> ڳ

ڳ


 
亯Դϴ
ȫ
07-05-27 21:39
4,923
 
ȳϼ
ؼ ν Ͻôٰ
л ó ƽð Ǽ̳׿
ʵб ˻ Ź
θԿ Ǽ̰ Ͽ ˱
찡 ϴ

Rh(-)ȸ ֽð
, Ȱ, ( ϴ^^), ó ϼ̳׿
켱 ȸ ̳ Ȱ ȸ
̸ ڹ Ͽ ̷ϴ

ڶ ó Բ
Ҿ ȸ ȿ , ڿ縦 Ͽ
ڽ Ϻθ ָ
ڱ̳ ھƼ, ư ȭ ġ
õ ε ٲ ͵̽ð

׷
ȸ ȸԵ ڹ Ȱ 縦 Ѵϴ

ٸ ü ǰ 簡 Ǵ κ ʿϹǷ
ȸ ȸ, Ժ κ ϰ ǰ Ƿ
Ʒ Ͻñ⸦ ٶϴ
ȸ ó Ȩ ޴ٿ ȸ Ұ
Ͻð ׿ ϼŵ ǽðڽϴ

̸Ϸ 亯 ϼ
亯 ø ֽʽÿ^^

׻ ǰϽð ñ⸦ 帳ϴ






* -ȸ ڷԴϴٸ ̶ ǽñ⸦ ٶϴ


: [ڷ]Rh(-)ȸ ȸ
: ȫ

Rh(-) (Rh Negative Blood Type)̶  ŸԴϱ?

Rh ̱ε鿡 20% ѵ Ͽ
츮󿡼 Rh 1,000 ߿ 1-3 年ϴ.
е鵵 Ž Ͽ Rh ã´ٴ
Դϴ.
Rh 缺 θ ̿ Rh ڳడ ֽϴ.
츮 Rh θ κ Rh 缺Դϴ.
 Rh 缺 θ𿡰Լ Rh ڳడ ִ
Rh ڴ D CcEe Ǿ ֽϴ.
츮 ϴ Rh D Īϴµ
Rh 缺 D ڸ ִ ̰
Rh D ڸ ʴ Դϴ.
D ڸ ִ 츦 d ǥմϴ.
ڴ ΰ 븳(allel) Ǿ Ƿ
Rh(D) õ ڴ DD, Dd, dd Դϴ.
߿ DD Dd Dڸ ϳ ̻ Ƿ
ǥ Rh 缺Դϴ.
׸ D ڰ dd Rh ǥ˴ϴ.
츮 κ DD ڸ Ҽ Dd ڸ ֽϴ.
θ ڰ Dd Ǿ ִ 쿡 ڳ ߿
4 1 Ȯ dd, Rh ֽϴ.
Rh ̶ ؼ ó ϴ ׷ ʽϴ.
̸ ٸ ʿ
Ǵ Rh 缺 Ʊ⸦ ӽϿ ټ Դϴ.
׷ Rh鿪۷κҸ (RhIG Ǵ Rhogam) ֻϸ ų ִ
anti-D
Rh Rh ڿ ȥص
Ż ȯ ְ Ǿϴ.



Ҹ ̶ ֻ Դϱ?

