Igazi test. Igazi ekunqandeni. Kulungiswa yegazi: coagulation

Igazi - kuba main zizalela emhlabathini zomzimba womuntu. Ngokuqhubekayo afundwa ke futhi usinika amaseli zihlangana nomoya-mpilo zonke metabolites ebalulekile, ke wenza imisebenzi yayo eziyisisekelo. Ngaphezu kwalokho, igazi futhi isivikelo ukwethulwa sebuningini Amagciwane ukubhebhetheka kwezifo ezithathelwanayo, kanye nokuvimbela ukopha uma umonakalo ka nanoma yisiphi isitsha esenziwe. Kuncike kuyinto coagulation uhlelo ekhethekile ehlanganisa isethi eziyinkimbinkimbi amaprotheni. Manje sixoxa ngezinto ngokuningiliziwe ngalokhu.

Isakhiwo hemostasis

Kufanele uthole ukuthi yini lesi simiso hemostasis. It siqukethe izingxenye ezimbili abasiphikisayo kwezinye ngalinye - coagulation futhi anticoagulation. Kodwa ngesikhathi esifanayo, baba umphelelisi nomunye, ukuze igazi awushintshanga imingcele yayo qualitative, futhi wakwazi zidla nezinye izicubu. Eyokuqala uthola inzuzo nge ukopha uma kudingeka ukwakha inesikhala a obturation igazi ihlule evulekile odongeni isitsha. Eyesibili icushiwe ngokushesha emva operation wokuqala, kanjalo uvimbele ukudala ezinye ekunqandeni nokuthuthukiswa anda thrombosis imiphumela enjalo ezinzima, ezifana sohlangothi isilethikusebenza.

Ngakho-ke, ngo-izifo eziningi ezathathwa ukuhlaziywa isiyonke igazi. Igazi ekunqandeni kanye seeding yayo webhaktheriya - umgomo kulolu cwaningo. ungenza uphethwe yini futhi ukwelashwa okufanele ngokususelwa kwidatha yayo.

Izingxenye ekucubunguleni jikelele wegazi

Phakathi yezingxenye kohlelo coagulation hlala ebalulekile njengoba amaseli namaprotheni. Lokhu ngokuyinhloko izinhlayiya zegazi, okuyinto, ngaphezu umsebenzi wayo ophambili nosemqoka, futhi ahlinzeke ukudla endothelium abami ingaphakathi yonke imithambo yegazi. Inombolo yabo ingatholakala ngokufaka ezidlulayo lwasemtholampilo segazi. Nokho, ekunqandeni, akuxhomekile nje kuphela esimweni inombolo yabo, kodwa futhi ku izinga yabo. Ngakho, lapho i-ukuguquguquka umsebenzi esingokwemvelo kula maseli ukuthuthukisa thrombocytopathia, ukuwazi futhi esibonakala ngokuqina amaningi, kunzima ukuyeka ukopha, okungase luholele ukulahlekelwa ukuphila. Enye elula, enikeziwe ngisho ukuhlaziya enemininingwane basemtholampilo igazi - isikhathi ekunqandeni Lee-White. Okunqumayo ezizamazamisa amashubhu nge substrate kuthathwe lize Nonseparated ihlule obukhulu.

izici isici

Amaphrotheni zifakwe ukwakheka kohlelo coagulation, okukhulunywe izici nantathu. ulimi lwawo luhluke itholakala lokuthi ngokuvamile zingabantu esimweni okungasebenzi kuze kukhona isizathu nemisebenzi yabo, kanye iketango eziyinkimbinkimbi kokwethulwa zabo, lapho benza yelikhono lezi ukusabela. Ngakho, lesi simiso kuqhathaniswa angawodwa. Quality Izimpawu umsebenzi wabo kwi kwegazi ewumngcingo - "igazi ekunqandeni" noma "coagulation". Kuhlanganisa inani elilinganiselwe ongakhetha, kodwa udokotela ongumnikazi ulwazi ngazo, ungakwazi ngokunembile ubizwe imbangela iziyaluyalu hemostasis, ngisho nesifo ecashile. Ngakho, emagama yegazi "ekunqandeni" zisendaweni ebalulekile kumuzwa basemtholampilo Uchwepheshe ngamunye, futhi ngenxa yalokho siyakuvuna sixoxe ngaso kabanzi.

izinkomba letibalulekile coagulation

Ngakho, kulolu cwaningo siqukethe imiqondo elandelako ukhiye.

