Kodi Coagulogram ndi chiyani ndipo zimachitika bwanji?

Zamkati

• Ndi chiyani
• Zatheka bwanji
• Mayeso a Coagulogram
• 1.Kukhetsa magazi nthawi (TS)
• 2. Prothrombin nthawi (TP)
• 3.Kulowetsedwa Tsankho Thromboplastin Nthawi (APTT)
• 4. Nthawi ya Thrombin (TT)
• 5. Kuchuluka kwa ma platelet

Coagulogram imafanana ndi gulu loyesedwa magazi lomwe adokotala apempha kuti awone momwe magazi amatsekera, kuzindikira kusintha kulikonse ndikuwonetsa chithandizo cha munthuyo kuti apewe zovuta.

Kuyesaku kumafunsidwa makamaka asanachite opareshoni kuti awone kuwopsa kwa wodwalayo kuti atuluke magazi panthawiyi, mwachitsanzo, ndikuphatikizira nthawi yotaya magazi, nthawi ya prothrombin, nthawi yoyambira ya thromboplastin, nthawi ya thrombin ndikuwunika kuchuluka kwa ma platelet.

Ndi chiyani

Coagulogram imawonetsedwa makamaka asanachite opareshoni, koma atha kufunsidwanso ndi dokotala kuti afufuze zomwe zimayambitsa matenda am'magazi ndikuwunika chiwopsezo cha thrombosis, makamaka azimayi omwe amagwiritsa ntchito njira zolerera.

Kuphatikiza apo, coagulogram imawonetsedwa nyama ikalumidwa yomwe ili ndi poizoni yemwe amatha kusokoneza kugwirana ntchito ndikuwunika anthu omwe amagwiritsa ntchito ma anticoagulants, monga Heparin ndi Warfarin, mwachitsanzo. Dziwani ma anticoagulants ena komanso nthawi yomwe amawonetsedwa.

Zatheka bwanji

Coagulogram iyenera kuchitidwa ndi munthu amene akusala kudya kwa maola 2 kapena 4 ndipo amakhala ndi magazi omwe amatumizidwa kuti akawunikidwe, kupatula Bleeding Time (TS), yomwe imachitika pomwepo ndipo imakhala ndikuwona nthawi yomwe amatenga magazi kuti asiye.

Ndikofunikira kuti kuyezetsa kusanachitike, kugwiritsa ntchito mankhwala opatsirana pogonana kumadziwitsidwa, chifukwa kumatha kusokoneza zotsatira zake kapena kuganiziridwa pofufuza, mwachitsanzo. Chifukwa chake, ndikofunikira kupeza chitsogozo kuchokera kwa dokotala chokhudza kuyimitsidwa kwa kugwiritsa ntchito mankhwalawa musanachite coagulogram.

Mayeso a Coagulogram

Coagulogram imakhala ndimayeso ena omwe amawunika kupezeka kwa zinthu zonse zomwe zimakhudzana ndi kuphimba magazi ndipo, chifukwa chake, heestasis, yomwe imafanana ndi zomwe zimachitika mkati mwa mitsempha yamagazi yomwe imayesetsa kusunga madzi amwazi kuti apewe mapangidwe kapena magazi. Mvetsetsani chilichonse chokhudza hemostasis.

Mayeso akulu omwe amapezeka mu coagulogram ndi awa:

1.Kukhetsa magazi nthawi (TS)

Mayesowa amafunsidwa ngati njira yothandizira mayeso ena ndipo ndiwothandiza kuzindikira kusintha kulikonse kwa ma platelet ndipo amachitika pobowola khutu pang'ono khutu, lomwe limafanana ndi luso la a Duke, kapena podula mkono wotchedwa njira ya Ivy, ndiyeno kuwerengera nthawi yomwe magazi amatuluka.

Kuti muchite njira ya Ivy, kukakamizidwa kumagwiritsidwa ntchito padzanja la wodwalayo kenako ndikumadulidwa pang'ono pamalowo. Pankhani yaukadaulo wa a Duke, una wa khutu umapangidwa pogwiritsa ntchito lancet kapena cholembera chotayika. Pazochitika zonsezi, magazi amayesedwa pamasekondi 30 aliwonse pogwiritsa ntchito pepala losefa, lomwe limayamwa magazi patsamba lino. Kuyesaku kumathera pomwe pepala losefa silikutenganso magazi.

