Nzira dzeLabhoritari dzeKuongorora Chirwere
Kuongororwa kwechirwere inzira inokosha muhutano, inobatsira kuona chikonzero chezviratidzo zvemurwere uye kuona kurapwa kwakakodzera. Kuwedzera pakuongororwa kwekiriniki kwakadai sekubvunzurudzwa kwechiremba (kutora nhoroondo) uye kuongororwa kwemuviri, nzira dzemurabhoritari dzinoita basa rakakosha nekuti dzinopa ruzivo rwakajeka nezvemamiriro emuviri. Kuongororwa kwemurabhoritari kunobatsira vanachiremba kuongorora mashandiro enhengo, kuona hutachiona, kuona kusarongeka kwemetabolism, uye kutarisa mhinduro yekurapwa. Chinyorwa chino chinokurukura nzira dzakasiyana-siyana dzemurabhoritari dzinowanzo shandiswa kuongorora zvirwere, misimboti yadzo yekushanda, uye mienzaniso yekushandiswa kwadzo.
1. Basa uye Chinangwa cheKuongororwa kweLaboratory
Kuongororwa kwemurabhoritari kunoitwa nezvinangwa zvakasiyana-siyana. Chekutanga, kuongororwa, uko kunoona chirwere muvanhu vane hutano hwakanaka, senge kuongororwa kweshuga muropa kuti vaone chirwere cheshuga nekukurumidza. Chechipiri, kusimbisa kuongororwa, senge kuongororwa kwePCR kuti vasimbise hutachiona hwehutachiona. Chechitatu, kuona kufambira mberi kwechirwere, senge kushandisa mamwe mamaki egomarara ane chekuita nekuoma kwechirwere. Chechina, kutarisa kurapwa, semuenzaniso, kutarisa INR muvarwere vanotora warfarin inobvisa ropa. Nekuti mhedzisiro yacho ndeyenhamba uye inoyerwa, bvunzo dzemurabhoritari dzinobatsira kuderedza kuzviisa pasi pesarudzo dzezvekurapa.
2. Kuongororwa kweHematology
Hematology ibazi remurabhoritari rinoongorora masero eropa nezvimwe zvikamu zvawo zvine chekuita nawo. Kuongororwa kweropa kunonyanya kuitwa ndiko kuverengwa kweropa kwakazara (CBC). Kuongororwa uku kunoyera hemoglobin, hematocrit, masero matsvuku eropa (RBC), masero machena eropa (WBC), kuwanda kwemaplatelet, uye maindices emasero matsvuku eropa (MCV, MCH, MCHC).
– Anemia inogona kufungidzirwa kubva mu hemoglobin yakaderera, uye rudzi rwechirwere runogona kutungamirirwa kuburikidza neMCV (microcytic, normocytic, macrocytic).
– Utachiona hwebhakitiriya hunowanzoonekwa nekuwedzera kwemasero machena eropa ane ma neutrophils akawanda, nepo hutachiona hunowanzo ratidza kuwedzera kwemasero machena eropa.
– Dambudziko rekugwamba kweropa rinogona kufungidzirwa kuti rinokonzerwa nehuwandu hushoma hwemaplatelet kana kuti kusashanda zvakanaka kwemaplatelet.
Pamusoro peCBC, hematology inosanganisirawo kuongororwa kweropa kuti ione chimiro chemasero eropa, izvo zvinobatsira pakuongorora malaria, leukemia, kana zvirwere zvemasero eropa zvakaita se sickle cell anemia.
3. Kemikari yekiriniki
Kuongororwa kwemakemikari ekiriniki kunoongorora makemikari akasiyana-siyana ari muropa, seramu, kana plasma ane chekuita nekushanda kwenhengo uye kugaya kwayo. Mimwe miedzo inowanzoitwa inosanganisira:
– Glucose muropa: yekuongorora nekutarisa chirwere cheshuga.
– Mafuta: huwandu hwemafuta ese, LDL, HDL, uye triglycerides kuti uongorore njodzi yechirwere chemwoyo nestroke.
– Kushanda kwechiropa: SGOT/AST, SGPT/ALT, bilirubin, uye albumin kuongorora hepatitis, cirrhosis, kana matambudziko egallbladder.
