Hemostasiogram: ukuthi kuyini, indlela qeda kulungiswa ukusebenza

Kaningi, e inqubo isifo, odokotela batusa iziguli zabo tekuhambela hemostasiogram cwaningo unelungelo. Kuyini lokhu? Yini ongayifunda nalesi yokuhlola? Kanjani futhi nini ukuthatha ukuhlolwa? Kungakanani ngeke inqubo yami? Izimpendulo zale mibuzo athungatha indoda ebhekene isidingo aphase socwaningo olufanayo.

Hemostasiogram: kuyini?

ukuhlola Modern has arsenal yayo eziningi ezihlukahlukene Luhlolokulinganisa lwetivivinyo neluhlolo, ngawo ungakwazi amise ukusazi ngokunembile isifo esikuphethe. Omunye ucwaningo ngowokuthi hemostasiogram, yena coagulation. Hlobo luni ukuhlaziywa, futhi ngaphansi kwaziphi izimo kubalulekile ukwenza?

Lena isifundo esibalulekile esenza ukuba ukutadisha izinqubo wegazi coagulation. hemostasis uhlelo wenza imisebenzi emibili: kulolu hlangothi, kusekela igazi ngaphakathi ezitsheni esimweni woketshezi, ngakolunye - basabela ukulimala semithambo futhi iqala izindlela Yeka ukopha. Ngokwemvelo, ukungasebenzi uhlelo esinjalo siholela yezinkinga eziyingozi, okuyinto kwezinye iziguli ukuqeda lethally.

Nquma khona amaphutha ohlelweni ezinjalo kusiza coagulation. Hlobo luni ukuhlaziywa, siyazwisisa. Manje-ke kubalulekile ukucabangela kanye neminye imininingwane mayelana cwaningo.

Kunoma ikuphi, sincoma enifeza ukuhlolwa?

Yiqiniso, kuhle, ngezikhathi ezithile umuntu ngamunye ayeyoba nakho ukuthatha igazi isampula ekunqandeni izinqubo. Kodwa manje, le test wenziwa khona izinkomba ezithile:

• izifo zesibindi Sinzima.
• Endocrine (amazinga ama-hormone sithinta igazi ekunqandeni inqubo).
• Pathologies izinhlelo urinary futhi senhliziyo.
• Uma isiguli izifo ezithize sokuhlasela kwamasosha omzimba.
• umongozima avamile, ukopha izinsini eqinile.
• varicose emithanjeni.
• Uma isiguli ezimbi imikhuba, ukuba umlutha wotshwala.
• Ukufisa yakha nemihuzuko ezinkulu ngisho ngesikhathi ukulimala kancane.
• Imiphumela Kubi coagulation ngaphambi.
• Hemostasiogram kubaluleke kakhulu ngesikhathi sokukhulelwa. It ezinqunyiwe abesifazane ukuthi nginesifo hypertonicity lesizalo, preeclampsia, intrauterine ukukhula retardation kanye nezinye izinkinga. Futhi izinkomba kaningana, umlando libangela ukuphuphuma kwezisu.
• Lolu cwaningo luphinde lwenziwe ngaphambi kokuba uhlinzwe, ukuhlukumeza ekunqandeni igazi kungaholela ekufeni isiguli phakathi nokuhlinzwa.

hemostasiogram enwetshiwe futhi evamile: uyini umehluko?

Ezimweni eziningi, iziguli ekunike Assay ejwayelekile ukuthi kuhilela ukuthola nemingcele ezifana thrombin nesikhathi prothrombin, fibrinogen futhi prothrombin. Futhi Uchwepheshe ubala linani zegazi igazi neuropathy, kanye INR inquma RKMF (encibilikayo fibrin monomer izakhiwo).

