Xav txog tias koj tab tom txiav zaub hauv chav ua noj thiab txiav koj txhais tes tsis tau xav txog. Los yog cia peb hais tias ib tug me nyuam yaus poob thaum ua si thiab mob nws lub hauv caug. Thaum xub thawj, muaj me ntsis ntshav, tab sis tom qab ib pliag, txawm tias peb tsis ua dab tsi los xij, qhov ntshav tsuas yog nres xwb, puas yog? Qhov no tsis yog lwm yam xwb. Qhov no yog ib qho kev tiv thaiv zoo kawg nkaus hauv peb lub cev. Hauv kev kho mob, peb hu qhov no ua hemostasis . Hais yooj yim, qhov no yog cov txheej txheem ntuj uas tiv thaiv kev los ntshav ntawm qhov txhab thiab npaj lub cev los kho qhov txhab ntawd.
Yog li cas cov txheej txheem no hu ua hemostasis tshwm sim?
Zaj dab neeg no zoo li yog ib zaj dab neeg nthuav heev. Lo lus hemostasis muaj ob ntu. "Hemo" txhais tau tias "ntshav" thiab "stasis" txhais tau tias "nres" lossis "tuav ruaj." Hauv cov lus yooj yim, nws txhais tau tias "nres cov ntshav ntws." Cov txheej txheem no pib hauv ob peb feeb tom qab raug mob. Nws yog ib txwm muaj ntshav los ntawm kev raug mob rau ob mus rau xya feeb.
Qhov no tsis yog ib kauj ruam xwb. Nws tshwm sim ua ntau kauj ruam, zoo li ib pab neeg ua haujlwm txawj ua haujlwm ua ke los ua kom tiav ib qhov project. Cia peb saib plaub kauj ruam tseem ceeb.
| Cov kauj ruam | Yuav ua li cas (hauv cov lus yooj yim) |
|---|---|
| Kauj Ruam 1: Kev ntsuas cov hlab ntsha | Cov hlab ntsha ntawm qhov chaw raug mob nruj zoo li nias lub yeeb nkab dej. Qhov no ua rau cov ntshav ntws qeeb. |
| Kauj Ruam 2: Ua ib lub qhov ntsaws ib ntus | Cov platelets, ib hom qe ntshav me me uas ntab hauv peb cov ntshav, maj mam mus rau qhov chaw raug mob thiab lo rau nws. Lawv sib sau ua ke thiab kaw qhov txhab ib ntus. Nws zoo li muab lub hau rau ntawm lub raj mis. Qhov no kuj hu ua thawj hemostasis . |
| Kauj Ruam 3: Pib txoj kev sib txuas ntawm cov ntshav coagulation | Tam sim no txoj haujlwm tiag tiag pib lawm. Dab tsi nyob hauv cov ntshavCov protein hu ua coagulation factors raug ua haujlwm ib qho tom qab ib qho, ua kom lub foob ib ntus ntawd muaj zog dua. Qhov no zoo li kev sib txuas lus. Qhov no hu ua secondary hemostasis . |
| Kauj Ruam 4: Kev tsim cov ntshav txhaws tas mus li | Thaum kawg, cov platelets thiab cov protein tshwj xeeb hu ua fibrin sib koom ua ke los ua ib qho ntshav khov kho, zoo li cov cib thiab cov av nplaum uas ua phab ntsa. Qhov no kaw tag nrho qhov txhab. Tom qab ntawd, thaum qhov txhab kho, cov ntshav khov kho no yaj thiab tsim cov tawv nqaij tshiab. |
Hais yooj yim xwb, hemostasis yog peb lub cev lub "paster" ntuj. Yog tsis muaj nws, txawm tias qhov khawb me me tuaj yeem ua rau peb los ntshav ntau thiab txawm tias ua rau peb tuag taus.
Yog tias cov txheej txheem no tsis ua haujlwm ces yuav ua li cas?
Txawm hais tias cov txheej txheem no feem ntau ua haujlwm tau zoo heev, qee zaum nws tuaj yeem ua yuam kev. Tom qab ntawd muaj ob qho teeb meem tshwm sim:
1. Hypocoagulability: Qhov no yog thaum cov ntshav tsis khov zoo thaum xav tau. Txawm tias yog qhov txhab me me tuaj yeem ua rau los ntshav ntev, ua rau muaj kev raug mob thiab mob.
2. Kev ntshav txhaws ntau dhau: Qhov no yog thaum cov ntshav txhaws hauv lub cev thaum tsis xav tau. Qhov no tuaj yeem ua rau muaj kev phom sij heev.
Yog tias cov ntshav txhaws ntau dhau (Hypercoagulability)
Qhov no txaus ntshai vim tias cov ntshav txhaws uas tsis xav tau uas tsim nyob rau hauv lub cev (uas peb hu ua thrombosis ) tuaj yeem mus ncig los ntawm cov hlab ntsha thiab nkag mus rau hauv cov kabmob tseem ceeb xws li lub hlwb, lub plawv, thiab lub ntsws. Qhov ntawd yog qhov tshwm sim.
- Mob stroke: Yog tias cov ntshav txhaws thaiv cov hlab ntsha uas nqa cov ntshav mus rau lub hlwb.
- Mob Plawv Nres: Yog tias cov ntshav txhaws thaiv cov hlab ntsha uas xa cov ntshav mus rau lub plawv.
