Hemostasis - ndichiyani? kuphwanya hemostasis

Ambiri mwa ife anali kuyesedwa kwa hemostasis. Kodi ndi chifukwa muyenera fufuzani? Yankho la funso limeneli ayenera kuyamba ndi kulongosola zimene maso athu magazi ndi zimene njira ndi logwirira ntchito izo.

Ntchito yoyamba hemostasis

anthu ochepa chabe amene akudziwa kuti magazi athu - komanso nsalu, yekha madzi. Amakhala plasma, ndi chuma cha zinthu zamadzimadzi, komanso maselo ofiira, maselo oyera ndi maselo othandiza magazi kuundana, zomwe zili plasma monga zinaimitsidwa. Zonsezi mosalekeza limayenda limodzi yaikuluikulu mitsempha, mitsempha ndi capillaries kubweretsa mpweya ku maselo, mphamvu ndi kuchita khamu la ntchito zina. Chotero chitsanzo chosavuta cha dongosolo lathu magazi. Nkofunika kuti magazi anali kugwirizana bwino. Ngati wandiweyani kwambiri, magazi kuundana anapanga. Ndipotu, ngati kwambiri wochepa thupi, munthu amadwala magazi ochuluka. Kumalimbikitsa magazi athu mu chikhalidwe akadakwanitsira analengedwa ndi chikhalidwe cha dongosolo, lotchedwa hemostasis. Kodi mtundu wa dongosolo ndipo kodi limagwirira ntchito yake?

Ntchito yachiwiri hemostasis

dongosolo hemostatic ndi zovuta. Kuwonjezera kukhalabe anakhumba magazi kukhuthala ndi fluidity, lili ndi bala machiritso (wotseka magazi) kuti mabala ndi zina mtima choipa. Makoma a yotsirizira anapanga ndi zigawo zitatu minofu, omwe amachita mbali kuonetsetsa Ndime yosalala magazi m'thupi. Ngati pa zifukwa zina, kukhulupirika kwa mpanda chotengera chake chawonongeka ndipo magazi iri yofulumira ku kusiyana, ndipo munthu amatsegula magazi. Kukuletsa akapsa dongosolo thupi la coagulation magazi, kapena hemostasis. Iye ali mitundu iwiri - pulayimale ndi sekondale.

Pulayimale hemostasis: izo

mtundu uwu kutha kwa magazi amatchedwa mtima-kupatsidwa zinthu za m'mwazi hemostasis. Limagwirira ntchito yake imakhala pochititsa kuphipha ya chotengera owonongeka kuchepetsa ake ndipo blockage wa "mipata" othandiza magazi kuundana. Mbali kuonongeka aumbike kutumphuka, magazi ndinayima. Anthu amati, "mwazi clotted." Anthu amene alibe mavuto ndi hemostasis, ndondomeko imafuna maminiti 3. njira yake ya kanthu ili. Pa makoma chotengera pafupi bala akuyamba guluu wolimba, mwachitsanzo mafunsidwe, guluu wolimba wa othandiza magazi kuundana. mawonekedwe awo umakhala anamaliza ndi padziko spikes kuoneka ndi zomwe kupereka mgwirizano wamphamvu ndi maselo othandiza magazi kuundana ena. Chifukwa ndi ogwirizana iwo pamodzi (loitanirana), ndipo aumbike mwa pulagi kupatsidwa zinthu za m'mwazi. Mu 1 ml magazi ayenera kuchokera 150 mpaka 300 zikwi wathanzi kupatsidwa zinthu za m'mwazi mawonekedwe zolondola. Apo ayi ndondomeko clotting ndi akusokoneza.

ndi hemostasis sekondale zimene

Glued othandiza magazi kuundana kuyamba secrete mu mwazi yogwira zinthu kwachilengedwenso ndi mankhwala kuchititsa constriction makoma chotengera ndi mapangidwe sekondale sizingasinthe kogwirizana. Imodzi ndi kupatsidwa zinthu za m'mwazi Chinthu chapadera zofunika kwambiri kwa clotting enzyme thrombin, womwe zimakhudza mapangidwe Ulimbo mapuloteni. Ulusi mapuloteni ndi maziko a magazi aumirira. Kulenga mtundu wa maukonde imene opiringizidwa maselo ofiira ndi maselo oyera. Ulimbo anachokera ku mapuloteni.Tiligu wina - fibrinogen. Kudziwa kuchuluka kwa magazi, amapereka magazi hemostasis. Kodi izo - fibrinogen - nanga kufunika kwake? mapuloteni Izi ndi mbali yaikulu mu clotting magazi. muyeso wake amachititsa thrombosis, ndipo alibe - kukha magazi. Wakudziko ndi kuchokera 1.5 kuti 3,0 g / L fibrinogen. Ngati ndi oposa 4.5 g / L, pakhoza kukhala matenda monga TB, matenda opha ziwalo, matenda a mtima, khansa, chibayo, fuluwenza, ndipo chiwerengero cha mavuto ena, kuphatikizapo zilonda zamoto, opaleshoni ntchito mankhwala ena. Kuchuluka kwa mapuloteni osachepera 1.5 g / L chifukwa matenda enaake, DIC, matenda a chiwindi, myeloid khansa, toxemia, gawo cesarean pa yobereka, polycythemia, njoka towuluka, B12 akusowa ndi vitamini C.

