Kuthiridwa magazi kwa agalu

 Hemotransfusion ndi kuikidwa magazi kwa nyama zodwala ndi magazi athunthu, kapena zigawo zake, kapena mapuloteni a plasma. Iyi ndi ndondomeko yovuta kwambiri.Mu 80% ya milandu, kuikidwa magazi kwa agalu kumachitika chifukwa cha kuchepa kwa magazi m'thupi, ndipo mu 20% - ndi hemorrhagic shock. Kuthiridwa mwazi nthaŵi zina kumapulumutsa moyo wa galu ndipo kumathandiza kwambiri kuthetsa vuto lalikulu.

Cholinga chothira magazi agalu

1. Kulowa m'malo. Ma erythrocyte omwe adalandira kuchokera kwa wopereka amakhalabe m'magazi a wolandira kwa miyezi 1-4, zomwe zimawonjezera kuchuluka kwa okosijeni m'matumbo.
2. Kukondoweza - zimakhudza machitidwe osiyanasiyana ndi ziwalo za galu.
3. Kusintha kwa hemodynamics. Kupititsa patsogolo ntchito ya dongosolo la mtima, kuonjezera miniti ya mtima, ndi zina zotero.
4. hemostatic target. Homeostasis imalimbikitsidwa, hyperoagulation yapakati imawonedwa.

Zizindikiro za kuikidwa magazi agalu

1. Kudziwika pachimake magazi, amene anasonyeza ndi wotumbululuka mucous zimagwira ntchito zosiyanasiyana, ofooka ndi pafupipafupi zimachitika, ozizira paws.
2. Kutayika kwa magazi kosatha komanso kusakhazikika kwa hemodynamics, zomwe zikuwonetsa kusowa kwa okosijeni ku minofu yochulukirapo.
3. Non-kuchira magazi m'thupi osiyanasiyana etiologies.
4. Cholowa kapena anapeza coagulopathy, thrombocytopenia, leukopenia, hypoproteinemia.

Kuthiridwa magazi kwa agalu

Njira yosavuta yopezera zinthu kuchokera kumagazi atsopano. Choncho, chimagwiritsidwa ntchito Chowona Zanyama mankhwala. Erythrocyte zamzitini, zosungidwa zozizira (kutentha 3 - 6⁰C) ndikugwiritsidwa ntchito kwa masiku 30 kapena mpaka erythrocytes atasintha. Erythromass ndiyofunikira kubwezeretsa nkhokwe ya erythrocyte (ya kuchepa kwa magazi) kapena pachiwopsezo chodzaza ndi madzi owonjezera. Amagwiritsidwanso ntchito pakutaya magazi kwambiri (kuphatikiza ndi ma crystalloids). Plasma ndiyofunikira kuti mubwezeretse zomwe zimapangitsa kuti magazi aziundana, kuphatikiza. zigawo zosakhazikika. Zinthuzo zimasungidwa pa -40⁰C mkati mwa chaka chimodzi. Asanayambe kuikidwa magazi, amatenthedwa mpaka +1 - 30⁰C, ndiyeno jekeseni m'thupi la galu mwamsanga.

Njira zoyendetsera

Monga lamulo, magazi ndi zigawo zake zimayendetsedwa kudzera m'mitsempha. Ngati n'kosatheka kubaya magazi mumtsempha (abscesses, edema kwambiri), kulowetsedwa kwa intraosseous kumagwiritsidwa ntchito.

Kuopsa ndi Zovuta za Kuthira Magazi mwa Agalu

Pachimake mavuto amagwirizana ndi kuphwanya asidi-m'munsi zikuchokera magazi, zolakwika njira kuikidwa magazi, ndi hemodynamic kusokonezeka. Zovuta zochedwetsa zitha kulumikizidwa ndi kuikidwa magazi otenthedwa kwambiri, otaya magazi kapena omwe ali ndi kachilombo: post-transfusion (hemolytic) shock, citrate (anaphylactic) shock, matenda opatsirana. Zosagwirizana ndi immunological (mawonekedwe owopsa) zimawonekera ngati kutentha thupi. Chifukwa chake ndi zomwe zimachitika pakati pa antigen ndi antibody yokhudzana ndi mapulateleti, ma granulocytes kapena ma lymphocyte, kapena kuipitsidwa ndi bakiteriya m'magazi. Nthawi zina thupi lawo siligwirizana (urticaria ndi kuyabwa ndi zidzolo). Kuchulukirachulukira kwa kayendedwe ka magazi kumawonetsedwa ndi kusanza, tachycardia, irritability, chifuwa, kupuma movutikira kapena cyanosis. Zowopsa zina:

• edema ya pulmonary
• matenda opatsirana
• malungo
• pambuyo kuikidwa magazi kuchulukana kwa kuzungulira kwa magazi
• hypervolemia
• pachimake pambuyo kuikidwa magazi zochita
• syndrome ya kulephera kwa ziwalo zingapo, etc.

