Igazi smear

I-smear yegazi luvavanyo lwegazi olunika ulwazi malunga nenani kunye nokumila kweeseli zegazi. Ihlala yenziwe njengenxalenye okanye kunye nokubalwa kwegazi (CBC).

Isampulu yegazi iyafuneka.

Isampulu yegazi ithunyelwa elebhu. Apho, uchwephesha webhu uyayijonga phantsi kwemicroscope. Okanye, igazi lingahlolwa ngumatshini ozenzekelayo.

I-smear ibonelela ngolu lwazi:

• Inani kunye neentlobo zeeseli ezimhlophe zegazi (umahluko, okanye ipesenti yohlobo ngalunye lweseli)
• Inani kunye neentlobo zeeseli zegazi ezimile ngokungaqhelekanga
• Uqikelelo olubi lweeseli ezimhlophe zegazi kunye nokubalwa kweplatelet

Akukho lungiselelo lukhethekileyo luyimfuneko.

Xa kufakwa inaliti ukutsala igazi, abanye abantu baziva iintlungu eziphakathi. Abanye baziva behlaba okanye behlaba kuphela. Emva koko, kunokubakho ukubetha okanye ukukrala kancinci. Oku kuya kuhamba kungekudala.

Olu vavanyo lunokwenziwa njengenxalenye yovavanyo lwempilo ngokubanzi ukunceda ukufumanisa izifo ezininzi. Okanye, umboneleli wakho wezempilo unokucebisa olu vavanyo ukuba unempawu ze:

• Nasiphi na isifo segazi esaziwayo okanye esikrokrelwayo
• Umhlaza
• Ileukemia

I-smear yegazi ingenziwa kwakhona ukujonga iziphumo ebezingalindelekanga ze-chemotherapy okanye ukunceda ukufumanisa isifo, njenge-malaria.

Iiseli ezibomvu zegazi (ii-RBCs) ngesiqhelo zinobukhulu obufanayo nombala kwaye zinombala okhanyayo embindini. I-smear yegazi ithathwa njengesiqhelo ukuba kukho:

• Ukubonakala okuqhelekileyo kweeseli
• Umahluko oqhelekileyo weeseli ezimhlophe zegazi

Amaxabiso esiqhelo ahluka kancinci phakathi kweelebhu ezahlukeneyo. Ezinye iilebhu zisebenzisa imilinganiselo eyahlukeneyo okanye ukuvavanya iisampulu ezahlukeneyo. Thetha nomboneleli wakho malunga nentsingiselo yeziphumo zakho zovavanyo.

Iziphumo ezingaqhelekanga zithetha ubungakanani, imilo, umbala, okanye ukutyabeka kwee-RBCs akuqhelekanga.

Ezinye izinto ezingaqhelekanga zinokuhlelwa kwinqanaba le-4:

• 1+ kuthetha ukuba ikota yeseli ichaphazelekayo
• 2+ kuthetha ukuba isiqingatha seeseli sichaphazelekayo
• 3+ kuthetha ukuba iikota ezintathu zeeseli zichaphazelekayo
• 4+ kuthetha ukuba zonke iiseli zichaphazelekayo

Ubukho beeseli ezibizwa ngokuba ziiseli ekujoliswe kuzo kunokuba ngenxa:

• Ukusilela kwe-enzyme ebizwa ngokuba yi-lecithin cholesterol acyl transferase
• I-hemoglobin engaqhelekanga, iprotheni kwii-RBCs ezithwala ioksijini (hemoglobinopathies)
• Ukunqongophala kwentsimbi
• Isifo sesibindi
• Ukususwa kwepeni

Ubukho beeseli ezimile okomhlaba onokubakho ngenxa:

• Inani eliphantsi lee-RBCs ngenxa yomzimba owatshabalalisayo (immune hemolytic anemia)
• Inani eliphantsi lee-RBCs ngenxa yee-RBCs ezimile okweeparreshe (ifa lomzimba elifa)
• Ukwanda kokwahlulwa kwee-RBCs

Ubukho be-RBCs ezinemilo embhoxo zinokuba luphawu lwe-elliptocytosis yelifa okanye i-ovalocytosis yelifa. Ezi ziimeko apho ii-RBCs zimile ngokungaqhelekanga.

Ubukho beeseli eziqhekekileyo kunokuba ngenxa:

• Ivalvu yentliziyo eyenziweyo
• Ukuphazamiseka apho iiproteni ezilawula ukujiya kwegazi ziye zisebenze kakhulu (zisasazwe intravascular coagulation)
• Usulelo kwinkqubo yokwetyisa evelisa izinto ezinetyhefu ezitshabalalisa ii-RBCs, ezibangela ukulimala kwezintso (hemolytic uremic syndrome)
• Ingxaki yegazi ebangela ukuba amahlwili egazi enze kwimithambo yegazi encinci ejikeleze umzimba kwaye ikhokelele kwinani eliphantsi leplatelet (thrombotic thrombocytopenic purpura)

Ubukho bohlobo lwee-RBCs ezingafakwanga ezibizwa ngokuba zii-normoblast kunokuba ngenxa:

• Umhlaza osasazekile waya kumongo wethambo
• Ingxaki yegazi ebizwa ngokuba yi-erythroblastosis fetalis echaphazela umntwana ongekazalwa okanye usana olusandul 'ukuzalwa
• Isifo sephepha esiye sasasazeka sisuka emiphungeni siye kwamanye amalungu omzimba ngegazi (isifo sephepha esisifo sephepha)
• Ukuphazamiseka komongo wethambo apho umongo uthathelwa indawo sisihlunu esibuhlungu (i-myelofibrosis)
• Ukususwa kwepeni
• Ukonakala kakhulu kwee-RBCs (hemolysis)
• Ukuphazamiseka apho kukho ukuphazamiseka okugqithisileyo kwehemoglobin (thalassemia)

