Coagulation - ntoni na? Kokuhlaziya of coagulation igazi: Iimpawu kunye nezinga

"Coagulation - ntoni na?" - wabuza xhungu, izigulane abathunyelwe ukuba azihlole. Eneneni, abantu abaqhelekileyo ujamelene isifundo efanayo kungafane, ngokuqhelekileyo ngelokulungiselela kutyando ekunokukhethwa kulo. Igama esebenzayo imifanekiso kwaye bonke abasetyhini abakhulelweyo. Uhlalutyo inkqubo coagulation ukuthwala umntwana yonke ezintathu.

Phantsi igama obscure isifundo undixokisa ukopha. Cwangcisa i parameters bafunda usenokwahluka ngokuxhomekeke elabhoratri. Uhlalutyo kubonisa kwaye zisasazwa. Kwimeko yokuqala ukuba uzimisele kuphela adibanisela ngqo inkqubo ekunqandeni ukuhlukunyezwa yenzekile. Coagulation eziku - uhlobo uphando, nto leyo, ukongeza ubunjani kunye nezifundo zamanani kunye iziphene. Ingasetyenziswa ukuchonga ukuphazamiseka zegazi, thrombosis ezahlukeneyo, ukuswela yeemeko ezithile kwamahlwili kunye like. D.

I iseti iindlela ezisetyenziswayo ukuze ufumane isiphumo kuxhomekeke umfanekiso lwezonyango, uhlobo uhlalutyo ngezifo. Kufuneka kuqatshelwe ukuba okotshiweyo le coagulation egazini - lo ngumngeni omkhulu hayi kuphela nje oqhelekileyo, kodwa ngamanye amaxesha kuba ugqirha. Ngokuqhelekileyo, ukuze senze ukuxilongwa, kuthatha iimvavanyo kakuhle ekhethwe ambalwa.

Inkqubo ye coagulation igazi

Makhe siqwalasele indlela inkqubo ekunqandeni imisebenzi. Xa inyathelo lokuqala i umonakalo imichiza okanye mechanical ukuya emithanjeni yabelwa thromboplastin - into eyodwa kuvusa coagulation reaction. Emva koko, ukusebenza izinqumisi kwenzeka - iiproteni ezithile ngokuqhelekileyo uhlala egazini kwaye zinika indawo yokwenzakala benqanawa eludongeni thrombus Ukwakheka.

Ngaphezu koko, thrombin (icandelo yendalo kwinkqubo coagulation evela prothrombin) iyazingenela neprothini lwefibrinogen opholileyo, iyiguqule ibe iifom fibrin ihlwili esebenzayo isiseko. Iziqalelo igazi, kuquka iiplatelets, "Badidekile" kuthungelwano lwe fibrin. Ngenxa yoko, zegazi ihlwili wonqanyulwa, kwaye ucinezele ukwenza thrombus wokuvala oqolileyo umonakalo udonga nemithambo. Ngokwahlukileyo koko, inkqubo coagulation igazi emzimbeni kwakhona imisebenzi inkqubo protivosvertyvaniya. Bebonke zikuvumela ukuba ukugcina igazi kwimo yesiqhelo.

izifundo ekunqandeni okhulelwe

Njengoko sele kukhankanyiwe, ezintathu nganye, kwaye kwezinye iimeko yaye ngokufuthi ngakumbi, abasetyhini abakhulelweyo uya coagulation. Yintoni na kwaye kutheni na kuyimfuneko, oomama abakhulelweyo wazi ngokuzibonela. Inyaniso kukuba xa ixesha lokubeleka umsebenzi nosana yenkqubo coagulation iphela uyaphuculwa. Le yinkqubo yendalo enxulumene noko kubonakala unyango isangqa igazi uteroplacental. Umama okhulelweyo ulungiselela oko ngenxa ilahleko enokwenzeka legazi ngethuba lokubeleka.

Ukuze ubone iinkalo igazi ekunqandeni kunye neengxaki ezithile zokukhulelwa wavelisa coagulation. Kwathi uhlalutyo kwi nezingacwangciselwanga amaxesha Ugqirha ukubuza ukuba kukho ukutenxa kule hemostatic iparameters yesiqhelo (amacandelo kwegazi negazi nempahla, evumela intsebenziswano agcine ingqibelelo iindonga nemithambo kwaye uyeke ukopha kwimeko umonakalo). Igazi ukuba izifundo ezithathwe kwi kusasa ungatyanga ukusuka apho iphuma khona.

