I-APTTV: okujwayelekile. I-APTTV ngesikhathi sokukhulelwa: kuvamile

I-APTTV inqunywe njengesikhashana esenziwe ku- thromboplastin esikhishiwe. Lesi sibonakaliso sibhekisela ekucwaningweni kwesistimu ye-coagulation yegazi futhi sibonisa indlela yangaphakathi nejwayelekile yokugcoba, okungukuthi, lesi yisikhathi esithathayo ukwakha i-clot blood. Lokhu kuhlolwa kuyingxenye yocwaningo olubizwa ngokuthi i-coagulogram elisondelene kakhulu nesifundo se-coagulation.

Ukuhlolwa kwegazi kwe-APTT: kuvamile

Kulesi sifundo, isikhathi esidingekayo sokwakhiwa kwe-clot sinqunywe. Lapho uhlola igazi ku-APTT, umkhuba omuntu onempilo uphakathi kwamasekhondi angu-25 no-40. Uma ezinye izici ze-clotting (i-prothrombin, i-INR, i-fibrinogen, njll) ishintsha, khona-ke ipharamitha ye-APTT iphendula ngokuqinile kulokhu. Umkhuba we-APTT egazini labesifazane abakhulelwe kungamasekhondi angu-17-20.

Kungani isifundo esinikezwe owesifazane okhulelwe abelwe APTTV?

Ngesikhathi sokukhulelwa, izinguquko eziningana zomzimba zenzeka emzimbeni wesifazane. Lokhu kusebenza futhi ekunqandeni kwegazi. Igazi lomama okhulelwe ngokuvamile luba lukhulu kakhulu. Isizathu sokumisela isifundo se-coagulogram yishintsho ekuhloleni kwegazi jikelele, okusho ukuthi emva kokubhaliswa kokukhulelwa, owesifazane unikeza njalo.

Uma ukuhlolwa kwegazi okonke kubonisa ukukhuphuka kwezingxenye zefomathi, lokhu kungasho ukwanda kwegazi, futhi kunesenzakalo sokubeka i-coagulogram ehlanganisa ukuhlaziywa kwe-APTT. Isilinganiso salesi sibonakaliso kwabesifazane abakhulelwe sasihluke kakhulu futhi sinamasekhondi angu-17-20. Lokhu kungenxa yokunyuka kancane kancane kwe-fibrinogen ngesikhathi sokukhulelwa, okuyinto ngesikhathi sokubeletha ifinyelela inani lika-6 g / l, kuyilapho abantu abanempilo ngokuvamile bephakathi kuka-2.0 no-4.0 g / l.

Emzimbeni wesifazane okhulelwe, ezinye izinqubo azisebenzi, lokhu kusebenza futhi ku-hemostasis. Lokhu kuyinto evamile, kodwa ukuphambuka okuvela kumkhuba kwenzeka. Ukuze ugweme imiphumela engalungile yengane nengane, i-coagulogram inqunywe.

Iziphi izifundo ezifakwe ku-coagulogram?

Ukufunda i-coagulogram kungaba yisisekelo nesiphambili. Ucwaningo lwesisekelo lubandakanya imingcele elandelayo:

1. Iprothrombin (Inkomba ye-PTH - prothrombin).
2. I-INR (International Ratio Ratio, okungukuthi, Standard for Determining Coagulation).
3. I-APTTV.
4. I-Fibrinogen.

Uma kunesidingo, imingcele eyengeziwe ingabelwa:

• Amaprotheni C - nokuntuleka kwawo okuphezulu kwe-thrombosis.
• I-Antithrombin ibhekisela ohlelweni lwe-anticoagulation, futhi ukuntuleka kwayo kungase kuholele ekutheni i-thrombosis.
• D-dimer - ikhishwe lapho i-clot yegazi ihlehla. Inombolo yayo ekhulayo ibonisa ukwakheka kwezindwangu zegazi egameni legazi.
• Lupus anticoagulant.
• I-ATS (isikhathi sokubalwa esicushiwe).
• Isikhathi sokuvuselelwa kwe-plasma.
• Ukubekezela nge-plasma i-heparin.
• I-RFMK (i-fibrin-monomer complexes).

Izinkomba ze-coagulogram zithini?

Inkomba ye-APTTV ngesikhathi sokukhulelwa (evamile imizuzwana engu-17-20.), I-Fibrinogen neminye imingcele, ikakhulukazi ezikhathini zakamuva, ibaluleke kakhulu ekuvimbeleni izinkinga. Ngakho-ke, ukwanda kwe-PTI (prothrombin) ngenhla kuka-150% kungabonisa ukuphazamiseka okuphansi. Lokhu kuyingozi kakhulu empilweni yomama ozayo nomntanakhe.

