Uru:
- Ikike ịghọta na ọtụtụ n'ime laabu njehie na-eme na tupu nyocha usoro na-eji artificial ọgụgụ isi na sample adaba njikwa.
- Ikike ịkọwa ihe nrịbama HIL (hemolysis, icterus, lipemia) yana ka nnyonye anya na-emetụta ụdị ule.
- Ikike ị were ntụnye njụ/anabata nnabata nke ọgụgụ isi mmadụ dị ka akwụkwọ wee jiri iwu ụlọ nyocha nyochaa mkpebi ikpeazụ.
Mgbe a na-ekwu maka njehie ụlọ nyocha, ọtụtụ ndị mmadụ na-ata ngwa na nha. Otú ọ dị, e nwere eziokwu a na-emeghachi ugboro ugboro ruo ọtụtụ iri afọ: ọnụ ọgụgụ ka ukwuu nke njehie ụlọ nyocha adịghị eme na ngwaọrụ (usoro nyocha), ma tupu ihe nlele ahụ abanye n'ime ngwaọrụ ahụ, ya bụ, n'oge nyocha nke mbụ. Ọbara ewepụtara n'aka onye ọrịa na-ezighi ezi, nlele etinyere na tube na-ezighi ezi, oke ezughị oke, ogologo oge na-echere, sel gbajiri site na ịma jijiji - ọ nweghị nke ọ bụla n'ime ihe ndị a bụ ihe kpatara ngwaọrụ ahụ, mana ha niile na-agbagha nsonaazụ ya. Akụkụ kachasị njọ bụ nke a: a na-atụle ihe nlele nke nwere njehie tupu nyocha nke ọma na ngwá ọrụ ma na-emepụta nọmba "dị ọcha"; Ọnụ ọgụgụ ahụ ezighi ezi, mana o doro anya na ọ dị njọ. Ya mere, usoro nyocha nke mbụ bụ usoro nchebe mbụ na nke kachasị mkpa maka nchekwa ndị ọrịa.
Gịnị kpatara njehie tupu nyocha na-adịkarị na nkeji a; nnyonye anya bụ isi nke na-emebi àgwà nlele-karịsịa HIL indices (hemolysis, icterus, lipemia) - yana otu ha si emetụta ụdị ule; yana otu esi eji AI n'enweghị ihe ọ bụla na njikwa nlebara anya. Ụkpụrụ bụ isi: AI na-enyocha nlebara anya nlebara anya ma mepụta akwụkwọ ajụ / nnabata; Onye ọkachamara na-eme mkpebi ikpeazụ, dịka iwu ụlọ nyocha si dị.
Kedu ihe kpatara eji etinye mperi n'usoro nyocha tupu oge nyocha
Oge nyocha tupu nyocha bụ akụkụ ebe ọtụtụ aka mmadụ na ọtụtụ mgbanwe na-abata. Isi mmalite nke mperi:
- Nchọpụta onye ọrịa na ihe nlele: Ịkpọ onye ọrịa na-ezighi ezi bụ mmejọ kacha dị ize ndụ; a na-ekwu na ọ bụ onye nrịanrịa si na ya pụta.
- tube na-ezighi ezi: tube ọ bụla nwere ihe mgbakwunye dị iche iche (anticoagulant ma ọ bụ gel) na ya. EDTA tube na-ejikọta potassium ma na-ebelata calcium; Ịhọrọ tube na-ezighị ezi na-agbagọ nsonaazụ.
- Oke ezughị oke/oke oke: Ọ bụrụ na emebie oke ọbara anticoagulant, ule mgbochi (coagulation) agaghị ezighi ezi.
- Hemolysis: Usoro ịgbasa ọbara, na-eji ezigbo agịga, agụụ siri ike, ma ọ bụ ịma jijiji, na-akụda mkpụrụ ndụ ọbara uhie.
- Ichere na nchekwa: N'ihe nlele na-echere ogologo oge, glucose na-ebelata na potassium na-abawanye; Bilirubin hapụrụ na ìhè na-eweda ya ala.
- Mmetọ ahịrị IV: Ọbara ewepụtara site na ogwe aka na-anata mmiri na-agwakọta akụkụ nke mmiri ahụ.
Ihe a na-ahụkarị na njehie ndị a bụ na ngwaọrụ ahụ nwere ike ọ gaghị ahụ ha. Ngwa dị ka nlele delta na ndenye HIL na-enweta ụfọdụ mperi tupu nyocha, mana ọtụtụ na-ezere site na usoro nnabata nke ọma.
