Amasu Okuthatha Amasampula Omchamo Ezilwaneni
Ukusampula umchamo kuyinqubo ebalulekile ekuhlolweni kwezilwane zezokwelapha ngoba kuqukethe ulwazi oluningi mayelana nempilo yomzimba. Ngokuhlola umchamo, odokotela bezilwane bangahlola ukusebenza kwezinso, isimo somswakama, izinkinga ze-metabolic (njengesifo sikashukela), izifo zomgudu womchamo, kanye nezinkinga zesistimu ezithinta ezinye izitho zomzimba. Kodwa-ke, ikhwalithi yemiphumela yokuhlaziya umchamo ithonywa kakhulu yindlela yokwenza amasampula. Amasampula angcolile, lawo agcinwe isikhathi eside kakhulu, noma lawo aqoqwe ngendlela engafanele angaholela ekuchazeni kabi imiphumela. Ngakho-ke, ukukhetha indlela, ukunemba kwenqubo, kanye nokuphathwa ngemva kokuqoqwa kubalulekile ekutholeni isampula emele.
Inhloso kanye nezinkomba zokuqoqwa komchamo
Ngokuvamile, ukusampula umchamo kusetshenziselwa ukuhlolwa ngokomzimba (umbala, ukucaca, iphunga, ivolumu), ukuhlolwa kwamakhemikhali (i-pH, iphrotheni, i-glucose, ama-ketone, i-bilirubin), kanye nokuhlolwa nge-microscope kwe-sediment (amangqamuzana egazi, amakristalu, amabhaktheriya, ama-cast). Izinkomba zokusampula umchamo zifaka phakathi izilwane ezinezimpawu zokuchama njalo, ukuchama okubuhlungu, i-hematuria, ukuncipha kwesifiso sokudla, ukuhlanza, i-polyuria-polydipsia, noma njengokuhlolwa okuvamile ngaphambi kokuhlinzwa kwe-anesthesia nezinye izinqubo zezokwelapha. Emfuyweni, ukuhlolwa komchamo kungasetshenziswa futhi ukuqapha ukuphazamiseka kwe-metabolic kanye nesimo sempilo yomhlambi.
Ukulungiselela Okuvamile Ngaphambi Kokuthatha Isampula
Ngaphambi kokuqoqa isampula, kubalulekile ukulungiselela imishini nokuqinisekisa ukuthi isilwane singubani kanye nenhloso yokuhlolwa. Imishini evame ukudingeka ihlanganisa isitsha esingenamagciwane esinesembozo, amagilavu, isirinji nenaliti (yezindlela ezithile), isibulala-magciwane, ukotini/igauze, kanye nelebula lokufaka ilebula isampula. Umchamo omusha kufanele uqoqwe, okungcono kakhulu umchamo wokuqala ekuseni, njengoba ngokuvamile ugxile kakhulu futhi umele imingcele eyahlukene.
Izici zokucindezeleka nazo kudingeka zicatshangelwe. Ukucindezeleka kungathinta imvamisa yokuchama, amazinga kashukela egazini, futhi kubangele ngisho nokungcola ngenxa yokulawula okunzima kwezilwane. Ezilwaneni ezincane ezifana namakati nezinja, indlela ezolile kanye nokuzibamba okufanele kuzonciphisa ingozi yokulimala futhi kube lula inqubo. Ezilwaneni ezinkulu njengezinkomo noma amahhashi, ukuphathwa okuphephile kubalulekile kokubili kumqhubi kanye nesilwane.
Indlela Yokuthatha Amasampula Omchamo
Kunezindlela eziningana zokuqoqa amasampula omchamo ezilwaneni. Ukukhetha indlela kuncike ohlotsheni, isimo sesilwane, ukutholakala kwemishini, inhloso yokuhlola (isb., amasiko amabhaktheriya adinga isampula engenamagciwane kakhulu), kanye nekhono lomuntu osebenzisa umchamo.
1. Ukuqoqwa Komchamo Okuzenzakalelayo (Ukubamba Kwamahhala)
Indlela elula kakhulu ukuqoqa umchamo ngesikhathi sokuchama okuzenzakalelayo. Isampula iqoqwa esitsheni esihlanzekile noma esingenamagciwane. Ezinjeni, le ndlela ilula ngokuqondisa isitsha emgudwini womchamo. Emakatini, kungenziwa ngokusebenzisa ibhokisi elikhethekile elingamunci umchamo (isb., ama-pellet epulasitiki) ukuvimbela ukumuncwa komchamo, bese uthela isampula esitsheni esingenamagciwane.
