Yintoni iCoagulogram kwaye yenziwa njani?

Umxholo

• Yenzelwe ntoni
• Kwenziwa njani
• Uvavanyo lweCoagulogram
• Ixesha lokopha (TS)
• 2.Prothrombin ixesha (TP)
• 3.Ixesha eliSebenziweyo leTromboplastin (APTT)
• Ixesha leThrombin (TT)
• 5. Inani leeplatelets

I-coagulogram ihambelana neqela lovavanyo lwegazi olucelwe ngugqirha ukuvavanya inkqubo yokujiya kwegazi, echonga naluphi na utshintsho kwaye oko kubonisa unyango lomntu ukuze kuthintelwe iingxaki.

Olu vavanyo luyacelwa ikakhulu ngaphambi kotyando lokuvavanya umngcipheko wesigulana wokopha ngexesha lenkqubo, umzekelo, kwaye ibandakanya ixesha lokopha, ixesha leprothrombin, ixesha elisebenzayo le-thromboplastin, ixesha le-thrombin kunye nokuvavanywa kwesixa seeplatelets.

Yenzelwe ntoni

I-coagulogram ibonakaliswe ikakhulu ngaphambi kotyando, kodwa inokucelwa ngugqirha ukuba aphande unobangela wezifo ze-hematological kwaye ajonge umngcipheko we-thrombosis, ngakumbi kwabasetyhini abasebenzisa izinto zokuthintela ukukhulelwa.

Ukongeza, i-coagulogram iboniswa emva kokulunywa kwesilwanyana esinetyhefu enokuphazamisa inkqubo yokugungqa kunye nokubeka iliso kubantu abasebenzisa i-anticoagulants, njengeHeparin kunye neWarfarin, umzekelo. Yazi ezinye ii-anticoagulants kwaye xa zibonisiwe.

Kwenziwa njani

I-coagulogram kufuneka yenziwe nomntu ozila ukutya iiyure ezi-2 ukuya kwezi-4 kwaye iqulathe ingqokelela yesampulu yegazi ethunyelweyo ukuba ihlolwe, ngaphandle kweXesha leGazi (TS), elenziwa kuloo ndawo kwaye liqulathe ukujonga ixesha elithathayo lokopha lingayeki.

Kubalulekile ukuba ngaphambi kokuba kwenziwe uviwo, ukusetyenziswa kweziyobisi ze-anticoagulant kwazisiwe, kuba inokuphazamisa isiphumo okanye ithathelwe ingqalelo xa uhlalutya, umzekelo. Ke, kubalulekile ukuba ukhokelwe ngugqirha malunga nokumiswa kokusetyenziswa kwesiyobisi ngaphambi kokwenza i-coagulogram.

Uvavanyo lweCoagulogram

I-coagulogram ineemvavanyo ezithile ezivavanya ubukho bazo zonke izinto ezibandakanyekileyo ekunqandeni igazi kwaye, ngenxa yoko, iheestasis, engqinelana neenkqubo ezenzeka ngaphakathi kwimithambo yegazi ejolise ekugcineni ulwelo lwegazi ukuthintela ukwakheka kwamahlwili okanye ukopha. Qonda yonke into malunga neheestasis.

Iimviwo eziphambili ezikhoyo kwi-coagulogram zezi:

Ixesha lokopha (TS)

Olu vavanyo luhlala lucelwa njengendlela yokuncedisa ezinye iimviwo kwaye iluncedo ekufumaneni naluphi na utshintsho kwiiplatelets kwaye lwenziwa ngokwenza umngxunya omncinci endlebeni, ohambelana nobuchule bukaDuke, okanye ngokusika ingalo ebizwa ngokuba yi-Ivy technique, kwaye ke ubala ixesha lokuphuma kwegazi.

Ukwenza ubuchule be-Ivy, uxinzelelo lusetyenziswa kwingalo yesigulana emva koko kwenziwa ukusikwa okuncinci kwindawo leyo. Kwimeko yendlela yeDuke, umngxunya endlebeni wenziwa kusetyenziswa i-lancet okanye istylus esilahlayo. Kuzo zombini ezi meko, ukopha kuyavavanywa rhoqo kwimizuzwana engama-30 kusetyenziswa iphepha lokucoca ulwelo, elifunxa igazi elikwisiza. Uvavanyo luphela xa iphepha lokuhluza lingasafunisi gazi.

