Isasazwe i-intravascular coagulation (DIC)

Ukusasazwa kwe-intravascular coagulation (DIC) sisifo esibi apho iiproteni ezilawula ukujiya kwegazi ziye zisebenze ngaphezulu.

Xa wenzakele, iiproteni ezisegazini ezenza amahlwili egazi ziye kwindawo yokwenzakala ukunceda ukuyeka ukopha. Ukuba ezi proteni zisebenza ngokungaqhelekanga emzimbeni wonke, ungaphuhlisa i-DIC. Unobangela oyintloko uhlala ubangelwa kukudumba, usulelo, okanye umhlaza.

Kwezinye iimeko ze-DIC, amaqhekeza egazi amancinci kwimithambo yegazi. Olunye lala maqhina anokuvala imithambo lize lisike igazi eliqhelekileyo kumalungu afana nesibindi, ingqondo okanye izintso. Ukungabikho kokuhamba kwegazi kungonakalisa kwaye kubangele ukulimala okukhulu kumalungu.

Kwezinye iimeko ze-DIC, iiproteni ezijiyayo egazini lakho ziyaphela. Xa oku kusenzeka, unokuba semngciphekweni wokopha kakhulu, nokuba kukwenzakala okuncinci okanye ngaphandle kokulimala. Unokuba nokuphuma kwegazi okuqala ngokuzenzekelayo (ngokwakho). Esi sifo sinokubangela ukuba iiseli ezibomvu zegazi ziqhekeze kwaye ziqhekeze xa zihamba ngemikhumbi emincinci ezele ngamahlwili.

Imiba yomngcipheko kwi-DIC ibandakanya:

• Ukuphendula ngokutofelwa igazi
• Umhlaza, ngakumbi iintlobo ezithile zegazi
• Ukudumba kwepancreas (pancreatitis)
• Usulelo egazini, ngakumbi ziibhaktheriya okanye ukungunda
• Isifo sesibindi
• Ubunzima bokukhulelwa (njenge-placenta eshiye ngasemva emva kokubeleka)
• Utyando lwamva nje okanye i-anesthesia
• Ukulimala kakhulu kwezicubu (njengokutsha nokulimala entloko)
• I-hemangioma enkulu (isitya segazi esingakhange senziwe ngokufanelekileyo)

Iimpawu ze-DIC zinokubandakanya nayiphi na kwezi zinto zilandelayo:

• Ukopha, kwiindawo ezininzi emzimbeni
• Amahlwili egazi
• Ukuthuthuzela
• Yehla kuxinzelelo lwegazi
• Ukuqhawukelwa ngumphefumlo
• Ukudideka, ukulahleka kwememori okanye utshintsho kwindlela yokuziphatha
• Ifiva

Unako ukufumana naluphi na olu vavanyo lulandelayo:

• Gcwalisa ukubalwa kwegazi ngovavanyo lwe-smear yegazi
• Ixesha lecandelo le-thromboplastin (PTT)
• Ixesha leprothrombin (PT)
• Uvavanyo lwegazi lwe-Fibrinogen
• I-D-dimer

Akukho lunyango oluthile lwe-DIC. Injongo kukufumanisa nokunyanga oyena nobangela we-DIC.

Unyango oluxhasayo lunokubandakanya:

• Utofelo-gazi ukuthatha indawo yezinto ezijija igazi ukuba kwenzeka ukopha okuninzi.
• Iyeza elincinci legazi (heparin) ukuthintela ukujiya kwegazi ukuba isixa esikhulu sokujiya senzeka.

Iziphumo zixhomekeke kwinto ebangela ukuphazamiseka. I-DIC inokubusongela ubomi.

Iingxaki ezivela kwi-DIC zinokubandakanya:

• Ukopha
• Ukungabikho kokuhamba kwegazi kwiingalo, emilenzeni, okanye kwizitho ezibalulekileyo
• Ukubetha

Yiya kwigumbi likaxakeka okanye utsalele umnxeba ku-911 ukuba wopha ongayeki.

Fumana unyango kwangoko kwiimeko ezaziwayo ukuzisa kwesi sifo.

Ukusetyenziswa kwecoagulopathy I-DIC

• Ukubumba kwegazi
• Meningococcemia kumathole
• Amahlwili egazi

U-Levi M. Usasaze i-intravascular coagulation. Ku: Hoffman R, Benz EJ, Silberstein LE, et al, ii-eds. I-Hematology: Imigaqo esisiseko kunye nokuziqhelanisa. Umhla wesi-7. IPhiladelphia, PA: Elsevier; Ngo-2018: isahluko 139.

UNapotilano M, uSchmair AH, uKessler CM. Ukuxinana kunye nefibrinolysis. Ku: McPherson RA, Pincus MR, ii-eds. Ukuchongwa kweKlinikhi kaHenry kunye noLawulo ngeendlela zeLebhu. Umhla we-23. ISt Louis, MO: Elsevier; Ngo-2017: isahluko 39.