Kufalitsa kugunda kwamitsempha yamagazi (DIC)

Kufalitsa kwa intravascular coagulation (DIC) ndi vuto lalikulu pomwe mapuloteni omwe amalamulira kutsekeka kwa magazi amayamba kugwira ntchito kwambiri.

Mukavulala, mapuloteni m'magazi omwe amapanga magazi amagundulu amapita kumalo ovulala kuti akathandize kutaya magazi. Mapuloteniwa akakhala otanganidwa mthupi lonse, mutha kukhala ndi DIC. Choyambitsa chake nthawi zambiri chimakhala chifukwa cha kutupa, matenda, kapena khansa.

Nthawi zina DIC, magazi amaundana m'magazi. Zina mwazotsekerazi zimatha kutseka zotengera ndikudula magazi abwinobwino m'ziwalo monga chiwindi, ubongo, kapena impso. Kuperewera kwa magazi kumatha kuwononga ndikuwononga kwambiri ziwalo.

Nthawi zina za DIC, mapuloteni otseka m'magazi anu amatha. Izi zikachitika, mutha kukhala ndi chiopsezo chachikulu chotaya magazi, ngakhale kuvulala pang'ono kapena osavulala. Muthanso kukhala ndi magazi omwe amayamba zokha (paokha). Matendawa amathanso kupangitsa kuti maselo ofiira ofiira agawike ndikuphwanya akamadutsa mumitsuko yaying'ono yodzaza ndi kuundana.

Zowopsa za DIC ndizo:

• Kuyankha magazi
• Khansa, makamaka mitundu ina ya khansa ya m'magazi
• Kutupa kwa kapamba (kapamba)
• Matenda m'magazi, makamaka mabakiteriya kapena bowa
• Matenda a chiwindi
• Zovuta za mimba (monga placenta yomwe imatsalira pambuyo pobereka)
• Opaleshoni yaposachedwa kapena anesthesia
• Kuvulala kwakukulu kwa minofu (monga pakuwotcha ndi kuvulala kumutu)
• Hemangioma yayikulu (chotengera chamagazi chomwe sichinapangidwe bwino)

Zizindikiro za DIC zitha kuphatikizira izi:

• Kutuluka magazi, kuchokera kumasamba ambiri mthupi
• Kuundana kwamagazi
• Kulalata
• Kutaya magazi
• Kupuma pang'ono
• Kusokonezeka, kukumbukira kukumbukira kapena kusintha kwa machitidwe
• Malungo

Mutha kukhala ndi mayeso awa:

• Kuwerengera kwathunthu kwamagazi ndikuyezetsa magazi
• Nthawi yapadera ya thromboplastin (PTT)
• Nthawi ya Prothrombin (PT)
• Mayeso a magazi a Fibrinogen
• D-dimer

Palibe mankhwala enieni a DIC. Cholinga ndikudziwitsa ndi kuthana ndi zomwe zimayambitsa DIC.

Chithandizo chothandizidwa ndi ichi:

• Kuika ma plasma m'malo mwa zinthu zotseka magazi ngati magazi akutuluka ambiri.
• Mankhwala ochepetsa magazi (heparin) kuti ateteze magazi osagundana ngati kuwundana kukuchitika.

Zotsatira zimadalira pazomwe zikuyambitsa vutoli. DIC ikhoza kukhala pangozi.

Zovuta zochokera ku DIC zitha kuphatikiza:

• Magazi
• Kupanda magazi kumikono, miyendo, kapena ziwalo zofunika
• Sitiroko

Pitani kuchipinda chodzidzimutsa kapena itanani 911 ngati mukukhetsa magazi omwe samaima.

Pezani chithandizo mwachangu pazikhalidwe zomwe zimadziwika kuti zimabweretsa vutoli.

Kugwiritsa ntchito coagulopathy; DIC

• Mapangidwe a magazi
• Meningococcemia pa ana a ng'ombe
• Kuundana kwamagazi

Levi M. Adafalitsa kugwirana kwamitsempha. Mu: Hoffman R, Benz EJ, Silberstein LE, et al, olemba. Hematology: Mfundo Zoyambira ndi Zochita. Wachisanu ndi chiwiri. Philadelphia, PA: Elsevier; 2018: mutu 139.

Napotilano M, Schmair AH, Kessler CM. Coagulation ndi fibrinolysis. Mu: McPherson RA, Pincus MR, olemba., Eds. Henry's Clinical Diagnosis and Management by Laboratory Methods. Wachitatu. St Louis, MO: Elsevier; 2017: mutu 39.