Ngesiphumo se-TS, kunokwenzeka ukuvavanya i-hemostasis kunye nobukho okanye ukungabikho kwe-von Willebrand factor, into ekhoyo kwiiplatelets ezinendima ebalulekileyo kwinkqubo yokunqanda igazi.Nangona olu vavanyo luluncedo ekufumaneni utshintsho kwi-heestasis, lunokubangela ukungonwabi ngakumbi kubantwana, njengoko uvavanyo lunokwenziwa ngokwenza umngxunya endlebeni, umzekelo.

Usiqonda njani iziphumo: Emva kokugrumba umngxunya, ugqirha okanye ingcali ejongene noviwo ibala ixesha eligazi kunye nokujonga ngephepha lokucoca elifunxa igazi elivela kuloo ndawo. Xa iphepha lokuhluza lingasafunisi gazi, uvavanyo luyapheliswa. Ukuba uvavanyo lwenziwe kusetyenziswa i-Ivy Technique, eyingalo, ixesha eliqhelekileyo lokopha liphakathi kwemizuzu emi-6 ukuya kwayi-9. Kwimeko yendlela kaDuke, eyindlebe, ixesha eliqhelekileyo lokopha liphakathi kwemizuzu emi-1 ukuya kwemithathu.

Xa ixesha lide kunexesha ekubhekiswa kulo, kuyathethwa kuvavanyo lwe-TS olwandisiweyo, lubonisa ukuba inkqubo yokujiya kwehlwili ithathe ixesha elide kunesiqhelo, elinokuthi libonakalise isifo sika-von Willebrand, ukusetyenziswa kweziyobisi ze-anticoagulant okanye i-thrombocytopenia, umzekelo. Yazi oonobangela abaziintloko be-thrombocytopenia.

2.Prothrombin ixesha (TP)

I-Prothrombin, ekwabizwa ngokuba yi-Coagulation Factor II, yiprotheyini esebenzayo ngexesha lenkqubo yokujiya kwaye umsebenzi wayo kukukhuthaza ukuguqulwa kwe-fibrinogen kwi-fibrin, yenze iplagi yesibini okanye ecacileyo yeplatelet.

Olu vavanyo lujolise ekuqinisekiseni ukusebenza kwendlela yokugungxula okungaphandle, kuba ibandakanya uvavanyo lwexesha elithathwa ligazi ukwenza i-buffer yesibini emva kokuvezwa yi-calcium thromboplastin, eyi-reagent esetyenzisiweyo kuvavanyo.

Usiqonda njani iziphumo: Kwiimeko eziqhelekileyo, emva koqhakamshelwano lwegazi ne-calcium thromboplastin, indlela yangaphakathi iyenziwa, kusebenze izinto ze-VII kunye no-X zokuxinana kwaye, ngenxa yoko, factor II, eyi-prothrombin, ekhuthaza ukuguqulwa kwe-Fibrinogen ibe yi-Fibrin, ukunqanda ukopha. Le nkqubo ihlala ithatha phakathi kwemizuzwana eli-10 ukuya kweli-14.

Nangona kunjalo, kwezinye iimeko i-coagulogram ibona i-PT eyandisiweyo, oko kuthetha ukuba ukwenziwa kwe-prothrombin kwenzeka ixesha elide kunesiqhelo. Ukunyuka kwamaxabiso e-PT kuhlala kwenzeka xa kusetyenziswa ii-anticoagulants, ukunqongophala kwe-vitamin K, ukusilela kwe-VII kunye neengxaki zesibindi, umzekelo, kuba iprothrombin iveliswa esibindini.

Kwiimeko ezinqabileyo, i-PT inokuncipha, njengakwimeko yokusetyenziswa kwesongezelelo se-vitamin K okanye iipilisi zokucwangcisa nge-estrogen, umzekelo. Qonda ngakumbi malunga nesiphumo sovavanyo lwexesha leProthrombin.

3.Ixesha eliSebenziweyo leTromboplastin (APTT)

Olu vavanyo lukwasetyenziselwa ukuvavanya i-hemostasis, nangona kunjalo ivumela ubukho okanye ukungabikho kwezinto ezixineneyo ezikhoyo kwindlela yangaphakathi ye-coagulation cascade eqinisekisiweyo.

