Xa ukhulelwe, umzinzi uya kukuxelela ukuba uthathe iqela leemvavanyo: unyanzelekile, apho bonke abafazi abakhulelweyo kufuneka bathathe emigqeni ethile, kunye neyongezelelweyo - ukuba bayayidinga. I-coagulation ngexesha lokukhulelwa ngenye yeemvavanyo eziyimfuneko. Yenza kanye kanye kwi-trimester (kulula ukuyithetha, kanye emva kweenyanga ezintathu). Kodwa ukuba ibhinqa liya kubhaliswa emva kweveki le-12 yokukhulelwa, kuya kuba nezifundo ezimbini ezinjalo: ngokukhawuleza xa ibhinqa ibhaliswe kwaye ngaphambi kokushiya umama-kwiiveki ezingama-30.
Ukongezelela, uhlalutyo kwi-coagulogram ngexesha lokukhulelwa lwenziwa emva kwexesha lokunyanga, ukuba kukho ukungaqhelekanga kwiirhafu, nangaphambi kokubeleka, ukuba uya kunikwa isigaba se-caesarean. Igazi kwi-coagulogram ngexesha lokukhulelwa lithathwa, njengoluhlalutyo lwe-biochemical - ukusuka kwiimvini nasezintwini ezingenalutho.
I-coagulogram yegazi ibonisa ntoni?
Izalathisi eziphambili ze-coagulogram yomntu onempilo:
ixesha lokuvala - imizuzu emi-5-10;- ixesha eliye laqalisa ukusebenza (ATS) - 50 - 70 seconds;
- ixesha elisebenzayo le-thromboplastin (APTT) - imizuzu engama-24 ukuya kwe-35;
- Iprothrombin index - 80 - 120%;
- umxholo we-fibrinogen - 2 - 4 g / l;
- ixesha lokuthintela - imizuzu eyi-11 ukuya ku-17.8;
- i-compact-monomer complexes (RNMC) - 4 mg / 100 ml;
- Umsebenzi we-fibrinolytic - 183 - 263 imizuzu;
- i-trombotest-IV-V i-degree;
- i-fibrinogen - 5.9 - 11.7 μmol / l;
- i-fibrinogen B - engekho;
- i-plasma ixhomekeke kwi-heparin - imizuzu eyi-3 ukuya kwe-11;
- ixesha lokukhupha i-Duroku ukuya kwi-4 imizuzu;
- Ukuhoxiswa kwe-clot yegazi-44 - 65%;
- ixesha lokubuyiswa kweplasma (VPR) liyimitha engama-60 ukuya kwe-120.
Kutheni uguqula iziphumo ze-coagulation ngexesha lokukhulelwa?
Izibonakaliso ze-coagulation ngexesha lokukhulelwa zihluke ngokuqhelekileyo, kuba umzimba ulungiselela ukuzalwa okuzayo, ekulahlekeni kwegazi ngexesha elide, kwaye igazi liqala ukukhawuleza ngokukhawuleza. Oku kubonakala nakwi coagulogram elula, xa kuphela inani leeplatelet lichongiwe - iimbalo zegazi apho isiseko se-thrombus sakhiwa (ngokuqhelekileyo inani labo lisuka kwi-150 ukuya ku-400 x 109 / L), ixesha lokuvala (imizuzu emi-5 ukuya kwe-10 kuxhomekeke kwindlela) i-fibrinogen kunye neprothrombin index.
I-blood coagulability ikwandisa umzimba, kwaye oku kuyacaca xa kulungiswa ezinye izikhombisi:
- i-fibrinogen - iprotheni apho i-fibrin ihlanganiswa ngexesha lokuphuma kwegazi - ngexesha lesithathu lokukhulelwa lixabiso likhula ukusuka ku-2 ukuya ku-4 ukuya ku-6 g / l;
- Inkcazo yeprothrombin kwabasetyhini abakhulelweyo akufanele ihluke kwiingqungquthela eziqhelekileyo: iprothrombin - iprotheyini ye-plasma yegazi, apho i-thrombin yenziwa khona-isalathisi iphakanyiswa ukuba ukuphazamiseka kweplate ephuthumayo kwenzeka.
Kutheni unika i coagulogram eyongezelelweyo ngexesha lokukhulelwa?
Kwezinye iilabhuyibrari ngokukhawuleza okanye ekuphambukeni kwimiqathango okanye isantya kwi coagulogram elula i coagulogram xa ukhulelwe. Kodwa ulwalathiso lwe-coagulogram ekhethekileyo luyenzelwa izibonakaliso ezizodwa: kukukhulelwa okuphindaphindiweyo, ukukhulelwa kwangaphambili kunye nokukhulelwa emva kokukhawuleza kwe-gestosis, ukufa kwe-fetal intrauterine, izifo zegazi, iimbali zexesha elide lokungabikho komntwana, ukukhulelwa komzimba.
Ixesha elincinciweyo le-thromboplastin (APTT) libonisa ubukho bezinto zokucima, ngaphandle kokuba akunakwenzeka ukwenza i-clot yegazi. Kubabhinqileyo abakhulelweyo, kufutshane ukuya kumasekhondi angu-17 ukuya kwe-20 (i-thrombus esuka kwi-fibrinogen ngoncedo lwabo lwenziwa ngokukhawuleza). I-anupoagulant ye-Lupus ayifanele ibekho kubasetyhini abakhulelweyo, kodwa ivela kwizifo ezizimele kunye ne-toxicosis emva kokukhulelwa, ubukho bayo bubangela ukwanda kwe-APTT. Ixesha loThrombin (imizuzwana eyi-11 ukuya kweyesi-18) kwabasetyhini abakhulelweyo bayanda ukuya kuma-18 ukuya kwangu-25 imizuzwana. Eli xesha liyinqanaba lokugqibela lokucima igazi, xa i-fibrin strands ivela kwi-fibrinogen phantsi kwesenzo sokuthintela (i-coagulation factor).
Yintoni ekuthintela utshintsho kwi-coagulogram xa ukhulelwa?
Ukuba iparameters ze-coagulogram zihlukileyo kwizinto eziqhelekileyo, ngokokuqala, okokuqala, kufuneka siyiqwalasele kwicala lale tshintsho eyenzekayo: i-blood coagulation yanda okanye, ngokuthe ngqo, yanciphisa. Yenza oku bhetele kuneengcali. Enyanisweni, ukwehla kwindlela yokugcoba igazi kungabangelwa yinkampani engaphambi kwe-placenta kunye nokunyuka kwegazi: iindawo zokugcina ukugaqamana kwegazi ziphelile kwaye i-coagulation syndrome, eyingozi yobomi, ingakhula. Kwaye ukunyuka kwegazi lokuqhawula igazi kubangela uhlobo oluthile lwe-thrombosis.