Ngezinye izikhathi labetibambile okubizwa ngokuthi hemostasiogram enwetshiwe. Kuyini lokhu? Empeleni, lolu cwaningo efanayo, kodwa ngaphezu okungenhla izinkomba laboratory inquma nemingcele eziningana, kuhlanganise antithrombin III, lupus anticoagulant , no-D dimer. Kusukela ukuhlaziywa ingaphezu isikhathi ukudliwa, izindleko ke emtholampilo kancane ephakeme.

Ukulungiselela isivivinyo

Ukuze coagulation (hemostasiogram) unembile, kudinga ukulungiselele. Specimen labetibambile esiswini esingenalutho. Ngaphezu kwalokho, iziguli ziye hhayi Kunconywa amahora 8-12 ngaphambi inqubo. Ivunyelwe kuphela baphuze amanzi okumsulwa-non-carbonated.

Ngaphezu kwalokho, ngosuku olwandulela ukulethwa yokuhlaziya kudingeka ubeke umkhawulo umsebenzi ngokomzimba, ukugwema ukuhlala ucindezelekile, unethezeke bese ubuthongo. Kusukela utshwala kunemithi noma amaphilisi owaphuzayo (njenge-aspirin, yaziwa, thins egazini) udinga ukunikeza okungenani yesonto elilodwa ngaphambi inqubo. Uma kukhona esiphuthumayo ukuthatha yonke imithi ngalesi sikhathi, udinga ukunikeza uhlu kudokotela wabo, kusukela izidakamizwa eziningi kuthinte imiphumela yokuhlaziya.

Abesifazane abaveli akhuthazwa ukuba ihlolwe esesikhathini. Phakathi nale nkathi, ukuncipha Umzimba ulahlekelwa ethile yegazi, okungase kubangele lezivakashi ukwandisa ekunqandeni yayo futhi ngaleyo ndlela baphendukezele idatha zangempela mayelana homeostasis.

Kanjani ukuba bahlolelwe?

Kukhona umbuzo obalulekile ngoba esigulini ngasinye inikezwa hemostasiogram: kanjani ukuthatha ukuhlaziywa? Sishilo kakade ukuthi ukulethwa amasampula kufanele sigcwaliswe esiswini esingenalutho, okusho ukuthi inqubo enqunyiwe ekuseni (ngokuvamile kusukela 8 ekuseni kuya ku-11 ekuseni).

Igazi hemostasiogram ethathwe emthanjeni. inqubo Standard - usebenzisa oyinyumba isipetu uchwepheshe uyahoxa adingekayo igazi ivolumu (kuthatha imizuzu embalwa). Amasampula yathunyelwa ukuhlolwa laboratory. By the way, ezimweni eziningi imiphumela ukuhlaziywa zilungele ngemuva kwamahora 2-3 kuphela ngemuva kokubeletha.

Lapho cwaningo?

Ivelaphi hemostasiogram? Inqubo efanayo wenziwa cishe kuzo zonke esibhedlela kanye isikhungo sezokwelapha, ngakho izinkinga nge search for ukulethwa kwento ye cwaningo ngeke luvuke. Ngakolunye uhlangothi, namanje kangcono ukufunda imicabango yabantu ngomsebenzi laboratory ethile ngokucophelela, ngenxa imiphumela yocwaningo kuncike Yiqiniso obengeziwe ukwelashwa.

Hemostasiogram: ukusebenza kulungiswa

Ngemva kokuhlaziya nesineke ngokuvamile uthola ifomu itafula, okuyinto abababalayo wathola phakathi kwemigomo ucwaningo. Imiphumela kudingeka ubone onguchwepheshe ngokushesha ngangokunokwenzeka, ngoba kungacacisa ukuthi, njengoba kufakazelwa hemostasiogram yakho. Efunda okwakubhalwe kulowo mbhalo izibalo - kunzima ngokuzimela isiguli zonke izibalo abaqondi. Kwifomu, njengoba umthetho, nemingcele ezilandelayo zilotshwe:

