Thrombophilia - ndichiyani? Thrombophilia: Zoyambitsa, Zizindikiro, Matendawa ndi Chithandizo

Boma la chiwopsezo thupi thrombosis mtima, amene angathe anawathetsa akuyambiranso ndipo ndi malo osiyana, wotchedwa thrombophilia. Matendawa akhoza kukhala mwina chibadwa kapena kugula. Chifukwa cha matenda nthawi zambiri kuchuluka magazi clotting. Kukomoka, matenda akhoza kusonyeza zosiyanasiyana thrombosis m'malo osiyanasiyana. Thrombophilia ambiri kwambiri anthu ndipo amapezeka zosiyanasiyana. Matendawa amafunika chithandizo ndi mankhwala kapena njira opaleshoni.

Thrombophilia: ndichiyani?

Kudwala amatanthauza matenda a dongosolo magazi, akuwonetseredwa mu chizolowezi thrombosis ndi hemostatic matenda. Angapo kobwereza thrombosis mu thrombophilia chingachitike n'chiyani zoopsazo opaleshoni, nkhawa thupi, kapena pa mimba. Chikhalidwe ndi oopsa chifukwa kungachititse kuti mavuto monga embolism m'mapapo mwanga, sitiroko, m'mnyewa wamtima infarction, thrombosis kwambiri m'mitsempha. Nthawi zambiri mitundu patsogolo amapha.

Research, matenda ndi mankhwala a thrombophilia nawo mbali zingapo zokhudza mankhwala. Hematology amaphunzira katundu matenda a magazi, phlebology - matenda ndi mankhwala a thrombosis wa mitsempha, kuchotsa magazi kuundana nawo mtima madokotala. thrombus mapangidwe chifukwa mu kusokoneza otaya yachibadwa magazi, amene anatsagana ndi chitukuko cha zinthu zoopsa ndi ovuta kuchiza. Mu nthawi kuteteza vuto, muyenera nthawi kuziyeza kuti clotting magazi. Ponseponse kwa akazi Mwachitsanzo, magazi venous mphindi 5-10.

zimayambitsa

Zinthu zimene zingachititse chitukuko cha matenda, ochepa. Pafupifupi aliyense akanatha kulimbana ndi matenda monga thrombophilia. ndi chikhalidwe chimene oopsa, odwala ambiri zina sakudziwa nkomwe kuti akuthandizeni m'malo mochedwa. Pali mndandanda wa zifukwa zimene zimathandiza chitukuko cha kudwala.

Kumtundu (kapena majini) thrombophilia kumachitika chifukwa cha kutengera za kumtundu matenda. Asamuka kale matenda magazi (thrombocytosis, erythremia, antiphospholipid syndrome) angakhalenso chifukwa chitukuko. zinthu woopsawo monga atherosclerosis, khansa, matenda fibrillation, varicose mitsempha, ndi matenda autoimmune. Mwina zosayembekezereka wa ukuwonjezeka thrombophilia pambuyo sitiroko kapena mtima. M'dera chiopsezo, odwala amene akunenepa, kutsogolera moyo wongokhala, kutenga kulera m'thupi, musadye m'mbuyomu atavulala kapena opaleshoni. Pa zaka oyambirira matenda ndi zina zambiri amapezeka anthu achikulire. Pofuna kupewa matenda kapena chimachitika osayamba, Ndi bwino nthawi pochitika chiyeso thrombophilia.

chithunzi matenda

Chipatala kuwonekera kwa matenda yodziwika ndi kuwuka yosalala ndi nthawi ya pano, kotero odwala sizinayende zindikirani kusintha udindo thanzi, ndiponso musadziponye madandaulo iliyonse. Laboratory magawo akhoza oterewa thrombophilia, zambiri matenda chithunzi zina, kumachitika zaka zingapo zitatha. Zizindikiro Bright kumachitika pamene aumirira ndi wapanga. Mlingo wa kutsekeka wa lumen chotengera ndi kutanthauzira za thrombus bwanji popereka zizindikiro.

