Kev kuaj ntshav smear yog ib txoj hauv kev zoo uas tso cai rau koj los kuaj xyuas ntau yam kab mob. Cov xwm txheej tseem ceeb rau kev siv tau zoo ntawm txoj kev kuaj mob no yog kev soj ntsuam nruj ntawm cov txheej txheem kev npaj smear thiab kev kawm ua haujlwm raws li kev ua raws li algorithm.
Nyob rau hauv kev xyaum, nws yog deb ntawm ib txwm ua tau kom tau txais cov ntaub ntawv lub hom phiaj nyob rau hauv lub moj khaum ntawm kev siv hematological ceev diagnostics. Kev kawm txog ntshav smear ua rau nws ua tau kom meej meej sai thiab ntxiv cov ntaub ntawv tau txais. Cov txheej txheem no tso cai rau koj los txheeb xyuas qee lub ntsiab lus uas tsis tshwm sim thaum lub sijhawm kho mob tsis siv neeg tshawb fawb, piv txwv li, kev hloov pauv hauv cov duab erythrocyte nrog rau kev hloov pauv ntawm leukocyte Performance index mus rau sab laug, uas yog, mus rau qhov tsis paub qab hau neutrophil, los yog muaj qhov tshwm sim. kab mob. Hauv qee qhov xwm txheej, cov txheej txheem no tso cai rau kev kuaj pom tseeb.
Kev tshawb fawb algorithm
Nws tom ntej:
- Tam sim tom qab kuaj, ntshav yuav tsum tau muab tso rau hauv sai saiAnticoagulant tube los tswj cov cell zoo.
- Methylene xiav stain tso cai txheeb xyuas cov reticulocytes.
- Kev ntsuas yog nqa tawm ntawm ib txheej nyias ntawm cov smear nrog kev nyeem ntawv ntawm qib ntawm nws cov pigtails hauv lub tshuab tsom.
- Los ntawm kev kuaj xyuas cov ntshav smear, APEL algorithm txhais tau tias.
qhov kev tshuaj ntsuam no siv rau dab tsi?
Rau lub hom phiaj:
- Raws li ib feem ntawm kev txiav txim siab qhov tsis sib xws ntawm cov duab thiab qhov loj me, nrog rau kev hloov pauv ntawm cov qe ntshav liab, platelets, cov qe ntshav dawb thiab ntau hom qe ntshav (xws li cov ntawv tsis paub tab) nrog rau lawv feem pua.
- Rau kev kuaj mob ntawm ntau yam kab mob cuam tshuam nrog kev kawm tsis zoo, kev ua haujlwm lossis kev puas tsuaj ntau dhau ntawm cov khoom zoo li qub.
- Txhawm rau saib xyuas cov tsim ntawm cov hlwb nrog lawv cov qib ntawm kev loj hlob hauv leukemia, tom qab kev kho hluav taws xob, thiab tseem yog ib feem ntawm kev tsis sib haum xeeb hauv kev tsim cov hemoglobin.
Qhov kev kawm no raug txiav txim thaum twg?
Yog tias, raws li qhov tshwm sim ntawm kev tshuaj xyuas dav dav thiab cov qauv leukocyte (uas tau sau tseg rau ntau qhov kev qhia dav dav), pom muaj qhov nce ntxiv ntawm cov leukocytes, atypical lossis tsis paub tab hlwb raug kuaj pom, ces yuav tsum tau noj ntshav smear. Ntawm lwm yam, qhov kev tshawb fawb no tseem ceeb rau kev ua tiav hauv ntau qhov xwm txheej:
- Tawm tsam keeb kwm yav dhau los ntawm kev xav tias muaj kab mob uas cuam tshuam rau cov hlwb.
- Thaum siv tshuaj uas tuaj yeem cuam tshuam rau lawv cov khoom.
Raws li ib feem ntawmRau kev soj ntsuam ntshav smear, cov kws kho mob feem ntau siv cov kua dej hauv cov hlab ntsha lossis cov hlab ntsha.
Kev npaj
Thaum ua piv txwv cov khoom siv biomaterial nrog qhov nruab nrab txoj kab uas hla ntawm cov hlab ntsha nthuav dav, cov ntshav yuav tsum ntws sai sai rau hauv lub raj tshuaj uas muaj cov tshuaj tiv thaiv coagulant. Ethylenediaminetetraacetate feem ntau siv vim tias nws ua rau nws muaj peev xwm khaws tau cov khoom zoo li qub. Muaj tseeb tiag, txhawm rau tiv thaiv ntau yam ntawm morphological cell degradation, lub sijhawm ncua ntawm kev noj cov khoom tshiab thiab zoo homogenized thiab npaj cov kev npaj yuav tsum luv li sai tau.
Kev npaj ntawm smears pib nrog kev poob ntshav (feem ntau tsuas yog ib qho ntawm lub raj capillary) ntawm ntug ntawm lub tshuab ntsuas kab. Nws yog ces smeared los ntawm txhais tau tias ntawm ib tug thib ob iav ntsiab zawv zawg tshaj thawj. Ib qho kev npaj smear zoo muaj lub npe hu ua "miv tus nplaig" thaum kawg, qhia tias tus qauv tau ua kom raug thiab ua rau nws muaj peev xwm ua tau zoo heev.
Xim
Xim yog ua los ntawm tus qauv txheej txheem. Ua ntej cov txheej txheem no, cov ntshav npaj tau smear yog qhuav hauv huab cua los ntawm kev tuav lub iav swb, uas ua rau nws muaj peev xwm zam kom tsis txhob muaj qhov tsis muaj teeb pom kev zoo nyob hauv nruab nrab ntawm erythrocytes. Vim li no, kev txhais lus yuam kev ntawm hypochromia raug cais tawm.
