlike ʻole ʻo ABO

ʻO A, B, AB, a me O nā ʻano nui ʻehā o ke koko. Hoʻokumu ʻia nā ʻano ma nā mea liʻiliʻi (nā molekoki) ma ka ʻili o nā huna koko.

Ke loaʻa ke koko i nā poʻe i loaʻa hoʻokahi ʻano koko mai kekahi me kahi ʻano koko ʻokoʻa, hoʻonāukiuki paha i kā lākou ʻōnaehana pale. Kapa ʻia kēia incompatibility ʻo ABO.

Ma muli o nā ʻenehana hoʻokolohua o kēia au, kākaʻikahi loa kēia pilikia.

ʻO nā ʻano koko ʻokoʻa:

• ʻAno A
• ʻAno B
• ʻAno AB
• ʻAno O

ʻO ka poʻe i loaʻa hoʻokahi ʻano o ke koko e hana i nā protein (antibodies) e hana i ko lākou ʻōnaehana pale pale e kūʻē i hoʻokahi a i ʻole nā ​​ʻano koko ʻē aʻe.

Ke hōʻike ʻia nei i kekahi ʻano o ke koko e hiki ai i kahi hopena. He mea nui kēia i ka wā e pono ai i kekahi e loaʻa i ke koko (transfusion) a i ʻole he transplant ʻōnaehana. Pono e kūlike nā ʻano koko e hōʻalo i kahi hopena incompatibility ABO.

O kahi laʻana:

• ʻO ka poʻe me ke ʻano ʻA ke ʻano e kūʻē i nā ʻano B a i ʻole ke ʻano AB.
• ʻO ka poʻe me ke ʻano B ke ʻano kūʻē e kūʻē i ke ʻano A a i ʻole ke ʻano AB.
• ʻO ka poʻe me ke ʻano O ke ʻano e kūʻē i ka type A, type B, a i ʻole type AB ke koko.
• ʻO ka poʻe me ke koko ʻAno AB ʻaʻole lākou e kūʻē i ka type A, type B, type AB, a i ʻole type O.

ʻAʻohe kumu o ke koko i kumu o ka pale pale i ka wā e hāʻawi ʻia ai i ka poʻe me ke ʻano ʻA, ke ʻano B, a me ke ʻano o ke koko AB. ʻO kēia ke kumu e hiki ai ke hāʻawi ʻia i nā kahena O ke koko i ka poʻe o kēlā me kēia ʻano koko. ʻO nā kānaka me ke ʻano koko O, ua kapa ʻia lākou he poʻe hāʻawi laula. Akā ʻo ka poʻe me ke ʻano O hiki ke loaʻa ke koko O wale nō.

Pono e hoʻohālikelike i ke koko a me ka transfusions plasma e hōʻalo ai i kahi hopena pale. Ma mua o ka loaʻa ʻana o ke koko i kekahi, hoʻāʻo maikaʻi ʻia ke koko a me ke kanaka e loaʻa ana iā ia e hōʻalo i kahi hopena. ʻO ka maʻamau, kū ka hopena ma muli o ke kuhi hewa o ke kahunapule e loaʻa ai i kekahi ke koko kīnā ʻole.

ʻO nā aʻe aʻe nā ʻōuli o ABO incompatible transfusion react:

• ʻEha kua haʻahaʻa
• Koko i ka mimi
• ʻO Chills
• Manaʻo o "ka hopena hopena"
• Fiva
• ʻO Nusea a me ka luaʻi
• Pokole o ka hanu
• Hoʻonui i ka helu o ka puʻuwai
• Paʻi ma ka pūnaewele infusion
• ʻEha ʻeha
• Puʻupuʻu
• ʻO Bronchospasm (spasm o nā mākala e kau ana i ka akemāmā; ke kumu o ka uha
• ʻIli melemele a keʻokeʻo o nā maka (jaundice)
• Hewa kōwi koʻikoʻi
• Kaomi haʻahaʻa
• Hoʻomaʻamaʻa intravascular coagulation (DIC)

E hana ka mea mālama ola i kahi hoʻokolohua kino. E hōʻike mau nā hōʻike koko:

• Kiʻekiʻena ka pae bilirubin
• Hōʻike ka helu piha o ke koko (CBC) i ka hōʻino ʻia o nā hunaola ʻulaʻula a i ʻole anemia
• ʻAʻole kūlike ke koko o ka mea loaʻa a me ka mea hāʻawi
• ʻO ka lactate dehydrogenase kiʻekiʻe (LDH)
• ʻO ke kiʻekiʻe urea nitrogen urea (BUN) a me ka creatinine; i ka hōʻeha hōʻeha
• Ka manawa prothrombin hoʻolōʻihi a i ʻole ka manawa thromboplastin hapa (nā hopena o DIC)
• Hōʻike antiglobulin pololei pololei (DAT)

Hōʻike nā hōʻike mimi i ka hiki ʻana o hemoglobin ma muli o ka haki ʻana o nā hunaola ʻulaʻula.

Inā loaʻa kekahi hopena, pono e hoʻopau koke ʻia ke transfusion. Hoʻokomo pū ʻia ka mālama ʻana:

• Nā lāʻau lapaʻau i hoʻohana ʻia e mālama i nā hopena maʻi (antihistamines)
• Nā lāʻau lapaʻau i hoʻohana ʻia e mālama i ka pehu a me nā maʻi āpau (steroid)
• Nā Fluids i hāʻawi ʻia ma o kahi aa (intravenously)
• ʻO nā lāʻau e hoʻāla i ke kahe o ke koko inā hāʻule haʻahaʻa ia

Hiki i ka launa ʻole o ABO ke lilo i pilikia nui e hopena i ka make. Me ka lapaʻau kūpono a me ka manawa kūpono, manaʻo ʻia kahi ola hou.

Nā pilikia e hopena paha me:

• Hewa ʻole nā ​​hakuʻala
• Ke kahe haʻahaʻa e pono ai i ka mālama nui
• Make

Kāhea aku i kāu mea nāna i hāʻawi inā loaʻa i kahi transfusion a i ʻole transplusion ke koko i kēia manawa a loaʻa iā ʻoe nā ʻōuli o ke kūlike ʻole o ABO.

ʻO ka hoʻāʻo ʻana o nā mea hāʻawi a me nā ʻano ʻāpana o ke koko ma mua o ka transfusion a i ʻole ke transplant hiki ke pale i kēia pilikia.

Ka hopena transfusion - hemolytic; ʻO ka hopena hemolytic transfusion koʻikoʻi; AHTR; Kūlikeʻole o ke koko - ABO

• Pēpē Jaundiced
• Nā Antibodies

Kaide CG, Thompson LR. Hoʻomaʻamaʻa transfusion: nā huahana koko a me nā koko. I: Roberts JR, Custalow CB, Thomsen TW, eds. ʻO Roberts a me Hedges 'Nā Kauka Lapaʻau i ka Medicine Emergency a me ka Care Acute. ʻEpekema 7 Piladelapia, PA: Elsevier; 2019: chap 28.

ʻO Manis JP. ʻO nā ʻāpana o ke koko, ka nānā ʻana o nā mea hāʻawi koko, a me nā hopena transfusion. I: Rifai N, ed. ʻO Tietz Textbook of Clinical Chemistry a me nā Molecular Diagnostics. ʻElua huaʻōlelo St Louis, MO: Elsevier; 2018: chap 81.

ʻO Nester T. Ke kaukino a me nā hopena transfusion. I: Kellerman RD, Rakel DP, eds. ʻO Conn's Current Therapy 2020. Piladelapia, PA: Elsevier; 2020: 394-400.