Iyini iCoagulogram futhi yenziwa kanjani?

-Delile

• Yenzelwe ini
• Kwenziwa kanjani
• Ukuhlolwa kweCoagulogram
• 1.Isikhathi sokopha (TS)
• Isikhathi se-Prothrombin (TP)
• Isikhathi se-Thromboplastin Esingasebenziwe (APTT)
• Isikhathi se-Thrombin (TT)
• 5. Inani lamaplatelets

I-coagulogram ihambelana neqembu lokuhlolwa kwegazi elicelwe ngudokotela ukuthi ahlole inqubo yokuvala igazi, akhombe noma yiziphi izinguquko futhi ngaleyo ndlela akhombise ukwelashwa komuntu ukuze agweme izinkinga.

Lokhu kuhlolwa kucelwa ikakhulukazi ngaphambi kokuhlinzwa ukuhlola ubungozi besiguli bokuphuma ukopha ngesikhathi senqubo, ngokwesibonelo, futhi kufaka isikhathi sokopha, isikhathi se-prothrombin, isikhathi se-thromboplastin esinqunyelwe, isikhathi se-thrombin kanye nokuhlolwa kwenani lama-platelet.

Yenzelwe ini

I-coagulogram ikhonjiswa ikakhulukazi ngaphambi kokuhlinzwa, kepha futhi ingacelwa ngudokotela ukuthi aphenye imbangela yezifo ze-hematological kanye nokubheka ubungozi be-thrombosis, ikakhulukazi kwabesifazane abasebenzisa izinto zokuvimbela inzalo.

Ngaphezu kwalokho, i-coagulogram ikhonjiswa ngemuva kokulunywa kwesilwane esinobuthi obungaphazamisa inqubo ye-coagulation kanye nokuqapha abantu abasebenzisa ama-anticoagulants, njenge-Heparin ne-Warfarin, ngokwesibonelo. Yazi amanye ama-anticoagulants nokuthi akhonjiswa nini.

Kwenziwa kanjani

I-coagulogram kufanele yenziwe nomuntu ozila ukudla amahora amabili kuya kwayi-4 futhi iqukethe ukuqoqwa kwesampula segazi elithunyelwa ukuyohlaziywa, ngaphandle kwe-Bleeding Time (TS), eyenziwa khona lapho futhi equkethe ukubuka isikhathi esithathayo ukopha kuyeke.

Kubalulekile ukuthi ngaphambi kokuba kwenziwe ukuhlolwa, ukwaziswa ngemithi elwa namagciwane kuyaziswa, ngoba kungaphazamisa umphumela noma kubhekwe lapho kuhlaziywa, isibonelo. Ngakho-ke, kubalulekile ukuthola ukuqondiswa okuvela kudokotela maqondana nokumiswa kokusetshenziswa komuthi ngaphambi kokwenza i-coagulogram.

Ukuhlolwa kweCoagulogram

I-coagulogram inezinye izivivinyo ezihlola ubukhona bazo zonke izinto ezihilelekile ekunqandeni igazi futhi, ngenxa yalokho, i-heestasis, ehambelana nezinqubo ezenzeka ngaphakathi kwemithambo yegazi ezihlose ukugcina uketshezi lwegazi ukuze kugwenywe amahlule ukopha. Qonda konke mayelana ne-heestasis.

Izivivinyo ezinkulu ezikhona ku-coagulogram yilezi:

1.Isikhathi sokopha (TS)

Lokhu kuhlolwa kuvame ukucelwa njengendlela yokugcwalisa ezinye izivivinyo futhi kuyasiza ukuthola ushintsho kuma-platelet futhi kwenziwa ngokwenza imbobo encane endlebeni, ehambelana nendlela kaDuke, noma ngokusika ingalo ebizwa ngokuthi yi-Ivy technique, bese ubala isikhathi lapho ukopha kuyeka khona.

Ukwenza inqubo ye-Ivy, ingcindezi isetshenziswa engalweni yesiguli bese kusikwa okuncane esizeni. Endabeni yenqubo kaDuke, imbobo endlebeni yenziwa kusetshenziswa i-lancet noma ipeni elahlwayo. Kuzona zozimbili lezi zigameko, ukopha kuyahlolwa njalo ngemizuzwana engama-30 kusetshenziswa iphepha lokuhlunga, elimunca igazi kuleyo ndawo. Ukuhlolwa kuyaphela lapho iphepha lokuhlunga lingasamunci igazi.