Ҹ̳ ΰ̶ ׿ ̳ ڵ鿡 ܾԴϴ
 å Ͽ [ΰ] ǰ ִ
[Ҹ] Ͽ 帮ڽϴ
Rh D ̿ܿ C, E, d, c, e ֽ
׿ ȿ Ÿ Ḏ
D ִ Rh() ϰ
D Rh(-) մϴ
D û Dҵ ,
D ִ ޹ Ұ ϴ
Rh(-) (dd) Ұ 0.5ml Rh() (DD, Dd) ϴ
û D Ұ ܼ
׿-ü ˴ϴ
Rh Rh缺 ¾ ӽŰ Ŀ ߻ϴ
ϱ Ͽ Rh-ü ü() ҽŰ
-D -r-globulin ֽϴ -D- r -globulin(׵𰨸۷κҸ) ü ϸ
¾ƿ ü Rh(׿,) ü ü ϱ
ıǾϴ Ż Rh ȯ Rh(D)鿪 ۷κҸ(RhGAM-ΰ)ν
ſ ֽϴ
̴ ü ϱ Ͽ ü 鿪(immune system)
鿪(ǵ鿪,passive immunity) Դϴ
Ʈ 񿣳 ϰ ִ Baxter AG[Partobulin-Inject]
Ҹ̶ Ī ڻ翡 , ϰ ٸ() Ǹϰ ֽϴ
-D(Rh) IG 1ml 1250 I.U.(250 ũα׷) Ǿ ְ
1ȸ ֻ(ʵ) · Ǿ ֽϴ
츮 ͼ [ΰ] й
츮 ߴ [ΰ]̳ ó ǰ ִ
չ [Ҹ] ǰ̹Ƿ ϼ ׿̳ ϴ [ΰ]̶
δ Rh 鿪۷κҸ̶ ǹ̸ Ƿ
Ʋ ƴ Դϴ
ǰ [Ҹ]̸ ԰ [ 1ML]̸
ް 113115̸ 11312 124427 ܰ
԰̳ ް ټ ̰
ó (30%-50%) ȯڿ ûǴ ˻ᳪ Բ
ٸǷ ̰ ֽϴ
ΰ̵ Ҹ̵ ̰ D׿ ü 濡
ֱٿ E׿ Ż ¾Ƽı
ڱó (erythroblastosis fetalis)̳
ǰ ִٰ ϴ
ΰ Żƿ Rh(E) ü ˻
˻縦 ݵ ؾѴٰ մϴ
ӽ 28-34ֿ ֻϰ Rh缺(D-缺, D缺) 72ð ̳
Rh 𿡰 ֻ縦 Ͽ ȿ ֽϴ



ӳ е [RhװƼ ť]?

. Ż ȯ(Ȳ, ) Ű ī

. Rh(D)缺 Ʊ⸦ ù ӽſ Ȥ ¹ Ͽ Rh(D)缺
Ʊ ҷ ɼ ִ
. Rh(D)缺 Ʊ ׿ Ͽ ü(û -D)
ȴ()
. ° ӽŽ Rh(D)缺 Ʊ⸦ Ǹ ̹ ü ¹ Ѿ
Ʊ  Ʊ Ͽ ƱⰡ ִ


. ü (Ʊ ̵ )

. ӽ-¹ݹڸ, õ, õ, ڱÿ ӽ
. и-굵,
. , , ¼, ΰ, -->(*Ư ûҳ )

. (Rh 鿪۷κҸ, Rh IG, Ҹ, ΰ-Rhgam)

. ӽ. Ŀ -
. ӽ 28(7) : 300g I.M.-ӽ 7 ֻ
. 72ð(3) : 300g I.M(ֻ)

. ΰ (, ڿ) ¼ -
. ӽ 3 ̳ ¼ : 72ð 50g ֻ
. ӽ 3 Ŀ ¼ : 72ð 300g ֻ

, ӽŰ õ RhװƼ ť Ծ(ڱ⺸ȣ)

. ̼ (κ ȹ )
. Ұϰ ΰ, , ,
. εϰ ȥӽ Ͽ з ˷ ó
. ӽĿ ΰ ǻ翡 Rh Negative Ҹ
. ̼ ӽĿ
. ߻Ȳ(, ) ( )
. Ż ȯ ȯ ʿ 쿡 (ä 3 ̳ Rh(-)O)
. ȣڿ RhװƼ I.Q.

