ʻIli koko

ʻO ke kuʻi koko kahi hōʻike koko e hāʻawi i ka ʻike e pili ana i ka helu a me ke kinona o nā hunaola koko. Hana pinepine ʻia ma ke ʻano he ʻāpana o a i ʻole me kahi helu piha o ke koko (CBC).

Pono kahi laʻana koko.

Hoʻouna ʻia ka laʻana o ke koko i kahi lab. Ma laila, nānā ka ʻenehana hoʻokolohua iā ia ma lalo o kahi microscope. A i ʻole, e nānā ʻia paha ke koko e kahi mīkini automate.

Hāʻawi ka smear i kēia ʻike:

• ʻO ka helu a me nā ʻano o nā hunaola keokeo (ʻokoʻa, a i ʻole ka pākēneka o kēlā me kēia ʻano cell)
• ʻO ka helu a me nā ʻano o nā ʻula koko ʻano ʻē
• Kuhi kūpono ʻia o ke keʻokeʻo koko keʻokeʻo a me ka helu platelet

ʻAʻole pono kahi hoʻomākaukau kūikawā.

Ke hoʻokomo ʻia ke kui kele e huki i ke koko, manaʻo kekahi poʻe i ka ʻeha kaulike. ʻIke wale kekahi i kahi ʻōniʻu a i ʻole kui. Ma hope, loaʻa paha i kahi kūpikipiki a i ʻole ka ʻūlū iki. Hele koke kēia.

Hana ʻia kēia hōʻike ma ke ʻano he ʻāpana o ka hōʻike olakino olakino e kōkua i ke kuhi ʻana i nā maʻi he nui. A i ʻole, hiki i kāu kauka olakino ke ʻōlelo i kēia hōʻike inā loaʻa iā ʻoe nā hōʻailona o:

• ʻO nā maʻi maʻi koko a ʻike ʻia paha
• Kanesa
• Leukemia

Hana ʻia paha kahi pāheʻe koko e nānā i nā hopena o ka chemotherapy a i ʻole e kōkua i ke kuhi ʻana i kahi maʻi, e like me ka malaria.

ʻO nā hunaola ʻulaʻula (RBC) like ka nui a me ke kala a he māmā ke ʻano o ke kikowaena. Manaʻo ʻia ke kahe koko inā he:

• ʻO ke ʻano maʻamau o nā hunaola
• ʻOkoʻa ke keʻokeʻo koko keʻokeʻo maʻamau

Hiki ke loli iki nā pae waiwai maʻamau i waena o nā hale hana ʻokoʻa. Hoʻohana kekahi mau labs i nā ana like ʻole a i ʻole nā ​​hoʻāʻo i nā laʻana like ʻole. E kamaʻilio i kāu mea hāʻawi e pili ana i ke ʻano o kāu mau hopena hōʻike.

ʻO nā hopena maʻamau ka manaʻo o ka nui, ke ʻano, ke kala, a i ʻole ka uhi ʻana o nā RBC ʻaʻole maʻamau.

Hiki ke kau ʻia kekahi mau mea kūpono ʻole ma ka pālākiō 4:

• 1+ ke ʻano o ka hopena o nā hunaola
• 2+ ʻo ia ka hopena o ka hapalua o nā hunaola
• 3+ ʻo ia hoʻi ʻekolu mau hapahā o nā hunaola e hoʻopili ʻia
• 4+ ʻo ia hoʻi ka hopena o nā hunaola āpau

ʻO ke kū ʻana o nā hunaola i kapa ʻia he mau puʻupuʻu target ma muli o:

• Ka hemahema o kahi enzyme i kapa ʻia ʻo lecithin cholesterol acyl transferase
• Hemoglobin maʻamau, ka protein i nā RBC e hāpai i ka oxygen (hemoglobinopathies)
• Ka hemahema hao
• Maʻi maʻi ate
• Wehe ʻeleʻele

Hiki ke loaʻa nā pūnaewele puni honua i:

• ʻO ka helu haʻahaʻa o RBC ma muli o ke kino e luku ana iā lākou (immune hemolytic anemia)
• ʻO ka helu haʻahaʻa o nā RBC ma muli o kekahi RBC i hoʻohālikelike ʻia e like me nā spheres (herherary spherositosis)
• Hoʻonui i ka haki o nā RBC

ʻO ke kū ʻana o RBC me kahi ʻano oval he hōʻailona paha ia o ka elliptocytosis hereditary a i ʻole ovalositosisosis hoʻoilina. ʻO kēia nā kūlana i ʻano kino ʻole ai nā RBC.

