Dr. Komarovsky about blood tests

There are no people in the world who would not be prescribed blood tests. Such laboratory diagnostics is carried out not only for sick children, but also quite healthy - for preventive purposes. And all because the clinical blood test is a very informative and accurate method that allows to identify violations in the children's body at the very initial stages. About what analyzes are and how they are decrypted, says the well-known children's doctor Yevgeny Komarovsky.

Under the universal and running name "blood test" hides a great variety of laboratory tests. There is a general analysis and biochemical, there is an immunological examination, and there are tests for very specific infectious diseases. In total, there are more than a hundred different parameters that can be determined in the blood of a small patient. The doctor prescribes in this or that situation exactly the analysis, the results of which are necessary for him to establish an accurate diagnosis.

When conducting a clinical analysis of blood is of great importance to identify the ratio of the number of certain cells. If, for example, there was bleeding and the child lost a lot of blood, the red blood cells increase, and if there is a violation of blood clotting, the platelets decrease or increase. Thus, the numbers as a result of the analysis do not just exist. For the doctor, they represent the most important information that characterizes the functioning of the organism as a whole.

A blood test is a general test or a KLA, as it is abbreviated to pediatricians, directing the baby to the laboratory. Also, no one explains to parents that the very concept of “norm” in children is completely different, not the same as in adults. In the form, where the laboratory technicians record the results of the blood composition study, the norms are presented only by adults, since the form itself is approved by the Ministry of Health. Children's form with children's norms does not exist in nature. This explains the excessive anxiety of moms who compare the results of the offspring with the printed standards (adults) and find a lot of deviations.

Yevgeny Komarovsky recommends that you prepare for the blood test, especially for parents. Since the composition of the blood is in direct correlation with the fact that the peanut ate and whether he ate at all. It is better to donate blood on an empty stomach and in the morning. This may require some effort - to persuade the child without breakfast to go to the clinic, because at home the material for close laboratory studies are not collected.

Blood can be taken either venous - from a vein, or capillary (from a finger). For general analysis, both options are valid. If the material is taken from the finger (which happens most often), then the scarifier must be used sterile, disposable. The same requirement applies to equipment for the capture of venous blood. If the child has to donate blood several times during the illness (for monitoring, assessing the dynamics of therapy, etc.etc.), it is best to create similar conditions - donate blood at the same time each timeThis will provide more accurate results.

This question for moms and grandmothers is the most burning. On the one hand, parents are not at all obliged to study all complex medical terms and norms, but on the other hand, everything that concerns a child’s health is very interesting. Komarovsky talks about how to independently understand the complex terms of the form of a clinical blood test. You need to start with basic concepts that always begin with professional decoding.

This is a protein that is located inside the red blood cells of the largest - red blood cells. It performs the transport functions - it delivers oxygen to the organs, it takes the product of the decomposition of oxygen - carbon dioxide. AT hemoglobin includes a separate component that is not related to proteins, called heme. Heme is a haven of iron, its sole function is to provide the blood with a certain color, naturally red.

In order to understand whether the baby has enough hemoglobin protein, the protein concentration in grams per liter of fluid is detected in the laboratory under laboratory conditions. If mom and dad have normal hemoglobin concentrations in adulthood, then in children, regardless of gender, the norms are the same.

When conducting a clinical study of karapuz blood, the laboratory technician is tasked with counting the number of red blood cells per liter of blood. Consider them under a powerful microscope, and the result is calculated per liter of fluid. If we write the resulting number from the analysis form, the form itself must be increased several times, since the result is obtained with twelve zeros. Therefore, the data is reduced. Also in the form indicate the average hemoglobin content in one erythrocyte. To do this, the previously mentioned hemoglobin parameter is simply divided by the number of red blood cells that are counted under a microscope.

Since blood is formed elements in the plasma, the hematocrit is the ratio of plasma and formed elements. In order not to think for a long time why it is necessary to calculate such a ratio, Komarovsky advises to present compote. The ratio of fruits and berries in it and water - this is the hematocrit. To make it clearer, hematocrit itself determines blood density (as a percentage).

Erythrocyte sedimentation rate (ESR) is another ability of the largest blood cells, which is used to judge the state of health in general. Violations and abnormalities in the ESR and other parameters of erythrocytes are clinically important for the diagnosis of anemia in a child, some blood disorders. Neither the presence of the virus, nor of the bacteria, these indicators themselves do not indicate.

Although as a result of any long-term illness, the blood thickens somewhat, therefore, after the flu or ARVI, in which the baby has a fever, red blood cells, hemoglobin and hematocrit will change. But in the inflammatory process there is an increase in ESR in the blood. For this reason, Komarovsky urges mothers not to rejoice, if suddenly during the course of the illness or after it the baby has a high hemoglobin.

