Uhlalutyo on PTI: eqhelekileyo. PTI: abafazi eziqhelekileyo

indeksi Prothrombin (PTI) - yenye nemvavanyo zaselaborathri ibalulekileyo, nto leyo olwahlula imeko kwenkqubo coagulation. Oku kuboniswa njengepesenti. Iintlobo ngeentlobo iimeko eyabelwe analysis PTI. UNorma abantu abaphile 95-105%.

Blood ekunqandeni oluqhutywa kwiindawo ezimbini - iindlela extrinsic kunye analo. Ixabiso lika-IPT ibonisa kanye indlela extrinsic of coagulation.

Yintoni prothrombin?

Ukwenziwa amahlwili egazi kunye egazi kwenzeka phantsi kweempembelelo iproteni ethile - thrombin, umhlaba ophantsi kweempembelelo iinkqubo ezithile zengqo- aguqulwa ukusuka prothrombin. Ngenxa yoko, neprothini lesibini prothrombin ekunqandeni factor. Oveliswa kunye inxaxheba vitamin K esibindini.

index Prothrombin (ukuba SWIR) ukufumanisa umsebenzi prothrombin. Olu vavanyo zibalwe njengepesenti izalathi si zokunikwa plasma yegazi isigulana ukuba isampuli yolawulo. Kuba olawula inkqubo coagulation unikwe uvavanyo lwegazi kwi PTI. Ummiselo kwiilebhu ezahlukeneyo zisenokuthi zahluke kancinane, kodwa ke ezi yantlukwano azikho kakhulu. Baxhomekeke imichiza akusetyenziswa elabhoratri. Phantsi kweemeko ezithile, ezifana imithambo varicose, isifo sentliziyo okanye emva komsebenzi kumazinga intliziyo kwizigulana emiselwe ngugqirha, njengoko kwezi meko kuyimfuneko kukuzuza anticoagulation igazi (ekunciphiseni amahlwili wayo). Oku kwenziwa kuthintelo thrombosis.

Ngubani na oqeshwe yi uhlalutyo kwi PTI?

Ngokuqhelekileyo isifundo izinga IPT kwabasetyhini ngokufanayo abantu. Eli nani utshintsha kuphela ngexa lokukhulelwa, kwaye kukho eziliqela yezizathu, esiza kuxubusha kamva. Kwezinye iimeko, chemistry igazi wamisa PTI? Ummiselo zesifundo, umzekelo, xa uthatha anticoagulants lingaba ngaphantsi kabini. Izigulane ukuthatha la machiza kufuneka esweni rhoqo kwaye INR PTI. Uphando PTI ngokuyimfuneko wenziwe kule meko zilandelayo:

• Ngaphambi kokuba imisebenzi.
• Abantu abafumana unyango anticoagulant ukuthintela egazi.
• Abasetyhini ngethuba lokukhulelwa.
• Abantu abaphethwe zizifo yenkqubo coagulation, ezifana yegazi varicose.
• Xa izifo komzimba.
• Xa yamafutha kunye nesifo sentliziyo.
• Xa ezimbi isibindi, ezifana ukuqina.
• Xa ukuswela vitamin K.
• In antiphospholipid syndrome.
• Sokuhluza iimvavanyo ze coagulation.

Ngexa lokukhulelwa, qiniseka ukuba uphumelele uvavanyo for PTI. Ummiselo e abasetyhini ngexesha lokukhulelwa engaphezulwana nje kancinane kune koko nabanye abantu besempilweni. Oku kungenxa yotshintsho kumanqanaba hormone ukuvela ejikeleza ezongezelelweyo Esibelekweni-placental.

