Hemostasiogram: yintoni, njani Kwathi, zokucazulula ukusebenza

Lidla inkqubo kufunyaniswe isifo, oogqirha bacebisa izigulane zabo ukuba bangenele hemostasiogram Study. Yintoni na? Yintoni onokuyifunda ngale vavanyo? Njani yaye nini ukuthatha uvavanyo? Iyakuxabisa malini yonke indlela yam? Iimpendulo zale mibuzo ukhangela umntu lijongene imfuneko yokuba bapase isifundo efanayo.

Hemostasiogram: ntoni na?

uxilongo Modern anayo isixhobo yayo ezininzi iintlobo ngeentlobo iimvavanyo neemviwo, apho unako ukuseka ukuxilongwa. Enye uphando ibalulekileyo hemostasiogram, yena coagulation. Loluphi uhlobo analysis, yaye yintoni iimeko kuyimfuneko ukwenza ntoni?

Olu luphononongo ebalulekileyo ekuvumela ukuba sifunde iinkqubo ze coagulation kwegazi. inkqubo hemostasis owenza imisebenzi ezimbini: kwelinye icala, ixhasa igazi ngaphakathi iimpahla ngokwaseburhulumenteni engamanzi, yaye kwelinye - abasabela kukwenzakala nemithambo kwaye esazisa neendlela ndiyeke ukopha. Ngokuqhelekileyo, onjalo ukungasebenzi inkqubo kukhokelela iingxaki eziyingozi, nto leyo ukuba ezinye izigulane kuphela lethally.

Ukumisela ubukho kwiimpazamo kuhlelo kukusiza coagulation. Yiyiphi hlobo lokuvandlakanya, siyaqonda. Ngoku kuyimfuneko ukuba siqwalasele nezinye iinkcukacha malunga isifundo.

Kuyo nayiphi na imeko, sincoma zokwenza uvavanyo?

Kakade ke, ngokuyinene, ukususela kumaxesha ngamaxesha umntu ngamnye kufuneka athathe iinkqubo ekunqandeni isampulu yegazi. Kodwa ngoku, olu vavanyo lwenziwa phambi ezibonisa ezithile:

• izifo zesibindi Severe.
• Yonyango (hormone kwakhona kuchaphazela inkqubo igazi ekunqandeni).
• Ezimbi zeenkqubo wokuchama kunye sentliziyo.
• Ukuba isigulana umntu izifo ezithile sokuhlasela.
• nokopha rhoqo, nokopha kakhulu.
• mithambo Varicose.
• Ukuba ogulayo imikhwa emibi, butywala.
• Kuxhaphake ukwenza ukugruzuka ezinkulu nokuba ukonzakala encinane.
• iziphumo Poor coagulation kwangaphambili.
• Hemostasiogram ebaluleke kakhulu ngexesha lokukhulelwa. It omiselwe abafazi kwafunyaniswa hypertonicity zesibeleko, yokukhulelwa, abazizidalwa ngokukhula intrauterine kunye nezinye iingxaki. Kwakhona ebonisa ukukhulelwa ezininzi, yimbali kwezisu.
• Uphononongo kwakhona olwenziwe phambi utyando, njengoko njengechasene ekunqandeni igazi kunokukhokelela ukufa isigulane xa kusenziwa utyando.

hemostasiogram Extended nobesiqhelo, yintoni umahluko?

Kwiimeko ezininzi, izigulane luhlu kulingwa umlinganiselo kubandakanya nokumisela ezifana iparameters njengoko thrombin kunye nexesha prothrombin, lwefibrinogen kunye prothrombin. Kwakhona zeengcali sibala inani zegazi egazini peripheral, kwaye INR imisela RKMF (enyibilikayo izakhiwo monomer fibrin).

Ngamanye amaxesha wabamba hemostasiogram ekuthiwa-elide. Yintoni na? Eneneni, kwesi sifundo, kodwa ukongezelela izikhombisi elebhu ngasentla umisela nezinye iparameters eziliqela, kuquka antithrombin III, lupus anticoagulant , kunye D-dimer. Ekubeni analysis ngakumbi ixesha, iindleko ukuze eklinikhi ephakamileyo kancinane.

Kwamalungiselelo ovavanyo

Ukuze coagulation (hemostasiogram) ichanile, ifuna ukulungiswa ethile. Ndlovu egcinwe ungatyanga. Ngaphezu koko, izigulane ziye akukhuthazwa iiyure 8-12 phambi le nkqubo. Avumelekile kusela kuphela amanzi acocekileyo ezingezo-nezihlwahlwazayo.

Ukongeza, ngosuku phambi kokuba unikezelo zohlalutyo kufuneka anciphise umsebenzi emzimbeni, xiphephana, baphumle kunye nokulala. Ukususela utywala kunye namayeza ezithile (ezifana aspirin, olwaziwa, mlomo igazi) kufuneka ukuba ubuncinane kwiveki enye phambi kokuba le nkqubo. Ukuba kukho imfuno engxamisekileyo athathe nawaphi na amayeza ngeli xesha, kufuneka unikeze uluhlu nogqirha wabo, kuba amachiza amaninzi kuchaphazela iziphumo zohlalutyo.

