APTTV: chizoloŵezi. APTTV pa nthawi yoyembekezera: nthawi zonse

APTTV imatsimikiziridwa ngati nthawi yowonjezera ya thromboplastin. Chizindikiro ichi chimatanthawuza kuphunzira za magazi omwe amagwiritsa ntchito magazi ndipo amasonyeza njira yeniyeni yowonjezeramo, mwachitsanzo, iyi ndiyo nthawi yomwe imatenga nthawi yopanga magazi. Mayesowa ndi mbali ya kafukufuku wotchedwa coagulogram yomwe imayesa kwambiri kuphunzira za coagulation.

Mayeso a magazi a APTT: mwachizolowezi

Mu phunziro ili, nthawi yofunikira kuti mapangidwe a clot atsimikizidwe. Poyesera magazi pa APTT, chizoloŵezi cha munthu wathanzi chili pakati pa masekondi 25 ndi 40. Ngati zinthu zina zowonongeka (prothrombin, INR, fibrinogen, ndi zina zotero) zisintha, ndiye kuti APTT imapangidwira kwambiri. Chizoloŵezi cha APTT mu magazi a amayi apakati ndi masekondi 17-20.

Nchifukwa chiyani phunziro lopatsidwa kwa amayi oyembekezera lapatsidwa kwa APTTV?

Pakati pa mimba, kusintha kwambiri kwa thupi kumachitika mthupi la mkazi. Izi zimagwiranso ntchito kuzimitsa magazi. Mwazi wa mayi wapakati nthawi zambiri umakhala wolimba kwambiri. Chifukwa chokhalira phunziro la coagulogram ndi kusintha kwa mayeso ambiri a magazi, omwe, atatha kulembedwa kuti atenge mimba, mayiyo amapereka nthawi zonse.

Ngati kuyezetsa magazi kwawonetsera kuwonjezeka kwa mawonekedwe a mawonekedwe, izi zikhoza kutanthawuza kuwonjezereka kwa magazi, ndipo pali nthawi yolemba coagulogram yomwe ikuphatikizapo kusanthula APTT. Mlingo wa chizindikiro ichi kwa amayi apakati ndi wosiyana kwambiri ndipo umakhala masekondi 17-20. Izi zimachitika chifukwa cha kuwonjezereka kwa fibrinogen pa nthawi ya mimba, yomwe nthawi yobereka imafika mtengo wa 6 g / l, pomwe anthu odwala nthawi zambiri amakhala pakati pa 2.0 ndi 4.0 g / l.

Mu thupi la mayi wapakati, njira zina sizigwira ntchito, izi zimagwiranso ntchito kwa hemostasis. Izi ndi zachilendo, koma zopotoka zomwe zimakhala zochitika zimachitika. Kuti mupewe mavuto omwe angakhalepo kwa mwana ndi mayi, coagulogram imayikidwa.

Kodi ndi coagulogram yotani?

Phunzirani coagulogram ikhoza kukhala yoyamba komanso yopita patsogolo. Phunziro loyamba likuphatikizapo magawo otsatirawa:

1. Prothrombin (PTH - prothrombin index).
2. INR (International Normalized Ratio, i.e., Standard for Determining Coagulation).
3. APTTV.
4. Fibrinogen.

Ngati ndi kotheka, magawo ena angaperekedwe:

• Mapuloteni C - ndi kusowa kwake kwakukulu kwa thrombosis.
• Antithrombin imatanthawuza dongosolo la antiticoagulation, ndipo kusowa kwake kumathandizanso ku thrombosis.
• D-dimer - yamasulidwa pamene magazi amatha. Nambala yake yowonjezera imasonyeza kupangika kwa magazi m'magazi.
• Lupus anticoagulant.
• ATS (yochitidwa nthawi yowerengera).
• Nthawi ya kukonzanso pulasitiki.
• Plasma kulekerera heparin.
• RFMK (makina osungunuka a fibrin-monomer).

Kodi zizindikiro za coagulogram zikuti chiyani?

Ndondomeko ya APTTV pa nthawi ya mimba (yachibadwa 17-20 seconds), Fibrinogen ndi magawo ena, makamaka posachedwapa, ndi ofunika kwambiri kuti tipewe mavuto. Choncho, kuwonjezeka kwa PTI (prothrombin) pamwamba pa 150% kungasonyeze kuti palipunthwitse. Izi ndizoopsa kwambiri pa moyo wa mayi wamtsogolo ndi mwana wake.