Ngomphumela we-TS, kungenzeka ukuhlola i-hemostasis nokuba khona noma ukungabikho kwe-von Willebrand factor, okuyisici esikhona kuma-platelets anendima ebalulekile enqubweni yokuvala igazi.Yize lokhu kuhlolwa kuwusizo ekutholeni izinguquko ku-hemostasis, kungadala ukungakhululeki ikakhulukazi ezinganeni, njengoba ukuhlolwa kungenziwa ngokwenza imbobo endlebeni, ngokwesibonelo.

Uwuqonda kanjani umphumela: Ngemuva kokumba umgodi, udokotela noma uchwepheshe obhekele ukuhlolwa ubala isikhathi lapho igazi liguqa futhi liqaphe ngephepha lokuhlunga elimunca igazi kuleyo ndawo. Lapho iphepha lokuhlunga lingasamunci igazi, ukuhlolwa kuyanqanyulwa. Uma ukuhlolwa kwenziwe kusetshenziswa i-Ivy Technique, okuyiyo engalweni, isikhathi esivamile sokopha siphakathi kwemizuzu engu-6 nengu-9. Endabeni yenqubo kaDuke, okuyindlebe leyo, isikhathi esivamile sokopha siphakathi kwemizuzu engu-1 no-3.

Lapho isikhathi siside kunesikhathi sokukhomba, kuthiwa ekuhlolweni kwe-TS enwetshiwe, okukhombisa ukuthi inqubo yokujiya ithathe isikhathi eside kunokujwayelekile, okungakhombisa isifo sika-von Willebrand, ukusetshenziswa kwemithi elwa namagciwane noma i-thrombocytopenia, isibonelo. Yazi izimbangela ezinkulu ze-thrombocytopenia.

Isikhathi se-Prothrombin (TP)

I-Prothrombin, eyaziwa nangokuthi yi-Coagulation Factor II, iyiprotheni esebenza ngesikhathi senqubo yokujiya futhi umsebenzi wayo ukukhuthaza ukuguqulwa kwe-fibrinogen ibe yi-fibrin, yakhe ipulaki lesibili noma elichazayo leplatelet.

Lokhu kuhlola kuhlose ukuqinisekisa ukusebenza kwendlela yokuqina kwangaphandle, ngoba iqukethe ukuhlolwa kwesikhathi esithathwa yigazi ukwakha ibhafa yesibili ngemuva kokuvezwa yi-calcium thromboplastin, eyi-reagent esetshenzisiwe esivivinyweni.

Uwuqonda kanjani umphumela: Ngaphansi kwezimo ezijwayelekile, ngemuva kokuthintana kwegazi ne-calcium thromboplastin, indlela eyengeziwe iyasetshenziswa, kwenziwa kusebenze izici VII kanye no-X ze-coagulation futhi, ngenxa yalokho, i-factor II, eyi-prothrombin, ekhuthaza ukuguqulwa kwe-Fibrinogen ibe yi-Fibrin, imisa ukopha. Le nqubo ivame ukuthatha phakathi kwemizuzwana eyi-10 nengu-14.

Kodwa-ke, kwezinye izimo i-coagulogram ithola i-PT enwetshiwe, okusho ukuthi ukwenziwa kwe-prothrombin kwenzeka esikhathini eside kunokujwayelekile. Ukwanda kwamanani we-PT kuvame ukwenzeka lapho kusetshenziswa ama-anticoagulants, ukushoda kukavithamini K, ukushoda kwe-factor VII nezinkinga zesibindi, ngokwesibonelo, ngoba i-prothrombin ikhiqizwa esibindini.

Ezimweni ezingavamile, i-PT ingancipha, njengasendabeni yokusebenzisa izithasiselo zikavithamini K noma amaphilisi okuvimbela inzalo ane-estrogen, ngokwesibonelo. Qonda okuningi ngomphumela wokuhlolwa kwesikhathi se-Prothrombin.

Isikhathi se-Thromboplastin Esingasebenziwe (APTT)

Lokhu kuhlolwa kusetshenziselwa ukuhlola i-hemostasis, kepha kuvumela ubukhona noma ukungabi bikho kwezinto ezi-coagulation ezikhona endleleni yangaphakathi ye-coagulation cascade ukuze iqinisekiswe.

