Kusatshalaliswe i-coagulation ye-intravascular (DIC)

Ukusatshalaliswa kwe-intravascular coagulation (DIC) yisifo esibi lapho amaprotheni alawula ukujiya kwegazi asebenza ngokweqile.

Lapho ulimele, amaprotheni asegazini akha amahlule egazi aya endaweni yokulimala ukusiza ukumisa ukopha. Uma lawa maprotheni esebenza ngokungajwayelekile emzimbeni wonke, ungahlakulela i-DIC. Imbangela eyisisekelo imvamisa ibangelwa ukuvuvukala, ukutheleleka, noma umdlavuza.

Kwezinye izimo ze-DIC, amahlule amancane egazi akha emithanjeni yegazi. Amanye ala mahlule angavimba imithambo futhi anqamule ukutholakala kwegazi okujwayelekile ezithweni ezinjengesibindi, ubuchopho noma izinso. Ukuntuleka kokuhamba kwegazi kungalimaza futhi kudale ukulimala okukhulu ezithweni.

Kwezinye izimo ze-DIC, amaprotheni ajiyisayo egazini lakho ayadliwa. Uma lokhu kwenzeka, ungaba nengozi enkulu yokopha kakhulu, ngisho nokulimala okuncane noma ngaphandle kokulimala. Ungaba futhi nokopha okuqala ngokuzenzekelayo (kukodwa). Lesi sifo singenza nokuthi amangqamuzana akho abomvu egazi aqhekeke futhi ahlukane lapho ehamba emithanjeni emincane egcwele amahlule.

Izici ezinobungozi ze-DIC zifaka:

• Ukusabela kokumpontshelwa igazi
• Umdlavuza, ikakhulukazi izinhlobo ezithile ze-leukemia
• Ukuvuvukala kwamanyikwe (pancreatitis)
• Ukutheleleka egazini, ikakhulukazi ngamagciwane noma ukhunta
• Isifo sesibindi
• Izinkinga zokukhulelwa (njenge-placenta esele ngemuva kokubeletha)
• Ukuhlinzwa kwakamuva noma i-anesthesia
• Ukulimala kakhulu kwezicubu (njengokusha nokulimala ekhanda)
• I-hemangioma enkulu (isitsha segazi esingakhiwanga kahle)

Izimpawu ze-DIC zingafaka noma yikuphi okulandelayo:

• Ukopha, kusuka kumasayithi amaningi emzimbeni
• Amahlule egazi
• Ukulimaza
• Yehlisa umfutho wegazi
• Ukuphelelwa umoya
• Ukudideka, ukulahleka kwememori noma ukushintsha kokuziphatha
• Imfiva

Ungaba nokuhlolwa okulandelayo:

• Qedela ukubalwa kwegazi ngokuhlolwa kwegazi nge-smear
• Isikhathi esithile se-thromboplastin (PTT)
• Isikhathi se-Prothrombin (PT)
• Ukuhlolwa kwegazi le-Fibrinogen
• I-D-dimer

Akukho ukwelashwa okuqondile kwe-DIC. Inhloso ukunquma nokuphatha imbangela eyisisekelo ye-DIC.

Imithi yokwesekwa ingafaka:

• Ukumpontshelwa i-Plasma ukufaka izinto zokuvala igazi uma kuvela ukopha okukhulu.
• Umuthi omncane wegazi (i-heparin) ukuvimbela ukujiya kwegazi uma kwenzeka inani elikhulu lokujiya.

Umphumela uncike kulokho okubangela ukuphazamiseka. I-DIC ingasongela impilo.

Izinkinga ezivela ku-DIC zingafaka:

• Ukopha
• Ukuntuleka kokugeleza kwegazi kuya ezingalweni, emilenzeni, noma ezithweni ezibalulekile
• Unhlangothi

Iya egumbini labezimo eziphuthumayo noma ushayele ku-911 uma wopha okungapheli.

Thola ukwelashwa ngokushesha kwezimo ezaziwa ngokuletha lesi sifo.

Ukusetshenziswa coagulopathy; I-DIC

• Ukwakheka kwegazi
• I-Meningococcemia ematholeni
• Amahlule egazi

ULevi M. Kusatshalaliswe i-coagulation ye-intravascular. Ku: Hoffman R, Benz EJ, Silberstein LE, et al, ama-eds. I-Hematology: Izimiso Eziyisisekelo Nokuzijwayeza. Umhla wesi-7. IPhiladelphia, PA: Elsevier; 2018: isahluko 139.

UNapotilano M, uSchmair AH, uKessler CM. I-Coagulation kanye ne-fibrinolysis. Ku: McPherson RA, Pincus MR, abahleli. UHenry’s Clinical Diagnosis and Management by Laboratory Methods. Umhla ka-23. ISt Louis, MO: Elsevier; 2017: isahluko 39.