Wolumikizira thrombosis, amene amayamba ndi magazi kuundana mu mtima lumen wa wolumikizira bedi limodzi ndi mapangidwe thrombus mu lumen wa ziwiya latuluka, ndi intrauterine yoopsa imfa padera angapo, matenda pachimake inatsekeratu insufficiency, ischemic sitiroko.

Venous thrombosis a m'munsi malekezero zizindikiro matenda zimapezeka mu mawonekedwe a kusintha trophic wa khungu, aakulu kutupa malekezero m'munsi, maonekedwe a ululu, kumverera kwa kulemera ku malekezero m'munsi.

Mezentealny thrombosis m'mimba kumachitika pamene magazi aumirira ku kutanthauzira ziwiya mesenteric ndi limodzi mwa zizindikiro monga lotayirira chimbudzi, kusanza, mpeni-lakuthwa ululu.

Pamene kwa chiwindi thrombosis mtsempha anayamba hydrothorax (Budd-Chiari syndrome), ascites, edema a linga zapambuyo m'mimba ndipo m'munsi malekezero, timathawa kusanza, kupweteka kwambiri m'dera epigastric.

thrombophilia hematogenous

Thromboses bwanji boma la pakhoma mtima, kuwononga ndi kuchepetsa kukana, kuthandiza m'mbuyo otaya magazi ndi chitukuko cha matenda ena hemodynamic kuti imakhudzana ndi kusintha kukhuthala ndi clotting. Thrombophilic boma nthawi zambiri kugwirizana ndi pamaso pa matenda mtima monga atherosclerosis, mtima choipa intimal, vasculitis toxigenic, m'thupi kapena chiyambi opatsirana. Angapo thromboembolism kobwereza mwina chifukwa kusintha mu katundu wa magazi yokha, amene amapereka ufulu wolankhula za matenda dzina lake "hematogenous thrombophilia." pathologies kugwirizana ndi chitukuko cha chizolowezi thupi kukhala thrombosis, chifukwa cha kuvutika mu coagulation, mkhutu magazi hemostatic angathe.

Thrombophilia hematogenous choyambiriracho kungakhale kobadwa nako kapena kugula. Pa limagwirira waukulu secrete matenda amene amayamba ndi: conjugated mosinthana thrombogenic, kupatsidwa zinthu za m'mwazi kukanika, mkhutu fibrinolysis, chopinga, nthenda kapena chofunika coagulation sangathe lalikulu thupi anticoagulant. Komanso china olekanitsidwa osauka chifukwa cha zotsatira mankhwala kapena njira zachipatala iatrogenic thrombophilia.

cholowa thrombophilia

Kutanthauzira kobadwa nako kapena cholowa thrombosis akhoza kukhala maziko a izi mawonetseredwe matenda: thrombosis ali aang'ono, thrombosis milandu mtsempha wamagazi m'mapapo mwanga, mesenteric, m'munsi miyendo ndi mbiri banja, yomwe akutchulidwa choyamba thrombosis kobwereza venous pamaso zaka 30 zakubadwa, thrombosis pa mimba oyambirira, thrombotic zosokonezeka. Cholowa kapena majini thrombophilia anatsimikiza patapita matenda mabuku odwala amene ali ndi chiopsezo cha matenda oyamba thrombophilic.

Kobadwa nako mawonekedwe a matenda mwina ndi chikhalidwe chosiyana. Mu matenda a matenda kutenga nkhani zolembera zachibadwa thrombophilia. Chinthu choyamba chimene chimapangitsa kuti chitukuko cha matenda - kumakhala kutengera za kumtundu. Pankhaniyi, matenda zisadzachitike pakalibe zinthu zimene hule njira ya chitukuko. The chachiwiri - ndi kusintha kwa majini pa chitukuko embryonic. Ndinasintha kuchuluka posachedwapa ndende zinthu zimene poyera ndi kusintha jini. Pakati pawo, iwo amene anachokera ku zochita za anthu: mpweya poizoni ntchito zina chakudya, asatayike, kuwonongeka kwa malo (mankhwala banja, utsi, mankhwala) masoka zopangidwa. N'zosatheka kuneneratu mavuto jini kungakhale modifiable, kotero mutagenesis ankaona kuti ndondomeko mwachisawawa, lomwe limapezeka palokha ndipo amatha kusintha makhalidwe cholowa.