- Kab Mob Pulmonary Embolism: Qhov no tuaj yeem tshwm sim thaum cov ntshav txhaws ( Deep Vein Thrombosis - DVT ), uas feem ntau tsim nyob rau hauv cov hlab ntsha tob hauv ceg, tawg xoob thiab nyob hauv cov hlab ntsha hauv lub ntsws.
Qee hom mob qog noj ntshav, tej yam mob caj ces (piv txwv li Factor V Leiden , Protein C deficiency ), thiab lwm yam mob (piv txwv li Antiphospholipid syndrome , kev kis kab mob hnyav - sepsis ) tuaj yeem ua rau cov ntshav txhaws ntau ntxiv li no.
Yog tias cov ntshav txhaws txo qis ntau dhau (Hypocoagulability)
Qhov no yog qhov txawv. Vim tias koj cov ntshav tsis khov zoo, txhua qhov kev raug mob tuaj yeem ua rau muaj kev phom sij. Txawm tias yog qhov txiav me me tuaj yeem ua rau los ntshav ntau dhau. Kuj tseem tuaj yeem muaj cov ntshav tsis pom hauv lub cev.
Cov piv txwv tseem ceeb ntawm qhov no yog:
- Kab mob ntshav tsis khov (Hemophilia): Qhov no yog ib yam kab mob uas lub cev tsis tsim ib lossis ntau yam uas yuav tsum tau ua kom cov ntshav khov.
- Kab mob Von Willebrand: Qhov no yog ib yam kab mob caj ces uas zoo ib yam li hemophilia.
- Thrombocytopenia: Kev txo qis ntawm cov platelets, uas yog cov hlwb ntshav tseem ceeb. Qhov mob no tuaj yeem pom hauv qee hom mob qog noj ntshav (piv txwv li, leukemia ).
Yuav ua li cas koj thiaj paub tias muaj teeb meem zoo li no?
Yog koj muaj cov tsos mob no, koj tus kws kho mob yuav xa koj mus rau kws kho mob ntshav. Nws yuav nug txog koj cov tsos mob thiab xaj kom kuaj ntshav.
Ib txhia ntawm cov kev xeem ntawd yog:
- Kev suav ntshav tag nrho (CBC)
- Kev suav cov ntshav platelet
- Lub Sijhawm Los Ntshav
- Lub Sijhawm Prothrombin (PT)
- Lub Sijhawm Ua Haujlwm Ib Nrab Thromboplastin (aPTT)
- Qib Fibrinogen
Thaum twg koj yuav tsum mus ntsib kws kho mob?
Yog koj muaj tej yam tsos mob, koj yuav tsum tsis txhob tsis quav ntsej lawv. Tej no yuav yog tej xwm txheej ceev.
| Pawg tsos mob | Tej yam yuav tsum tau them sai sai rau |
|---|---|
| Cov cim qhia tias ntshav txhaws ntau ntxiv (Hypercoagulability) - Cov no yog xwm txheej ceev, mus rau ETU tam sim ntawd! | |
| Lub hlwb (tuag tes tuag taw) | Ib sab ntawm lub cev loog, hais lus tsis tau zoo, ib sab ntawm lub ntsej muag qaug zog, mob taub hau heev. |
| Kab mob plawv (kab mob plawv) | Mob hauv siab, ua pa nyuaj, tsis muaj zog, lub plawv dhia ceev, tsaus muag. |
| Hauv lub ntsws (Pulmonary Embolism) | Ua tsis taus pa tam sim ntawd, mob hauv siab, hnoos tawm ntshav, daim di ncauj xiav lossis cov ntiv tes xoo, tsaus muag. |
| Hauv ceg (DVT) | Mob, o, thiab liab ntawm thaj chaw puab tais lossis lwm qhov ntawm ceg. |
| Cov tsos mob ntawm hypocoagulability - tham nrog koj tus kws kho mob yog tias koj muaj cov no. | |
| Cov yam ntxwv feem ntau | • Ntswg los ntshav ntau zaus thiab nyuaj rau tso tseg. • Cov pos hniav los ntshav thaum txhuam koj cov hniav. • Txawm tias yog ib qho qhov txhab me me los ntshav ntev heev. • Muaj qhov mob (cov pob xiav/ntshav) ntawm lub cev yam tsis muaj laj thawj. |
Cov Lus Qhia Txog Kev Coj Mus Tsev
- Hemostasis yog ib qho txheej txheem ntuj tsim, tseem ceeb uas peb lub cev tiv thaiv kev los ntshav los ntawm kev raug mob.
- Qhov no yog ib qho txheej txheem nyuaj uas muaj ntau kauj ruam.
- Qee zaum cov txheej txheem no tuaj yeem ua tsis tiav. Ob qho mob no, hu ua hypercoagulability lossis hypocoagulability, tuaj yeem ua rau muaj kev phom sij.
- Cov tsos mob xws li mob hauv siab tam sim ntawd, ua pa nyuaj, lossis tsis nco qab ib sab ntawm lub cev yuav yog ib qho cim qhia tias muaj ntshav txhaws. Yog tias muaj li no, mus rau chav kho mob ceev (ETU) ntawm tsev kho mob tam sim ntawd.
- Yog tias koj muaj qhov mob liab tsis muaj laj thawj, lossis yog tias koj los ntshav ntau los ntawm cov qhov txhab me me, tsis txhob tsis quav ntsej thiab nrog koj tus kws kho mob tham.
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