***ӽŰ ġ
ӽŰ ְ
ư ǰ ƹ ϴ


Rh ü˻ - Rh Antibody Identification Test

ӽ ¾ ǰ , ̿ ˻  Դϴ
¾ ¾Ƽı
̳ Żƿ Ÿ Ȯ 5%̸()
ġ(ΰ 72ð ̳ Ҹ ֻ)
ι° ӽſ ־ Ȯ 10-15% մϴ
ġ ӻ ġϻ Ȯ
κ 쿡 ǰϰ Ʊ⸦ մϴ
׷, ϳ Ȯ Ǵ θŭ
Ͻþ ġ ϼž մϴ
ùӽſ ǻ Ͽ
ġ
ι° ӽ Ŀ D׿ ü ġ Ȯ ʿ䰡
̷ Rh ü˻(ַ D׿) Ͻð
ֱٿE׿ ϴ ׽Ʈ ð ˴ϴ
Ż ȯ ͸μ Ͻð ˴ϴ
󵵰 1:1̳ 1:2, 1:510 ̹ ̰ 1:32 쵵 ֽϴ
ı Ǵ ħϿ Ȳ Ÿ
¾Ƽ̳ ź ų ִٰ մϴ
պ̳ к ˻縦 Ѵٰ ϴ Ʒ Ͻþ
ñ ٶϴ

Rh ڰ Rh 缺 ްų
Rh Rh 缺 Ʊ⸦ ӽϿ ۵Ǿ
Rh ü ϱ ϴ ˻Դϴ.
Rh Ż ȯ ̿˴ϴ.
˻ 5 ̾Ƽ ˻縦 ϰ
˻ Ⱓ Ϸ ɸٰ մϴ.
2 쳪 , ä 24ð ̻
˻ϱ⿡ ϴϴ.
׸, ׿ ˻ պ ӻ󺴸 ࿡ ٷδ
Rh ü ˻ ǿ޿ ʰ
պ ǻ ˻ Ƿڰ 쿡 ϴ
ִ ˻ ƴ϶ մϴ.
׸, ˻ պ ˻ ٷδ
Rh ü ABOü ˻
ȴٰ ϳ׿
, ˻簡 ġ װ͵ ˻ ϰ û Ǵ 찡
ٰ մϴ
˾ƺ 뱸 Դϴ
Ư ٸ ̹Ƿ Ͻð
̶ DZ⸦ ٶϴ.
ģ ֽ ׿ в 縦 帳ϴ
մϴ.


رȯ(exchange transfusion, replacement transfusion)


. ù ü
1924 Ʈ Ƶε尡 Ż Ȳ ġḦ ó õ ̷
̷ Ⱑ Ͽ

. ġ ȯ

. Rh
. ABO  Żƿ ȯ
.  ε ߻Ͽ ̴
. ׳ ϴ 츮ǻ ๰ߵ
. ȥ, Ż, 䵶ı, ġ

.

. ƿ ƿ ī׸ ־ ݺѴ
. ư ʵƿ ī׸ ÿ ־ ȯѴ
. () ̿ȴ
. 밳 ÷ ż Ѵ
. Rh ȯڿ ̳ Rh ϳ
̸ ۿ Rh O Ѵ
. ABO ȯڿ Rh O Ѵ
. ȯ ȯڿ Ѵ


.

ġ ϸ ü,
׸ ۵ ¾ ϰ ν ֿ ʷϴ
Ȳ ϴµ ִ


. ۿ

ũ, , Į, Į, , , , õ,

. ü

. Ȳ
. ȯ
. Ŀ ġ ڵ
. 迡 ü


***ȯ ߰

Ż ȯ (Hemolytic disease of the newborn, HDN)
Ȳ Żƿ պ ʷ Ƿ
ϰ ϰ Ű
ü ϱ Ͽ ȯ Ѵ.

豳ȯ

- ABO HDN : κ O. 7 ̳ O ϰ
- ABO HDN : AB ż  .
- Rh HDN : Rh ̰ Ʊ Rh 缺. Rh .
- Rh HDN : ABO ֱ α .