This is not a sign of good health, as many people think, but a sign of thickening of the blood, but because the toddler is shown frequent warm drinks, which will help correct hematocrit. The average rate of hemoglobin in the blood of infants up to 1 month is 160-200 g / l, at the age of up to 5 years - 110-140 g / l, and then - 120-140 g / l. The total number of red blood cells at the age of 1 month reaches 4-5Х10 ^ 12, per year and further - 4-4,5Х10 ^ 12. Hematocrit at 1 month is normally 45%, at 1 year - 35%, at 5 years - 37%, and at 10 years - 39%.

These cells are an important component of the blood coagulation system. If there are few of them, the blood will be slower when injured or cut, which threatens to develop bleeding. These cells, like erythrocytes, are measured in terms of the quantity per conditioned liter of blood. The norms in childhood are rather blurred - from 10010 g / l to 40010 g / l. High platelets are talking about too thick blood, in which the formation of blood clots inside blood vessels is possible. This happens in children infrequently.

Yevgeny Komarovsky advises parents to pay attention to these blood cells, as this is a rather informative section for deciphering a children's blood test. In the blood leukocytes perform the role of the official representative of immunity. Since the immune system is acutely responsive to any changes in the state of health, this is immediately reflected in the concentration of leukocytes.

In babies, these protective "fighting" cells in the blood are always significantly larger than in adults. This can be explained by the fact that the immunity of the child is constantly in the process of learning, formation and development. If a child has an increase in the level of such cells, then they are talking about the presence of leukocytosis, if there are few protective cells, then they are talking about leukopenia. The causes of leukocytosis can be a variety of bacterial diseases, purulent inflammatory processes, hypoxia. But the deficiency of leukocytes (leukopenia) is usually observed during viral infection, with poisoning and other toxic states.

Leukocytes have many forms and types, each has its own functions, and therefore the analysis form indicates several types of these protective blood cells, the exact number of each species will help find out exactly what happened to the baby - his immunity fights the virus or the bacterium, is there a pathological decline or increased immune responses. The percentage of different types of leukocytes is called a leukocyte formula.

The amount of neutrophils is determined in the blood of a child. This is a type of protective cells that can attack a virus, a bacterium. Segmented nuclear neutrophils are considered the strongest. When a danger arises for the body, they appear first in the blood. The more severe the child’s condition, the more neutrophils will be detected in his blood, and not the segment-nuclear, but the band-nuclear ones. In the very grave condition of a baby, both metamyelocytes and myelocytes are determined in the blood.

Leukocyte eosinophils are needed to neutralize allergens. Therefore, their amount in the blood increases during periods of exacerbation of an allergic reaction or during infection with parasites. Basophils are the most mysterious of leukocytes. Their purpose is not fully understood, but they are determined with rare diseases.

Something like this, in a simplified form, looks like UAC. But in practice, mothers may encounter other data. For example, in the laboratory a lot of work, and the laboratory technician does not determine all the above indicators, limited to only the main ones. Sometimes there is no appropriate equipment. Due to the optimization of the healthcare system, laboratory diagnostics doctors are not enough, and therefore often in children's clinics are limited only to the determination of hemoglobin, ESR and total leukocyte count.

It should be noted that, Despite the high accuracy, clinical blood analysis without an experienced doctor who can correctly interpret the results, has no value. An experienced specialist, looking at the form from the laboratory, will be able to determine with great precision whether the baby is sick - with a bacterial or viral ailment, is there an inflammation, is it serious and extensive, does immunity work as it should. But to determine the sugar in the blood, the ratio of vitamins and micro-and macronutrients will help another analysis - biochemical, and this is - is another story.

Yevgeny Komarovsky advises parents to take a general blood test with all seriousness, if the doctor gives this direction, it means you need to donate blood and find answers to questions that the doctor also has. If the child is ill, and the pediatrician does not prescribe the KLA, it should be clarified with him whether this study is necessary. The fact is that sometimes the management of polyclinics limits the number of laboratory tests, and then all less serious cases of children's diseases are limited only by the visual diagnosis of the local doctor. It is better to do the analysis, even if this requires going to another laboratory or donating blood for a fee.

But to ask the appropriate question to the doctor you need at least for your own comfort. The health worker is required by law to provide comprehensive explanations on all issues that arise. Modern pediatric school also adheres to this rule.

What is it - a clinical blood test? What is its benefit? What interesting things can be learned by making such an analysis? And why is it so often prescribed by some doctors? The answers to all these questions are waiting for you in the next video from Dr. Komarovsky.