Izinzuzo zale ndlela ukuthi ayihlaseli kakhulu, ayibuhlungu, futhi ayidingi mishini ekhethekile. Inkinga ukuthi isampula ingcoliswa kalula ngamagciwane avela esikhumbeni, ezinweleni, endaweni ezungezile, noma emgudwini wokuzala. Ngakho-ke, le ndlela ifaneleka kakhulu ekuhlolweni okuvamile (isb., amandla adonsela phansi athile, i-pH, i-glucose), kodwa ayifaneleki kangako ekukhuleni komchamo ngenxa yengozi eyengeziwe yokuthola imiphumela engamanga.
2. Ukufakwa kwe-Catheterization ye-Urethral
Ukufakwa kwe-catheter kwenziwa ngokufaka i-catheter engenamagciwane nge-urethra iye esinyeni. Le ndlela ivame ukusetshenziswa ezinjeni zesilisa, kuyilapho inzima kakhulu kwezesifazane nasemakati. Le nqubo idinga indlela yokwelapha: indawo yesitho sangasese iyahlanzwa, kusetshenziswa i-catheter engenamagciwane, futhi kungasetshenziswa i-lubricant engenamagciwane ukuze kube lula ukufaka.
Inzuzo yokufaka i-catheter ukuthi isampula ihlanzekile kakhulu kune-free-catch futhi ivumela ukuphuma kwesinye uma kwenzeka ukugcinwa komchamo. Kodwa-ke, le ndlela ithwala ingozi yokulimala kwe-urethra, ukopha, ukutheleleka, futhi kungabangela ukucindezeleka noma ubuhlungu. Ukusetshenziswa kwe-catheter kungaholela nasekungcoleni okuhlukahlukene uma ukungazali kungagcinwa ngokuqinile. Kuma-bacterial cultures, ukufaka i-catheter kungcono kune-free-catch, kodwa kuseyi-sterile encane kune-cystocentesis.
3. I-Cystocentesis
I-Cystocentesis ukuqoqwa ngqo komchamo kusuka kwesinyeni kusetshenziswa inalithi kanye nesirinji odongeni lwesisu. Le ndlela ibhekwa njengesampula engenamagciwane kakhulu, okwenza inconywe kakhulu ekuhlolweni kokukhuliswa kanye nokuzwela kuma-antibiotic. Ivame ukwenziwa ezinjeni nasemakatini, ngokuvamile ngokushaya indlwabu yesinye noma isiqondiso se-ultrasound ukuze kutholakale ukunemba nokuphepha okwengeziwe.
Izinzuzo ze-cystocentesis zifaka phakathi ukungcola okuncane okuvela ku-urethra kanye nezitho zangasese, kanye nesampula efanelekile yokuhlaziywa kwe-microbiological. Okubi ukuthi inqubo iyahlasela futhi inezingozi ezifana ne-hematuria ngenxa yokulimala okuncane, ukuvuza komchamo, noma ukulimala kwezitho ezizungezile uma indlela ingalungile. I-Cystocentesis kufanele igwenywe uma isinye singagcwele kahle, uma kukhona ukuphazamiseka kokuqina kwegazi, noma uma kusolwa ukuthi kukhona inqwaba yesinye noma ukuqhekeka kwaso.
4. Ukuvezwa Kwesinye Ngesandla
Ukuvezwa ngesandla kuhilela ukucindezela isinyi odongeni lwesisu ukuze kubangele ukugeleza komchamo. Le ndlela isetshenziswa kakhulu ezilwaneni ezincane noma ezigulini ezinezinkinga zezinzwa ezingakwazi ukuphuma ngendlela evamile. Kodwa-ke, kufanele kuqashelwe njengoba ukucindezela ngokweqile kungabangela ukuphinda komchamo ungene ku-ureter noma ngisho nokuqhekeka kwesinyi, ikakhulukazi uma kukhona ukuvinjelwa kwe-urethra.
Le ndlela inengozi yokukhiqiza amasampula angcolile ngoba umchamo uphuma nge-urethra, njengasekubambeni okukhululekile. Ngaphezu kwalokho, ukuvezwa ngesandla akukhuthazwa ezilwaneni ezisolwa ngokuvinjelwa (isib. amakati amaduna anevimbekile) njengoba kungenza isimo sibe sibi kakhulu.