Kupyolera mu zotsatira za TS, ndizotheka kuyesa hemostasis ndi kupezeka kapena kupezeka kwa von Willebrand factor, chomwe chimapezeka m'maplateleti omwe ali ndi gawo lalikulu pantchito yotseka magazi.Ngakhale kuyesaku ndikothandiza pakuwona kusintha kwa hemostasis, kumatha kuyambitsa mavuto makamaka kwa ana, monga kuyesa kumatha kuchitika poboola khutu, mwachitsanzo.

Momwe mungamvetsere zotsatirazi: Pambuyo pobowola bowo, adotolo kapena waluso woyeserera amawerengera nthawi yomwe magazi amawundana ndikuwunika pogwiritsa ntchito pepala losefa lomwe limayamwa magaziwo. Pepala losefalayo silikutenganso magazi, kuyesa kumathetsedwa. Ngati kuyezetsa kunachitika pogwiritsa ntchito Ivy Technique, yomwe ndi mkono, nthawi yoyambira magazi imakhala pakati pa 6 ndi 9 mphindi. Pankhani yaukadaulo wa Duke, womwe ndi khutu, nthawi yodziwika yotaya magazi imakhala pakati pa 1 ndi 3 mphindi.

Nthawi ikakhala yayitali kuposa nthawi yolozera, akuti pakuyesa kwa TS, zomwe zikuwonetsa kuti njira yotseka magazi idatenga nthawi yayitali kuposa momwe zimakhalira, zomwe zitha kukhala zowonetsa matenda a von Willebrand, kugwiritsa ntchito mankhwala a anticoagulant kapena thrombocytopenia, mwachitsanzo. Dziwani zomwe zimayambitsa thrombocytopenia.

2. Prothrombin nthawi (TP)

Prothrombin, yomwe imadziwikanso kuti Coagulation Factor II, ndi protein yomwe imayambitsidwa panthawi yama coagulation ndipo ntchito yake ndikulimbikitsa kutembenuka kwa fibrinogen kukhala fibrin, ndikupanga pulagi yachiwiri kapena yotsimikizika.

Kuyesaku ndikufuna kuwonetsetsa momwe njirayo imagwirira ntchito, chifukwa imakhala ndi kuwunika kwa nthawi yomwe magazi amatenga kuti apange gawo lachiwiri pambuyo popezeka ndi calcium thromboplastin, yomwe ndi reagent yomwe imagwiritsidwa ntchito poyesa.

Momwe mungamvetsere zotsatirazi: Mumikhalidwe yabwinobwino, mukakhudzana ndi magazi ndi calcium thromboplastin, njira yakunja imayambitsidwa, poyambitsa zinthu za VII ndi X za coagulation ndipo, chifukwa chake, factor II, yomwe ndi prothrombin, yolimbikitsa kutembenuka kwa Fibrinogen kukhala Fibrin, kuletsa kutuluka magazi. Izi zimatenga masekondi 10 mpaka 14.

Komabe, nthawi zina coagulogram imazindikira PT yowonjezera, zomwe zikutanthauza kuti kuyambitsa kwa prothrombin kumachitika nthawi yayitali kuposa yachibadwa. Kuchulukitsa kwamalingaliro a PT nthawi zambiri kumachitika ma anticoagulants akagwiritsidwa ntchito, kuchepa kwa vitamini K, kusowa kwa factor VII komanso mavuto a chiwindi, mwachitsanzo, popeza prothrombin imapangidwa m'chiwindi.

Nthawi zambiri, PT imatha kuchepa, monga momwe amagwiritsidwira ntchito mavitamini K othandizira kapena mapiritsi oletsa kulera omwe ali ndi estrogen, mwachitsanzo. Mvetsetsani zambiri pazotsatira zoyesa za Prothrombin Time.

3.Kulowetsedwa Tsankho Thromboplastin Nthawi (APTT)

Kuyesaku kumagwiritsidwanso ntchito kuwunika hemostasis, komabe kumapangitsa kupezeka kapena kupezeka kwa zinthu zowundana zomwe zilipo munjira yamkati mwa coagulation cascade kuti zitsimikizidwe.