IPT ngexesha lokukhulelwa: yinto yamihla le

Ngexa lokukhulelwa, bonke abafazi kufuneka ukuba anyule coagulation isifundo. Oku kuquka:

1. PTI (index prothrombin).
2. INR (ratio nganye ezinga malungu abantu ngamazwe).
3. APTT (isebenze ixesha thromboplastin akakhethi).
4. Lwefibrinogen.

ibaluleke kakhulu Zonke ezi parameters. Ngenxa yoko, ukunyuka nge-IPT kwi zigaba zokugqibela zokumitha ukuya kwi-150% okanye ngaphezulu singachaza ukuba kukho ingozi abruption placental. Yaye kukho ukwehla kule salathisi phambi kokuba unikezelo ngezantsi 80% kukho umngcipheko ukopha ngexesha lokubeleka okanye kwithuba Kukudandatheka. Ngoko ke kubaluleke ngokukodwa ukuba ukuhlola inkqubo coagulation ekupheleni yokukhulelwa. Ukuze wenze oku, uphumelele uvavanyo PTI. Ummiselo yale index ngexesha lokukhulelwa isusela ukusuka 90 ukuya kwi-120%.

Yintoni na ukunyuka PB?

Ngoko ke, siye safumanisa ukuba ukuqina igazi kwandisa ixabiso le-IPT. Ummiselo yale index kubantu abasempilweni isusela ukusuka 95 ukuya 105%. Ukunyuka Isalathisi prothrombin asenokubonisa ukuba umngcipheko wokuhlaselwa zizifo ezifana:

• iposi engabalulekanga.
• Thromboembolism.
• Polycythemia.
• izifo Oncological.
• Kwecala ngumkhaya kwabasetyhini abakhulelweyo.

Yintoni eyenziwa kwinqanaba eliphantsi PTI?

Kwiimeko abafumana anticoagulants kwinqanaba PTI anokufumaneka kwi 45-40%. Kunye nesisongelo amahlwili egazi ithamo kula machiza ukulawula ugqirha. Emva ngokwandisa okanye ukunciphisa ithamo kufuneka bayeke uhlalutyo IPT. Izinga kwezi zigulane umiselwa gqirha khona. Ukuba index prothrombin sehlile izigulane abafumana anticoagulants, oku kubonisa, umzekelo, vitamin K imibala, isifo kakhulu isibindi okanye iphecana zesisu sisonke, yaye abafazi abakhulelweyo phambi kokuzalwa - malunga nengozi ukopha ngexesha yabasebenzi.

Yintoni INR?

Eli nani umgangatho ukuze kugqitywe ekunqandeni igazi. INR uyiphendula umsebenzi iiprothini igazi ezithile, ezo zinto amahlwili. iiproteni ziveliswa esibindini ezibandakanya vitamin K. Ezi zinto coagulation ukuphendula namayeza - anticoagulants, umz, "Dabigatran" "warfarin" okanye analogs zabo. Kulo mzekelo, hypocoagulation, ngamanye Igazi ekunqandeni elicothayo kakhulu. Ngokuba ezinye izigulane, kubalulekile, abaninzi banyanzelwa ukuba anticoagulants ubomi.

Uhlalutyo PTI igazi. INR: yamihla

Xa coagulogram, ngaphandle ekuhlalutyeni IPT, kunye nezinye izinto ezibalulekileyo. Xa kulawula ukuba izigulane anticoagulants IPT lihlile. Kodwa ke uhlahlelo izinga IPT zaselebhu ngalinye zisenokwahluka kancinane, ngoko yaqaliswa uvavanyo standardised - INR. Oogqirha ukuyisebenzisa ukulawula inkqubo coagulation igazi xa uthatha izigulane anticoagulants. Ngoko ke, kule meko INR yabelwe kunye zalathisi ezifana uvavanyo igazi PTI. INR eqhelekileyo kubantu abaphile 0.8 ukuya 1.2. Xa efumene ekunqandeni anticoagulant kwanciphisa kwenzeka hypocoagulation kunye INR angandiswa amaxesha 2-3 lo mmiselo, ezifana uqhaqho lwemiphunga yentliziyo okanye imithambo varicose ukunqanda ekumisweni thrombi. Ukuba igazi iba ziyatyeba, eli nani lenyuswa laya coagulability kwaye ngokufanelekileyo INR index kunciphisa.