Hiki ke loaʻa nā pūnaewele ʻāpana i:

• Pāpā puʻuwai puʻuwai
• ʻO ka maʻi kahi e mālama ai nā protein i ka hoʻopili ʻia ʻana o ke kōkō i lilo i overactive (hoʻolaha i ka coagulation intravascular)
• ʻO ka maʻi i loko o ka ʻōnaehana digestive e hana ana i nā mea ʻona e luku i nā RBC, e hōʻeha ana i ka hakuʻala (hemolytic uremic syndrome)
• ʻO ka maʻi koko e hana i nā kīʻaha koko e hana i nā kīʻaha koko liʻiliʻi a puni ke kino a alakaʻi i kahi helu platelet haʻahaʻa (thrombotic thrombositopenic purpura)

Ke kū nei o kahi ʻano RBC makua ʻole i kapa ʻia ʻo normoblasts ma muli o:

• Ua pālahalaha ʻia ka maʻi ʻaʻai i ka momona o ka iwi
• Kāhea ʻia ka maʻi koko erythroblastosis fetalis e hoʻopili i ka pēpē a i ʻole keiki hānau hou
• Tuberculosis i palahalaha aʻe mai nā akemā a i nā ʻāpana ʻē aʻe o ke kino ma o ke koko (miliary tuberculosis)
• ʻO ka maʻi o ka momona o ka iwi kahi e pani ʻia ka momona e ka fibrous scar tissue (myelofibrosis)
• Ka hemo ʻana o ka pelepela
• Ka haki nui ʻana o nā RBC (hemolysis)
• ʻO ka maʻi kahi e nui ai ka haki o hemoglobin (thalassemia)

Ke hōʻike nei ke alo o nā hunaola i kapa ʻia nā burr:

• Abnormally kiʻekiʻe kiʻekiʻe o ka naikokene neoneo huahana i loko o ke koko (uremia)

ʻO ke kū ʻana o nā hunaola i kapa ʻia he spur cells e hōʻike paha:

• Ka hiki ʻole ke apo piha i nā momona papaʻai ma o nā ʻōpū (abetalipoproteinemia)
• Maʻi maʻi ʻeha nui

Ke hōʻike nei ke alo o nā hunaola i hoʻohālikelike ʻia me ka waimaka:

• Myelofibrosis
• Ka nui o ka hao hao
• Thalassemia nui
• Ka maʻi ʻaʻai i ka momona o ka iwi
• Anemia ma muli o ka iwi iwi ʻaʻole e hana ana i nā kahe koko maʻamau ma muli o nā toxins a i ʻole nā ​​hunaola tumele (myelophthisic process)

Ke hōʻike nei ke alo o Howell-Jolly kino (kahi ʻano granule):

• ʻAʻole hiki i ka iwi o ka iwi ke hoʻohua i nā hunaola olakino maikaʻi (myelodysplasia)
• Ua wehe ʻia ʻo Spleen
• Anemia maʻi maʻi maʻi

Ke hōʻike nei ke alo o nā kino Heinz (nā ʻāpana o ka hemoglobin i hoʻololi ʻia):

• ʻO thalassemia Alpha
• Anemia hemolytic Congenital
• Nā maʻi i haki ai nā RBC ke hōʻike ʻia ke kino i kekahi mau lāʻau a i ʻole koʻikoʻi ʻia ma muli o ka maʻi (G6PD deficit)
• Kūleʻa ʻole o hemoglobin

Ke hōʻike nei ke alo o nā RBC makua ʻole iki:

• ʻO Anemia me ka hoʻihoʻi ʻana o ka iwi iwi
• Hemolytic anemia
• Hemorrhage

Ke hōʻike nei ke alo o ka stippling basophilic (kahi hiʻohiʻona i ʻike ʻia:

• Lāʻau make kēpau
• Ka maʻi o ka iwi iwi kahi e kuapo ʻia ka momona e ka fibrous scar tissue (myelofibrosis)

Ke hōʻike nei ke alo o nā maʻi sickle i ka anemia maʻi maʻi.

