Darah Lengkap
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Transcript of Darah Lengkap
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Darah Lengkap
Dr. Bastiana bermawi, SpPK
xt
Pemeriksaan
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kadar hemoglobin ( Hb )
Satuan : g % atau g / dl atau g / L . Hematokrit ( Hct ) atau packed cell volume ( PCV ). Satuan : % atau L / L Jumlah sel darah merah atau Red Blood cell Count ( RBC ) Satuan :…/cmm atau…./ L atau …x 1012/ L
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indeks sel darah merah :
a. mean cell ( corpuscular ) volume
( MCV ) , Satuan : fl
b. mean cell ( corpuscular ) hemoglobin
( MCH ) , satuan : pg
c. mean corpuscular hemoglobin
concentration ( MCHC ) ,Satuan : %
atau g / dl
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MCV = Mean Cell Volume
Menghitung MCV (Mean Cell Volume):
MCV= PCV/Ery X 10 (fL) (1 fL=10-12L= 1μm3)
N : dewasa = 80-100 fL , di bawah 1 thn = 76- 86 fL
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MCH =Mean Cell Hemoglobin
- Menghitung MCH (Mean Cell Hb):
MCH= Hb/RBC x 10 (pg)
(1pg=10-12g=1μμg)
N: Dewasa: MCH = 27-32 pg, Anak-anak: MCH =23-31 pg
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MCHC= Mean Cell Hb Concentration
MCHC (Mean Cell Hb Concentration) :
MCHC=Hb/PCV x 100 (g/dL)
Normal: MCHC = 32-36 g/dL
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Jumlah sel darah putih atau White Bood cell Count ( WBC ), Satuan : …./cmm atau ………./L atau …… x 109 / L
Hitung jenis sel darah putih ( differential leucocyte count )
Retikulosit , satuan : %
Laju endap darah ( LED ) , satuan : mm / jam
Jumlah trombosit, satuan …./ul, …/cmm, …..x 109/L
Hapusan darah tepi
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Pengambilan Sampel Darah :
Antikoagulansia : Pemeriksaan Darah Lengkap:
Ethylene Diamine Tetra-Acetic acid (EDTA)
- Macam : - Sodium EDTA (Na2EDTA) - Potassium EDTA (K2, K3EDTA) - Lithium EDTA
- Cara Kerja : - chelating agent - Dosis : - 1-2 mg untuk 1 ml darah
- Penyiapan :
buat larutan EDTA 10% dlm aquadest → bagi dalam botol-2 @ 20 μL (~ 2 mgEDTA) →
keringkan ( 1 btl utk 2 ml darah)
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Sodium Citrate : untuk pemeriksaan LED, Faal Hemostasis
- Konsentrasi :0.109 M (3.2%), 3.8%- Dosis :
1. LED Westergren – 4 vol drh : 1 vol Sitrat2. Faal Hemostasis - 9 vol drh : 1 vol
Sitrat
Heparin :- Untuk pemeriksaan OFT dan Mikrohematokrit- Dosis : 1 mg (0.1 – 0.2 ml larutan) atau
10-20 IU heparin / ml darah .
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Pengambilan sampel darah
Jika memakai tabung vacutainer warna tutup tabung vacutainer menunjukkan antikoagulan yang dipakai.
Pemeriksaan DL: EDTA (vacutainer tutup ungu /lavender).
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Prinsip Pemeriksaan complete blood count(CBC) dengan mesin hitung sel otomatis
Prinsip:
1. Tahanan listrik / impedansi
2. Prinsip optik
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Kelebihan penggunaan mesin hitung sel otomatis dibanding metode konvensional
presisi dan reprodusibilitas baik jumlah pemeriksaan banyak dengan
tenaga relatif sedikit.
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Reprodisibilitas pemeriksaan sel darah
Jenis sel
CV
Cara manual/
hemositometer ( % )
Cara otomatis
( % )
Sdm ± 11,0 ± 1,0
Sdp ± 16,0 ± 1,5
trombosit ± 22,0 ± 2,0
Retikulosit ± 33,9 ± 5,0
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Reprodusibilitas indek sel darah merah
Indek Cara pemeriksaan
% error (± 2 CV )
Hb Spektrofotometris
1,0 – 2,0
Otomatis <1,0
MCV Manual 9,5
Otomatis <1,0
MCH Manual 10,0
Otomatis 0,6 – 1,2
MCHC Otomatis 1,0 – 1,5
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Metode impedansi
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Ukuran relatif lekosit
DT lym baso mono eos netro
Ukuran lekosit sesudah lisis
Histogram lekosit
lym mid gran
50 100 150 200 250 300 350
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Jumlah sel
Histogram
Volume sel
Hb
PCV, MCH,MCHC MCV,RDW,MPV
DIHITUNG DITURUNKAN
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Volume lekosit
35 fl = limfosit
90 – 160 fl = monosit
160 – 450 fl = granulosit
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Prinsip metode optik
detektor Light scatter
Laser detektor ( 00 )
detektor
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