Abasetyhini na bayakhuthazwa ukuba kuvavanywa ngethuba sexesheni. Ngeli xesha, umzimba ulahlekelwa umlinganiselo othile wegazi, nto leyo ibangele ukuba bufutshane ukwandisa kwamahlwili yayo kwaye ngaloo ndlela bayasigqwetha data yokwenene malunga homeostasis.

ukuba bahlolelwe njani?

Kukho umbuzo obalulekileyo isigulane nganye yabelwa hemostasiogram: indlela ukuthatha uhlalutyo? Sele ekhankanywe ukuba ukuziswa zesampulu kufuneka uqhutywe kwi ungatyanga, nto leyo ethetha ukuba inkqubo emiselweyo kusasa (ngokwesiqhelo kwi-8 kusasa ukuya 11 am).

Igazi on hemostasiogram athathwa emthanjeni. inkqubo eqhelekileyo - usebenzisa technician isirinji engenazintsholongwane uyawususa umthamo wegazi eziyimfuneko (kuthatha imizuzu embalwa). Zesampulu bathunyelwa ukuya kufumana uvavanyo elebhu. Hi ndlela leyi, kwiimeko ezininzi iziphumo zohlalutyo bakulungele emva kweeyure 2-3 kuphela emva kokubeleka.

Apho uphando enjalo?

Phi hemostasiogram? Kwenziwa inkqubo efanayo lwenziwa phantse zonke esibhedlele kunye neziko lonyango, ngoko iingxaki kunye khangela yonikezelo umba wohlalutyo akayi kuvuka. Kwelinye icala, kungcono ukufunda ngenyameko izimvo malunga nomsebenzi ilebhu ethile, ngenxa yokuba iziphumo zophononongo ixhomekeke ikhondo ngakumbi unyango.

Hemostasiogram: zokucazulula ukusebenza

Emva kokuhlalutya isigulane idla lifumana ifom unabo, ezidweliswe ndafumanisa ngexesha parameters uphando. Iziphumo kufuneka ukubona ingcali ngokukhawuleza kangangoko kunokwenzeka, kuba unako ukubona, njengoko oko kungqinwa hemostasiogram yakho. Ezama amanani - kunzima ngokuzimeleyo isigulana kuzo zonke amanani bengayiqondi. Kwifomu, njengoko umthetho, imida zilandelayo abhalwe:

• APTT - isebenze ixesha thromboplastin buso, buso - ukuhlola umsebenzi indlela okunexabiso coagulation kwegazi.
• ixesha Prothrombin - eli parameter kuvumela ukuba ukuvavanya indlela extrinsic of coagulation egazini (eli lixesha apho plasma ihlwili luqala kongezwe esiqwini factor, prothrombin kunye calcium, edla 15-17 s).
• INR (ratio ngamazwe nganye) - ngexesha uphando elebhu ithelekisa iinkqubo coagulation igazi yomguli kunye plasma okhethekileyo ogama parameters kunxibelelana nemigangatho yamazwe ngamazwe.
• Inqanaba lwefibrinogen, iproteni ukuba xa uqalisa inkqubo ekunqandeni iguqulelwa fibrin (eyavela - 4.2 g / l).
• ixesha Thrombin - ubude bexesha eziyimfuneko ukuze kwakhiwe fibrin kunye lwefibrinogen (OK - kwisekhondi-11 ukuya kwi-18).
• Inani zegazi egazini (ngokwesiqhelo uvela iiseli 150 ukuya 400 lamawaka 1 l).
• Ubukho D-dimer (eli nani kufuneka ingadluli 248 ng / mg).

ixesha prothrombin

uphando Kakuhle olwenziwe kunceda ugqirha ufumanise malunga amanqanaba igazi yomguli of a prothrombin protein ethile. Lo yinxenye ebalulekileyo igazi inkqubo amahlwili, njengoko olungaphambi zempahla ichukumisa thrombus ukubunjwa, ngenxa yoko, ayeke ukopha. Le protein evela esibindini yabantu (ezwi yayo kufuna vitamin K). inqanaba ezinxaxhileyo prothrombin sinokubonisa ukunyhashwa wesibindi kunye lokugaya.

ixesha Prothrombin - yenye sisalathisi esibalulekileyo, nto leyo evumela ukuba ukuchaza hemostasiogram. Yintoni na? Enyanisweni ke ubude bexesha apho igazi "aphendule" enxebeni kwaye uvelisa ihlwili firbinovy. Xa umntu esempilweni, le nkqubo lwenzeka kunye 10-18.

Lidla ngexesha yolaborathri yophando nzulu umlinganiselo ixesha kuphela, kodwa kugqiba index prothrombin. Ngokwesiqhelo, le nani ubuncinane 93%. Ukunciphisa le mzobo ubonisa ukunyhashwa esibindini. Maxa wambi unxulunyaniswa ukuphazamiseka wokugaya novithamini K imibala, ukusetyenziswa aphezulu womchamo okanye amalungiselelo equlethe acetylsalicylic acid. Kwakhona ubonisa ubungozi ukopha. Kodwa ke ukunyuka kwisalathiso kwi 106% okanye ngaphezulu ibonisa utyekelo igazi ukwakha egazi.

