Coagulation - ndichiyani? Decoding ya coagulation magazi: zizindikiro ndi mlingo

"Coagulation - ndichiyani?" - anafunsa anadabwa, Odwala amene anandituma kutenga kudzipenda moteromo. Ndipotu anthu wamba akukumana ndi phunziro ofanana infrequently, zambiri pokonzekera opaleshoni voti. Choyimira yogwira akuti ndi amayi apakati. Analysis wa ndondomeko coagulation wotengera mwana aliyense trimester.

Mu mawu samveka kuphunzira mabodza magazi. Anapereka magawo anaphunzira zingasiyane malingana zasayansi. kusanthula ndi zimasonyeza ndiponso kufalitsidwa. Mbali yoyamba amaonekera basi mwachindunji akulumikiza clotting ndondomeko kuphwanya zinachitika. Coagulation kufalitsidwa - mtundu wa kafukufuku amene, kuwonjezera Mkhalidwe ndi maphunziro kachulukidwe ndi zilema. Thiabendazole angagwiritsidwe ntchito kuzindikira matenda kupatsidwa zinthu za m'mwazi, thrombosis zosiyanasiyana, akusowa zinthu zina clotting ndi zina zotero. D.

Chifukwa cha ntchito njira kupeza chifukwa zimadalira chithunzi matenda, mtundu wa kusanthula kudwala. Tikumbukenso kuti mawu olembedwa a coagulation magazi - ichi ndi vuto lalikulu osati kwa layman, koma nthawi zina komanso dokotala. Childs, kuti apange matenda zolondola, pamafunika pang'ono mayesero loyenera.

The ndondomeko ya coagulation magazi

Tiyeni tione mmene ntchito clotting dongosolo. Mu sitepe yoyamba mankhwala kapena makina kuwononga makoma chotengera ndi allocated thromboplastin - mankhwala wapadera kudzipheralo coagulation anachita. Ndiye, kutsegula zinthu clotting chikuchitika - mapuloteni yeniyeni kuti zambiri zopezeka mu magazi ndi kupereka malo kuvulazidwa ya chotengera khoma thrombus mapangidwe.

Komanso, thrombin (a zachilengedwe zikuluzikulu za dongosolo coagulation chifukwa prothrombin) imayendetsa ndi wofooka mapuloteni fibrinogen, otembenuka mu yolimbikira mitundu Ulimbo aumirira maziko. Zinthu za magazi, kuphatikizapo othandiza magazi kuundana, "kofunafuna" mu zopezera Ulimbo. Chifukwa, maselo othandiza magazi kuundana magazi aumirira kudula mbamuikha kupanga okhwima thrombus kutseka kuwononga khoma mtima. Koma dongosolo magazi coagulation m'thupi komanso amatha dongosolo protivosvertyvaniya. Pamodzi kulola kuti mukhale magazi boma yachibadwa.

maphunziro clotting mu mimba

Monga tanenera kale, aliyense trimester, ndi zina ndipo nthawi zambiri azimayi oyembekezera adzakhala coagulation. Kodi ndi chifukwa chiyani kuli kofunika, amayi oyembekezera kudziŵa mwachindunji. mfundo ndi yakuti pa gestation mwana ntchito dongosolo coagulation monga lonse bwino. Ichi ndi masoka njira kugwirizana ndi zooneka uteroplacental bwalo magazi chithandizo. Mayi woyembekezerayo choncho kukonzekera imfa zotheka magazi pobereka.

Kuzindikira maonekedwe a clotting magazi ndi mavuto ena mimba opangidwa coagulation. Pochitika kusanthula nthawi unscheduled dokotala akhoza kufunsa ngati pali zolakwika ku magawo yachibadwa hemostatic (zigawo Mitsempha ndi magazi, amene amalola mogwirizana kukhalabe okhulupirika kwa mpanda mtima ndi magazi asiye kutuluka mu nkhani ya kuwonongeka). Magazi kwa maphunziro anatengedwa m'mawa pa chopanda kanthu m'mimba kwa mtsempha wa.

Decoding ya coagulation magazi

Zotsatira kuphunzira kusanthula ayenera ufulu kwa katswiri. Osati wodziwa wapadera, anthu sangathe kumvetsa magawo coagulation adziwe digiri awo zopatuka mfundo muyezo. Tiyeni kuyesetsa kumvetsa intricacies kwa ndondomekoyi ndi kufotokoza magawo zofunika kuphunzira.

