Ropa rekuvhara ropa

Kuvhara ropa ndiko kukakosha kunonyanya kukosha kwechimiro chekurega kubuda ropa apo masvingo emidzi yeropa akaparara, uye ropa rinoputika kana risisina kudiwa. Izwi reropa coagulability harina kuenzaniswa nehutano hwe homeostasis, basa rekuchengeta ropa. Homeostasis ine nzira mbiri:

1. Primary - vascular-platelet. Nezvo, maplatelet anobata pamwe chete ndokuumba izvo zvinonzi "white thrombus", umo maplatelets anotora.
2. Secondary - coagulation (iyewo - coagulation of blood). Nezvo, kuvhara kwakanyanya kwemahara yakagadzirwa ne fibrin clot yakasikwa, iyo inonziwo "red blood clot". Iri zita rakapiwa kwaari nokuti fibrin mesh inowanzobatwa neyerythrocytes.

Nokudaro, chirongwa cheropa coagulation pane zvakaoma uye chikamu chayo mumuviri chinonyanya kukosha. Chero hutachiona hunobatanidza neropa rekuvhara ropa rinogona kuratidza zvirwere uye kutungamira kune iyo. Inofanirawo kujekeswa kuti danho rekupedzisira re homeostasis is fibrinolysis, umo ropa rinoputika apo mudziyo unotora uye kudiwa kwe fibrin clot kunonyangarika.

Zviratidzo zvekuongorora ropa coagulability

Ropa coagulation test rinonziwo coaguloramma. Kutora kuongororwa kweropa kwekuvhara, unofanirwa kuziva kuti chiratidzo cheizvi. Muzvirwere zvakasiyana-siyana, kuvhara ropa kunogona kunge kusina simba, uye kuvapo kwavo ndiyo chikonzero chekusimbisa kukwanisa kwekuvhara:

• autoimmune diseases;
• chiropa chisingawanzoshandi;
• utano hwemwoyo;
• varicose veins;
• chirwere cheshuga mellitus ;
• hemochromatosis .

Uyewo, kugoverana kuongorora kunodiwa kune zvimwe zviitiko:

• pamuviri;
• postoperative kana preoperative nguva;
• kudzora mukurapa anticoagulants;
• Kana kushungurudzwa kwekurasikirwa kweropa kwenguva refu kunokosha, cheki yekuvhara ropa inokosha.

Tsanangudzo yeropa rekuongorora kuvhara

Asati ataura pamusoro pemaitiro eropa rekuchera ropa, rinofanira kujekeswa kuti mu laboratori imwe neimwe idzi zviratidzo zvingangosiyana zvakasiyana, uye naizvozvo shoko rokupedzisira nderechiremba anoshanda. Inofanirawo kunzwisiswa kuti coagulogram yakaenzana yakasiyana panguva yekuzvitakura, zvichienderana ne trimester.

Nokudaro, kuongororwa kwega kwega kwekuvhara kune mitemo 8, iyo inopa kuenzanisa kwekuvhara ropa:

1. Muedzo weRopa rekuvhara nguva. Muitiro wekuvhara nguva ndeye 5-10 maminitsi (nekuda kweropa remhepo, uye nokuda kwema capillary - 2 maminitsi). Kuwedzerwa kwepiramu inoratidza hutachiwana hwechoagulability, uye kuderera kwekuvhara kwepamusoro.
2. APTTV inoshandiswa purogiramu yepromboplastin yenguva. Chimiro chinobva pamasere 24 kusvika ku35. Kuwedzera kwenguva kunoratidza kushaya simba kwekugadzirisa, uye kuderera munguva ye hypercoagulability.
3. Iyo prothrombin index ndiyo prothrombin nguva, iyo inowanikwa kuongororwa kunze kwekuvhara nzira. Mutengo wacho unobva ku80 kusvika ku20%. Kuyerera kwechiratidzo kunoratidza hypercoagulable, uye kuwedzerwa kwezvakaderera basa reropa coagulation.
4. Fibrinogen ipuroteni mu plasma. Kazhinji chimiro chacho chinobva ku59 kusvika ku11,7 μmol / l. Inogona kuwedzera nekuputika, pamuviri, kupisa uye kushaya mwoyo. Iyo slide inogona kutaura nezveDIC syndrome kana zvirwere zveropa.
5. Thrombin nguva ndiyo kuongorora kwechikamu chekupedzisira chekugadzirisa. Kazhinji, chiyero ichi chinobva pa11 kusvika ku17.8 seconds. Nekushayikwa kwe fibrinogen, hyperbilirubinemia, kana kuti kurapa ne heparin, pangava nekuwedzera, uye kuderera kwemazuva - nehuwandu hwe fibrinogen muropa, kana kuti neAIDS syndrome.
6. Nguva yeplasma recalcification inowanzoitika - kubva pamasekondi 60 kusvika 120.
7. Plasma kuvhiringidza heparin. Parizvino, kuedzwa uku hakusi kushandiswa nguva dzose. Chimiro chinobva pamaminetsi matatu kusvika ku11.
8. Kudzorera kweropa clot. Kazhinji parameter inobva ku44 kusvika ku65%.

Ko chiratidzo chekuvhara ropa chakaitwa sei?

Ropa rekudzivirira ropa rinowanzoitwa neine in vitro, asi, somuenzaniso, mukuongorora kwekushandiswa kweropa rose-thromboelastography, chiyero chekufananidza nemamiriro ezvinhu eInvivo inogoneka.

Kuita kuongororwa kwega kwega yega yekuvhara, maawa masere isati yamuedzo isingakodzeri kudya. Ropa kuti riongororwe rinotorwa kubva mumutsipa kuti riongorore ropa remhepo. Kuongorora kukosha kwekuvhara ropa remakumbo nemaaplatelets zvakakwana kuongorora ropa kubva munwe.