Cholowa thrombophilia angakhalenso chifukwa structural kapena kutengera mapangidwe kusintha DNA tinatengera kwa mbadwo wakale. Pali anapereka boma la jini matenda: recessive kapena lalikulu. Ngati chachiwiri, kudwala kusonyeza yokha mu zinthu zonse.

kuthi thrombophilia

Sikuti tinatengera komanso anapeza magwero mwina ndi matendawa. Wodwala matenda antiphospholipid syndrome (APS). Zinali choncho nthawi zambiri kumaonekera anapeza thrombophilia. Kodi izo, kodi njira ya chitukuko, ndi mmene nkhondo izo?

syndrome Antiphospholipid ndi chizindikiro zovuta kuti Chili deta zasayansi ndi zizindikiro matenda. The matenda limodzi ndi matenda a ubongo, thrombocytopenia m'thupi, yoopsa imfa syndrome, venous ndi thrombosis wolumikizira. Kuonetsetsa mawonekedwe APS: pulayimale, sekondale ndi zoopsa; serological mungachite: seronegative ndi seropositive. Syndrome ukapezeka ndi neoplastic, matenda, autoimmune kapena matenda awo sagwirizana kapena chifukwa cha tsankho mankhwala.

Development APS likhoza kulumikizidwa ndi zinthu zimenezi nthenda monga zilonda neoplasm (khansa, matenda lymphoproliferative, khansa), matenda (mycoplasmosis, HIV, chindoko), asymptomatic makope AFA, aakulu aimpso kulephera, matenda a mitsempha zotumphukira ndi mavavu mtima, chiwindi matenda, matenda connective minofu, ndi matenda autoimmune (matenda amene amatupitsa, zokhudza zonse vasculitis, SLE).

Thrombophilia mimba

Woyembekezera, majini kapena cholowa thrombophilia zambiri kumaonekera kwa nthawi yoyamba. Izi makamaka chifukwa cha kubwera kwa chachitatu, placental makope bwalo kuti ali pa mitsempha ya magazi katundu ndi zina. Mapangidwe magazi kuundana kumathandiza kuti chiwerengero cha mbali ya bwalo placental. The latuluka palibe capillaries, chimatilowetsa magazi a mayi kwa mitsempha, ndiye loyenda mwa villi chorionic, amalowa chingwe umbilical.

Mtembo wa mkazi wapakati amakhala ndi kuchuluka clotting magazi, omwe amachepetsa kutaya magazi panthawi yobereka kapena mwambo mavuto monga padera ndi placental abruption. Imathandiza kuti ndi chiopsezo cha magazi kuundana kuchuluka, ndipo ndicho mwa iwo lagona ngozi. Ngati iwo isanafalikire mu mitsempha chopatsa latuluka, ndi zakudya, hypoxia amapezeka amasiya otaya kwa mwana wosabadwayo. Malinga ndi mlingo wa clogging Mitsempha ndi chiwerengero cha magazi kuundana, ingathe kuchitidwa ndi mavuto aakulu, kubadwa masiku asanakwane padera, mimba kuchepa mphamvu, malformations kapena imfa yoopsa, fetoplacental insufficiency, placental abruption. iwo amaoneka, kawirikawiri pambuyo masabata 10. Mu nthawi yoyambirira ya thrombophilia mimba chosowa kwambiri. Ngati matenda akufotokozera pambuyo masabata 30, ndiye itha Nthawi zambiri, placental abruption, placental insufficiency kapena preeclampsia kwambiri. Kuzionetsetsa dokotala ayenera kulabadira clotting magazi, mlingo wa akazi "mu" zosiyana pang'ono ndi muyeso.