5. Amasu Akhethekile Emfuyo Nezilwane Ezinkulu
Ezinkomeni, ezimbuzini, nasezimvini, ukuqoqwa komchamo kungenziwa ngokuvusa i-perineum noma i-vulva (kwabesifazane) ukuze kuqale ukuchama, bese kuqoqwa umchamo. Emahhashini, umchamo ungaqoqwa ngesikhathi sokuchama okuzenzakalelayo, yize lokhu kudinga isineke nokuqapha ukuziphatha. Kwezinye izimo, ukufakwa kwe-catheter kungenziwa ezilwaneni ezinkulu, kodwa lokhu kudinga amakhono akhethekile kanye nezindawo ezanele.
Ezinyonini, ukuqoqwa komchamo kuyinkimbinkimbi kakhulu ngoba ukuphuma komchamo kuxutshwa nendle ngesimo sama-urate. Ukuhlolwa kuvame ukugcizelela kakhulu ekuhloleni indle nezinye izimo zezokwelapha kunokuhlolwa komchamo okujwayelekile, njengasezilwaneni ezincelisayo.
Ukuphathwa Kwesampula, Ukugcinwa, kanye Nokuthuthwa
Uma isampula isitholiwe, isinyathelo esilandelayo ukuphathwa ngendlela efanele. Isampula kufanele ifakwe esitsheni esingenamagciwane, esivalwe kahle, esibhalwe ukuthi isilwane singubani, usuku nesikhathi sokuqoqa, kanye nendlela yokuqoqa. Ukuhlolwa kufanele kwenziwe zingakapheli imizuzu engama-30-60 yokuqoqa ukuze kuvinjelwe izinguquko ze-pH, ukukhula kwamagciwane, ukuchithwa kweseli, kanye nokwakheka kwekristalu. Uma kudingeka ukubambezeleka, amasampula angagcinwa esiqandisini (cishe ama-2-8°C) futhi aphinde afudunyezwe ekushiseni kwegumbi ngaphambi kokuhlaziywa, ikakhulukazi ukuze kuhlolwe inhlabathi.
Ukuze kukhiqizwe amagciwane, ukuthuthwa kuyiswe elabhorethri kufanele kwenziwe ngokushesha okukhulu, kusetshenziswa izitsha ezihlanzekile, futhi kulandelwe izinqubo zochungechunge olubandayo uma kudingeka. Ukungcola ngesikhathi sokuvulwa kwesitsha noma ukusetshenziswa kwezinsimbi ezihlanzekile kufanele kugwenywe.
Izici Ezithinta Ikhwalithi Yesampula
Izici eziningana ezivame ukuthinta ikhwalithi yesampula zifaka phakathi ukungcoliswa kwemvelo, ukusetshenziswa kwezitsha ezingahlanzeki, ukuhlolwa okulibazisekile, kanye nokuvinjelwa okungalungile, okungaholela egazini emchameni ngenxa yokulimala. Imithi kanye nokudla kungathinta nombala, i-pH, kanye nokuba khona kwamakristalu. Ngakho-ke, umlando wezokwelapha wesilwane—kufaka phakathi noma yiziphi izindlela zokwelapha zamanje—kufanele ubhalwe phansi lapho kuthunyelwa amasampula.
Isiphetho
Amasu okuthatha amasampula omchamo ezilwaneni kumele akhethwe ngendlela efanele, kuye ngenhloso yokuhlola, isimo sesiguli, kanye nezinsiza ezitholakalayo. Ukubamba mahhala kulula kodwa kuthambekele ekungcoleni; ukufaka i-catheter kunikeza isampula ehlanzekile kodwa kuthwala ingozi yokulimala kanye nokutheleleka; kuyilapho i-cystocentesis ikhiqiza isampula engenamagciwane kakhulu futhi ilungele ukukhuliswa. Ukuvezwa ngesandla kwenziwa kuphela ngaphansi kwezimo ezithile ngokuqapha okukhulu, futhi ezilwaneni ezinkulu, kudingeka indlela ethile yohlobo. Kungakhathaliseki ukuthi iyiphi indlela, impumelelo yokuhlolwa komchamo inqunywa kakhulu yizinqubo ze-aseptic, ukuphathwa kahle kwesampula, kanye nokuhlolwa okusheshayo. Ngobuchwepheshe obuhle, amasampula omchamo angaba ithuluzi lokuxilonga elinembile futhi asize kakhulu ekunqumeni ukwelashwa kanye nokuqapha impilo yezilwane.
