Ukuqhawula ngegazi kukubaluleke kakhulu kwimizimba yokuyeka ukuphuma kwegazi xa iindonga zemithambo yegazi zonakaliswe, kunye neengcambu zegazi ziyachitheka xa zingasadingeki. Ingcamango yegazi coagulability ixhunyaniswe ngokungenakulinganiswa kunye nenkqubo ye-homeostasis, umsebenzi wokugcina igazi. I-homeostasis ineendlela ezimbini:
- Iiprayimari - i-platelet platelet. Ngaloo, iiplatelet zinamathele kunye kwaye zenzele okuthiwa "i-white thrombus", apho iiplatelet zihlala khona.
- I-secondary-coagulation (naye - i-coagulation yegazi). Ngaloo nto, ukukhutshwa okunamandla kwendawo eyonakaliswe nge-fibrin clot yenziwe, ebizwa ngokuba yi "red clot". Eli gama lanikwa kuye kuba i-fibrin mesh ngokuyinhloko iqukethe i-erythrocytes.
Ngaloo ndlela, inkqubo yegazi ye-coagulation yinkimbinkimbi kwaye inendima yayo emzimbeni ibaluleke gqitha. Naluphi na ukugula okuhambisana nokuxutywa kwegazi kunokubonisa izifo kwaye zikhokele kuyo. Kufuneka kwakhona kucaciswe ukuba isigaba sokugqibela se-homeostasis yi-fibrinolysis, apho i-clot yegazi iphela xa isitya sifumana kwaye isidingo se-fibrin clot siyanyamalala.
Izibonakaliso zokuhlalutya kwegazi
Uvavanyo lwegazi lwe-coagulation lubizwa ngokuba yi-coaguloramma. Ukuthatha uvavanyo lwegazi lokucima, kufuneka ufumane uphawu lokubakho. Kwimiba yezifo, ukuguqulwa kwegazi kunokungaphumeleli, kwaye ubukho babo buyisiseko sokuqinisekisa ukukwazi ukunqanda:
- izifo;
- umsebenzi wesibindi ongavamile;
- izifo zentliziyo;
- imilenze ye-varicose;
- isifo sikashukela ;
- hemochromatosis .
Kwakhona, ukuhlalutya i-coagulation kuyimfuneko kwiimeko ezithile:
- khulelwa;
- ixesha eliphambili emva kokusebenza okanye eliphambili;
- ukulawula kunyango lwe-anticoagulants;
- Ukuba ukukrokreka kokulahleka kwegazi kuyimfuneko, itekisi yokucima ifunekayo.
Ukuchazwa kweemvavanyo zegazi zokucima
Ngaphambi kokuthetha ngokuqhelekileyo ukuhlalutya kwegazi, kufuneka kucaciswe ukuba kwibhubhoratri nganye ezi zikhombisi ziyahlukahlukileyo, ngoko ke igama lokugqibela liza kugqirha ugqirha. Kufuneka ukuba kuqondwe ukuba ii-coagulogram ziyahlukahluka ngexesha lokukhulelwa, kuxhomekeke kwi-trimester.
Ngoko ke, ukuhlolwa kwegazi ngokupheleleyo kuqulethe iifom eziyi-8, ezinika ukuqikelelwa kwegazi lokuqhawula:
- Uvavanyo lwegazi lokuvala ixesha. Isiqhelo sexesha lokuvala i-5-10 imizuzu (ngenxa yegazi elimnyama, kunye ne-capillary - imizuzu emi-2). Ukwanda kwiparameter kubonisa i-coagulability ephantsi, kunye nokunciphisa ukugqithisa okungaphezulu.
- I-APTTV yithuba elisebenzayo le-thromboplastin. Isiqhelo sisuka kwi-24 ukuya kwi-35 imizuzwana. Ukwanda kwangexesha kubonisa amandla okugcoba, kunye nokunciphisa ngexesha lokuxhumela i-hypercoagulability.
- Inkcazo yeprothrombin yithuba leprothrombin, elifundwayo ukuhlola indlela yangaphandle yokucima. Isilinganiso sisuka kuma-80 ukuya kwi-120%. Ukuhla kwe-indicator kubonisa ukuxilongwa, kunye nokwanda kwindlela yokunciphisa igazi.
- I-Fibrinogen yiprotheni eplasma. Ngokuqhelekileyo isibonakaliso sivela ku-5.9 ukuya kwi-11.7 μmol / l. Inokunyuka ngokukrakra, ukukhulelwa, ukutshisa kunye nokuhlaselwa kwentliziyo. Isilayidi sinokuthetha nge-DIC syndrome okanye izifo zesibindi.
- Ixesha leThrombin luvandlakanyo lwesigaba sokugqibela se-coagulation. Ngokuqhelekileyo, lo mfanekiso uvela kwiimitha ezi-11 ukuya ku-17.8. Ngenxa yokungabikho kwe-fibrinogen, i-hyperbilirubinemia, okanye unyango nge-heparin, kunokunyuka, kunye nokuhla kwexesha - kunye nenani elikhulu le-fibrinogen egazini, okanye nge-ICE syndrome.
- Ixesha le-plasma kwakhona liqhelekile - ukusuka kumasekondi angama-60 kuya kwe-120.
- Ukunyamezela nge-plasma i-heparin. Okwangoku, lo vavanyo alisoloko lisetyenziswa. Isiqhelo sisuka kumithathu ukuya kwi-11 imizuzu.
- Ukurhoxiswa kwe-clot yegazi. Ngokuqhelekileyo iparameter ivela kwi-44 ukuya kuma-65%.
Uvavanyo lwe-clotting lwegazi lwenziwa njani?
Uvavanyo lwegazi lwe-coagulation luvame ukuqhutyelwa nge-in vitro, kodwa, ngokomzekelo, ekuhloleni kwegazi lonke-thromboelastography, umlinganiselo olingana neemeko ze-Invivo unokwenzeka.
Ukwenza ukuhlolwa kwegazi jikelele ukuvalwa, iiyure eziyi-8 phambi kokuba uvavanyo alufanelekanga ukutya. Igazi lokuhlalutya lithathwa kwi-vein ukuze lihlolwe igazi legazi. Ukuvavanya amandla okugcoba i-capillary igazi kunye neeplatelet ngokwaneleyo ukuhlaziya igazi eminwe.