APTT nthawi zambiri imakhala yofunikira kuwunika odwala omwe amagwiritsa ntchito Heparin, yomwe ndi anticoagulant, kapena omwe ali ndi vuto la kutseka magazi, kukhala othandiza kuzindikira zosintha zokhudzana ndi zotseka.

Pakuyesa uku, sampuli yamagazi omwe asonkhanitsidwa imawonekera kwa ma reagents, ndiyeno nthawi yomwe zimatengera kuti magazi awumire amawerengedwa.

Momwe mungamvetsere zotsatirazi: Mumikhalidwe yabwinobwino, APTT ndi masekondi 21 mpaka 32. Komabe, munthuyo akagwiritsa ntchito maanticoagulants, monga heparin, kapena akakhala ndi vuto linalake lamkati, monga zinthu XII, XI kapena VIII ndi IX, zomwe zimawonetsa hemophilia, nthawiyo imakhala yayitali kuposa nthawi yofotokozera ., akuwonetsedwa poyesa kuti APTT iwonjezeredwa.

4. Nthawi ya Thrombin (TT)

Nthawi ya thrombin imafanana ndi nthawi yofunikira kuti khungu ligwike pambuyo pa kuwonjezera kwa thrombin, chomwe ndichofunikira chotsekereza kuti fibrinogen mu fibrin itheke, yomwe imatsimikizira kukhazikika kwa chimbudzi.

Kuyesaku ndikofunika kwambiri ndipo kumachitika powonjezera thrombin m'malo otsika m'madzi am'magazi, nthawi ya coagulation yomwe imakhudzidwa ndi kuchuluka kwa fibrinogen yomwe ilipo mu plasma.

Momwe mungamvetsere zotsatirazi: Nthawi zambiri pambuyo pakuwonjezera kwa thrombin ku plasma, chotsekacho chimapanga pakati pa masekondi 14 mpaka 21, izi zimawerengedwa kuti ndi mtengo wolozera, womwe ungasiyane malinga ndi labotale yoyeserera.

TT imawerengedwa kuti ndi yayitali pamene munthuyo amagwiritsa ntchito ma anticoagulants, akupereka mankhwala osokoneza bongo, ali ndi vuto la XIII kapena kusowa kwa fibrinogen, mwachitsanzo.

5. Kuchuluka kwa ma platelet

Ma Platelet ndi tizidutswa ta ma cell omwe amapezeka m'magazi omwe amatenga gawo lofunikira mu heestasis, popeza ali ndi zinthu zofunika kuzimitsa, monga von Willebrand factor, mwachitsanzo.

Pakakhala kuvulala kwa minofu, ma platelet amapita mwachangu kumalo komwe adavulala, ndi cholinga chothandizira kuti magazi achepetse. Ma platelet omwe adalumikizidwa amadziphatika kumapeto kwa chotengera chovulalacho pogwiritsa ntchito von Willebrand factor ndikusintha kapangidwe kake ndikutulutsa zinthu mu plasma kuti ipeze ma platelet ochulukirapo pamalo ovulalawo ndikupanga pulagi yoyamba.

Chifukwa chake, kuwunika kuchuluka kwa ma platelet ndikofunikira mu coagulogram chifukwa zimalola adotolo kudziwa ngati pali kusintha kwa hemostasis yoyamba, ndikupangira chithandizo chamankhwala.

Momwe mungamvetsere zotsatirazi: Kuchuluka kwa ma platelet m'magazi kumakhala pakati pa 150000 ndi 450000 / mm³. Miyezo yotsika poyerekeza ndi momwe ikufotokozedwera ikuwonetsedwa pamayeso ngati thrombocytopenia, kuwonetsa kuti pali ma platelet ochepa, omwe angayambitse mavuto otseka magazi, okonda kutuluka magazi, kuphatikiza pakutha kuwonetsa kuperewera kwa zakudya, kusintha kwa mafupa Mafupa kapena matenda, mwachitsanzo.

Makhalidwe pamwambapa amatchedwa thrombocytosis, yomwe imatha kubweretsa kuwundana, komwe kumatha kuchitika chifukwa cha zizolowezi za moyo, monga kusuta kapena uchidakwa, mwachitsanzo, kapena chifukwa cha zovuta zamatenda, monga kuchepa kwa magazi m'thupi, myeloproliferative syndrome ndi leukemia , Mwachitsanzo. Phunzirani pazomwe zimayambitsa kukulitsa kwamaplatelet.