• Okokuqala. D-dimer kuyinto Isikhombisi esibalulekile thrombosis, futhi ngaleyo ndlela isetshenziselwa ekuhlonzweni ka thrombosis. Abakhulelwe ezitholakala esiningi (3-4 izikhathi) ekupheleni kwesikhathi esiyizinsuku ezinga-esesibelethweni, kodwa lena okufana kuyinsakavukela. Ukuthola ingabe lokuhlushwa enkulu kakhulu ubufakazi kakade ngenkambo sokugembula yokukhulelwa. Ngaphezu kwalokho, kwembulwa ukwanda kwezifo ezifana samathambo, ukuxakeka oluhambisana, izifo ezinzima.
• Eyesibili umqondo. isikhathi Prothrombin kathisha parallel Inkomba INR futhi pti (prothrombin Inkomba) ephawula isimo uhlelo igazi coagulation futhi kukalwa Koagulometers amafomula. Ichazwa ngokuthi i kokuhlaziywa kwamathenda hemostasis futhi ekwelapheni anticoagulants engesobala.
• Okwesithathu. Fibrinogen - iprotheni eziyinkimbinkimbi. Kuyinto the backbone kumiswa ihlule legazi - thrombus. ukwanda kwalo kuhambisana kwesibindi, isifo sezinso, isilethikusebenza, ukugula ngemisebe, umdlavuza. Nokho, njengoba waphawula ngesikhathi sokukhulelwa, ukuya esikhathini, futhi nge izinto zokuvimbela inzalo ngomlomo oyinhloko estrogen ingxenye.

izinkomba protivosvertyvaniya

• Umqondo lesine. Lupus coagulant iqembu amasosha platelet ayo, okuyinto siwukubonakaliswa inqubo ezinzima sokuhlasela kwamasosha omzimba. Ngokuvamile atholakala zokugula yokukhulelwa, isb. E. Gestosis. Ukuba khona kwawo kuchaza ezinzima yabo hemodynamic thuthuva - edema, umfutho wegazi, awokuthi yisisu. Ngakho-ke, igazi, "igazi ekunqandeni" ukuhlaziywa wenziwa ngoba bonke abesifazane abakhulelwe ukugwema lolu khetho.
• Wesihlanu. Antithrombin-3, ngokuphambene, kuyinto amaprotheni uhlelo anticoagulation kanye inhibitor thrombin. Uma isiguli kokulahlekelwa ukuhlolwa igazi, "igazi coagulation," kanye nokwehla okuholela le ngxenye, libonisa ingozi thrombosis. Futhi, incazelo antithrombin-3 Kubalulekile ukulawula seziguli ezithola eside anticoagulant izidakamizwa uchungechunge (izidakamizwa "TromboASS", "Cardiomagnyl", "clopidogrel").

efingqa

Ngaphezu okungenhla, kukhona aPTT ngesilinganiso ukuthi ibonisa ngokucacile kakhulu eyanele / kusilela yezici ka igazi ekunqandeni. Ngakho-ke kubalulekile ukuba sithole hemophilia kakhulu genesis ahlukahlukene, isifo von Willebrand sika, khona ngokweqile coagulation inhibitor noma anticoagulants reception. Kufanele kuqashelwe ukuthi i-Assay igazi ekunqandeni kungenziwa kuphela wabonisa. Nokho, uma usola ukuhlukumeza ngesikhathi uhlelo hemostatic, kunesidingo esiphuthumayo kumele ubonane nodokotela.