Hauv qee kis hauv lub neej, yuav luag txhua tus tau kuaj ntshav nrog cov kws paub txog kev noj qab haus huv txhawm rau tshuaj xyuas ntxaws. Qhov feem ntau ntawm cov no suav nrog suav cov qe ntshav tiav (suav ntshav), uas ntsuas qhov sib txawv ntawm cov khoom muaj nyob hauv cov ntshav, xws li cov qe liab (cov qe liab lossis erythrocytes), cov qe dawb (cov qe ntshav dawb), cov qe ntshav liab (lossis thrombocytes) thiab hemoglobin. Lwm yam khoom kuj tseem tuaj yeem suav nrog hauv kev sim, xws li cov roj (cholesterol) lossis qib ntshav qabzib. Txhawm rau nkag siab koj cov kev noj qab haus huv tsis zoo thiab tsis vam khom koj tus kws kho mob qhov kev txhais lus, nws yog ib qho tseem ceeb kom kawm paub yuav nyeem koj li kev kuaj ntshav li cas. Nco ntsoov ua tus kws kho mob hu rau kev sib tham ntxaws ntxaws ntawm cov txiaj ntsig thaum tsim nyog.
cov kauj ruam
Txoj Kev 1 ntawm 2: Nkag Siab Txog Cov Ntshav Ntshav
Kauj Ruam 1. Paub tias kev kuaj ntshav tau zoo li cas thiab nthuav tawm
Txhua qhov kev ntsuam xyuas ntshav, suav nrog suav cov ntshav thiab lwm yam kev ntsuas, yuav tsum suav nrog qee yam tseem ceeb xws li: tus neeg mob lub npe thiab cov ntaub ntawv, hnub xeem qhov kev xeem ua tiav thiab luam tawm, cov npe ntawm kev ntsuas ua tiav, kuaj thiab kws kho mob lub luag haujlwm rau qhov kev txiav txim, kuaj pom, tus nqi ib txwm muaj, qhov txawv txav qhov tseem ceeb thiab, tau kawg, ntau cov ntawv luv thiab ntsuas ntsuas. Rau cov kws tshaj lij tsis yog kws saib xyuas mob nkeeg, kev kuaj ntshav tuaj yeem zoo li tsis meej pem thiab hem, tab sis koj tsuas yog xav tau qee lub sijhawm txhawm rau txheeb xyuas cov ntsiab lus tseem ceeb no thiab yuav ua li cas lawv tau teeb tsa hauv kab ntawv taub hau thiab kab ntsug.
- Thaum koj paub cov hom ntawv, koj tuaj yeem luam theej tawm nplooj ntawv rau qhov ua tsis tau tiav (yog tias muaj), uas yuav sau lo lus "siab" lossis "qis" raws li lawv qhov txiaj ntsig.
- Nws tsis yog qhov yuav tsum tau los cim qhov qub ib txwm ntawm ib qho kev ntsuas ntsuas, vim tias lawv ib txwm yuav luam tawm hauv cov txiaj ntsig raws li lub hauv paus.
Kauj Ruam 2. Sib txawv ntawm cov qe ntshav thiab cov txiaj ntsig txawv txav tuaj yeem qhia tau li cas
Raws li tau hais ua ntej, cov hlwb tseem ceeb hauv lub cev yog xim liab, lossis cov qe ntshav liab, thiab dawb, lossis cov qe ntshav dawb. Cov qe ntshav liab muaj hemoglobin, uas nqa cov pa oxygen mus rau txhua qhov nqaij hauv lub cev. Leukocytes, nyeg, yog ib feem ntawm lub cev tiv thaiv kab mob thiab pab rhuav tshem cov kab mob me me xws li kab mob, kab mob thiab cab. Kev suav cov qe liab tsawg tuaj yeem qhia txog ntshav tsis txaus (tsis txaus oxygen nkag mus rau hauv cov ntaub so ntswg), tab sis cov pa ntau dhau (hu ua erythrocytosis) tuaj yeem qhia txog teeb meem pob txha. Cov qe ntshav dawb tsawg tsawg (hu ua leukopenia) kuj tseem tuaj yeem qhia tias muaj teeb meem pob txha lossis ua rau muaj kev phiv los ntawm kev noj tshuaj, tshwj xeeb yog kev kho tshuaj. Ntawm qhov tod tes, cov ntshav ntshav suav siab (hu ua leukocytosis) feem ntau sawv cev rau lub cev tiv thaiv kev kis tus kab mob. Qee cov tshuaj, tshwj xeeb tshaj yog steroids, tuaj yeem ua rau suav cov qe ntshav dawb ntau ntxiv.
- Qhov tseem ceeb ntawm cov qe ntshav liab txawv ntawm txiv neej thiab poj niam. Cov txiv neej zoo li muaj 20% txog 25% ntau dua cov qe ntshav liab, vim lawv feem ntau muaj cov leeg loj thiab loj dua, xav tau oxygen ntau dua.