1. Fibrinogen

mapuloteni Izi apanga mu chiwindi, kutembenuzira mchikakamizo cha zinthu zina magazi Ulimbo. chiwerengerochi ayenera akuphatikizapo coagulation magazi. Normal fibrinogen - 2-4 g / L. Ngati chinawonjezeka, zikutanthauza clotting kuchuluka, ndipo pali chiopsezo cha magazi kuundana. Childs, zinthu izi zimachitika asanabadwe, chibayo, pambuyo opaleshoni, ndi kachilombo ndi kutukusira kwa chilengedwe pachimake (TB, fuluwenza), m'mnyewa wamtima infarction ndi sitiroko (tsiku loyamba), ndi zilonda zamoto, hypothyroidism, kulera m'kamwa ndi estrogens. Yafupika fibrinogen mwina chifukwa kawopsedwe, matenda enaake kapena matenda a chiwindi mu mawonekedwe kwambiri, ndi akusowa vitamini B12 kapena C kulandira androgens anabolic mankhwala, mafuta nsomba, anticoagulants.

2. adamulowetsa tsankho thromboplastin nthawi (APTT)

Coagulation amasanthula nthawi imene, pambuyo kugwirizana kwa mankhwala enaake plasma kashiamu ndi zinthu zina anapanga magazi aumirira. Ngati mmodzi coagulation Chinthu ndi pansipa mwakale peresenti 30-40, aPTT kusintha mlingo. Mlingo avareji masekondi 30-40. nthawi achuluke ndi vitamini K akusowa, chiwindi matenda. Chifukwa kutalikitsa ndi aPTT ndi monga Motero, wosakwiya coagulation kungakhale amapatsira mwana wake.

3. Lupus anticoagulant

chizindikiro ichi nthawi zonse muli coagulation. Kodi chithunzi ichi? Ndani angafotokoze. Izi IgC oteteza ndi IgM, entailing kuwonjezeka mu aPTT. Mwachibadwa, amayi apakati sayenera umatulutsa. Chitetezo kuonekera pa nkhani ya matenda autoimmune, gestosis. Mimba ndi kudwala kawirikawiri zimabweretsa mimba lachibadwa, imfa yoopsa kapena infarction wa latuluka lapansi.

4. Prothrombin

Ndi zovuta mapuloteni omwe ali n'zofanana ndi thrombin (a mapuloteni kumene kumapangitsa mapangidwe magazi kuundana). Ichi ndi chimodzi mwa zizindikiro chofunika kwambiri coagulation. Prothrombin, ndi nawo vitamini K ali apanga mu chiwindi. Atalipenda mtengo uwu, dokotala akhoza kumvetsa kudwala m'mimba thirakiti chiwindi.

5. Nthawi prothrombin

Nthawi imene plasma powonjezera thereto mankhwala enaake calcium, thromboplastin ndi Ulimbo aumirira anapanga. chithunzi imeneyi yafotokozedwera masekondi ndi atakhala wofanana 11-15.

6. Prothrombin index (PTI)

Coagulation kumafuna ndendende njirayi m'malo amene m'mbuyomu. chiŵerengero iyi ndi nthawi clotting wa madzi adalinso ndi madzi a m'magazi a wodwala, anasonyeza kuti anthu a. Mu yachibadwa prothrombin chiŵerengero ayenera zosiyanasiyana peresenti 93-107. Zinthu za chizindikiro lino apanga maselo a chiwindi, matenda a chiwindi chiwerengero chawo yafupika, kotero IPT akhoza amatha kutumikira monga chizindikiro cha kudziwa boma la thupi zinchito.

Ngati PTI wautali kotero clotting ndi kuchuluka, ndipo pali chiopsezo thrombosis. Growth angayambe pamene mukumwa kulera m'kamwa ndi miyezi yomaliza ya adanyamula mwana. Kuchepetsa wa prothrombin index amasonyeza kuwonongeka kwa katundu magazi coagulation. Mapangidwe zinthu prothrombin zovuta amadalira vitamini K Koma sangathe ake, malabsorption mu intestine ndi (dysbacteriosis, enterocolitis) ndipo mwina zikuphatikizapo kuchepetsa IPT. Komanso, zingatipangitse kutenga mlingo waukulu wa aspirin okodzetsa.

