DIC-Syndrome

I-DIC-syndrome - isifo sokusasazwa kwe-intravascular coagulation - ukuphulwa kwe-hemostasis, ebonakala ngenguqu kwi-coagulability yegazi. Iziphumo ezincinci zamacandelo kunye namaqoqo eeseli zegazi zibangelwa ukungasebenzi kakuhle kweenguqu ezincinci kunye neenguqu ezinjengeentlobo, ezikhokelela ekuphuhliseni i-hypocoagulation, thrombocytopenia kunye nokuphuma kwamanzi.

Izizathu zokuphuhliswa kwe-DIC syndrome

I-DIC-syndrome ayisona isifo esahlukileyo kwaye sikhula kwimvelaphi yeemeko ezilandelayo:

• iinkqubo ze-septic ngexesha lokubeletha, isisu sokukhupha isisu kunye ne-catheterization eqhubekayo yeenqanawa ezinkulu;
• ukuxhatshazwa kwemithambo yegazi, iindonga ze-vascular kunye ne-parenchyma yezitho zangaphakathi ngexesha lokungenelela kokuhlinzwa okanye i-vascular prosthetics;
• iintsholongwane kwizigulane kunye nokunyanga kwegazi, ukuhanjiswa kweenkonzo;
• izimo zokutshatyalaliswa, ezibangelwa kukulimala, i-cardiogenic, i-hemorrhagic kunye nezinye izifo;
• izifo zegazi zomhlaza (myeloma, erythremia);
• Izakhiwo ezinobungozi kumathambo emiphunga, i-prostate nama-pancreas;
• izifo ezizimelayo (lupus erythematosus, glomerulonephritis , vasculitis enegazi);
• hemolysis ngokushisa;
• izilonda ezinobuthi xa inyoka inyoka ingena egazini;
• Ukusetyenziswa kwexesha elide kweziyobisi eziphucula ukugawula igazi kunye nokuveliswa kweplatelets.

Iimpawu ze-DIC syndrome

Iikliniki yesifo se-DIC idibene nesifo esibangela le meko.

I-DIC-syndrome ebonakalayo iyabonakala njengento ephazamisayo ebangelwa ukuphulwa kwazo zonke ii-link ze-hemostasis.

Ngesifo esingapheliyo se-DVS-syndrome kukho ukwanda okuqhubekayo kwimiboniso yeklinikhi kunye nemiqondiso:

• i-hypovolemia (ukunciphisa umthamo wegazi kwimithambo yegazi);
• umonakalo wombutho onamandla;
• ukuphazamiseka kweenkqubo zokuxilisa.

Ngexesha le-DIC-syndrome, izigaba zi:

1. Kwisigaba sokuqala, i-hypercoagulation kunye ne-hyperaggregation of platelets zenzeka.
2. Kwisigaba sesibini, kukho utshintsho kwi-clotting yegazi (hypercoagulation okanye hypocoagulation).
3. Kwinqanaba lesithathu, igazi liyayeka ukuwa.
4. Kwesigaba sesine, iimpawu ze-hemostatic zihlala ziqhelanisa okanye iimeko ezinzima zikhokelela kwisiphumo esibulalayo.
5. Isigaba sesine sithathwa njengemvume.

Ukuxilongwa kwe-ICE-syndrome

Uninzi lwamaxesha amaninzi, ukuxilongwa kusekwe kwisifo sokuqala se-DIC syndrome. Nangona kunjalo, kwizifo ezininzi (umzekelo, kwi-leukemia, i-lupus erythematosus), ukuxilongwa kunzima. Kwiimeko ezinjalo, i-laboratory diagnosis ye-DIC syndrome yenziwa, equka:

• ukufunyanwa kweelayithi yokuqhawula igazi ;
• Uhlalutyo lwe-clot yegazi kunye nexesha leprothrombin;
• ukufumanisa ukuphulwa kwi-thromboelastogram;
• iimvavanyo zeparacoagulation.

Unyango kunye nokukhuselwa kwe-DIC syndrome

Unyango lwe-DIC syndrome, njengomthetho, uqhutyelwa kwinqununu yokukhathalela kakhulu kwaye ijoliswe ekupheliseni i-clots yegazi eyenziwe, ukukhusela ukubunjwa kwegazi elitsha, kunye nokubuyisela ukujikeleza kwegazi nokulawula i-hemostasis. Ukongezelela, unyango olunzulu luqhutyelwa ukususa isigulane kwisimo sokutshatyalaliswa, i-Antibacterial okanye enye i-etiotropic unyango ivumela ukulwa nomzimba ochaphazelayo. Izigulane zinokumiselwa i-antiticoagulant, i-dislike, fibrinolytic kunye ne-substitution.

Kwi-ICE-syndrome engapheliyo, umzekelo, kwizigulane ezingenakwaneleyo, inqubo ye-plasmaphoresis iyasebenza. Iqulethwe kwimeko yokuba isigulane sithathwa 600 ml ye-plasma, eyatshintshwa ngamalungiselelo eplasma. Indlela ijolise ukususa emzimbeni wenxalenye yesiprotheyini kunye ne-immune complexes, kunye neemeko zokucima.

Uthintelo lwe-DIC syndrome lujoliswe ekupheliseni izizathu ezibangela ukuphuhliswa kwayo. Phakathi kwamanyathelo okukhusela:

• ukungenelela okutyathwayo, okuqhutywe yindlela encinci;
• unyango lwezinga eliphezulu lamathumba;
• ukukhusela inyoka kunye nokutyhefuza;
• Ukubandakanywa kwama-antiticoagulants kwiphilisi yezifo ezithathelwanayo, njl