Aia kahi pilikia iki i ka lawe ʻia ʻana o kou koko. ʻOkoʻa nā aʻa a me nā aʻa i ka nui mai kekahi mea hoʻomanawanui a i kekahi ʻē aʻe a mai kekahi ʻaoʻao o ke kino i kekahi. ʻOi aku ka paʻakikī o ka loaʻa ʻana o kahi laʻana koko mai kekahi poʻe ma mua o nā poʻe ʻē aʻe.

ʻO nā pilikia ʻē aʻe e pili ana i ke kau ʻana o ke koko he liʻiliʻi, akā hiki ke hoʻopili ʻia:

• Kahe nui ke koko
• Pāleʻale a ʻoluʻolu paha
• Nā punctures he nui e ʻimi i nā uaua
• Hematoma (kūkulu koko ma lalo o ka ʻili)
• Maʻiʻaʻai (i iki kamepiula i kēlā me kēia manawa ka ʻili i haki)

Poni pāheʻe; Helu piha o ke koko - peripheral; CBC - peripheral

• ʻUla koko ʻulaʻula, ʻili maʻiʻo
• Nā koko ʻulaʻula, ʻano kulu waimaka
• Nā koko ʻulaʻula - maʻamau
• Nā koko ʻulaʻula - elliptocytosis
• Nā koko ʻulaʻula - spherocytosis
• ʻO ka leukemia lymphocytic huikau - photomicrograph
• Nā hunaola ʻulaʻula - nā ʻāpana sickle he nui
• Malaria, ʻike microscopic o nā parasites cellular
• Malaria, photomicrograph o nā parasites cellular
• ʻUla koko ʻulaʻula
• Nā hunaola ʻulaʻula - maʻi pahi a me Pappenheimer
• Nā hunaola ʻulaʻula, nā hunaola target
• Nā mea i hana ʻia o ke koko

ʻO Bain BJ. Hoʻopili ke koko ākea. I: Goldman L, Schafer AI, eds. ʻO ka lāʻau lapaʻau Goldman-Cecil. 26th ed. Piladelapia, PA: Elsevier; 2020: chap 148.

ʻO Kliegman RM, St. Geme JW, Blum NJ, Shah SS, Tasker RC, Wilson KM. Nā maʻi koko. I: Kliegman RM, St. Geme JW, Blum NJ, Shah SS, Tasker RC, Wilson KM, eds. ʻO Puka Textbook of Pediatrics ʻo Nelson. 21st ed. Piladelapia, PA: Elsevier; 2020: chap 124.

ʻO Merguerian MD, Gallagher PG. ʻO elliptocytosis hoʻoilina, pyropoikilocytosis hoʻoilina, a me nā maʻi e pili pū ana. I: Kliegman RM, St. Geme JW, Blum NJ, Shah SS, Tasker RC, Wilson KM, eds. ʻO Puka Textbook of Pediatrics ʻo Nelson. 21st ed. Piladelapia, PA: Elsevier; 2020: chap 486.

Natelson EA, Chughtai-Harvey I, Rabi S. Hematology. I: Rakel RE, Rakel DP, eds. Puke aʻo o ka lāʻau lapaʻau ʻohana. 9th ed. Piladelapia, PA: Elsevier; 2016: chap 39.

ʻO Warner EA, Herold AH. Ka wehewehe ʻana i nā hoʻokolohua hoʻokolohua. I: Rakel RE, Rakel DP, eds. Puke aʻo o ka lāʻau lapaʻau ʻohana. 9th ed. Piladelapia, PA: Elsevier; 2016: chap 14.