– Kushanda kweitsvo: urea, creatinine, uye eGFR kuti uone kugona kusefa kweitsvo.
– Maelectrolyte: sodium, potassium, chloride, calcium yezvirwere zvemvura, kushaya mvura mumuviri, chirwere cheitsvo, uye matambudziko emwoyo.
Kemikari yekiriniki yakakosha nekuti zvirwere zvakawanda zvisingaperi zvinokura zvishoma nezvishoma uye hazviratidzi zviratidzo zvakajairika pakutanga. Zvakabuda murabhoritari zvinogona kupa zviratidzo zveyambiro pakutanga matambudziko asati aitika.
4. Dziviriro yezvirwere zvemuviri uye Serology
Nzira dzekudzivirira muviri dzinoshandisa maitiro ekudzivirira muviri kuti dzione hutachiona, zvirwere zvemuviri, uye mamiriro emuviri wekudzivirira muviri. Serology inoyera ma antibodies kana ma antigen muropa.
Muenzaniso wekushandiswa:
– Kuongororwa kweIgM/IgG antibody kuti vaone kuti chirwere ichi chatanga sei, zvakaita sedengue kana toxoplasmosis. IgM inowanzo ratidza kuti chirwere ichi chatanga, ukuwo IgG ichiratidza kuti chatanga kupararira kana kuti hachina dziviriro yemuviri.
– Kuongororwa kweHBsAg neAnti-HBs kwehepatitis B kuti vaone hutachiona uye mamiriro ekudzivirira chirwere.
– Kuongororwa kweANA (Antinuclear Antibody) kwezvirwere zvinofungidzirwa kuti zvinorwisa muviri zvakaita se lupus.
- Kuongororwa kweantigen nekukurumidza kuti uone hutachiona hwakawanda kuti huonekwe nekukurumidza.
Chakanakira nzira iyi ndechekuti inokurumidza uye iri nyore, asi dudziro yayo inofanira kungwarira nekuti masoja ekudzivirira chirwere anogona kuoneka kunonoka kana kuramba aripo kwenguva refu mushure mekunge hutachiona hwapera.
5. Clinical Microbiology
Zvidzidzo zvekiriniki zve microbiology zvinotarisa pakuona tupukanana tunokonzera zvirwere twakadai semabhakitiriya, fungi, uye tupukanana. Miedzo inowanzo sanganisira:
1. Kupenda uye maikorosikopu
Mienzaniso inosanganisira kudhirowa kweGram kuti kusiyanisa mabhakitiriya eGram-positive neGram-negative, kana kuongororwa kwemapute kuti kuonekwe utachiona hweTB.
2. Tsika (kubereka)
Mienzaniso yakaita seropa, weti, sputum, kana maronda inorimwa panzvimbo dzakasiyana siyana kuti ione rudzi rwebhakitiriya. Kukura kwebhakitiriya kunowanzoonekwa se "chiyero chakanaka" chezvirwere zvakasiyana nekuti zvinopa mhedzisiro chaiyo.
3. Kuongororwa kwekunzwa kwemishonga inorwisa mabhakitiriya
Kana mabhakitiriya aonekwa, bvunzo dzinoitwa kuti paonekwe mushonga unoshanda zvakanyanya. Izvi zvakakosha kudzivirira kushandiswa zvisina kunaka kwemishonga inorwisa mabhakitiriya uye kuderedza kusakwanisa kurwisa mishonga inorwisa mabhakitiriya.
Kuongororwa kwezvirwere zve microbiology kunobatsira kuziva chikonzero chehutachiona, kunyanya kana zviratidzo zvechirwere zvakafanana pakati pechirwere chimwe nechimwe.
6. Kuongorora Mamorekuru (PCR uye Matekiniki eGenetic)
Nzira dzemamorekuru, kunyanya PCR (Polymerase Chain Reaction), dzinogona kuona zvinhu zvemajini (DNA/RNA) kubva kuzvirwere zvevanhu kana zvirwere zvemajini. Nzira idzi dzinozivikanwa kuti dzinobata uye dzakanyatsojeka, zvichiita kuti dzive dzinobatsira zvikuru mu:
- Kuonekwa kwemavhairasi akadai sefuruwenza, HIV, kana SARS-CoV-2.