Ntchito yachitatu ya hemostasis

Mbali yomaliza ya machiritso chilonda - fibrinolysis, amene ali ndi udindo hemostasis nayenso. Ndi chiyani icho? Fibrinolysis ndi chiwonongeko cha plugging magazi aumirira ndi kubwezeretsa magazi kwa mitsempha kuonongeka. Kuchokera masekondi woyamba wa bala machiritso ndondomeko ndi chiyambi cha clotting magazi plasma adamulowetsa enzyme plasminogen. Amalima mapuloteni plasmin anadziphatika Ulimbo, ndi izo, ndi magazi aumirira. Pakati thrombus mapangidwe ndi kuvunda ayenera kukhala bwino, amene amathandiza hemostasis. Monga mukuonera, dongosolo ndi yovuta kwambiri. Kulephera ngakhale zinthu zing'onozing'ono kugwirizana ake kumabweretsa kusokonezeka kwa unyolo wonse ndi matenda aakulu.

Kulakwila hemostasis. ndi ndi zimene mmene tingadziwire

Pali kuyan'anila zotsatirazi:

- kuchuluka magazi clotting (hypercoagulable) imbaenda kuna mapangidwe mowiriza wa thrombi mu mitsempha, mitsempha, ndi ziwalo. Ndi zinadzala ndi matenda oopsa monga sitiroko ali aang'ono, padera kawirikawiri mu akazi, matenda ubongo (chifukwa cha thrombosis mu mitsempha ya ubongo), ndipo ena.

- Zochepa magazi clotting (hypocoagulation), imbaenda magazi lachibadwa. Kumachitika mu amapatsira mwana wake, matenda Von Willebrand, akusowa magazi kupatsidwa zinthu za m'mwazi kapena kusintha pathological, chiwindi matenda, osakwanira clotting zinthu thrombocytopathia.

- DIC, imene onse ali mitundu ya coagulation.

Kudziwa chifukwa cha kuvutika mu clotting magazi gwiritsirani hemostasiogram (coagulation), kapena kusanthula hemostasis. Ndi chiyani icho? Izi kusanthula chitachitidwa kwa amayi apakati, odwala asanachite opareshoni, anthu akuvutika ndi matenda a zotengera mtima ndi magazi, komanso odwala ndi kuvutika kwa clotting magazi. Coagulation ndi m'munsi, amene amasankha hematocrit, hemoglobin, chiwerengero cha zinthu zonse magazi ndi angapo zizindikiro zina. Mtundu wachiwiri wa coagulation - anawonjezera, n'kuika makamaka anthu ndi kuvutika magazi ndi pakati.

Mahomoni hemostasis ngati njira mankhwala

Ena akazi ndi kulephera kupita kumwezi, kuyambitsa kutaya mwazi wolemera yaitali. Pofuna kuthetsa vutoli, ntchito hemostasis m'thupi. Ndi chiyani icho? njira umagwiritsidwa zochizira atsikana, amene sakuikidwamo matenda monga fibroids, zotupa yamchiberekero, endometriosis. Pali njira zitatu za m'thupi hemostasis - esitirojeni, progestin ndipo losanganikirana. Esitirojeni ndi esitirojeni jakisoni intramuscularly. Woyamba masiku awiri kapena atatu kuchita lililonse maola 2.5-3. Mu masiku awa, mlingo utachepa. Pambuyo kukatseka magazi m'malo mwa estrogens ndi progestins kuchititsa mankhwala ndi wothandizila m'thupi. Progestogen njira ntchito pamene odwala mulibe magazi kwambiri, decompensated matenda enaake. cholinga chake - kupanga mlingo wa mahomoni imene mphamvu ali wokanidwa endotherm okongola uterine patsekeke. Matanthawuzo ntchito njira imeneyi ingagwiritsidwe HCG hemostasis ntchito gonadotropin.

Hemostasis pa mimba

Mimba amachititsa kusintha ambiri mu thupi la mkazi. Mmodzi wa iwo - kuchuluka kwa maselo othandiza magazi kuundana ndi, monga Motero, kukhuthala magazi. Izi ndi wabwinobwino zokhudza thupi ndondomeko, chifukwa pokonzekera adziwitse chamoyo genera. Komabe, ngati kwambiri aumbike othandiza magazi kuundana, tinganene thrombophilia, chikhalidwe imbaenda kuna mapangidwe kuundana mu mitsempha ya magazi. Thrombophilia ndi kuchotsa mimbayo, yoopsa kukula retardation, toxemia ndi mavuto ena. Choncho mwamtheradi zofunika kuchita mayeso chifukwa hemostasis pa mimba. Kodi izi zikutanthauza chiyani ndi pamene tiyenera kuchita? Choncho, ngati kusanthula izi kugwira pamaso lingaliro kupewa mavuto wotengera mwana. kusanthula izi ikuchitika mfundo 14, ndi kupereka molondola boma la magazi. Ngati chosayenerera wapezeka, adokotala akhoza mankhwala. Koma izi si koyenera. Nthawi zina kuonerera chokwanira cha mphamvu ya kupatuka pa.