- Hematocrit (feem pua ntawm cov ntshav ua los ntawm cov qe ntshav liab) thiab txhais tau tias lub cev sib xyaw (qhov nruab nrab ntawm cov qe ntshav liab) sawv cev rau ob txoj hauv kev los ntsuas cov qe ntshav liab - thiab ob qho tib si feem ntau siab dua rau cov txiv neej vim xav tau cov pa oxygen ntau dua.
Kauj Ruam 3. Paub txog kev ua haujlwm ntawm lwm yam hauv paus hauv ntshav
Ob qho ntxiv ntawm cov ntshav tau hais hauv kev kuaj ntshav ib txwm yog platelets thiab hemoglobin. Raws li tau sau tseg ua ntej, hemoglobin yog cov hlau ua cov hlau uas khi rau cov pa oxygen thaum cov ntshav ntws los ntawm lub ntsws, thiab cov platelets yog ib feem ntawm lub cev txhaws lub cev, pab tiv thaiv ntshav ntau dhau thaum raug mob. Qhov tsis muaj hemoglobin (vim qee qhov hlau tsis txaus lossis teeb meem pob txha) ua rau muaj ntshav tsis txaus, thaum cov ntshav platelet tsawg (hu ua thrombocytopenia) tuaj yeem tshwm sim los ntshav ntev, sab nrauv lossis sab hauv, vim raug mob lossis lwm yam teeb meem kev kho mob. Ntawm qhov tod tes, cov ntshav platelet ntau (hu ua thrombocytosis) qhia txog teeb meem pob txha lossis mob hnyav.
- Ob lub qe ntshav liab thiab qib hemoglobin tau txuas nrog, vim tias cov hemoglobin tau thauj mus rau hauv cov qe liab - txawm tias yuav muaj kev hloov pauv ntawm cov qe liab tsis muaj hemoglobin (teeb meem hu ua sickle cell anemia).
- Ntau lub tebchaw tuaj yeem "ntshav" cov ntshav, tuaj yeem tiv thaiv kev khov ntawm cov platelets thiab tiv thaiv kev txhaws. Qee qhov ua kom ntshav qis suav nrog: cawv, ntau yam tshuaj (ibuprofen, tshuaj aspirin, heparin, thiab lwm yam), qej thiab zaub txhwb qaib.
- Kev kuaj ntshav kuj suav nrog qib ntawm eosinophils (Eos), polymorphonuclear leukocytes (PML), txhais tau hais tias corpuscular hemoglobin (HCM), txhais tau tias lub cev corpuscular ntim (VCM) thiab hemoglobin concentration hauv hlwb (CHCM).
Txoj Kev 2 ntawm 2: Nkag Siab Lwm Yam Kev Ntsuas thiab Xeem
Kauj Ruam 1. Paub tias kev ntsuas lipid yog dab tsi
Kev ntsuam xyuas lipid yog cov kev kuaj ntshav ntau ntxiv uas pab txiav txim siab koj txoj kev pheej hmoo ntawm teeb meem plawv xws li atherosclerosis, plawv nres thiab mob hlab ntsha tawg. Cov kws kho mob yuav ntsuas cov txiaj ntsig ntawm kev ntsuas lipid ua ntej txiav txim siab seb puas yuav tsum tau siv tshuaj los txo qis cov qib roj cholesterol. Feem ntau nws suav nrog qhov muaj nuj nqis rau tag nrho cov roj (suav nrog tag nrho cov lipoproteins hauv cov ntshav), cov roj lipoprotein ntau ntom ntom (hom "zoo"), cov lipoprotein cov roj tsawg (cov "tsis zoo"), thiab triglycerides, feem ntau cov rog khaws cia hauv cov rog rog. Qhov tseem ceeb, tag nrho cov qib roj cholesterol yuav tsum qis dua 200 mg/dL ntxiv rau HDL rau LDL piv (ze rau 1: 2) kom txo qis kev pheej hmoo ntawm kab mob plawv.
- HDL tshem tawm cov roj cholesterol ntau dhau los ntawm cov ntshav thiab coj nws mus rau lub siab kom rov ua dua tshiab. Nws yog qhov zoo dua uas cov qib siab dua 50 mg/dL (tshwj xeeb tshaj 60 mg/dL). Tus nqi HDL tsuas yog ib qho uas yuav tsum tau ua kom siab dua hauv hom kev xeem no.
- LDL tso cov roj (cholesterol) ntau dhau hauv cov hlab ntshav ua rau muaj kev cuam tshuam rau kev raug mob thiab o, uas tuaj yeem ua rau mob atherosclerosis (cov hlab ntsha txhaws). Qhov zoo dua, qib yuav tsum qis dua 130 mg/dL (zoo dua hauv qab 100 mg/dL).