• APTT - isebenze ngokwengxenye thromboplastin isikhathi, ngokwengxenye - ukuhlola umsebenzi endleleni eziwumgogodla wegazi coagulation.
• isikhathi Prothrombin - lokhu ipharamitha ivumela ukuhlola indlela extrinsic wegazi coagulation (lena ngesikhathi lapho plasma ihlule iqala ukwengeza izicubu isici, prothrombin ne-calcium, ngokuvamile kuba 15-17 s).
• INR (international isilinganiso kwesejwayelekile) - ngesikhathi zocwaningo laboratory eqhathanisa igazi coagulation izinqubo lesiguli nge-plasma ekhethekile kabani nemingcele zivumelana namazinga omhlaba.
• Izinga fibrinogen iprotheni uma usuqala inqubo ekunqandeni iguqulwe ibe fibrin (okuhlushwa yayo - 4.2 g / l).
• isikhathi Thrombin - ubude besikhathi ezidingekayo ukuze kwakhiwe fibrin futhi fibrinogen (OK - kusukela imizuzwana 11 kuya ku-18).
• Isibalo izinhlayiyana zegazi (ngokuvamile ivela 150 kuya kwezingu-400 cells 1 l).
• EBukhoneni D-dimer (leli nani kumele singeqi 248 ng / mg).

prothrombin isikhathi

ucwaningo kahle olwenziwa kusiza udokotela ukuthola mayelana amazinga lesiguli igazi iprotheni prothrombin ethize. Kuyinto ebalulekile igazi ekunqandeni inqubo, njengoba obulandela into icuphe thrombus kumiswa, futhi ngenxa yalokho, ukopha. Lokhu amaprotheni ikhiqizwa isibindi womuntu (i-zamagama alo kudinga vitamin K). Ngeziphambeko prothrombin ezingeni kungase kubonise ukwephulwa isibindi ipheshana wokugaya ukudla.

isikhathi Prothrombin - kungenye kuyinkomba ebaluleke, okuyinto ikuvumela ukuba ichaze hemostasiogram. Kuyini lokhu? Eqinisweni ubude besikhathi okuyiwona igazi "iyaphendula" enxebeni ukhiqiza ihlule firbinovy. Kumuntu ophile kahle, le nqubo ithatha indawo 10-18.

Kaningi, ngesikhathi zocwaningo laboratory hhayi kuphela alinganise isikhathi, kodwa futhi inquma Inkomba prothrombin. Ngokuvamile, lesi sibalo okungenani 93%. Ukunciphisa lokhu sibalo kukhombisa ukwephulwa isibindi. Ngezinye izikhathi lihlotshaniswa ukuphazamiseka ipheshana wokugaya ukudla, vitamin K ukuntuleka kwamavithamini, ukungezwani ukusetshenziswa eliphezulu isisu noma amalungiselelo equkethe acetylsalicylic acid. Iphinde ukhomba ingozi ebangela ukopha. Kodwa ukwanda index 106% noma ngaphezulu sibonisa ukuthambekela igazi ukwakha amahlule.

Thrombin isikhathi kuyinsakavukela kanye nokusuka

Lena isici esibalulekile kakhulu lokho kwenza akwazi ukunquma hemostasiogram. Kuyini lokhu? isikhathi Thrombin - isikhathi kuthatha ukuba babe fibrinogen ngasebenzi ku fibrin. Kumuntu ophile kahle, bangamaphesenti 15-18.

Ngaphezu kwalokho, phakathi zocwaningo laboratory kuyadingeka ukunquma amazinga igazi fibrinogen. okuqukethwe Isilinganiso amaprotheni egazini kuyinto 2-4 g / l. Kuthiwa ezingeni fibrinogen ngezinye izikhathi bavuke. Lokhu kwenzeka, isibonelo, ngenyanga okugcina enkathi yokukhulelwa, futhi ngemuva kokushaywa yisifo sohlangothi, inhliziyo, ebukhoneni ukusha, izifo yegilo, ukuphatha njalo izinto zokuvimbela inzalo hormone. Ezimweni ezinjalo imizwa kubhekwa njengento evamile nesanda fibrinogen ukuze 6 g / l.