I-APTT imvamisa kubalulekile ukuqapha iziguli ezisebenzisa i-Heparin, eyi-anticoagulant, noma enezinkinga zokunqanda igazi, kube wusizo ekuboneni izinguquko ezihlobene nezici zokujiya.

Kulesi sivivinyo, isampula yegazi eliqoqiwe livezwa kuma-reagents, bese kubalwa isikhathi esithathayo sokuthi igazi lijiye.

Uwuqonda kanjani umphumela: Ngaphansi kwezimo ezijwayelekile, i-APTT ingamasekhondi angama-21 kuye kwangama-32. Kodwa-ke, lapho umuntu esebenzisa ama-anticoagulants, njenge-heparin, noma enenkinga yezici ezithile zomzila wangaphakathi, njengezici XII, XI noma VIII kanye ne-IX, ezibonisa i-hemophilia, isikhathi sivame ukuba side kunesikhathi sokubhekisela ., ekhonjiswa esivivinyweni sokuthi i-APTT inwetshiwe.

Isikhathi se-Thrombin (TT)

Isikhathi se-thrombin sihambisana nesikhathi esidingekayo sokwakheka kwehlwili ngemuva kokufakwa kwe-thrombin, okuyisici esidingekayo sokuvala i-fibrinogen ku-fibrin, eqinisekisa ukuqina kwehlwili.

Lokhu kuhlolwa kubucayi kakhulu futhi kwenziwa ngokufaka i-thrombin ezindaweni eziphansi ku-plasma yegazi, isikhathi se-coagulation sithonywe inani le-fibrinogen ekhona eplasma.

Uwuqonda kanjani umphumela: Imvamisa ngemuva kokufakwa kwe-thrombin kwi-plasma, amahlwili akha phakathi kwemizuzwana eyi-14 nengama-21, lokhu kubhekwa njengenani lesethenjwa, elingahluka ngokuya kwelabhorethri lapho kwenziwa khona ukuhlolwa.

I-TT ithathwa njengeside uma umuntu esebenzisa ama-anticoagulants, ethula imikhiqizo yokuwohloka kwe-fibrin, ene-factor XIII noma i-fibrinogen defence, ngokwesibonelo.

5. Inani lamaplatelets

Ama-platelet izingcezu zamaseli akhona egazini adlala indima ebalulekile ku-heestasis, ngoba aqukethe izinto ezibalulekile zenqubo yokujiya, njenge-von Willebrand factor, ngokwesibonelo.

Uma kukhona ukulimala kwezicubu, ama-platelet ahamba ngokushesha aye lapho kulimala khona, ngenhloso yokusiza enqubeni yokumisa igazi. Ama-platelet enziwe asebenza azinamathelisa endothelium yomkhumbi olimele esebenzisa i-von Willebrand factor bese eguqula ukwakheka kwawo futhi akhiphe izinto zibe ku-plasma ukuze kutholakale amaplatelet amaningi endaweni yokulimala bese enza ipulaki eyinhloko yeplatelet.

Ngakho-ke, ukuhlola inani lama-platelet kubalulekile ku-coagulogram njengoba kuvumela udokotela ukuthi azi uma kukhona ushintsho enqubweni ye-hemostasis eyinhloko, ancoma ukwelashwa okuqondile.

Uwuqonda kanjani umphumela: Inani elijwayelekile lama-platelet egazini liphakathi kuka-150000 no-450000 / mm³. Amanani aphansi kunenani lesethenjwa akhonjisiwe esivivinyweni njenge-thrombocytopenia, okukhombisa ukuthi kunenani elincane lamaplatelet ajikelezayo, angaholela ezinkingeni zokuvala igazi, akhethe ukuphuma kwegazi, ngaphezu kokukwazi ukukhombisa ukuswela kokudla, ushintsho ethanjeni umnkantsha noma izifo, isibonelo.

Amanani angaphezu kwesethenjwa abizwa ngokuthi i-thrombocytosis, engaholela ekuqandeni ngokweqile, okungenzeka ngenxa yemikhuba yokuphila, njengokubhema noma ukuphuza ngokweqile, isibonelo, noma ngenxa yezimo zokugula, njengokushoda kwe-iron anemia, i-myeloproliferative syndrome kanye neleukemia , Ngokwesibonelo. Funda ngezinye izimbangela zokwandiswa kweplatelet.