I-D-dimer ingavamile ukuthi ingabi ngaphezu kwama-248 ng / ml. Lokhu kungabantu abaphilile. Ngesikhathi sokukhulelwa, amanani ayo akhula. Ekupheleni kokukhulelwa kungaba ngaphezu kwexabiso langempela ngezikhathi ezingu-3-4. Lokhu kuyinto evamile. Ukwanda ku-D-dimer izikhathi ezingaphezu kwezingu-4 kusukela ekutholeni kokuqala kungabonisa isifo esibucayi - i-gestosis, futhi kwenzeka nakwabesifazane abakhulelwe abanesifo sikashukela noma isifo esinzima sezinso.

Esinye sezimbangela eziningi zokukhulelwa kwesisu kanye nokuhlukunyezwa kwemibandela ehlukene yi-AFS (antiphospholipid syndrome), ebonakala ngokwakhiwa kwe-thrombosis ene-arterial and venous. Ukuze kutholakale lokhu okuxilongwa, ama-antibodies emgqimbeni we-membrane wangaphandle (phospholipids), kanye ne-fibrinogen, i-D-dimer, i-prothrombin, ne-APTTV inqunywa. Ekukhulelweni, umkhuba wabo uhlukile emibonweni evamile yabantu abanempilo.

Kungani i-homeostasis isebenze ngesikhathi sokukhulelwa?

Izizathu eziyinhloko zalokhu kusebenziswa zilandelayo:

• Ngesikhathi sokukhulelwa, isizinda semvelo se-hormonal sishintsha.
• Kunomjikelezo owengeziwe wokujikeleza kwegazi - utero-placental.
• Umzimba wesifazane ulungiselela ukulahleka kwegazi okungenakuvinjelwa ngesikhathi sokubeletha.

Igazi elibi - yini okufanele uyenze?

Uma ngesikhathi sokukhulelwa, ucwaningo lubonisa ukuthi igazi likhulu, akufanele ukwesabeke ngokushesha. Cishe, udokotela uzobe eyala ukudla okulungiswayo. Okokuqala, usawoti nawo wonke ukudla okusawoti (ama-sausages, imikhiqizo ebhemayo, ukhukhamba okhethiwe, njll) kufanele ikhunjulwe ekudleni. Ukusuka kokudla okunamafutha kungcono nokuyeka. Kunalokho, udle imifino eminingi, amajikijolo nezithelo ezibomvu ne-orange. Zine-vitamin C ethe xaxa kunabanye, okungahlanza igazi.

Kuwusizo ukufaka ukudla okulandelayo ekudleni:

• Amajikijolo (ama-raspberries, ama-currants amnyama namabomvu, ama-mulberries, ama-plums, ama-strawberries, ama-cranberries, i-sea buckthorn, i-Kalina), kodwa kufanele aqaphele ukusetshenziswa kwama-raspberries kanye ne-viburnum - lawa majikijolo ayinakudliwa ngobuningi besifazane abakhulelwe;
• Izithelo ze-Citrus (ama-tangerines, ama-orang, i-lime, i-lemon, i-grapefruit);
• I-Garnet;
• Amabhilikri anomile;
• I-Ananas;
• Ama-Beet;
• Utamatisi;
• U-anyanisi nesweli;
• Birch sap;
• Chocolate ne-cocoa;
• Amafutha omifino (i-rapeseed, umnqumo, i-linseed);
• Izinongo kunokuba usawoti (i-turmeric, i-curry, i-oregano, i-paprika, i-dill, i- pepper yama-cayenne, i- ginger, i-thyme, isinamoni).

Imikhiqizo engakwazi ukuvimba igazi kumele ichithe ngokuphelele. Lezi zihlanganisa: ubhanana, amazambane, ukunye okunye okunezinhlayiya, zonke iziphuzo ze-fizzy nokuphuza utshwala.

Udinga ukuphuza okungenani ama-1.5 amalitha amanzi ngosuku. Kodwa amanzi kufanele aphuze futhi angenawo igesi.

I-DIC-Syndrome

Enye yezinkinga eziyingozi kunazo zonke ekusebenzeni kwe-obstetric yi-DVS-syndrome (deseminirovannoe intravascular coagulation). Esikhathini sokuqala, kukhona i-hypercoagulation (i-coagulation eyanda), eyabe isuswa esikhundleni se-hypocoagulation (ukwehla komthamo we-coagulation), okuholela ekulahlekelweni kwegazi okukhulu nokuphila kokusongela. I-DIC-syndrome ivame ukuthola ukugeleza okungalawulwa, bese kungabangela ukufa komfazi nengane yakhe.

Ukuze ugweme isimo esinjalo, isifundo se-coagulogram ngokuzimisela okudingekayo kwe-fibrinogen, i-PTI, i-APTTV inqunywe, okuyinto evamile lapho ukhulelwe imizuzwana engu-17-20. Ngokujwayelekile ukuhlolwa okunjalo, uma kwakungekho umlando wezinkinga zokukhulelwa kwangaphambilini, kunqunywe ku-trimester ngayinye. Izifundo ezinjalo zenziwe zingakapheli kulezi zimo uma:

• Okungenani okukodwa kokukhulelwa kwangaphambilini kwaphela ekukhulelweni kwesisu.
• Kukhona uphawu lwe-gestosis - ukuba khona kwamaprotheni emcimbini, ukuvuvukala kwemiphetho, umfutho wegazi ophezulu.
• Kunesongo sokukhulelwa kwesisu, isibonelo, ngesifo somfutho wegazi esibelethweni.