7. Thrombin nthawi

Iyi ndi nthawi imene fibrinogen ndi adziwonetsa Ulimbo. Mtengo wake normative - masekondi 15-18. Kuwonjezeka index izi anamuona kupanda kobadwa nako wa fibrinogen kapena kuwonongeka aakulu chiwindi. Kuchepetsa chizindikiro, mwachitsanzo kuchepetsa nthawi thrombin, akusonyeza pamaso pa paraprotein (immunoglobulin mapuloteni) kapena owonjezera fibrinogen. Childs chizindikiro mtengo ulamuliro pa fibrinolytics mankhwala kapena heparin.

8. Antithrombin III

Ndi woletsa wa thrombin, dongosolo mapuloteni anticoagulation. Iye ali kumafooketsa pa ndondomeko coagulation. Mlingo chizindikiro anatsimikiza mtima ankameteramo ubweya wa thrombin mu chitsanzo mayeso (chopinga). Avereji ya mtengo wa antithrombin III - peresenti 71-115. Kuchepetsa kolowera kuti 50 peresenti ya yachibadwa kumatanthauza chiopsezo thrombosis.

The tanthauzo la chizindikiro ichi n'zofunika kwambiri makamaka kwa amayi apakati akutenga anticoagulants. Mankhwalawa amagwiritsidwa ntchito pa mwana wobala, pamene magazi clotting ndi kuchuluka, ndipo pali ngozi mapangidwe insufficiency placental, mimba kuthetsedwa.

9. D-dimer

Ichi ndi chizindikiro zofunika kwa matenda a thrombosis, womwenso coagulation. chizindikiro Izi zikusonyeza? Iye akuwulula za ndondomeko ya thrombosis ndi fibrinolysis. Mwachibadwa, D-dimer ndi zosakwana 248 ng / ml. Chizindikiro msinkhu ndi kuyamba kukula mu magawo oyambirira mimba. Kusiya kufunika chizindikiro mwina upambana koyamba katatu anayi. Amaona ponseponse. A mlingo wapamwamba mu akazi ndi njira yovuta mimba (preeclampsia), komanso anthu amene amadwala matenda a impso, matenda a shuga.

10. othandiza

Iwo kumatanthauza kupereka hemostasis othandiza magazi kuundana. Iwo anapanga mu m'mafupa. Normative mtengo - 150-400 zikwi / ml. Nthawi zina, akazi wathanzi kukumana ndi kuchepa kupatsidwa zinthu za m'mwazi kuwerenga 130 zikwi. / L. Chochititsa chidwi kuchepa zinthu deta magazi otchedwa "thrombocytopenia" ndipo amapezeka chifukwa cha kuchepetsa mapangidwe othandiza magazi kuundana, kuwonjezeka mowa zawo kapena chiwonongeko. Ndi zakudya osakwanira yafupika kupatsidwa zinthu za m'mwazi mapangidwe. Pa DIC, tikambirana pansipa, izo akufotokozedwa maselo mphako magazi ukuwonjezeka.

11. DIC

Mogwirizana kwa maselo othandiza magazi kuundana, zinthu coagulation ndi ndondomeko fibrinolysis amapereka bwino pakati coagulation ndi anticoagulation kachitidwe. Ngati aliyense limasonyeza izi adzamva matenda mimba zingachititse ena mavuto aakulu. The owopsa a iwo mwiniwakeyo intravascular coagulation. Akufotokozera chifukwa cha kutsegula a dongosolo fibrinolytic ndi dongosolo coagulation. Mu amayi apakati, zimayambitsa DIC kungakhale amniotic madzimadzi embolism, msanga detachment wa latuluka, ndi endometritis.

12. syndrome antiphospholipid (APS)

Ndi zovuta zizindikiro zomwe thrombosis (venous ndi wolumikizira). Akazi ndi APS ndi chiopsezo cha padera ndi zosayembekezereka kuchotsa mimba lachibadwa, chifukwa mu nkhani iyi kuchuluka kwa ziwiya latuluka akawinduka ndi osauka fetoplacental insufficiency. Matenda matenda odana phospholipid, kuchuluka thrombogenesis kuwonjezera, komanso kudziwa chitetezo kwa nembanemba kunja chipolopolo (phospholipids).

pomaliza

coagulation ankaona zizindikiro si zochuluka. Monga taonera, kusankha magawo enieni kuphunzira kumatengera zifukwa zosiyanasiyana. Zotsatira za kuwunika lidzakhala lilipo tsiku lotsatira pambuyo popereka magazi.