Kokuhlaziya of coagulation igazi

Iziphumo zokufunda yokuhlaziya kufuneka kuthintelwa ukuba yincutshe. Hayi abanokwazi ezizodwa, abantu abayi kuba nako States imida coagulation uze uvavanye amaqondo zokutenxa kuyo amaxabiso esezantsi. Makhe sizame ukuqonda nezo inkqubo ze uchaze parameters esisiseko ye sifundo.

1. lwefibrinogen

Le protein ke kuhlelwe esibindini, ajike phantsi kwempembelelo yeemeko ezithile egazini ku fibrin. Eli nani kufuneka ibandakanye coagulation igazi. Normal lwefibrinogen - 2-4 g / l. Ukuba uyandiswa, imin kwamahlwili anda, kwaye kukho umngcipheko egazi. Ngokuqhelekileyo, livela le meko phambi kokuzalwa, inyumoniya, emva kotyando, kunye usuleleko kunye nokudumba endalo etsolo (tuberculosis, umkhuhlane), iposi engabalulekanga nobetho (ngomhla wokuqala), kunye ukutsha, hypothyroidism, izivimbela kunye estrogen. lwefibrinogen okwehlileyo abe ngenxa yokudla, ukuqina okanye hepatitis ngendlela eqatha, kukho ukuswela ivithamin B12 okanye C ukufumana androgens steroid, fish oil, anticoagulants.

2. lasebenza ixesha thromboplastin engaphelelanga (APTT)

Coagulation lihlola ixesha apho, emva kokuba uxhulumaniso ukuya plasma calcium chloride kunye nezinye izinto ukusekwa ihlwili legazi. Ukuba ubuncinane enye coagulation into ungaphantsi eqhelekileyo nge-30-40 ekhulwini, utshintsho kwinqanaba aPTT. I-avareji Izinga imizuzwana 30-40. Ixesha ukwandisa kunye vitamin K izivuka, isifo zesibindi. Isizathu sokuba ayolule i aPTT kwaye ngenxa yoko, coagulation kade kunokuba kubazali bakhe.

3. anticoagulant lupus

Le parameter usoloko iqulathe coagulation. Yintoni na le mzobo? Ngubani na oya kukuxelela. Le IgC omzimba kunye IgM, esizakukhokelela nokwanda aPTT. Ngokuqhelekileyo, abasetyhini abakhulelweyo, kufuneka ukuba ezo zakhiwayo. Zilwa buhlungu zivela kwimeko izifo samathambo, gestosis. Ukukhulelwa nale leengxaki zisoloko zibangela isisu zidityaniswe, ukufa ezingekazalwa okanye iqhosha ngumkhaya.

4. Prothrombin

It is a iproteni entsonkothileyo leyo siphu- thrombin (iproteni ukuba umntu ukuyilwa egazi). Le yenye yeempawu ezibalulekileyo coagulation. Prothrombin, kunye inxaxheba ivithamin K ukuba kuhlelwe esibindini. Emva kokuhlalutya eli xabiso, ugqirha ukuze kuchongwe ngezifo emathunjini phecana kunye zesibindi.

5. Ixesha prothrombin

Ixesha apho plasma ngokongeza noku calcium chloride, thromboplastin kunye fibrin ihlwili kwakhiwa. Eli nani lubonakaliswa imizuzwana kwaye iqhele ulingana 11-15.

6. Prothrombin index (PTI)

Coagulation uquka kanye olu khetho endaweni ezidlulileyo. Le ratio lelona xesha ekunqandeni plasma oluqhelekileyo kunye plasma yomguli, wavakalisa njengepesenti. Xa ratio prothrombin eqhelekileyo kufuneka kwahluka phakathi 93-107 ekhulwini. Imiba yale parameter ukuba kuhlelwe iiseli isibindi, isifo zesibindi inani labo lifinyele, ukuze IPT ekwaziyo ukuya kwiqondo elithile bakhonza njengoko parameter yokuqingqa sokusebenza yomzimba.

Ukuba PTI landa, ngoko amahlwili siyandiswa, kwaye kukho ingozi thrombosis. Ukukhula kwenzeka xa uthatha izivimbela yaye kwiinyanga zokugqibela ethwele umntwana. Ukuncitshiswa isalathiso prothrombin ibonisa ukonakala kweendlela iipropati coagulation kwegazi. Ukwenziwa imiba prothrombin entsonkothileyo kuxhomekeke vitamin K, kunjalo elibi wayo, malabsorption ethunjini (dysbacteriosis, enterocolitis) kwaye kubandakanya nokuncitshiswa IPT. Kwakhona, oku kungabangela ekuthatheni ngeedosi eziphezulu aspirin, womchamo.