Kauj Ruam 2. Paub txog qhov cuam tshuam ntawm kev kuaj ntshav qab zib
Qhov ntsuas ntsuas ntsuas cov piam thaj hauv cov ntshav thiab feem ntau yog ua tom qab yoo mov tau yim teev lossis ntau dua. Feem ntau nws tau xaj yog xav tias muaj ntshav qab zib (hom 1, 2 lossis mob plab). Ntshav qab zib tshwm sim thaum lub txiav tsis tuaj yeem tsim cov tshuaj insulin txaus (uas yog lub luag haujlwm txhawm rau khaws cov piam thaj los ntawm cov ntshav) lossis lub cev lub cev tsis tso cai rau nws tso cov piam thaj ib txwm. Raws li qhov tshwm sim, cov neeg uas muaj tus mob no muaj cov qib qab zib ntau ntau (hyperglycemia), suav tias yog siab thaum lawv hla 125 mg/dL cim.
- Cov tib neeg muaj kev pheej hmoo siab mob ntshav qab zib (feem ntau hu ua "ua ntej ntshav qab zib") feem ntau muaj cov piam thaj ntau ntawm 100 txog 125 mg/dL.
- Lwm lub tsev ntawm cov ntshav qab zib muaj xws li: kev nyuab siab heev, mob raum ntev, hyperthyroidism, thiab mob qog noj ntshav lossis mob qog noj ntshav.
- Cov ntshav qab zib tsis txaus (qis dua 70 mg/dL) sawv cev rau qhov teeb meem hu ua hypoglycemia, qee zaum tshwm sim los ntawm kev siv tshuaj insulin ntau dhau, kev quav dej quav cawv, thiab lub cev tsis ua haujlwm (lub siab, ob lub raum, lub plawv).
Kauj Ruam 3. Kawm paub txog BMP
Basic Metabolic Profile lossis Panel, qee zaum hu ua CHEM-7 lossis BMP, ntsuas ntau qhov sib txawv ntawm cov ntshav, xws li electrolytes (cov ntsiab lus nrog them nqi hluav taws xob, feem ntau yog ntsev ntsev), lwm yam zaub mov, protein, creatinine, enzymes siab, thiab qabzib. Feem ntau nws tau nug kom txiav txim siab tus neeg txoj kev noj qab haus huv, tab sis kuj tseem yuav saib tshwj xeeb ntawm lub raum, mob siab, txiav, cov qib electrolyte (xav tau rau kev ua haujlwm ntawm cov hlab ntsha ib txwm muaj thiab cov leeg sib zog), thiab cov kua qaub-hauv paus. BMP xav tau nrog suav cov ntshav hauv kev npaj rau kev kuaj mob lossis kuaj mob txhua xyoo.
- Sodium yog cov electrolyte uas xav tau los tswj cov qib ntawm lub cev uas tso cai rau kev ua haujlwm ntawm cov leeg thiab cov leeg. Txawm li cas los xij, ntau dhau kuj tuaj yeem ua rau mob ntshav siab (ntshav siab) thiab ua rau muaj kev pheej hmoo mob plawv. Cov qib ib txwm nyob nruab nrab ntawm 136 thiab 144 mEq/L. Lwm cov electrolytes, xws li potassium, tuaj yeem suav nrog hauv ntu no.
- Lub siab enzymes (ALT thiab AST) tau nce hauv cov ntshav los ntawm kev raug mob los yog mob-feem ntau tshwm sim los ntawm kev haus cawv ntau dhau lossis tshuaj (sau tseg, tom khw, lossis tsis raug cai) lossis kev kis mob xws li kab mob siab. Bilirubin, albumin thiab tag nrho cov protein yog qhov tseem ceeb uas tuaj yeem suav nrog hauv ntu no.
- Yog tias koj cov ntshav urea nitrogen (BUN) thiab qib creatinine siab dhau vim ua rau lub siab puas lossis mob, qhov no zoo li yuav qhia tias muaj teeb meem hauv lub raum. BUN yuav tsum nyob nruab nrab ntawm 7 thiab 29 mg/dL thiab creatinine ntawm 0, 8 thiab 1.4 mg/dL.
- Lwm cov ntsiab lus ntawm BMP tuaj yeem suav nrog albumin, chlorine, potassium, calcium, tag nrho cov protein thiab bilirubin. Qib qis lossis qib siab ntawm cov ntsiab lus no tuaj yeem qhia pom tias muaj qee tus kab mob.
Lub tswv yim
- Nco ntsoov tias muaj ntau yam xwm txheej uas tuaj yeem siv cov txiaj ntsig ntawm kev kuaj ntshav (hnub nyoog nce, poj niam txiv neej, qib kev ntxhov siab, qhov siab thiab huab cua ntawm qhov chaw nyob) thiab yog li ntawd nws yog ib qho tseem ceeb kom tsis txhob ua tiav cov lus xaus ntawm koj tus kheej kom txog thaum tham nrog kws kho mob
- Koj tuaj yeem kawm txhua qhov kev ntsuas ntsuas ntsuas yog tias koj xav tau, tab sis qhov no tsis yog qhov yuav tsum tau ua, vim tias kev sib piv ntawm tus nqi tam sim no nrog rau qhov ib txwm muaj yog txaus.