D-dimer sayenera kukhala oposa 248 ng / ml. Izi ndi za anthu abwino. Pakati pa mimba, mitengo yake imakula. Pamapeto pake mimba ingakhale yapamwamba kusiyana ndi mtengo wapachiyambi ndi 3-4 nthawi. Ichi ndichizolowezi. Kuwonjezeka kwa D-dimer kuposa maulendo 4 kuchokera ku mtengo woyambirira kungasonyeze kuti pali vuto lalikulu - gestosis, komanso limapezeka mwa amayi omwe ali ndi matenda a shuga kapena matenda a impso.

Chimodzi mwa zifukwa zambiri zobweretsera mimba ndi zolakwika za mawu osiyanasiyana ndi AFS (antiphospholipid syndrome), yomwe imadziwika ndi kupanga matenda oopsa komanso owopsa. Kuti adziwe izi, ma antibodies ku membrane ya kunja (phospholipids), komanso fibrinogen, D-dimer, prothrombin, ndi APTTV zimatsimikiziridwa. Pakati pa mimba, chizoloŵezi chawo chimasiyana ndi chikhalidwe cha anthu abwinobwino.

Nchifukwa ninji pakhomo la homeostasis likuyambitsidwa pa nthawi ya mimba?

Zifukwa zazikuluzikulu zowonjezera izi ndi izi:

• Pakati pa mimba, chikhalidwe cha thupi chimasintha.
• Pali mzunguli wambiri wa magazi - utero-placental.
• Thupi la mkaziyo likukonzekera kuti magazi asatetezedwe panthaŵi ya zowawa.

Mwazi wambiri - choti uchite chiyani?

Ngati panthawi ya mimba, maphunziro amasonyeza kuti magazi ndi ofiira, musamachite mantha nthawi yomweyo. Mwinamwake, dokotala adzapereka chakudya chokonza. Choyamba, mchere ndi zakudya zonse zamchere (sausages, mankhwala osuta fodya, nkhaka zophika, etc.) ziyenera kuchotsedwa ku zakudya. Kuchokera ku zakudya zonenepa ndi bwino kusiya. M'malo mwake, idyani masamba ambiri, zipatso ndi zipatso zofiira ndi lalanje. Iwo ali ndi vitamini C olemera kwambiri kuposa ena, omwe angathe kuchepetsa magazi.

Ndibwino kuti mukhale ndi zakudya zotsatirazi:

• Zipatso (raspberries, zakuda ndi zofiira currants, mulberries, plums, strawberries, cranberries, sea buckthorn, Kalina), koma wina ayenera kusamala pogwiritsa ntchito raspberries ndi viburnum - zipatsozi sizingathe kudyetsedwa kwambiri ndi amayi apakati;
• Zipatso za cititrus (mandangerines, malalanje, laimu, mandimu, mphesa);
• Garnet;
• Apricot owuma;
• Chinanazi;
• Beets;
• Tomato;
• Anyezi ndi adyo;
• Birch sap;
• Chokoleti ndi kakale;
• Mafuta a zamasamba (rapeseded, olive, linseed);
• Mankhwala m'malo mwa mchere (turmeric, curry, oregano, paprika, katsabola, tsabola wa cayenne, ginger, thyme, sinamoni).

Zida zomwe zingayambitse magazizi ziyenera kuthetsedwa. Izi zikuphatikizapo: nthochi, mbatata, buckwheat, zakumwa zonse zakumwa ndi mowa.

Muyenera kumwa pafupifupi 1.5 malita a madzi tsiku. Koma madzi ayenera kumwa mowa ndipo alibe mpweya.

DIC-Syndrome

Imodzi mwa mavuto owopsa kwambiri m'zochita za obstetric ndi DVS-syndrome (deseminirovannoe intravascular coagulation). Pa nthawi yoyamba, pali hypercoagulation (kuchuluka kwa coagulation), komwe kumalowetsedwa ndi hypocoagulation (kuchepa kwa coagulation mphamvu), zomwe zimayambitsa kuwonongeka kwakukulu kwa magazi ndi kuopseza moyo. Matenda a DIC nthawi zambiri amatenga madzi osadziletsa, ndipo amatha kufa kwa mkaziyo ndi mwana wake.

Pofuna kupewa zochitika zoterezi, kuphunzira kwa coagulogram ndi kutsimikiza kwa mphamvu ya fibrinogen, PTI, APTTV imaperekedwa, ndipo nthawi zambiri pamene ali ndi mimba ndi masekondi 17-20. Kawirikawiri kuyesa koteroko, ngati kunalibe mbiri ya mavuto a mimba yapitayi, imayikidwa mu trimester iliyonse. Maphunziro oterowo amapangidwa mosasamala pazochitika ngati:

• Mimba imodzi yapitayi inathera padera.
• Pali chizindikiro cha gestosis - kupezeka kwa mapuloteni mu mkodzo, kutupa kwa mapeto, matenda oopsa.
• Pali vuto lotiperewera, mwachitsanzo, ndi matenda oopsa a chiberekero.