Thrombin ixesha nanjengokwesimo kwaye ukutenxa

Le yenye into ebalulekileyo kakhulu eyenza kube lula ukufumanisa hemostasiogram. Yintoni na? ixesha Thrombin - ixesha elithathwayo ukuba lwefibrinogen baphola zibe fibrin. Xa umntu esempilweni, eli nani 15-18.

Ukongeza, ngexesha uphando kwelebhu kuyimfuneko ukuba ukujonga amanqanaba igazi lwefibrinogen. umxholo Umyinge we iiprothini igazi 2-4 g / l. Kuthiwa ukuba inqanaba lwefibrinogen maxa wambi kuvuka. Oku kwenzeka, umzekelo, ngenyanga zokugqibela zokumitha, yaye emva yokuhlaselwa isifo ngesibetho, intliziyo, phambi ukutsha, izifo lengqula, ulawulo ezondeleyo lokucwangcisa hormone. Kwiimeko ezinjalo ingqalelo eqhelekileyo ukwanda lwefibrinogen 6 g / l.

A Ukuncitshiswa enamandla kwiproteni elifana neli izifo zesibindi kakhulu (kubandakanywa kwesibindi kunye hepatitis), ukungabikho kweevithamini B lomzimba kunye ascorbic acid.

Enye i parameters zibalulekileyo kolu vavanyo kuthathwa APTT. Eli xesha apho Ihlwili igazi linokuba lisekwa kongezwe ikhalsiyam chloride kwi plasma. Ngokuqhelekileyo, kuthatha imizuzwana malunga 30-40. Esi salathisi kakhulu nangokuchanekileyo olwahlula umsebenzi kwenkqubo hemostatic.

ukopha ukuphazamiseka

Ngokuqhelekileyo, kukho inani kakhulu ezimbi, nto leyo ibonisa uhlalutyo. Hemostasiogram kunceda ukuchonga ezinye ekunqandeni ebalulekileyo igazi:

• Hypocoagulation - imeko apho sikhatshwa ukuhla kwesantya igazi ekunqandeni somzimba ukopha rhoqo (maxa wambi nkqu kukukhuhleka ezincinane).
• Hypercoagulation - a ngezifo ukuthi amagama ngokwandisa iqondo igazi ekunqandeni. Yena curls phezulu kwanaxa kungekho zokonzakala amanxeba.
• Thrombophilia - imeko apho olungaka andisiweyo thrombus Ukwakheka. Ngokuqhelekileyo, a ngezifo elinjalo kuyingozi kakhulu kwaye ukuba alunyangwanga kunokukhokelela ekufeni.

Kutheni ukuqhuba uphando ngexa lokukhulelwa?

Ngexesha lokukhulelwa, oku hlalutyo ibaluleke kakhulu kuba kunceda ixesha ezifumanekayo ukufumanisa iingxaki kunye nemingcipheko kunokwenzeka. Ngokomzekelo, ugqirha ukufumanisa ukuba ioksijini eyaneleyo kunye nezakhi usana ifumana, kunye negazi, ingaba odla Kusenokwenzeka imithambo yegazi, okanye nokopha ngethuba lokubeleka. Ngokuqhelekileyo, uhlalutyo wenziwa ngoko nangoko emva kwaso yobhaliso ngomonde esibhedlele, uze emva koko uye we 22 th 26 ngeveki.

Yimalini uhlalutyo?

Kakade ke, izigulane ezininzi, ingongoma ebalulekileyo iindleko uphando. Kubaluleke kangakanani lubekelwe hemostasiogram? Price, Kakade ke, kuxhomekeke kwizinto ezininzi. Umzekelo, kufuneka uthathe ingqalelo lobungcali iziqinisekiso kunye nemigaqo-nkqubo yezemali iziko lonyango, apho ukhetha ukusebenzisa le nkonzo. Iindleko yophando esisiseko isusela ngaphezulu uluhlu olubanzi kakhulu - ukusuka 400 ukuya 1300 engange.

hemostasiogram Extended, Kakade ke, into eninzi kakhulu - malunga 3000-4000 engange. Kakade ke, amanani kulo mzekelo azikho ezincinane kakhulu. Kodwa kufuneka siqonde ukuba iziphumo zeemvavanyo kunceda ugqirha ukuhlola isifo ngexesha ukulungisa. Hi ndlela leyi, kwezinye izibhedlele, esi sifundo siqhutywa simahla.

Iziphumo kunye nokuthembeka kwabo ixhomekeke iziqinisekiso kunye namava Uchwepheshe kuqhutywa isifundo. Ngoko ke, kufuneka ukusondela ngenyameko Ukukhethwa oyingcali, yaye iziko lonyango. Khumbula ukuba kuphela ugqirha izakhi ngokuchanekileyo iziphumo zeemvavanyo ukuvavanya imeko yomguli.