 Mapapo, chiwindi, endocrine glands ndi machitidwe ena ndi ziwalo zimatha kukhudzidwa. Kuchulukirachulukira kungayambitse kuchepa kwakukulu komanso kumangidwa kwa mtima. Kuika magazi kungayambitse mphamvu ya immunomodulatory ndikuwonjezera chiopsezo cha matenda a nosocomial, kuvulala kwakukulu kwa mapapu, matenda a autoimmune. Vuto lalikulu kwambiri ndi anaphylactic shock. Ngati zizindikiro zing'onozing'ono zikuwonekera, kuikidwa magazi kuyenera kuimitsidwa mwamsanga.

Kuika magazi kwa agalu ngati njira yothandizira

Njira imeneyi yakhala yofunika kwambiri m’zaka zaposachedwapa. Ubwino wake watsimikiziridwa mobwerezabwereza pochiza matenda angapo a hematological. Chifukwa cha kuphweka kwa magulu a magazi a canine komanso kuchepa kwa ma isoantibodies omwe amapezeka mwachilengedwe, madokotala amatha kunyalanyaza kusagwirizana kwa mitundu ya magazi pakati pa wolandira ndi wopereka. galu popanda kuwonongeka kwa thanzi (mpaka 10 ml / kg). Kuyesedwa kotsatira kwa magazi kumachitika kale kuposa masiku 45-60.

Yemwe angakhale wopereka

Kamodzi galu akhoza kuikidwa magazi a gulu lililonse. Koma ngati kuikidwa magazi pambuyo pake kukufunika, mtundu wa magaziwo uyenera kufanana. Agalu omwe alibe Rh amatha kulandira magazi opanda Rh okha. Mwazi uliwonse ukhoza kulandiridwa ndi agalu omwe ali ndi Rh-positive. Nthaŵi zina kuikidwa magazi mwamsanga kumafunika. Pachifukwa ichi, wopereka "mwachisawawa" amagwiritsidwa ntchito (galu wathanzi yemwe adapita kuchipatala kuti alandire katemera, kudula misomali, ndi zina zotero) kapena chiweto cha mmodzi wa madokotala. Nyama iyenera kukhala kuyambira zaka 1,5 mpaka 8, iyenera kukhala yathanzi kwambiri. Kulemera kwa thupi la galu wopereka (minofu) kuyenera kupitirira 25 kg. Magazi abwino ndi DEA 1.1. zoipa. Ngati woperekayo ndi wamkazi, ayenera kukhala wopanda pake. Woperekayo sayenera kukhala atachoka m'deralo.

Kuwunika momwe galu alili panthawi yoikidwa magazi

Mphindi 15-30 zilizonse panthawi ya kuikidwa magazi ndi 1, 12, 24 maola pambuyo pa ndondomekoyi, magawo awa amawunikidwa:

1. Khalidwe.
2. Ubwino ndi mphamvu ya kugunda.
3. Kutentha kwa rectum.
4. Chikhalidwe ndi mphamvu ya kupuma.
5. Mtundu wa mkodzo ndi plasma.
6. Mtundu wa mucosal, nthawi ya capillary refill.
7. Nthawi ya prothrombin ndi hematocrit imayang'aniridwa isanachitike, itangomaliza, komanso maola 12 ndi 24 mutayikidwa.