– Kuongororwa kwechirwere cherurindi uchishandisa ma molecular rapid tests (semuenzaniso GeneXpert).
- Kuonekwa kwekuchinja kwemajini mukenza kuti pave nekurapwa kwakanangana.
– Kuongororwa kwezvirwere zvemajini muvana vachangoberekwa kana kumwe kuongororwa kwevasati varoorana/vane pamuviri.
Zvipingamupinyi zvayo zvinosanganisira mitengo yakakwira uye kudiwa kwenzvimbo dzakakwana nehunyanzvi. Zvisinei, muzviitiko zvakawanda, kuongororwa kwemamorekuru kunokurumidza kuongororwa, zvichiita kuti kurapwa kutange nekukurumidza.
7. Kuongorora Weti uye Kuongororwa Kwemvura Mumuviri
Kuongororwa kweweti ibvunzo iri nyore asi ine ruzivo rwakawanda. Kuburikidza nekuongorora kwemuviri (ruvara, kujeka), kemikari (mapuroteni, glucose, maketone), uye microscopic (masero eropa, mabhakitiriya, makristaro), chiremba anogona kuongorora:
- Kutapukirwa kwehutachiona hwemudumbu (leukocytes, nitrite yakanaka, mabhakitiriya).
– Chirwere cheitsvo (proteinuria, macylinder).
– Chirwere cheshuga (glucose/ketones muweti).
Pamusoro peweti, rabhoritari inoongororawo zvimwe zvinwiwa zvemuviri, zvakaita se cerebrospinal fluid mu meningitis, pleural fluid muzvirwere zvemapapu, kana kuti zvinwiwa zvemajoini muzvirwere zvegout nemajoini. Kuongorora zvinwiwa izvi kunobatsira kuona kana chikonzero chiri hutachiona, kuzvimba, gomarara, kana chirwere chemetabolic.
8. Kurwara kwemuviri uye Cytology
Kuongororwa kwemuviri kunoongorora nhengo dzemuviri (biopsy) kuti kuone shanduko mumaumbirwo emasero nenhengo dzemuviri. Izvi zvakakosha pakuongorora kenza, zvirwere zvinogara zvichikonzera kuzvimba, uye mamwe matambudziko enhengo. Cytology inoongorora masero, akadai sePap smear kuti ionekwe kenza yemumuromo wechibereko nekukurumidza.
Kuongorora uku kazhinji ndiko kunonyanya kuratidza chirwere nekuti kunogona kuratidza hunhu hwemasero ekenza, huwandu hwegomarara, uye huwandu hwekupararira kwenyama isina kurongeka.
9. Muenzaniso weHunhu uye Dudziro yeMhedzisiro
Kunyatsoongorora chirwere hakungotsamiri pamuchina uye nzira yacho chete, asiwo pamhando yesampuli. Kutorwa kweropa zvisina kukodzera, weti yakasviba, kana kunonoka kuendeswa murabhoritari kunogona kukanganisa mhedzisiro. Uyezve, mhedzisiro yerabhoritari inofanira kududzirwa zvichienderana nemamiriro emurwere, mishonga yaari kushandisa, zera, uye mamiriro emuviri akadai sepamuviri. Nokudaro, kutaurirana pakati pevanachiremba, vanoongorora marabhoritari, nevarwere kwakakosha.
Mhedziso
Nzira dzemurabhoritari ndidzo dzinokosha pakuongorora zvirwere zvemazuva ano. Kubva ku hematology, clinical chemistry, immunology, microbiology, molecular diagnostics, kusvika ku anatomical pathology, imwe neimwe inopa maonero akasiyana pamamiriro emuviri nezvikonzero zvechirwere. Nekusarudza bvunzo kwakakodzera, mhando yakanaka yemuenzaniso, uye kududzira kwakanyatsonaka, marabhoritari anobatsira kuvandudza kunyatsoongorora, kukurumidzisa kurapwa, uye kutarisa kufambira mberi kwechirwere. Pakupedzisira, kushandiswa kwakakodzera kwenzira dzemurabhoritari kuchavandudza hutano uye kuchengetedzeka kwemurwere.