I-APTT ihlala ibalulekile ukubeka iliso kwizigulana ezisebenzisa iHeparin, eyi-anticoagulant, okanye enengxaki yokunqanda igazi, iluncedo ekuchongeni utshintsho olunxulumene nezinto ezijiyayo.

Kolu vavanyo, isampulu yegazi eliqokelelweyo libonakalisiwe kwii-reagents, kwaye ke ixesha elithathayo ukuze igazi lijiye libaliwe.

Usiqonda njani iziphumo: Kwiimeko eziqhelekileyo, i-APTT yimizuzwana engama-21 ukuya kwengama-32. Nangona kunjalo, xa umntu esebenzisa ii-anticoagulants, ezinje nge-heparin, okanye ukusilela kwezinto ezithile zendlela yangaphakathi, enje nge-XII, XI okanye VIII kunye ne-IX, ebonisa i-hemophilia, ixesha lihlala lide kunexesha ekubhekiswa kulo ., Ukuboniswa kuvavanyo lokuba i-APTT iyandiswa.

Ixesha leThrombin (TT)

Ixesha le-thrombin lihambelana nexesha elifunekayo lokuba iqokobhe lenziwe emva kokongezwa kwe-thrombin, eyimfuneko yokunqanda ukusebenza kwe-fibrinogen kwi-fibrin, eqinisekisa uzinzo lwehlwili.

Olu vavanyo lubuthathaka kakhulu kwaye lwenziwa ngokongeza i-thrombin kwiindawo eziphantsi kwi-plasma yegazi, ixesha lokuxinana eliphenjelelwa sisixa se-fibrinogen ekhoyo kwi-plasma.

Usiqonda njani iziphumo: Ngokwesiqhelo emva kokongezwa kwe-thrombin kwiplasma, i-clot yenza phakathi kwemizuzwana eyi-14 ukuya kwengama-21, oku kuthathwa njengexabiso lesalathiso, elinokwahluka ngokwelabhoratri ekwenziwa kuyo uvavanyo.

I-TT ithathwa njengexesha elide xa umntu esebenzisa ii-anticoagulants, ehambisa iimveliso zokuthotywa kwe-fibrin, ene-XIII okanye i-fibrinogen defence, umzekelo.

5. Inani leeplatelets

Iiplatelets ziziqwenga zeeseli ezikhoyo egazini ezidlala indima ebalulekileyo kwi-heestasis, kuba ziqulathe izinto ezibalulekileyo zenkqubo yokujiya, umzekelo, von von Willebrand factor.

Xa kukho ukwenzakala kwethishu, iiplatelets zihamba ngokukhawuleza kwindawo yokwenzakala, ngenjongo yokunceda kwinkqubo yokuma kwegazi. Iiplatelets ezisebenzayo ziyazincamathelisa kwi-endothelium yenqanawa eyonzakeleyo kusetyenziswa i-von Willebrand factor kwaye emva koko itshintshe ukwenziwa kwayo kunye nokukhupha izinto kwi-plasma ukuze zifumane iiplatelet ezingakumbi kwindawo yokwenzakala kwaye ke zenze iplagi ephambili.

Ke, ukujonga inani leeplatelet kubalulekile kwi-coagulogram njengoko ivumela ugqirha ukuba azi ukuba kukho utshintsho kwinkqubo ye-heestasis ephambili, ecebisa ngonyango oluthe kratya.

Usiqonda njani iziphumo: Inani eliqhelekileyo leeplatelets egazini liphakathi kwe-150000 kunye ne-450000 / mm³. Amaxabiso asezantsi kunexabiso lesalathiso abonisiwe kuvavanyo njenge-thrombocytopenia, ebonisa ukuba kukho inani elincinci leeplatelet ezijikelezayo, ezinokubangela iingxaki zokunqanda igazi, ukuthanda ukopha, ukongeza ekubonakaliseni ukusilela kwesondlo, utshintsho kwithambo Umongo okanye usulelo, umzekelo.

Amaxabiso angentla kwesalathiso abizwa ngokuba yi-thrombocytosis, enokuthi ibangele ukujiya okungaphaya, okunokwenzeka ngenxa yeendlela zokuphila, njengokutshaya okanye ukunxila, umzekelo, okanye ngenxa yeemeko zophendlo lwezifo, ezinje nge-iron anemia, myeloproliferative syndrome kunye neleukemia , umzekelo. Funda ngezinye izinto ezibangela ukwandiswa kweplatelet.