7. Ixesha Thrombin

Eli lixesha ngexesha apho lwefibrinogen uguqulwe fibrin. ixabiso layo olumisiweyo - imizuzwana 15-18. Ukwanda kule yesalkathisi ambona ukungabi naso of lwefibrinogen okanye umonakalo omkhulu esibindini. Ukunciphisa parameter, okt ukuncitshiswa kwexesha thrombin, ibonisa ubukho paraprotein (protein immunoglobulin) okanye ezingaphezu lwefibrinogen. Ngokuqhelekileyo, le ulawulo ixabiso isalathisi ngexesha fibrinolytics unyango okanye lweeHedfowuni.

8. Antithrombin III

Lo inhibitor of thrombin, inkqubo protein anticoagulation. Yena kunempembelelo ngxelo imbi ngenkqubo coagulation. Isalathisi Level emiselwe nomphetho owujikelezileyo thrombin kuvavanyo kwisampula (inhibition). ixabiso Umndilili antithrombin III - 71-115 ekhulwini. Ukunciphisa sethingi-50 ekhulwini eqhelekileyo iquka ubungozi thrombosis.

Kwinkcazelo yale salathisi kubaluleke kakhulu ingakumbi kwabasetyhini abakhulelweyo ngokuthatha anticoagulants. La machiza asetyenziswa kwi ngokuzala, xa igazi ekunqandeni siyandiswa, kwaye kukho ingozi yokuba ukuyilwa insufficiency placental, ukukhulelwa avalwe.

9. D-dimer

Esi sisalathisi esibalulekileyo lokufunyaniswa thrombosis, ebandakanya coagulation. Le parameter ubonisa? Yena utyhila iinkqubo thrombosis kunye fibrinolysis. Ngokuqhelekileyo, D-dimer lingaphantsi kwe-248 ng / ml. Esi salathisi mgangatho ziqala ukukhula xa nisaqala yokukhulelwa. Ukuba ushiye ixabiso parameter unakho igqithe sokuqala izihlandlo ezithathu okanye ezine. Kucingwa eqhelekileyo. izinga A ephezulu kwabasetyhini kunye ikhondo elinzima khulelwa (yokukhulelwa), kwakunye nabo abaphethwe isifo sezintso, isifo seswekile.

10. platelet

Ibandakanya ekunikeni ziiplatelets hemostasis. Bona eqalisiweyo umongo wethambo. ixabiso olumisiweyo - 150-400 amawaka / ml. Kwezinye iimeko, xa abasetyhini abasempilweni bangafumana ukuhla zegazi ubale ukuya 130 lamawaka. / L. ukuncitshiswa izinto data yegazi ebizwa ngokuba 'thrombocytopenia' kwaye kwenzeka ngenxa yokunciphisa ukuyilwa zegazi, okwandileyo okanye ukutshatyalaliswa kwabo. Ngokudla zaneleyo lifinyele zegazi Ukwakheka. E DIC, nto leyo eza kuxoxwa ngezantsi, nto ichazwa iiseli igazi emise ukunyuka.

11. DIC

Intsebenziswano ye zegazi, imiba coagulation kunye nenkqubo fibrinolysis inika ulungelelwano phakathi kweenkqubo coagulation kunye anticoagulation. Ukuba nayiphi na kwezi links ziya kufumana ukuphazamiseka ekukhulelweni kunokubangela ezinye iingxaki ezinzulu. Kuyingozi kakhulu kubo olunikezelwa coagulation intravascular. Yenzeka ngenxa ye ukusebenza inkqubo fibrinolytic kunye nenkqubo coagulation. Xa abafazi abakhulelweyo, oonobangela DIC inokuba amniotic fluid Embolism, wona ngaphambi ngumkhaya, endometritis.

12. I-antiphospholipid syndrome (APS)

It is a oluntsonkothileyo iimpawu okuluphawu thrombosis (lwemithambo kunye lwemithambo). Abasetyhini kunye APS kuba nengozi ephezulu kwesisu kunye nasisihlo ngokuqhomfa zidityaniswe, ngenxa yokuba kule meko ukwanda kwinani iimpahla ngumkhaya aphazanyiswa nokuphuhlisa insufficiency fetoplacental. Ukuxilonga anti-phospholipid syndrome, ukwanda thrombogenesis ukongeza, kananjalo ukubona antibodies inwebu lwangaphandle (phospholipids).

Ekuphetheni

Iimpawu coagulation sixoxe ngazo alupheli. Njengokuba sele sitshilo, ukukhethwa yemida ezithile isifundo ixhomekeke kwizinto ezahlukeneyo. Iziphumo zohlalutyo ziya kufumaneka ngosuku olulandelayo emva kokuba igazi.