diagnostics

Mawonetseredwe matenda a thrombosis anatsimikizira mu chipatala ntchito choyezera (cytological, amuzolengedwa, majini, coagulologic) ndi luso malangizo. Maonekedwe ndi chikhalidwe cha thupi lidzatidziwa kuti amaganiziridwa venous thrombosis (kutupa). Onse venous ndi wolumikizira limodzi ndi zowawa zonse kukanikiza ndi bloating. Nthawi zina khungu kutentha (venous) kumawonjezera m'chigawo cha kutanthauzira. Mu thrombosis gawo wolumikizira pafupi thrombus ndi zimawonedwa kuchepa kutentha, cyanosis (cyanosis), kupweteka kwambiri. zizindikiro - izi ndi zolembera loyamba thrombophilia, omwe chifukwa chofunika kukaona katswiri.

Mwachindunji ku chipatala anachita Kuphunzira bwinobwino wodwalayo. Onetsetsani kuti mayeso chifukwa thrombophilia, kuchita mtima ultrasound (Mzimuyo chikhalidwe, kukula ndi malo a magazi aumirira), kuchita mosiyana arteriography ndi venography, amene amalola kuti localize ndi kufufuza thunthu njira thrombotic. Komanso, radiographic ntchito, njira radioisotopic, kusanthula majini a polymorphisms kuzindikira ndende ya homocysteine.

chithandizo

Funso la kugonjetsa matendawa amapezeka amene akukumana ndi matenda a thrombophilia. ndi ndi mmene kuthana nawo pofuna kupewa mavuto aakulu chiyani? matenda chithandizo ayenera kukhala wopambana muwone nawo madokotala a ukatswiri zosiyanasiyana: opaleshoni mtima, phlebology panthawiyi, dokotala. Pa gawo loyamba m'pofunika kuphunzira njira etiopathogenic chitukuko matenda. zabwino mankhwala tingayembekezere pokhapokha kuwonongedwa kwa zimayambitsa muzu. Chinthu chofunika mankhwala ndi zakudya, zimene kuchotsa zakudya ndi mkulu mafuta m'thupi, ndi malire a mafuta ndi zakudya yokazinga. Ndi bwino kuti monga mu zakudya zipatso youma, zipatso ndi ndiwo zamasamba, therere mwatsopano.

mankhwala limapangidwa kugwiritsira antiplatelet, amene lowonjezera ntchito anticoagulation chithandizo magazi m'mitsempha, gemodelyutsiey. Nthawi zina m'pofunika kuti agwire kuikidwa plasma atsopano mazira pamodzi heparinization. M'MALO mankhwala analamula mawonekedwe cholowa, chimene chiri chifukwa chakuchepa kwa antithrombin III.

Easy thrombophilia (magazi mayeso kudzakuthandizani kudziwa mawonekedwe), mankhwala lyophilized plasma (mtsempha) kapena youma plasma chopereka. M'njira aakulu ntchito mankhwala fibrinolytic amene kutumikiridwa pa chotengera occluded ntchito catheter. Pamene matenda a thrombophilia chithandizo ayenera aliyense payekha payekha ndi zovuta, kuonetsetsa kusintha mwamsanga ndipo imayenera.

kupewa

Pofuna kuti anakumana ndi matenda aakulu kapena mavuto ake, zodzitetezera kuteteza ayenera kukhala nthawi. Odwala thrombophilia makamaka anagwira plasma kuikidwa pa mlingo wochepa ndi subcutaneous mankhwala "Heparin". Wodwalayo kwa prophylaxis ayenera kulemba mankhwala kuti kulimbitsa mtima khoma ( "Trental" mtsempha "papaverine" pakamwa).

Pakuti kupewa ndi kuchiza wa thrombophilia akulimbikitsidwa kugwiritsa ntchito mankhwala wowerengeka monga mankhwala. Choncho, pofuna kuchepetsa ntchito kupatsidwa zinthu za m'mwazi kudzakuthandizani tiyi kiranberi kapena madzi mphesa. magazi Rarefy pogwiritsa ntchito tincture wa Japanese mbewu Sophora. Komanso, ndi wolakalakika wakupatsa zakudya lamanja, zambiri kuyenda mu mpweya wabwino ndi kusiya zizolowezi zoipa.