Ubukho beeseli ezibizwa ngokuba ziiseli ze-burr zingabonisa:

• Umgangatho ophezulu ngokungaqhelekanga weemveliso zenkunkuma e-nitrogen egazini (uremia)

Ubukho beeseli ezibizwa ngokuba ziiseli zespur zingabonisa:

• Ukungakwazi ukufunxa ngokupheleleyo amanqatha okutya ngokusebenzisa amathumbu (abetalipoproteinemia)
• Isifo esibi sesibindi

Ubukho beeseli ezimile okweenyembezi zinokubonisa:

• Myelofibrosis
• Ukunqongophala kakhulu kwentsimbi
• I-Thalassemia enkulu
• Umhlaza kumongo wethambo
• I-anemia ebangelwa ngumongo wethambo ongavelisi iiseli eziqhelekileyo zegazi ngenxa yeetyhefu okanye iiseli zethumba (inkqubo ye-myelophthisic)

Ubukho bemizimba ye-Howell-Jolly (uhlobo lwegranule) lunokubonisa:

• Umongo wethambo awuvelisi iiseli zegazi ezoneleyo (myelodysplasia)
• Udakada lususiwe
• Isifo seanemia

Ubukho bemizimba ye-Heinz (i-hemoglobin eguqulweyo) inokubonisa:

• I-alpha thalassemia
• I-anemia ye-hemolytic engokwemvelo
• Ukuphazamiseka apho ii-RBCs ziyehla xa umzimba ubhenceka kumayeza athile okanye uxinezelekile ngenxa yosulelo (ukusilela kwe-G6PD)
• Uhlobo olungazinzanga lwehemoglobin

Ubukho be-RBCs ezingafakwanga kangako zingabonisa:

• I-anemia yokubuyisela umongo wethambo
• I-anemia yeHemolytic
• Ukopha

Ubukho be-basophilic stippling (imbonakalo ebonakalayo) inokubonisa:

• Ityhefu yelothe
• Ukuphazamiseka komongo wethambo apho umongo uthathelwa indawo sisihlunu esibuhlungu (i-myelofibrosis)

Ubukho beeseli zerhengqa bunokubonisa iaromy cell anemia.

Kukho umngcipheko omncinci ochaphazelekayo ekuthatheni igazi lakho.Imithambo yegazi kunye nemithambo iyahluka ngokobukhulu ukusuka kwisigulana ukuya kwesinye kunye nakwelinye icala lomzimba ukuya kwelinye. Ukufumana isampulu yegazi kwabanye abantu kunokuba nzima ngakumbi kunabanye.

Eminye imingcipheko enxulumene nokutsalwa kwegazi incinci, kodwa inokubandakanya:

• Ukopha kakhulu
• Ukufa isiqaqa okanye ukuziva ungenantloko
• Ukugqobhoza okuninzi ukufumana imithambo
• I-Hematoma (igazi elakhiweyo phantsi kolusu)
• Usulelo (umngcipheko omncinci nangaliphi na ixesha ulusu lwaphukile)

I-smear yesiphelo; Gcwalisa ubalo lwegazi - umda; I-CBC-yipheripherali

• Iiseli ezibomvu zegazi, iiseli zerhengqa
• Iiseli ezibomvu zegazi, imo yokwehla kweinyembezi
• Iiseli ezibomvu zegazi-ziqhelekileyo
• Iiseli ezibomvu zegazi - elliptocytosis
• Iiseli ezibomvu zegazi - i-spherocytosis
• Leukemia Acute lymphocytic - photomicrograph
• Iiseli ezibomvu zegazi-iiseli ezininzi zeerheng
• I-Malaria, umbono omncinci wee-parasites zeselula
• Isifo seengcongconi, ifotomicrafograph yesidleleli seselfowuni
• Iiseli ezibomvu zegazi - iiseli zerhengqa
• Iiseli ezibomvu zegazi - irhengqa kunye nePappenheimer
• Iiseli ezibomvu zegazi, ekujolise kuzo iiseli
• Izinto ezenziwe ngegazi

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IKliegman RM, iSt. Geme JW, iBlum NJ, i-Shah SS, iTasker RC, uWilson KM. Ukuphazamiseka kwegazi. Ku: Kliegman RM, St Geme JW, Blum NJ, Shah SS, Tasker RC, Wilson KM, ii-eds. Incwadi kaNelson yeNcwadi yePediatrics. Umhla wama-21. IPhiladelphia, PA: Elsevier; 2020: isahluko 124.

I-Merguerian MD, iGallagher PG. I-elliptocytosis yelifa, ifa le-pyropoikilocytosis, kunye nokuphazamiseka okunxulumene noko. Ku: Kliegman RM, St Geme JW, Blum NJ, Shah SS, Tasker RC, Wilson KM, ii-eds. Incwadi kaNelson yeNcwadi yePediatrics. Umhla wama-21. IPhiladelphia, PA: Elsevier; 2020: isahluko 486.

UNatelson EA, uChughtai-Harvey I, uRabi S.Hematology. Ku: Rakel RE, Rakel DP, ii-eds. Incwadi yesikhokelo samayeza osapho. Umhla we-9. IPhiladelphia, PA: Elsevier; 2016: isahluko 39.

Isilumkiso EA, uHerold AH. Ukutolika iimvavanyo zaselebhu. Ku: Rakel RE, Rakel DP, ii-eds. Incwadi yesikhokelo samayeza osapho. Umhla we-9. IPhiladelphia, PA: Elsevier; 2016: isahluko 14.