HIL indices: hemolysis, icterus, lipemia
Ndị na-enyocha biochemistry ọgbara ọhụrụ na-atụ ụcha na ntubidi nke serum ma na-akọpụta ndabichi atọ n'ọnụ ọgụgụ: Indices HIL.
- Hemolysis (H): ndakpọ nke mkpụrụ ndụ ọbara uhie na ngwakọta nke ọdịnaya ha na serum; ọbara ọbara na-egosi pink-acha ọbara ọbara. Ọ ụgha na-abawanye bekee (potassium, LDH, AST) na-lekwasị na cell.
- Icterus (I): Ọdịdị ọbara ọbara na-acha odo odo-oroma n'ihi nnukwu bilirubin; elele eleghi anya na ụfọdụ ule colorometric.
- Lipemia (L): Ọ bụ urukpuru/mmiri ara ehi n'ihi oke abụba (triglycerides) na serum; Ọ na-egbochi ọtụtụ ule site na imebi nnyefe ọkụ ma nwee ike igosi ọkwa dị ala nke ụfọdụ electrolytes.
Tebụlụ na-esonụ na-achịkọta mmetụta nke ndabichi HIL na ụfọdụ ule (mmetụta dị iche iche site na usoro, rụtụ aka na ntinye ngwugwu ngwaọrụ gị):
nnyonye anya
Nwere ike ibuli adịgboroja
Nwere ike idebe adịgboroja
akara ngosi
Hemolysis (H)
Potassium, LDH, AST, ígwè
haptoglobin (n'ule ụfọdụ)
Pink-acha ọbara ọbara ọbara
Icterus (m)
(dabere na usoro)
Ụfọdụ ule colorometric
odo-oroma ọbara
Lipemia (L)
(n'ihi blur)
Sodium (n'ụdị ụfọdụ)
Mmiri ara ehi, urukpuru serum
Ihe dị mkpa: Ntinye aka HIL na-emetụta ọ bụghị naanị ọdịdị nke ihe nlele kamakwa izi ezi nke nsonaazụ. Ọgụgụ potassium nke 6.5 mmol/L n'ime nlele hemolyzed nwere ike ịbụ elu dị elu ọ bụghị ezigbo hyperkalemia (lee nkeji 4).
Akpachara anya: Iwepụta ihe nlele nwere nnukwu nnyonye anya index site n'ịsị "nsonaazụ apụtala, ka anyị ziga ya" pụtara ịkọ akụkọ ụgha dị ka ọ dị mma. A na-akwado ndị nyocha nnyonye anya site na iji ihe nlele ọhụrụ ma ọ bụ jiri usoro kwesịrị ekwesị kọsaa ya.
Kedu ka AI si enyere aka na nnabata nlele
AI bara uru dị ka nyocha na mnemonic na njikwa tupu nyocha. Ọ nwere ike nyochaa indices HIL na ule nyocha wee mepụta ịdọ aka ná ntị dịka "ọkwa hemolysis na nlele a na-emetụta nsonaazụ potassium, nkwenye chọrọ"; nwere ike ịdepụta enweghị nkwekọrịta nke tube ozugbo; nwere ike nyefee ihe ndepụta dabere na iwu ụlọ nyocha maka njụ/anabata mkpebi; Enwere ike ịkwadebe nchịkọta nzaghachi nye ndị ọrụ iji melite ogo nlele (usoro nchịkọta ọbara, oge njikwa). Mana njụ na nnabata mkpebi bụ ọkachamara mere ka ụlọ nyocha gị kwadoro nnabata nnabata-ịjụ; Atụmatụ AI bụ ihe atụ.
Ngwa ngwa adịghị ike / Ike siri ike
Ngwa ngwa adịghị ike:
Ihe nlele a ọ dị mma, anyị kwesịrị iziga nsonaazụ ya? Echere m na enwere hemolysis.
Ihe a na-ekwu anaghị akọwapụta ọnụọgụ hemolysis index, anaghị agụnye ule ndị e mere, na anaghị agụnye njirisi laabu. AI na-enye azịza n'ozuzu; Ọ nweghị ike ịkọwapụta nke nyocha na-emetụta yana ihe a ga-eme.