Magulu a magazi a agalu

Amakhulupirira kuti agalu ali ndi mitundu 7 ya magazi. Izi sizowona kwathunthu. Mndandanda wa A - G ndi dongosolo la magulu a magazi, kapena m'malo mwake, 1 yokha mwa zosankha za "kumasulidwa" kwa 1961. Kuyambira pamenepo, zoyesayesa zambiri zapangidwa kuti ziwongolere deta, ndipo mu 1976 adapanga dzina la DEA, lomwe tsopano likuvomerezedwa ku United States. Malinga ndi mayinawa, machitidwe amagazi amatha kusankhidwa kukhala DEA 1.1, DEA 1.2, DEA 3, DEA 4, DEA 5, DEA 7 ndi DEA 8. Dongosolo la DEA 1 ndilofunika kwambiri pazachipatala. Dongosololi lili ndi 3 gene-protein pairs ndi 4 zotheka phenotypes: DEA 1.1., 1.2, 1.3 ndi 0. Galu mmodzi ali ndi phenotype imodzi yokha. Koma agalu alibe ma antibodies ku ma antigen a gulu lina, kotero galu yemwe sanaikidwe magazi kale akhoza kuikidwa magazi popanda kugwirizana kwa DEA 1.1, ndipo kuthiridwako kudzakhala kogwira mtima. Koma ngati kuikidwanso magazi kachiwiri kuli kofunika, mavuto angakhale otheka. Pamene DEA 1 imayikidwa mu wolandira woipa (phenotype 0) wa magazi a wopereka wabwino DEA 1 (phenotype iliyonse kupatula 0), thupi la wolandira pambuyo pa masiku 7 mpaka 10 limatha kupanga ma antibodies ku antigen DEA 1, yomwe imawononga. maselo ofiira aliwonse, okhala ndi antigen iyi. M'tsogolomu, wolandira woteroyo adzafunika kuikidwa magazi okha a DEA 1-negative, mwinamwake, m'malo mwa masabata a 3, erythrocytes opereka adzakhala m'thupi la wolandirayo, makamaka, maola ochepa okha, kapena ngakhale mphindi zingapo. kumathetsa chiyambukiro cha kuthiridwa mwazi, ndipo kungawonjezere mkhalidwewo. Pankhaniyi, wopereka wabwino wa DEA 1 akhoza kuikidwa magazi a DEA 1-negative, komabe, ndi chikhalidwe chakuti woperekayo sanalandirepo. Antigen ya DEA 1 imayimiridwa ndi mitundu ingapo: DEA 1.1, DEA 1.2., DEA 1.3. magazi DEA 1. ma antibodies opangidwa ndi iwo nthawi yomweyo amawononga maselo ofiira amagazi ndi DEA 1.1. ndi kuyambitsa pachimake hemolytic anachita, wodzala ndi mavuto aakulu. Pankhaniyi, maselo ofiira a magazi ndi DEA 1.2 ndi 1.3 agglutinate ma antibodies awa, koma osawawononga (ngakhale izi ndizoyipa kwa wodwalayo). Ngati tilankhula za dongosolo la DEA 3, galu akhoza kukhala DEA 3 zabwino kapena zoipa. Kuthiridwa magazi abwino a DEA 3 mu nyama yokhala ndi ma antibodies oyenera (opezedwa kapena aumwini) amawononga maselo ofiira a magazi a woperekayo ndipo angayambitse kuikidwa magazi m'masiku asanu otsatira. Dongosolo la DEA 4 lilinso ndi + ndi - phenotypes. Popanda katemera, agalu omwe alibe DEA 4 alibe ma antibodies ku DEA 4. Kuthiridwa magazi mobwerezabwereza kwa wolandira DEA 4-negative, ngakhale pamaso pa ma antibodies ku DEA 4, sikumayambitsa hemolytic reaction. Komabe, mlandu wa hemolysis umadziwika mwa galu yemwe adalandira magazi osagwirizana kangapo motsatizana. Dongosolo la DEA 5 lilinso labwino komanso loyipa. 10% ya zinyama za DEA 5-negative zili ndi ma antibodies ku DEA 5. Kuikidwa magazi kwa wodwala wozindikira kumayambitsa hemolytic reaction ndi kufa kwa erythrocyte ya woperekayo mkati mwa masiku atatu. Dongosolo la DEA 6 lili ndi ma phenotypes awiri, + ndi -. Nthawi zambiri, palibe ma antibodies ku antigen iyi. Kuthiridwa magazi kwa munthu wozindikira kumapangitsa kuti munthu azitha kuikidwa magazi pang'onopang'ono komanso kuchepa kwapang'onopang'ono kwa moyo wa opereka maselo ofiira a magazi. Dongosolo la DEA 7 lili ndi ma phenotypes atatu: negative, 3, ndi Tr. Ma antibodies kupita ku Tr ndi 0 amapezeka mu 25% ya zinyama zopanda DEA, koma alibe zotsatira zodziwika bwino za hemolytic. Koma ndi chidziwitso chotsatira, ena amapangidwa omwe amatha kuwola magazi opereka pasanathe masiku atatu. Dongosolo la DEA 8 silinaphunzire bwino. Kuphatikiza pa zomwe tafotokozazi, pali machitidwe ena omwe sanaphatikizidwe mu DEA, popeza adapezeka posachedwa, ndi machitidwe angapo enieni a mitundu ina (mwachitsanzo, agalu akum'mawa - Shibu-in, etc.) Pali zida zodziwira matenda. pofuna kudziwa kusakhalapo kapena kupezeka kwa ma antigen a DEA 1.1., 1.2, 3, 4, 5 ndi 7, koma ndi okwera mtengo kwambiri. Monga lamulo, kwenikweni, makamaka m'matauni ang'onoang'ono, palibe opereka okonzeka, ndipo kugwirizana kumatsimikiziridwa "pa galasi".