ʻO nā kūpuna Hemoglobin

ʻO nā ʻano hemoglobin i hoʻololi ʻia i nā ʻano hemoglobin. ʻO Hemoglobin kahi protein i nā hunaola ʻulaʻula e neʻe i ka oxygen a me carbon dioxide ma waena o nā māmā a me nā kino o ke kino.

Kūkākūkā kēia ʻatikala i ka hoʻokolohua i hoʻohana ʻia e ʻike a ana i ka nui o nā hemoglobin i loaʻa i kou koko.

Hana ʻia ka hoʻāʻo e hoʻohana ana i kahi nila kuʻikuʻi e ʻohiʻohi i kahi hāpana o ke koko mai kahi aa a i ʻole kahi aʻa. Hōʻiliʻili ʻia paha ka laʻana mai kahi aa a i ʻole ke aʻa i loko o ka pulima, ʻūlū, a lima paha.

Ma mua o ka huki ʻia ʻana o ke koko, hiki i ka mea mālama ola ke hoʻāʻo i ka holo ʻana i ka lima (inā ʻo ka pulima ka pūnaewele). Ma hope o ka huki ʻia ʻana o ke koko, kau ʻia ke kaomi i ka pūnaewele puncture no kekahi mau minuke e kū ai ke kahe ʻana.

ʻAʻole pono kahi hoʻomākaukau kūikawā.

No nā keiki, kōkua paha ia i ka wehewehe ʻana i ke ʻano o ka hoʻāʻo a me ke kumu o ka hana ʻia ʻana. Hiki paha i kēia ke hōʻemi i ka makaʻu.

Hiki paha iā ʻoe ke ʻeha iki a i ʻole ke kuʻi ke hoʻokomo ʻia o ka nila. Hiki paha iā ʻoe ke hāwele i kahi kani ma ka pūnaewele ma hope o ka huki ʻia ʻana o ke koko.

Hoʻohana ʻia ka hōʻike carboxyhemoglobin e kuhikuhi i ka lāʻau make kalapona. Hoʻohana ʻia ia e ʻike i nā loli i ka hemoglobin i hopena ʻia mai kekahi mau lāʻau. Hiki i kekahi mau kemika a lāʻau paha ke hoʻololi i ka hemoglobin no laila ʻaʻole holo pono hou ia.

ʻO nā ʻano maʻamau o hemoglobin:

• Carboxyhemoglobin: ʻO kahi ʻano like ʻole o hemoglobin i hoʻopili ʻia i ka carbon monoxide ma kahi o ka oxygen a ʻo carbon dioxide paha. ʻO nā nui o kēia ʻano hemoglobin maʻamau e pale i ka neʻe maʻamau o ka oxygen e ke koko.
• Sulphhemoglobin: ʻO kahi ʻano maʻamau o ka hemoglobin hiki ʻole ke hāpai i ka oxygen. Loaʻa paha ia i kekahi mau lāʻau e like me dapsone, metoclopramide, nitrates a i ʻole sulfonamides.
• Methemoglobin: Hoʻohuli ʻia kahi pilikia ke hoʻololi ʻia ka hao mahele o hemoglobin i mea e lawe ʻole ai i ka oxygen. ʻO kekahi mau lāʻau a me nā hui ʻē aʻe e like me nitrites i hoʻolauna ʻia i loko o ke kahe o ke koko ke kumu o kēia pilikia.

Hōʻike nā kumukūʻai aʻe i ka pākeneka o nā hemoglobin derivatives e pili ana i ka huina hemoglobin:

• Carboxyhemoglobin - emi ma mua o 1.5% (akā e like paha me 9% i nā mea puhipaka)
• Methemoglobin - emi ma mua o 2%
• Sulphhemoglobin - ʻike ʻole ʻia

Hiki ke loli iki nā pae waiwai maʻamau i waena o nā hale hana ʻokoʻa. E kamaʻilio i kāu mea hāʻawi e pili ana i ke ʻano o kāu mau hopena hōʻike.

Hōʻike nā hiʻohiʻona ma luna i nā ana maʻamau no nā hopena no kēia mau hoʻāʻo. Hoʻohana kekahi mau keʻena hoʻokolohua i nā ana like ʻole a i ʻole hoʻokolohua i nā hoʻohālikelike like ʻole.

Hiki i nā pae kiʻekiʻe o nā hemoglobin ke alakaʻi i nā pilikia olakino nui. ʻAʻole ʻae nā ʻano hoʻololi o hemoglobin i ka neʻe maikaʻi ʻana o ka oxygen ma o ke kino. Hiki i kēia ke alakaʻi i ka make ʻana o nā kiko.

ʻO nā waiwai aʻe, koe wale nō ka sulfhemoglobin, e hōʻike i ka pākēneka o nā hemoglobin derivatives ma muli o ka huina hemoglobin.

ʻO Carboxyhemoglobin:

• 10% a 20% - hoʻomaka nā ʻōuli o ka lāʻau make kalapona monoxide
• 30% - ʻona ʻona kalapona monoxide ʻino i kēia manawa
• 50% a 80% - nā hopena i ka make ʻana o carbon monoxide make paha

Methemoglobin:

• 10% a 25% - nā hopena i ke kala ʻalani bluish (cyanosis)
• 35% a 40% - hopena i ka hanu a me ka ʻeha o ke poʻo
• Ma luna o 60% - nā hopena i ka lethargy a me ka stupor
• Ma luna o 70% - hopena paha i ka make

Sulphhemoglobin:

• ʻO nā waiwai o 10 gram no kēlā deciliter (g / dL) a i ʻole 6.2 millimoles i kēlā me kēia lita (mmol / L) ke kumu o ka ʻili bluish o ka ʻili ma muli o ka nele o ka oxygen (cyanosis), akā ʻaʻole ia e hoʻopilikia i nā hopena i ka hapa nui o ka manawa.

Methemoglobin; ʻO Carboxyhemoglobin; Sulphhemoglobin

• Hōʻaʻo koko

ʻO Benz EJ, ʻo Ebert BL. ʻO nā ʻano hemoglobin e pili ana me ka hemolytic anemia, ka loli ʻana o ka oxygen, a me ka methemoglobinemias. I: Hoffman R, Benz EJ, Silberstein LE, et al, eds. Hematology: Nā Kumumanaʻo a me ka Hoʻomeheu. ʻEpekema 7 Piladelapia, PA: Elsevier; 2018: chap 43.

ʻO Bunn HF. Hele i nā anemias. I: Goldman L, Schafer AI, eds. ʻO ka lāʻau lapaʻau Goldman-Cecil. 25th hua. Piladelapia, PA: Elsevier Saunders; 2016: chap 158.

ʻO Christiani DC. Nā hōʻeha kino a me nā kemika o ka hū. I: Goldman L, Schafer AI, eds. ʻO ka lāʻau lapaʻau Goldman-Cecil. 25th hua. Piladelapia, PA: Elsevier Saunders; 2016: chap 94.

ʻO Nelson LS, Ford MD. Lāʻau make ʻino. I: Goldman L, Schafer AI, eds. ʻO ka lāʻau lapaʻau Goldman-Cecil. 25th hua. Piladelapia, PA: Elsevier Saunders; 2016: chap 110.

ʻO Vajpayee N, Graham SS, Bem S. Nānā maʻamau o ke koko a me ka iwi iwi. I: McPherson RA, Pincus MR, hua. ʻO kā Henry's Clinical Diagnosis a me Management e nā Laboratory Methods. 23rd Ed. St Louis, MO: Elsevier; 2017: chap 30.