Mgbasa ozi siri ike:
Ọrụ gị: onye enyemaka ọkachamara n'ụlọ nyocha na-akwadebe ntule nlebara anya nke ọma. Mkpebi bụ nke m. Ihe atụ: serum. HIL indices: hemolysis 3+ (elu), icterus nkịtị, lipemia nkịtị. A mụrụ ule: potassium, sodium, AST, ALT, creatinine, LDH. Ọrụ: (1) akara ule nke ọkwa hemolysis a na-emetụta, (2) na-atụ aro "nlekọta ọhụrụ / akụkọ na ntinye nnyonye anya / ọ dịghị emetụta" maka ule ọ bụla emetụtara, (3) kọwaa ule na-adịghị emetụta iche. Deekwa ọnụ ụzọ m ga-elele iji mechaa njirisi ịjụ ụlọ nyocha m. Kwadebe akwụkwọ ka m wee mee mkpebi ikpeazụ.
Ngwa ngwa siri ike na-enye ndeksi HIL ọnụ ọgụgụ, gụnyere ndepụta ule, na-arịọ maka ndụmọdụ nnwale site na nnwale, wee hapụ mkpebi ahụ n'aka ọkachamara.
Obere ikpe atọ
Ikpe 1 - Nhazi ziri ezi. Otu ihe atụ gosiri hemolysis 3+ na ule ndị a mụrụ gụnyere potassium, LDH, AST. AI na-emepụta akwụkwọ "nnwale atọ ndị a na-emetụta hemolysis nke ukwuu, a na-atụ aro nlele ọhụrụ; creatinine na sodium na-emetụta ọkwa a." Ọkachamara ahụ na-enyocha njirisi ụlọ nyocha, rịọ maka nlele ọhụrụ maka potassium/LDH/AST, wee kọọ ndị ọzọ na ndetu nnyonye anya. A na-egbochiri akụkọ ụgha banyere hyperkalemia.
Ikpe 2 - ijide tube ezighi ezi. Olu ọbara dị na tube na-abata maka nyocha coagulation dị n'okpuru akara akara. Na arịrịọ-tube-olu njikwa, AI dọrọ aka ná ntị "citrate tube ezughị oke, anticoagulant-blood ratio na-emebi, INR / aPTT bụ ihe a na-apụghị ịdabere na ya". Ọkachamara ahụ jụrụ ihe nlele ahụ wee rịọ maka nlele ọhụrụ. A na-egbochi nsonaazụ mkpụkọ na-ezighi ezi yana ọgwụ ọgwụ na-ezighi ezi. Ihe nkuzi: oke olu dị oke mkpa na coagulation.
Ikpe 3 - Ọnyà lipemia. Ihe nlele sitere n'aka onye ọrịa na-eri nri bụ nke nwere oke lipemic. YZ na-echetara na lipemia nwere ike ime ka sodium dị ala na-enweghị atụ na ụzọ ụfọdụ electrolyte. Ọkachamara ahụ na-enyocha ma usoro ụlọ nyocha na-emetụta nsonaazụ ya ma, ọ bụrụ na ọ dị mkpa, na-akwado ya site na iji ihe nlele ibu ọnụ ma ọ bụ usoro kwesịrị ekwesị. Ihe nkuzi: nnyonye anya dabere na usoro; Ihe ncheta ahụ dị mkpa, mana a na-eme mkpebi ahụ n'ụzọ nke gị.
Ndebiri ozugbo enwere ike iṅomi
Nlele Nlebaanya Nlebaanya TEMPLATE Ụdị ihe atụ: [serum/plasma/ọbara dum]. HIL indices: hemolysis [x],icterus [x], lipemia [x]. Nnwale na-agba ọsọ: [ndepụta]. Maka ule ọ bụla, kaa akara ma nnyonye anya ọ metụtara ma tụọ “nlele / akụkọ ọhụrụ nwere ndenye nnyonye anya / emetụtaghị ya”. Mkpebi bụ nke m; Deekwa ụzọ m ga-esi dokwuo anya recriteria m.
AKWỤKWỌ Nlele NKWUKWU NKWUKWU ỊKWỤKWỤKWỤKWỤKWỤKWỤKWỤKWỤKWỤKWỤKWỤKWỤKWỤKWỤKWỤKWỤKWỤKWỤKWỤKWỤKWỤKWỤKWỤKWỤKWỤKWỤKWỤKWỤKWỤKWỤKWỤKWỤKWỤKWỤKWỤKWASỊEnwere iwu nnwale ndị a yana ụdị/ mpịakọta tube kwekọrọ. Lelee ma ọ bụrụ na ejiri tube ziri ezi na oke zuru oke maka usoro ọ bụla; Ọ bụrụ na enweghị ndakọrịta ọ bụla, lelee "[ajụjụ ajụjụ - ihe kpatara]". Lelee oke olu karịsịa maka coagulation. Data: [ndepụta].