Hypocoagulation. Kwezinye iimeko ke into efunekayo?

Izinga IPT kulingwa isusela ukusuka 95 ukuya kwi-100% kunye INR we 0.8 ukuya 1.2. Khumbula, le migaqo kufuneka ibe ngabantu abaphile ngokupheleleyo. Kodwa ke kukho iimeko xa INR kubalulekile ukugcina manani aphezulu, ngokulandelelana, izalathisi PTI oko kuba ngezantsi eqhelekileyo, oko kukuthi, kuya kuba ubume anticoagulation. Loo uburhulumente kuzuza uthatha anticoagulants. Ithamo unako kumiselwa kuphela ngugqirha. Izigulane ngokuqhubekayo ukufumana amayeza rhoqo kufuneka athathe uvavanyo igazi ngenxa INR.

• Kwimeko fibrillation atrial amaxabiso INR kufuneka zigcinwe kuluhlu 2.0-3.0.
• karhulumente ezinzima - PE (Embolism pulmonary) - nayo ifuna ukugcina amanqanaba INR ngaphakathi 2.0-3.0.
• Emva kotyando intliziyo ifuna anticoagulation, ngoxa kwimeko amanani vana INR aortic kufuneka zigcinwe ngendlela uluhlu olufanelekileyo 2.0-3.0, kunye ezase vana mitral - kwinqanaba 2.5-3.5.
• Kwezinye iziphene, kwemithambo yenhliziyo (mitral okanye isiphene aortic), kunye noKhuselo kwinqanaba thromboembolic yale isalathisi kufuneka ibe phakathi 2.0-3.0.
• Xa unyango amanani thrombosis INR lwemithambo kufuneka ilingane 2.0-3.0.

Ngokunciphisa amazinga ngezantsi imida yokwakha INR ukwandisa ithamo "Warfarin" kunye analogue yayo. Oku kwenziwa kuphela phantsi kweliso unyango kunye nokuhlolwa elebhu. Kodwa ke ukunyuka anticoagulation (ukwanda INR) ngentla epasejini obuvumelekileyo kunokuchaphazela ngokungalunganga impilo kwizigulane. Kuyingozi kakhulu ezahlukeneyo ukopha. Iiplastiki yangaphakathi (zesibeleko, isisu okanye intracavitary) kunye langaphandle athe ukwenzakala okanye amanxeba ezahlukeneyo. Ukuba amanani INR ephezulu imida kuvumelekile elalathelwe kwimeko ethile, i ithamo anticoagulants kufuneka incitshiswe. Ezinye izigulane kufuneka ukulawula inqanaba lobomi INR.

Indlela ukuba athathe uvavanyo igazi ngenxa INR ne-IPT?

Igazi izifundo ezinjalo asebenze kwigumbi imithi. igazi lwemithambo kuthathwa yaba tube uvavanyo kunye anticoagulant, indima edla lo citrate sodium. Umlinganiselo phakathi kwegazi lirhoxisiwe kwaye anticoagulant ukuba ube 9: 1. isampuli ethatyathiweyo ixubene kakuhle inverting ityhubhu ukuthintela ukwakhiwa lihlwili. Igazi wathumela ngoko nangoko elebhu. Uhlalutyo kufuneka aveze zingadlulanga iiyure ezimbini emva kokuba yokuqokelelwa igazi. Ukungaphumeleli ukulandela le imiqathango bayasigqwetha uhlalutyo. Igazi lidla kusetyenzwa kusasa ungatyanga, kodwa lo hlalutyo ingenziwa ngamanye amaxesha yi cito ukuba kuyimfuneko, ie ngokungxamisekileyo.