PEMERIKSAAN HEMATOLOGI
May 14, 2019 | Author: Nur Jayanti | Category: N/A
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Pemeriksaan hematologi (Darah Perifer Lengkap/DPL) Click toC. editWijaya, Master subtitle style Dr. Fatma Sp.PK Bagian Patologi Klinik FK-UR/RSUD Arifin Ahmad Pekanbaru
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Pemeriksaan Hematologi
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Bahan pemeriksaan darah vena atau darah kapiler dengan antikoagulan EDTA Jumlah sampel : ± 3 ml sesuai dengan jenis pemeriksaan Stabilitas sampel 2 jam pada suhu kamar, 24 jam pada suhu 40C Persiapan :(-)
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Komposisi darah
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Volume darah : 7-8% BB Komposisi darah : 45% sel darah Eritrosit Hemoglobin mengangkut O2 dan CO2 Leukosit sistem imun Trombosit hemostasis 55% cairan (plasma/serum) –
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Hematopoiesis
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Jenis-jenis pemeriksaan hematologi •
Darah rutin Hemoglobin (Hb), LED, hitung leukosit, hitung jenis leukosit Darah perifer lengkap (DPL) atau complete blood count (CBC) Hemoglobin (Hb), Hematokrit (Ht), Jumlah trombosit, Jumlah leukosit dan hitung jenis leukosit (differential count), Jumlah eritrosit, Nilai eritrosit rata-rata (NER), RDW, MPV Laju Endap Darah (LED) Pemeriksaan khusus Hitung retikulosit Coomb Test –
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I. Hemoglobin (Hb)
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Kadar hemoglobin dapat ditentukan dengan cara Kolorimeterik visual cara Sahli Fotoelektrik cara sianmethemoglobin atau hemoglobinsianida Cara sianmethemoglobin adalah cara yang dianjurkan untuk penetapan kadar hemoglobin di laboratorium oleh WHO Alasan : larutan standar sianmethemoglobin sifatnya stabil, –
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Cara Sahli kurang baik Tidak semua macam hemoglobin diubah menjadi hematin asam misalnya karboksihemoglobin, karboksihemoglobin, methemoglobin dan sulfhemoglobin . Selain itu alat untuk pemeriksaan hemoglobin cara Sahli tidak dapat distandarkan ketelitian yang dapat dicapai hanya ±10%. –
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Pada bayi baru lahir, kadar hemoglobin lebih tinggi dari pada orang dewasa yaitu berkisar antara 13,6 19, 6 g/dl. Kemudian kadar hemoglobin menurun dan pada
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Bila kadar hemoglobin lebih tinggi dari nilai rujukan, maka keadaan ini disebut polisitemia. Hb > 20 g/dl hemokosentrasi penutupan pembuluh darah kapiler Polisitemia Polisitemia ada 3 macam yaitu Polisitemia vera, suatu penyakit yang tidak diketahui –
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II. Hematokrit (Ht) •
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Nilai hematokrit : volume semua eritrosit dalam 100 ml darah % dari volume darah. Hematokrit menunjukkan kadar eritrosit, bukan masa eritrosit total Cara menentukan
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Peningkatan hematokrit ditemukan pada polisitemia, penurunan hematokrit ditemukan pada anemia Ht < 20 % gaga agal ja jantung tung dan dan kem kemat atiian Ht > 60%pemb embekua ekuan n darah arah spo spontan tan Pada keadaan hidremia seperti hamil hematokrit
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III. Jumlah eritrosit
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Basofil dan eosinofil
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Basofil
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Eosinofilia •
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Eosinofil fagositosis, granul mengandung anti histamin Eosinofilia suatu keadaan dimana jumlah eosinofil lebih dari 300/µl darah. Eosinofilia : alergi dan infestasi parasit seperti cacing. Histamin yang dilepaskan pada reaksi antigen-antibodi merupakan substansi khemotaksis yang menarik eosinofil. Penyebab lain eosinofilia penyakit kulit kronik, infeksi dan infestasi parasit, kelainan hemopoiesis seperti
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Eosinofil
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Netrofilia •
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Suatu keadaan dimana jumlah netrofil lebih dari 7000/µl dalam darah tepi. Penyebab : infeksi bakteri akut, keracunan bahan kimia dan logam berat, gangguan metabolik seperti uremia, nekrosis jaringan, kehilangan darah dan kelainan mieloproliferatif. Faktor yang mempengaruhi respons netrofil terhadap infeksi, seperti penyebab infeksi, virulensi kuman, respons penderita, luas peradangan dan pengobatan. Infeksi oleh bakteri seperti Streptococcus hemolyticus dan Diplococcus pneumoniae menyebabkan netrofilia yang berat, sedangkan infeksi oleh Salmonella typhosa
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Netrofil segmen
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Rangsangan yang menimbulkan netrofilia dapat mengakibatkan dilepasnya granulosit muda keperedaran darah dan keadaan ini disebut pergeseran ke kiri atau shift to the left. Pada infeksi ringan atau respons penderita yang baik, hanya dijumpai netrofilia ringan dengan sedikit sekali pergeseran ke kiri. Sedang pada infeksi berat dijumpai netrofilia berat dan
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Limfositosis
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Suatu keadaan dimana terjadi peningkatan jumlah limfosit lebih dari 8000/µl pada bayi dan anak-anak serta
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Monositosis •
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Monositosis suatu keadaan dimana jumlah monosit lebih dari 750/µl pada anak dan lebih dari 800/µl darah pada orang dewasa. Monositosis :
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Neutropenia •
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Suatu keadaan dimana jumlah netrofil kurang dari 3000/µl darah. Penyebab netropenia Gangguan pembentukan pembentu kan netrofil di SST penyakit hematologi seperti leukemia, infeksi virus, obat, –
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Limfopenia
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Eosinopenia dan lain-lain
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X. Laju Endap Darah (LED)/ Eryhtrocyte Sedimentation Rate (ESR)
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