Ngingathatha kanjani i-test test ye-coagulogram?

Igazi lokuhlolwa okunjalo lithathwe emgqeni ekamelweni lokunakekela ekuseni kusisu esingenalutho. Abesifazane abakhulelwe benza lokhu kokubonisana kwabesifazane. Ukuze uthole izinkomba ezinokwethenjelwa kuyadingeka ukugcina izimo eziningana ezilula:

• Ukudla okudlule akufanele kube ngaphambi kwamahora angu-10-12 ngaphambi kokuhlolwa.
• Akunconywa ukuthatha noma yimiphi imithi ngaphambi kokunikela ngegazi. Uma isiguli sithatha imithi ethinta uhlelo lwe-coagulation, lokhu kufanele kuboniswe kusiqondiso.
• Akunconywa ukuphuza ngaphambi kokunikeza ikhofi yegazi legazi, itiye, iziphuzo ze-carbonated kanye nokunye utshwala. Ungaphuza kuphela ingilazi yamanzi okuphuza ahlanzekile.
• Isimo somzwelo singathinta nomphumela, ngakho-ke kungcono ukuhlala phambi kwehhovisi imizuzu embalwa bese uzinzile.
• I-muscular overstrain ingahle ihlanekeze imiphumela yokuhlaziywa, ngakho-ke, nje ngaphambi kokunikeza igazi nosuku olwedlule, akukhuthazwa ukuvakashela ama-gyms futhi uhlanganyele emisebenzini enzima ngokomzimba.

Ku-APTT, ukujwayelekile kwabesifazane namadoda kunemizuzwana engu-25 kuya kwangu-40. Ngokusho kobulili, akufani, kodwa ngesikhathi sokukhulelwa kuyancipha kancane. Ukuchazwa kwemiphumela yocwaningo kwenziwa kuphela ngabachwepheshe.

Kubiza malini?

Abesifazane abakhulelwe ekubonisaneni kwabesifazane, lolu cwaningo luvame ukukwenziwa mahhala, uma nje kunesiqondiso esitembuwe esivela kudokotela. Zonke ezinye izakhamizi, uma zifisa, zingadlulisa imali enjalo yokucwaninga. I-coagulogram enwetshiwe ibiza cishe ama-ruble angu-3500. Imingcele eyisisekelo izoba eshibhile - kusuka kuma-ruble angu-700 kuya ku-1300.

Yini i-APTTV ekhombisa ngezansi kokujwayelekile?

Ekuhlolweni kwesistimu ye-coagulation, enye yemingcele esemqoka yinkomba ye-APTT. Isilinganiso saso sisuka kumasekhondi angu-25 kuya kwangu-40. Khumbula, leli pharamitha libonisa isikhathi esithathayo ukugcoba ngokuphelele igazi bese wenza i-clot yegazi. Uma lesi sibonakaliso singaphansi kwamasekhondi angu-25, leli qiniso lingabonisa ukuqina kwegazi kanye nengozi ye-thrombosis. Kulaba besifazane abakhulelwe, i-APTTV, isimiso singamasekhondi angu-17 kuya kwangu-20. Ngokuvamile, lesi simo ngesikhathi sokukhulelwa asidingi ukwelashwa futhi sidlula emva kokulethwa. Ukwengeza, igazi eliningi liyakwazi ukwakhiwa kwamaminerali, okuvame ukushiwo abesifazane abakhulelwe abanezinombolo eziphansi ze-hemoglobin.

Iyini ukwanda kwe-APTTV?

Inani le-APTT elingaphezu kwesimiso singabonisa ukuba khona komuntu wesifo njengesifo se-hemophilia, izifo ezinamandla zesibindi, isibonelo i-cirrhosis, noma ukungabi nalutho lwe-vitamin K. Ngaphezu kwalokho, ukwanda kwaleli pharamitha kubonakala kulezi zimo ezilandelayo:

• Ngokuntuleka kwezici ze-coagulation.
• Endabeni yokwelashwa kwesiguli ngama-anticoagulants, isibonelo, "Heparin" noma "Warfarin".
• I-pathologies yegazi, njengesifo se-von Willebrand.
• Nge-DIC-syndrome.

Ukutadisha okunjalo uhlelo lwe-coagulation, njenge-coagulogram, akusizi kuphela abesifazane abakhulelwe, kodwa kubo bonke abantu. Uma kwenzeka noma yikuphi okungajwayelekile, udinga ukubona udokotela.