ѹ Ż ׷ 5-10% 10-15 mL ϰ
ŭ ȯ .
Ż ׷ 2 ȯ .
ٷ ǿ¿ ġϰų
װ±⸦ Ͽ µ ÷ . Ͽ .

ȿ

: ׷ 2 ȯ ָ ȯ 60% .
CBC: Ǽ 50-70% ҵ ϳ ȭ .
20-25% ҵ.



ڻ Rh(-)ȸȸ :


1973 2 ߾׿ Rh(-)ȸ ó Ǿ
1980 4 ڻ翡 ȸ Ǹ鼭
Ἲϰ âȸ Ͽϴ
1981 7 װȸ ü
Rh(-)ȸ ػ ķ
ȸ DZ⿡ ̸ϴ
1996 4 ȸ ἺǾ
1997 5 1ȸ ȸȸ 强 ֵǾϴ
2002 3 ڻ ûϿ
2002 7 1 ڻ
Rh(-)ȸ ȸ Ǿϴ
2002 8 31 âȸ Ͽ
2002 10 12 ڻ Rh(-)ȸ ȸ ߴ
翡 Ǿ
2004 6ȸ ȸ ȸ Ѹ λ꿡 ֵǾϴ
2005 1 23 ȸ ȸ ȸ(ȸ:泲 ׿ ȸǽ)
Ȳ Ǿϴ
14 ȸ
ڿȰ ڿȰ ϸ鼭
ÿ ̸ ֽϴ
ϴٴ ϴ ̳ ص
ƴϾ ̰Ϳ
RhװƼ ε鿡 ͺȣ Ǹ ϱ ȸ
30 Ե Ǿ
ÿ ̷ Rh(-)ȸ , ӿ ûο ӵǰ ֽϴ


Rh(-)ȸ  üԴϱ?

Rh(-)ȸ
츮 ü α 0.35%
15 Rh(-) ڷ
ڿ ü̸
üԴϴ.
ȯ ߻ ӻθ

ް ִ ȯڵ

1̸ 200 Ѵ
س ʹüԴϴ.
Ѹ RH(-) ڶ
޴
ּ Ӹ ƴ϶,
ȸ ȣ ǰ ȸ ȳ ߱ϸ
ε
1973 âǾ
ÿ ̸ ȸ ߱,
ȣ, Ῥ
ǰ
ϰ ֽϴ.


Rh(-)ȸ ȸ  ϳ?

ѹ̱ Rh(-) ڻ üν
ڻ Rh-ȸȸ ֽϴ
Rh(-)ȸ ȸ ׿  մϴ
ȸ ü Rh(-) ڿ е Բ
췯 äο ſ ֽϴ
Rh-ȸ 14 ȸ ΰ ἺǾ ֽϴ.
ȸ Ȩ(http://www.rh.or.kr) ܿ
[Rh-ȸ]-[ȸμҰ] Ŭϸ ȸ ΰ ȳ˴ϴ.
׸, Ͻô ȸ ŬϽø
ȳ ص帮 ֽϴ.
Rh(-)ȸ Ͻø ȸԲ ϰ ӿ
Ǹ Ͻø ģϰ 亯 帱̴ϴ.
ȸ ټ ̰ Ƿ Ͻñ ٶϴ.
޵Ǵ Rh(-)ȯڰ ߻ϸ
׿ ó ü ϰ ִ ̳
BIMS( Ȯνý) Ͽ
α ׿ ̼۵Ǿ մϴ
׸ ֶο Rh(-)ȸ ȭ
ȸ Ȯϰ ִ û ȭ 帳ϴ
޴ ȯڳ ִ ȸ ʹ ϴ
׷ ڿ(ѹα 0.35%, 15) ִ 츮
μ ģ ְ ֵ
, ȸ ȫϰ ϸ [RhװƼť] Ծ ؼ
ȸ ԰ ΰ踦 ִٰ մϴ
ڻ üν ںν
ڿȰ ڿȰ μ
ڱ ھƽ ϰ Ǹ μ
õϴ ū ñ⸦ ٶϴ
̰  Rh(-)ȸ̸ 켱 θԲ ӿ ϼż
Ʊ ̸ ȸ ֽϴ.
̼ 쿡 ǽðڽϴ
ε Rh(-)ȸ ϼż Ͻð ָ ñ ٶϴ.
մϴ

