Tai biến truyền máu và xử trí

DIEN DAN YHOC

Chuyen de trong thang

TAI BIEN TRUYEN MAU VA XlT TRI

Pham Quang Vinh*

Mb dau

Mdu dugc sudung ngdy cdng nhieu vd <f ddu ky ihudi y hgc phdi trien thi ir do sir dung nhieu mdu vd

cdc che phdm li'r mdu Mdu phai lav lir ngudi hien mdu. mdu truyen vdo ar the phai dam hao haul ddng cua

cdc le hdo mdu. do vdv Iriiven mdu Id dira Id chirc cua mpi cir ihe ndy sang mdt ca the khde. Truyen mdu da

giiip y hgc giai quyet dugc nhieu khd khdn Irong dieu Iri benh. Nhieu khi Iriiyen mdu Id phmmg lien duy nhdi

de cim ngudi benh. Tuy nhien. dd cd nhieu hdu qua ddng tiec do truyen mdu gdy ra. Cdc thdy ihudc cdn biet

cdc nguv cir cd the xav ra khi Iriiven mdu ddng thai cdn ndm rd nguyen nhdn. dien bien de cd the de phdng

vd xir Iri lot khi cdn thief

Cdc hgu qua xdu do iriiven man cd the cd nguyen nhdn ve mien dich do khdng cd sir phii hop giira ngudi

cho vd ngirdi nhdn. ciing cd ihe do qua Irinh chudn hi. do ky ihiidl ihirc hien gdy nhiem khudn don vi mdu

hav qua lai do Iriiven mdu. Ngodi ra hdu qua liem dn Id ldm Idy Iriiven mdi sd benh. ddng lo nggi hien nay

Id benh do virus HIV. virus viem gan. giang mai...

Hdu qua xdu cd the xudi hien khi iriiven mdu hav sau iriiyen mdu nhieu ngdy. nhieu ihdng.

1. Nguven nhan tai bien truven mau

/. 1. Nguyen nhdn mien dich

Phan irng giua khang the trong co' t|-ie nguoi

nhan khang lai kliang nguy en a nuiu va tJ-ianii phan

mau truyen vao hoac ngugc lai gay tai bien truyen

mau.

Plian irng do bat dong nliom mau he ABO la

tai bien truyen mau nang. Khac voi cac he khac

la a he nhom man ABO nhirng nguai thieu khang

nguyen A hay B tren h6ng can thi trong huyet thanh

chira san khang the khang lai khang nguyen A va

B. vi vay bat bugc khi truyen man phai hoa hgp he

ABO [4].

D6i vai cac khang nguyen hbng can khac

cimg CO the gay tai bien truyen mau nhirng thubng

khang the chi xuat hien khi co' the dirge mien djch.

Dieu kien mien djch (tiep xiic khang nguyen) la do

truyen man hay phu nirchuade nhieu lan. Khi benh

nhan duoc truven hdnsi can chira khan<> imuven "la"

veS'i CO' the. vi dii truyen hdng can cb khang nguyen

E (mgt khang nguyen thuoc he Rh) cho benh nhan

kh6ng CO khang nguyen nay thi benh nhan se sinh

khang the ch6ng E (ggi la khang the bat thirong).

Lan sau neu benh nhan lai dugc truyen mau ciing

CO khang nguyen E thi phan irng se xay ra. Mgt

s6 khang nguyen co the kich thich sinh khang the

manh va phan irng manh vbi khang the la khang

nguyen D (he Rh) khang nguyen K (he Kell).

Phu nir chira de nhieu lan cimg co nguy co sinh

khang the vi moi lan mang thai, mau thai nhi cb the

mang khang nguyen khac nguai me (do b6 truyen

cho). Trong qua trinh mang thai, dae biet la khi chiia

de. he mien djch cua me nhan dien khang nguyen

o' mau con va sinh khang the. Neu sau nay ngudi

phu nu' nay hien mau thi mau mang khang the bat

thuong. con neu nguoi phu nir nay can dugc truyen

nuiu va neu mau truyen vao co khang nguyen tirong

irim voi khang the biit thuang sinh ra do mang thai

'^Khoa Hiivel hgc - Truven mdu. Benh vien Bgch Mai

6 JYHQCLAMSAN G SoSO (Thang03/2010)