• Ukunciphisa eqinile amaprotheni siyenzeka ngokumelene ezinzima isibindi isifo (kuhlanganise isifo sokusha kanye ne-hepatitis), ukungabi umzimba B amavithamini kanye ascorbic acid.

Omunye nemingcele ebaluleke kakhulu kulolu vivinyo ubhekwa APTT. Lesi sikhathi phakathi okungase kwakheka ihlule legazi ngokwengeza calcium chloride-plasma. Ngokuvamile, kuthatha imizuzwana mayelana 30-40. Le nkomba kuyinto kakhulu ngokunembile ephawula umsebenzi ohlelweni hemostatic.

ukopha iziyaluyalu

Ngokwemvelo, kukhona lenqwaba pathologies, okungase ukhombise ukuhlaziywa. Hemostasiogram kuyabaveza ezinye ezibalulekile igazi ekunqandeni:

• Hypocoagulation - isimo okuyinto kuhambisana ukwehla igazi ekunqandeni amazinga e komzimba ukopha njalo (ngezinye izikhathi okwenziwa ngisho imihuzuko elincane).
• Hypercoagulation - a zokugula ukuthi libhekene okwandisa degree of igazi ekunqandeni. Yena curls ngisho nalapho engekho ukulimala kanye amanxeba.
• Thrombophilia - isimo lapho lenyuka propensity ngoba thrombus kumiswa. Yebo, zokugula enjalo kuyingozi kakhulu futhi uma ingelashwa kungaholela ekufeni.

Kungani ungenza ucwaningo phakathi nenkathi yokukhulelwa?

Phakathi nenkathi yokukhulelwa, le ukuhlaziywa kubaluleke kakhulu ngoba kusiza isikhathi etholakalayo ukuxilonga yezinkinga izingozi ezingase zibe khona. Ngokwesibonelo, udokotela angakwazi ukubona ukuthi unayo i-oksijini eyanele nezakhi ingane ithola, kanye negazi, kungaba odla kungenzeka imithambo yegazi, noma nokopha bokubeletha. Ngokuvamile, ukuhlaziywa Kwenziwa ngokushesha ngemva isiteji ukubhaliswa isiguli esibhedlela, bese kuya 22 th-26 th ngesonto.

Yeka ukuthi kuyinto ukuhlaziywa?

Yiqiniso, i-iziguli eziningi, iphuzu elibaluleke kuyinto izindleko ucwaningo. Ngakho malini kuzobiza hemostasiogram? Inani Yiqiniso, kuxhomeke ezicini eziningi. Ngokwesibonelo, udinga ukuba acabangele professional neziqu nezinqubomgomo zezimali isikhungo sezokwelapha, lapho unquma ukusebenzisa amasevisi. Izindleko zocwaningo eziyisisekelo ububanzi ezahlukahlukene kakhulu - kuka-400 no-ruble angu-1300.

hemostasiogram enwetshiwe Yiqiniso, kuyabiza - ruble mayelana 3000-4000. Yiqiniso, izinombolo kulokhu akuzona elincane kakhulu. Kodwa kumelwe siyaqonda ukuthi imiphumela yokuhlolwa ukusiza udokotela ukuxilonga izifo isikhathi sokulungisa. By the way, kwezinye izibhedlela, lokhu Isifundo siqhutshwa mahhala.

Imiphumela nokwethembeka kwabo kuncike iziqu nesipiliyoni zalabo abanolwazi owenza lokhu kuhlola. Ngakho-ke, kudingeka ngokucophelela ukukhethwa onguchwepheshe, futhi isikhungo sezokwelapha ukuzifinyelela. Khumbula ukuthi udokotela kuphela kungaba kahle wokufunda imiphumela yokuhlolwa futhi ukuhlola ngezimo zesiguli.