ڴ ȸ Ͽ 帮ڽϴ
(뱸 帮ڽϴ)

.ȸ ȸ, Ժ

ȸ : ݿ ( 5000- 6)
Ժ : 縸( 1ȸ-г )

*ȸ 뵵 :
-ȸ, ۳ȭ
- dz, ȸ
-
- ڷ μ, ߼ۺ
-ȸ, ϰȸ
- Ļ
-ȸ ȸ
-ȸ 繫 ȭ-
-Ȩ -
-ӿ Ÿ ȸ 湮 Ȱ -

*Ժ 뵵 :
- , Ժ(ȸ ø غ)

.Rh(-)ȸȸ ȸ

ӿ 3 : 5
ȸ : 800( 9600)

*뵵 :
1.(1 2)-
¦:ȸ ȸ, Ȧ:ӿũ
2., â ȸ
3.ӿ ȸ
4.ȸ ȫȰ
5.繫
6.
7.Ȩǿ
8.Ÿ ȸ 

.׿
10 ( ټ ̰ ֽϴ)
-ڻ Ÿ ü Ը


Rh(-)ȸ Ȱ (뱸 Դϴ)

1.ڿ Ȱ
û ڿ
ķ
׿
û ȭ
ڿ

2.ڿ Ȱ
ü Ȱ (ȯ, ȭ, Ƿ ...)
ӿ α׷
ڻ
̿ ƿ, ο 湮

3.ȸ
ȸ(3, 7)
dz(5)
ȸ(9)
ϰ ȸ(8)
۳ȭ (11)
ȸ 1ȸ (ų 1)
ȭ Ȱ(ÿ ׸ )
RhװƼ ť Ծ Ϲ , ȫ
Rh(-) RhװƼ ť Ծ
̷, û α׷




Rh(-) ȸ ̷ :

21C ȭ ô ϰ з ô մϴ
ȭ ̴ ߱ϰ Ǽ ظ
ִ ô븦 ̿ ռ õϴ
ູ ôԴϴ
׸ 21C NQ ߸ Ƴ ô մϴ
Ҿ ϴ ġ ų ھư ϰ ֽϴ
ھƽ ϰ ΰ ȸ ൿ ô뿡
ʿϰ ߹޾ƾ ΰ Դϴ
ڹ ڼ Ǫ ڱڽŰ Բ ִ ̸
ȸμ 븦 ΰ ΰ ִ ȸ Ǽϴµ
Դϴ ̷ ϴ ü ǽ ߷̸
ڱ ߽ɿ ŻϿ ü ߽ ϰ ൿμ Ҿ ϰ
Ѱ Դϴ
Ǹ ִ õ ̷ ġ âϴ ִ õ Դϴ
ȭ ô, ô, ȭ ô뿡 Rh(-)ȸ ȸ 14
ȸ ȸԵ ڿȰ ڿȰ ް ִ
װƼε鿡 ູ ̷ մϴ
̷ ظ ǰ ׸ ִ ʴ
ū Դϴ
մϴ


Rh(-) ȸ :