Ndingatani kuti nditenge magazi kuti ndipange coagulogram?

Magazi pofuna kufufuza kotero amachotsedwa ku mitsempha mu chipinda chachipatala m'mawa pa chopanda kanthu m'mimba. Azimayi amachita izi powonana ndi amayi. Kwa zizindikiro zodalirika ndizofunika kusunga zinthu zingapo zosavuta:

• Chakudya chomaliza chiyenera kukhala pasanathe maola 10-12 chisanachitike.
• Sikoyenera kuti mutenge mankhwala aliwonse musanapereke magazi. Ngati wodwala akumwa mankhwala omwe amakhudza coagulation system, izi ziyenera kuwonetsedwa motsatira.
• Sikovomerezeka kumwera musanapereke kofi ya magazi, tiyi, zakumwa za carbonated komanso mowa kwambiri. Mukhoza kumwa kokha kapu ya madzi abwino akumwa.
• Mkhalidwe wamtima ukhoza kuthandizanso zotsatira, kotero ndi bwino kukhala patsogolo pa ofesi kwa mphindi pang'ono ndikukhazikika.
• Muscular overstrain ikhoza kusokoneza zotsatira za kusanthula, chotero, asanatipatse magazi ndi tsiku lomwelo, sikoyenera kuti tipite ma gym ndi kugwira ntchito yaikulu.

Kwa APTT, chizoloŵezi cha amayi ndi abambo ndi masekondi 25 mpaka 40. Malinga ndi kugonana, sizimasiyana, pokhapokha panthawi yoyembekezera imachepa pang'ono. Kutanthauzira kwa zotsatira za phunziroli kumachitika kokha ndi akatswiri.

Zimalipira ndalama zingati?

Amayi oyembekezera pa zokambirana za amayi, phunziro ili limapangidwa kwaulere, ngati pali chitsogozo chochokera kwa dokotala. Nzika zina zonse, ngati zikhumba, zikhoza kupereka malipiro oterewa. Coagulogram yowonjezereka imawononga pafupifupi 3500 ruble. Zigawo zoyamba zidzakhala zotsika mtengo - kuchokera ku ruble 700 mpaka 1300.

Kodi APTTV imasonyeza chiyani pansipa?

Mu kafukufuku wothandizana nawo, imodzi mwa magawo akulu ndi chiwerengero cha APTT. Mphamvu yake imachokera pa masekondi 25 mpaka 40. Kumbukirani, izi zimasonyeza nthawi yomwe imatenga magazi ndikupanga magazi. Ngati chizindikiro ichi chili pansi pa masekondi 25, izi zingasonyeze kuwonjezeka kwa magazi komanso chiopsezo cha thrombosis. Mu amayi apakati, kwa APTTV, chizoloŵezi ndi masekondi 17 mpaka 20. Kawirikawiri, vutoli panthawi yoyembekezera silikufuna chithandizo ndi kupitirira pambuyo pa kubereka. Kuonjezera apo, magazi ambiri amatha kukonzekera zitsulo, zomwe nthawi zambiri zimaperekedwa kwa amayi apakati omwe ali ndi nambala yachepa yotchedwa hemoglobin.

Kodi kuwonjezeka kwa APTTV ndi chiyani?

Mtengo wa APTT pamwamba pa chizoloŵezi ungasonyeze kukhalapo kwa munthu yemwe ali ndi matenda monga hemophilia, matenda aakulu a chiwindi, mwachitsanzo cirrhosis, kapena kusowa kwa vitamini K. Kuwonjezeranso, kuwonjezeka kwa chigawochi kumawonetsedwa m'mabuku otsatirawa:

• Chifukwa chosowa zinthu.
• Pankhani ya kuchiritsa wodwala ndi anticoagulants, mwachitsanzo, "Heparin" kapena "Warfarin".
• Ndi nthendayi ya magazi, mwachitsanzo matenda a von Willebrand.
• Ndi DIC-matenda.

Kuphunzira koteroko kwa coagulation system, monga coagulogram, sikuthandiza kwa amayi apakati okha, koma kwa anthu onse. Ngati pali zovuta zina, muyenera kuwona dokotala.