Tej zaum yuav muaj lwm yam khoom siv xim. Piv txwv li, Wright's stain muab cov dej nag. Qhov no tshwm sim thaumcov xim tsis tau hloov dua tshiab tom qab qee lub sijhawm, cov iav swb tau nyob rau hauv cov tshuaj pleev xim rau lub sijhawm ntev los yog tsis zoo ntxuav. Yog li ntawd, qhov sib xyaw ntawm cov xim tuaj yeem txhais tau tias muaj cov kab mob cab thiab cov kab mob hauv cov ntshav. Tsis tas li ntawd, staining ntawm smear nrog cell morphology tuaj yeem hloov pauv los ntawm kev tiv tauj cov swb nrog formalin vapor. Cov qauv feem ntau stained raws li txoj kev Romanovsky raws li methylene xiav thiab eosin.
Classic xim ntawm cov ntshav smears, raws li txoj cai, txawv ntawm qhov ceev ceev. Tsis ntev los no, cov txheej txheem zoo li no muaj lawv qhov zoo, txij li lawv tiv taus cov kev hloov pauv hauv acidity ntawm kev daws thiab tsim cov tshuaj depot. Tab sis, txawm li cas los xij, lawv tsis tshua muaj txiaj ntsig hauv kev kuaj pom polychromatophiles thiab tsis hloov xim ntawm granules ntawm basophils thiab mast hlwb.
Yuav kom tau txais cov duab tshwj xeeb ntawm cov reticulocytes, staining nrog tshiab methylene xiav yog xav tau. Hauv cov raj yas kuaj, cov ntshav poob yog sib xyaw nrog ob NBM cov ntsiab lus. Lub raj tso rau ntawm chav sov li kaum feeb. Ib qho me me tom qab sib tov yog muab tso rau ntawm ib lub iav swb thiab smeared tib yam li thaum lub sij hawm smear. Tom qab ntawd lub swb yuav qhuav sai sai thiab tshuaj xyuas hauv qab lub tshuab ntsuas qhov ntsuas siab.
YSystematic Study
Raws li ib feem ntawm qhov kev ntsuam xyuas, nws tseem ceeb heev uas yuav tsum tau coj los ntawm ib txoj kev tshawb fawb. Microscopy ntawm cov ntshav smear tau uaib txheej nyias nrog lub taub hau, thickens ntawm nws lub hauv paus. Cells raug soj ntsuam ntawm daim duab nyias, raws li cov tuab tuab nqa cov ntaub ntawv me me. Ntawm qhov kev nthuav dav tsawg, qhov tsis zoo ntawm qhov smear, feem ntau nws qhov sib npaug, feem ntau yog kuaj xyuas kom pom cov platelet aggregates lossis atypical hlwb (lymphoblasts lossis dendritic ntsiab lus).
Cov txheej yuav muaj zigzag lossis pigtail zoo li, uas tso cai rau koj kom pom tseeb ntau cov qe ntshav hauv APEL txoj kev tshawb fawb, qhov twg A qhia txog lwm yam kab mob atypical nrog cab, P qhia platelets, E qhia erythrocytes, thiab L txog. cov qe ntshav dawb.
Kev kuaj ntshav ntshav yog cov txheej txheem zoo sib xws uas tso cai rau koj txhawm rau kuaj xyuas ntau yam kab mob. Cov xwm txheej tseem ceeb rau kev siv tau zoo ntawm txoj kev no yog kev coj ua nruj ntawm cov txheej txheem tshuaj ntsuam xyuas smear nrog kev tshuaj xyuas kom ua raws li cov txheej txheem algorithm.
Cov txiaj ntsig txhais li cas?
Kev hloov pauv ntawm cov ntshav smear tsis tas yuav ua kom kuaj tau. Feem ntau qhov no qhia tau hais tias muaj qee yam kab mob, uas txhais tau tias muaj kev kuaj mob tom ntej txhawm rau txhawm rau kuaj pom tseeb.
Rationale for analysis
Muaj ntau yam kab mob loj, thiab tib lub sijhawm muaj kev cuam tshuam, tiv thaiv cov khoom ntawm cov hlwb uas ncig hauv cov hlab ntsha tuaj yeem hloov pauv. Feem ntau, tsuas yog cov ntsiab lus paub tab nkag mus rau hauv cov khoom siv biomaterial no los ntawm cov pob txha pob txha,Tab sis nyob rau hauv ib tug xov tooj ntawm pathologies, piv txwv li, nyob rau hauv leukemia, immature analogs nyob rau hauv daim ntawv ntawm blasts tau nkag mus rau hauv nws. Hauv qee lub xeev cov kab mob, piv txwv li, nrog cov kab mob loj heev, cov yam ntxwv impurities yuav tshwm sim hauv leukocytes, cov hlwb lawv tus kheej ua atypical, xws li, piv txwv li, kis kab mob mononucleosis.
Nrog qhov tsis txaus ntawm cov hlau lossis vitamin B 12, nrog kev tsis sib haum xeeb ntawm hemoglobin synthesis, cov khoom thiab cov tsos ntawm cov qe ntshav liab tuaj yeem hloov pauv. Kev kuaj pom ntawm cov kab mob pathological hauv cov nyiaj ntau dhau hauv cov smear ua rau nws muaj peev xwm xav tias muaj cov kab mob pathology uas ua rau lawv thiab sau ntawv mus kuaj ntxiv rau tus neeg mob. Cov ntshav smear tuaj yeem raug muab tshuaj tsis tu ncua rau cov neeg uas muaj kab mob oncological ntawm cov pob txha pob txha lossis cov qog ntshav qab zib ua ib feem ntawm kev saib xyuas lub zog thiab saib xyuas cov txiaj ntsig ntawm kev kho mob.