Nhazi nhazi njehie tupu nyocha tupu nyocha ekewapụta ihe kpatara njụ maka ihe nlele ndị a jụrụ ( njirimara, tube na-ezighi ezi, hemolysis, oke ezughị oke, mkpụkọ, njikwa/jide). Gosi ụdị kachasị na nkwanye maka mmelite. Nke a bụ nchịkọta nkwalite ịdịmma; O nweghị ozi nkeonwe/onye ọrịa. Data: [ndepụta].
AKWỤKWỌ Nzaghachi Ọbara Ọbara Ọbara dị elu n'otu nkeji. Depụta akwụkwọ nkuzi nke na-akọwapụta ihe nwere ike ịkpata ịchịkọta na njikwa ọbara ( dayameta agịga, agụụ, ịma jijiji, oge njikwa, okpomọkụ) na aro ndozi. Jiri asụsụ na-ewuli elu, ọ bụghị ebubo ebubo.
Mmejọ ndị nkịtị
- Na-eche na nnyonye anya bụ naanị agba. HIL na-emebi izi ezi nke nsonaazụ ya; Agaghị akọpụta ruo mgbe achọpụtara nyocha emetụtara.
- Na-emejọ potassium dị elu na nlele hemolyzed dị ka ezigbo. Spurious hyperkalemia bụ ọnyà tupu nyocha nke ọma.
- Na-amapụ oke olu na coagulation. Ọkpụkpụ citrate ezughi oke na-eme INR/aPTT enweghị ntụkwasị obi.
- Na-agbaghaghị ihe nlele ewepụtara na ahịrị IV. Mmetọ mmiri mmiri na-agbagọ nsonaazụ.
- Na-emejọ ntụnye ọjụjụ AI maka mkpebi. Enyere ajụ/anabata nke ọma dịka usoro ụlọ nyocha akwadoro siri dị.
NDỤMỌDỤ: Mee ajụjụ abụọ ka ọ bụrụ ihe nlegharị anya na ihe nlele ọ bụla: "Enwekọtara ihe nlele a n'ụzọ ziri ezi, site n'aka onye ọrịa ziri ezi, na tube ziri ezi?" na "Olee ule nnyonye anya (HIL) na-emetụta?" Nlebara anya tupu nyocha gị na-ekpebi izi ezi nke usoro niile na-esote.
Na nchịkọta
Ọtụtụ njehie ụlọ nyocha na-eme n'oge nyocha tupu nyocha, tupu nlele abanye na ngwaọrụ ahụ, a na-atụkwa njehie ndị a nke ọma na ngwaọrụ ahụ, na-emepụta nsonaazụ "dị ọcha ma na-ezighị ezi". njirimara, ụdị tube, olu, hemolysis, njigide, na mmetọ bụ isi mmalite. HIL indices (hemolysis, icterus, lipemia) na-ebuli ma ọ bụ wedata ụfọdụ ule; A naghị akọ ndị nyocha emetụtara na-enweghị nkwenye. Ọgụgụ isi nwere ike nyochaa nlebara anya nlebara anya, nnyonye anya ọkọlọtọ na enweghị nnabata, wee wepụta akwụkwọ jụrụ / nnabata; mana a na-eme mkpebi ikpeazụ nke ọma dịka njirisi akwadoro nke ụlọ nyocha gị. Nlebara anya tupu nyocha bụ usoro nchebe mbụ maka nchekwa ndị ọrịa.
Ọrụ ngwa
Rụpụta ihe atụ (yana ndenye aha HIL na ndepụta nke ule na-agba ọsọ) wee nweta nkọwapụta nnwale site na AI na ndebiri “Sample Suitability Assessment”. Maka ule ọ bụla emetụtara, kwado mkpebi gị dabere na njirisi njụ nke ụlọ nyocha gị. Wee were ndebiri "Nhazi Error Pre-Analytical Error Classification" chịkọta ndepụta nke ihe atụ ndị a jụrụ ajụ iji chọpụta ihe na-ebutekarị yana nkwanye maka mmelite.
ndetu
- [] Anlere m ihe nlele NJ, ụdị tube na ịdị mma olu.
- [] Atụlere m ndepụta HIL na ndabere ule.
- [] Akọghị m ndị nyocha metụtara nnyonye anya na-enweghị nkwenye.
- [] Anlere m oke olu/nticoagulant dị na nlele coagulation.
- [ ] Emere m ọjụjụ/anabata mkpebi dabere na njirisi akwadoro ụlọ nyocha m.
- [] A kwadebere m nchịkọta mmelite maka nsogbu ndị na-emekarị dị ka hemolysis dị elu.