ѹα Rh (-) üν ڻ ü
ڻ Rh-ȸ ȸ ֽϴ
׿  ϰ ȸ ü Rh(-) ڿ
е Բ 췯 äο ſ ֽϴ
Rh-ȸ 14 ȸ ΰ ἺǾ ֽϴ.
ü Ȩ(http://www.rh.or.kr) ϰ ֽϴ
޵Ǵ ټ ̴ ְ Rh(-)ȯڰ ߻ϸ
׿ ó ü ϰ ִ ̳ α ׿ ̼۵Ǿ
մϴ(ü ȯ 70-80%)
׸ ֶο ȸ ȭ ȸ
Ȯϰ ִ û ȭ 帳ϴ(ü ȯ 20-30%)
޴ ȯڳ ִ ȸ ʹ ϴ
ȯ 90% ̻ ȸ ȸԴϴ
׷ Rh(-) ڿ(ѹα 0.3%, 15) ִ 츮
μ ģ ְ ֵ ϸ
ȸ ȫϰ ϸ [RhװƼť] Ծ ؼ ȸ ԰
ΰ踦 ϰ ֽϴ
ڻ üν ںν ڿȰ ڿȰ
μ ڱ ھƽ ϰ Ǹ μ õϴ
ã ֽϴ
ڹ ִ ൿ õϴ ּ, 縮 ʰ
Ÿ 縦 õϴ ͼ, ƹ ϸ鼭
ܷ Ȱ ϴ 밡, õ ϴ Ӽ
ȯ ϴ Rh(-)ȸ ̷ ִ 400cc
ݵ ӵǰ ֽϴ

Rh(-)ȸ ȫ

츮 ִ ʳ
Rh Negative ̽ Եκ ۵Ǿ
츮 ִ ׺е ʽɿ
Ĺ Ͽ ϱְ ֽϴ
Ƚϰ θ
帧 ӵǰ ְ
ü ٶ
츮 ǽ ȣ Բ ϰ ֽϴ
⿡ 츮 ڱå Ұ
ƴϸ ȵǾ⿡
츮 ħ ʾҽϴ
׷ ϳ
츮 ε Ÿ ü մϴ
ͳ̶ ְ
̹ ,
츮 İ ֽϴ
¼ 츮 ش Ǽ̰ ͵ ´ٸ
з̶ ̸ Ǿ
ϰ ִ 𸨴ϴ
츮 ſ ä
ȭ ӿ Ƴ⸦ ˹ް
ҽ ô ı ٱġ鼭
ä ʽϴ
Բ ϰ Բ ƾϴ Ģ տ
̸ Ҹϴ
츮 Դϴ
ȸ ӿ !
ô밡 ƴ϶ ȫ ô ϳ׿..
ڹ̸ ṵ̈ ʴ
鼭 ˷ϴ
ǰ ֳ׿..
Ȱ ð
Ⱦġð Ǹ ô е鲲
̷ Ƿ ǹ̰ ְڽϱ
׷ ô ͳ ٰ ƿ켺̳׿..
,
̷ ֿ ûԴϴ
ûҳ Ĺ鵵 츮 ϺԴϴ
ڽ ߵDZ⸦ ٶ θ Ȱ Ĺ Ƴ Ȱ
Ĺ谡 ڸ ԵǾ ؾϴ ͵
谡 Ĺ谡 ִٸ
Ⲩ 㸮 ƴϴ
ᱹ ǰ Բ ɵ ʽϴ
ϰ ϸ Դϴ
400cc
װƼε ֽϴ
մϴ





*ó : ڻ Rh(-)ȸȸ[http://www.rh.or.kr]
뱸Rh(-)ȸ[http://doosonmor.org]
* : ฮ, ǻ , ¾ д


ڷ, Ȯ, м , ׿ ,
ǰɻ򰡿 ڹ, ׿ ,Ÿ Ͽ
Ұߵ 鿴 帳ϴ
뱸Rh(-)ȸ Ȱϰ ִ ڷ̸
ȸԲ ̶ ǽø ϰڽϴ
ѹα Ͻô Rh(-) ڵ Ͽ
ǰ ٵ åڰ ߰DZ⸦ Ҹմϴ
մϴ


ۼ : ڻ Rh(-)ȸȸ .ȫ ڿ켺

ó :

ڻ Rh(-)ȸȸ http://www.rh.or.kr
뱸Rh(-)ȸ http://www.doosonmor.org
ī http://cafe.daum.net/ichisalang1





 0.35%  ! 
<br/ >ѹα  ʿմϴ .