Paunenge uri nepamuviri, gynecologist ichakuudza kuti utore boka rekuongororwa: zvinotenderwa, izvo vakadzi vose vane pamuviri vanofanira kutora mune dzimwe mitsetse, uyezve - kana vachichida. Coagulation panguva yekudzivirira ndeimwe yezvidzidzo zvinotarisirwa. Itai kamwechete mu trimester (zviri nyore kutaura, kamwe chete mwedzi mitatu). Asi kana mukadzi akazonyora mushure memakore gumi nemaviri ekudzivirira, ipapo pachava nekudzidzira kwakadaro kwakadaro: pakarepo apo mukadzi anyoresa uye asati asvika pakuberekwa - pavhiki makumi matatu.
Uyezve, kuongororwa kwekakogulogram panguva yekuzvitakura kunoitwa mushure mokurapa, kana pakanga pasina kuipa mumitengo, uye asati aberekwa, kana iwe uchapiwa chirwere chekushaya chirwere. Ropa pa coagulogram panguva yekuzvitakura inotorwawo, sekuenzaniswa kwehupenyu hwemagetsi - kubva mumavheya uye pasina mimba isina chinhu.
Ropa coagulogram rinoratidzei?
Zviratidzo zvikuru zvemunhu ane utano coagulogram:
nguva yokuvhara - maminitsi mashanu kusvika ku10;- yakagadziriswa nguva yekudzoka (ATS) - 50 - 70 seconds;
- yakagadzirirwa nguva yepromboplastin nguva (APTT) - 24 kusvika kumaminitsi 35;
- prothrombin index - 80 - 120%;
- zvinyorwa zve fibrinogen - 2 - 4 g / l;
- thrombin nguva - 11 - 17.8 seconds;
- soluble fibrin-monomer complexes (RNMC) - 4 mg / 100 ml;
- basa re fibrinolytic - 183 - 263 maminitsi;
- trombotest - IV - V degree;
- fibrinogen - 5.9 - 11.7 μmol / l;
- fibrinogen B - zvakaipa;
- plasma inobvumirana ne heparin - 3 - 11 maminitsi;
- nguva yekubuda ropa Duroku kusvika kumaminitsi makumi mana;
- kubviswa kweropa ropa - 44 - 65%;
- nguva yeplasma recalcification (VPR) inenge 60 - 120 seconds.
Nei uchigadzirisa migumisiro ye coagulation panguva yekuzvitakura?
Zviratidzo zvekudzivirira pamuviri panguva yekuzvitakura zvakasiyana kubva kare, nokuti muviri uri kugadzirira kuberekwa kunouya, kushaya kurasikirwa kweropa panguva iyo, uye ropa rinotanga kupera nokukurumidza. Izvi zvinoratidzika kunyange ne-simple coagulogram, apo chete nhamba yemaplatelet yakatsanangurirwa - nhengo dzeropa dzinobva pakadzika tsrombussi (kazhinji nhamba yavo inobva 150 kusvika 400 x 109 / L), nguva yekuvhara (5-10 maminitsi zvichienderana nehutano) fibrinogen uye prothrombin index.
Ropa coagulability rinowedzera physiologically, uye izvi zvinoratidzwa apo kusarudza zvimwe zviratidzo:
- fibrinogen - puroteni inobva iyo fibrin inogadzirwa panguva yekubuda ropa - panguva yechitatu yemamiriyoni ekuzvitakura kwayo inowedzera kubva 2 kusvika 4 kusvika ku6 g / l;
- iyo prothrombin index muvakadzi vane pamuviri haafaniri kunge yakasiyana nedzimwe nharasi dzinowanikwa: prothrombin - protein ye plasma yeropa, iyo iyo thrombin inoumbwa - iyo nhamba inomuka kana kupera kwemavara kusati kwaitika kunoitika.
Sei uchipa coagulogram yakakura munguva yekuzvitakura?
Mune dzimwe ma laboratori panguva imwe chete kana pakutsauka kubva pachimiro kana kuti kutaridzika muchokuroagulogram isina kuwedzera iyo coagulogram yakasimbiswa pakuzvitora inopedzwa. Asi kutungamirirwa kwekodhigram yakasiyana-siyana inogadzirirwa zviratidzo zvakananga: ihwohwo hutachiwana huzhinji , zvakanyanya kutanga uye kuberekwa pamuviri gestosis, intrauterine fetal death, zvirwere zveropa, nhoroondo yakareba yekusagadzikana, kunowanzopererwa.
Yakagadzirirwa chikamu thromboplastin nguva (APTT) inoratidza kuvepo kwekuvhara zvinhu, pasina izvo zvisingabviri kuumba ropa clot. Madzimai ane pamuviri, inopfupiswa kusvika pamaminetsi makumi maviri nemakumi maviri (makumi maviri nemakumi maviri (thrombus kubva kuFibrinogen) uye rubatsiro rwavo rwakaumbwa nokukurumidza). Lupus anticoagulant inofanira kunge isipo muvakadzi vane pamuviri, asi inowanikwa mune zvirwere zvisingagadziriswi uye pakupera kwekushaya toxicosis kwokuzvitakura, kuvapo kwayo kunounza kuwedzera kweAAPTT. Thrombin nguva (11 - 18 seconds) muvakadzi vane pamuviri inowedzera kusvika 18 - 25 seconds. Ino ndiyo chikamu chekupedzisira chekuvhara ropa, apo michina ye fibrin inoumbwa kubva ku fibrinogen pasi pechiito che thrombin (coagulation factor).
Chii chinodzivisa kuchinja mu coagulogram munguva yekuzvitakura?
Kana zviyero zve coagulogram zvakasiyana nezvakanaka, saka, kutanga kune dzose, tinofanira kubhadhara kune rumwe rutivi kuchinja uku kwakaitika: ropa coagulation yakawedzera kana, zvakananga, yakadzikira pasi. Uye itai zviri nani kupfuura nyanzvi. Zvechokwadi, kuderera kwekodagulation simba reropa kunogona kuva mugumisiro wekutora nguva isati yasvika yepascenta uye kuora ropa: dzimba dzekugadzirisa ropa zvinhu zvinopera uye intravascular coagulation syndrome, iyo inopisa upenyu kune amai, inogona kukura. Uye kuwedzerwa kweropa kuvhara kunotungamirira kune rumwe rudzi rwetrombosi.