Cov ntshav plab yog qhov tseem ceeb ntawm lub cev kom tsis txhob los ntshav thaum cov phab ntsa ntawm cov hlab ntsha puas tsuaj, thiab ntshav txhaws thaum lawv tsis tas yuav ntxiv lawm. Lub tswv yim ntawm ntshav coagulability yog inextricably txuas nrog lub cev ntawm homeostasis, qhov kev ua haujlwm ntawm uas yog los khaws cia cov ntshav. Homeostasis muaj ob lub tswv yim:
- Qib Heev - vascular-platelet. Nrog nws, platelets lo ua ke thiab ua daim ntawv hu ua "white thrombus", uas nyob hauv platelets predominate.
- Secondary - coagulation (nws kuj - coagulation ntawm cov ntshav). Nrog nws, lub ntom blockage ntawm qhov chaw uas muaj qhov fibrin clot yog tsim, uas yog hu ua "red blood clot". Lub npe no tau muab rau nws vim hais tias fibrin mesh yeej muaj erythrocytes.
Yog li, cov txheej txheem ntawm cov ntshav coagulation yog qhov nyuaj thiab nws txoj hauj lwm hauv lub cev yog qhov tseem ceeb heev. Cov kab mob qog nqaij hlav ntshav muaj peev xwm qhia tau kab mob thiab ua rau nws. Nws kuj yuav tsum tau qhia meej tias qhov kawg ntawm lub tsws ntawm homeostasis yog fibrinolysis, uas cov ntshav khov ua rau thaum cov hlab rov qab thiab xav tau lub cev fibrin.
Kev ntsuas rau kev ntsuam xyuas ntawm ntshav coagulability
Cov ntshav coagulation kuaj kuj hu ua coaguloramma. Yog xav kuaj ntshav kom ntshav khov, koj yuav tsum tau txiav txim seb qhov twg yog qhov tseem ceeb. Nyob rau hauv ntau hom kab mob, ntshav khaus tej zaum yuav impaired, thiab lawv lub xub ntiag yog lub hauv paus rau kev tshawb xyuas lub peev xwm ntawm kev poob qab:
- autoimmune kab mob;
- txawv txav lub siab ua haujlwm;
- kab mob plawv;
- varicose leeg;
- ntshav qab zib mellitus ;
- hemochromatosis .
Kuj, coagulation analysis yog tsim nyog rau tej yam kev mob:
- cev xeeb tub;
- postoperative lossis preoperative lub sijhawm;
- tswj kev kho cov tshuaj anticoagulants;
- Yog tias muaj teeb meem ntawm cov ntshav mus ntev yuav tsim nyog, ib daim tshev rau cov ntshav yuav tsum tau ua.
Txhais ntawm kev kuaj ntshav rau cov ntshav
Ua ntej yuav sib tham txog tus qauv ntshav khov kho, nws yuav tsum qhia kom meej tias txhua yam hauv cov kev kuaj no tej zaum yuav txawv me ntsis, thiab yog li ntawd lo lus kawg yog rau tus kws kho mob. Nws kuj yuav tsum to taub hais tias cov nqi ntsuas coagulogram txawv thaum lub caij cev xeeb tub, nyob ntawm seb lub sijhawm me nyuam hnub nyoog li cas.
Yog li, tag nrho cov kev kuaj ntshav rau clotting muaj 8 cai, uas muab kev kwv yees ntawm cov ntshav khawm:
- Kev ntsuam xyuas ntshav rau lub sijhawm khaus. Qhov qee lub sij hawm qis yog 5-10 feeb (rau cov ntshav venous, thiab rau capillary - 2 feeb). Ib qho kev nce nyob rau hauv cov parameter qhia tias tsis tshua muaj coagulability, thiab txo qis hauv kev khaus.
- APTTV yog ib lub sijhawm ua muaj txig ua rau lub plhaw . Cov qib no yog txij li 24 mus rau 35 feeb. Qhov nce nyob rau hauv lub sij hawm qhia tias ib tug pluag coagulation muaj peev xwm, thiab ib tug txo nyob rau hauv lub sij hawm rau hypercoagulability.
- Qhov tshuaj ntsuam prothrombin yog lub sij hawm prothrombin, uas yog nyeem txog kev ntsuam xyuas lwm txoj kab sab nraud. Tus nqi yog los ntawm 80 mus rau 120%. Ib qho qis hauv qhov ntsuas tau qhia tias muaj hypercoagulable, thiab nce rau hauv kev txo qis ntawm ntshav coagulation.
- Fibrinogen yog ib qho protein nyob hauv cov ntshav. Feem ntau qhov ntsuas yog los ntawm 5.9 mus rau 11.7 μmol / l. Nws tuaj yeem ua rau mob o, muaj menyuam hauv plab, kub hnyiab thiab plawv nres. Tus swb tau tham txog DIC syndrome lossis kab mob siab.
- Thrombin sij hawm yog qhov kev luj xyuas ntawm theem kawg ntawm kev coagulation. Feem ntau, qhov no yog ntawm 11 mus rau 17.8 seconds. Muaj qee qhov tsis muaj zog ntawm fibrinogen, hyperbilirubinemia, lossis kev kho mob nrog heparin, tej zaum yuav muaj qhov nce, thiab txo qis - nrog ntau ntau cov fibrinogen nyob rau hauv cov ntshav, los yog nrog ICE syndrome.
- Lub sij hawm ntawm lub plasma recalcification yog ib txwm - txij li 60 mus txog 120 vib nas this.
- Plasma kam rau ua rau heparin. Tam sim no, qhov kev xeem no tsis yog ib txwm siv. Tus txheej txheem yog li 3 mus rau 11 feeb.
- Retraction ntawm cov ntshav khov. Feem ntau qhov kev ntsuas yog los ntawm 44 txog 65%.
Tus kab mob ntshav khov no ua tau li cas?
Kev kuaj ntshav heev yog feem ntau ua nrog rau hauv vitro, tiam sis, piv txwv li, hauv kev soj ntsuam ntawm cov coagulation ntawm tag nrho cov ntshav - thromboelastography, kev ntsuas approximate tus mob ntawm Invivo tau.
Txhawm rau tso ntshav kuaj ntshav rau 8 xuab moos ua ntej qhov kev kuaj tsis tsim nyog noj. Ntshav rau qhov kev ntsuas yog muab los ntawm cov leeg los ntsuam xyuas cov ntshav venous. Txhawm rau ntsuas qhov kev muaj peev xwm ntawm cov qog nqaij hlav ntshav thiab platelets txaus los soj ntsuam ntshav los ntawm cov ntiv tes.