Heparin tih damdawi i hman a ngai tawh em? Operation hnuah emaw, thisen zam loh nan doctor-in he damdawi hi a pe che a ni mai thei. Mahse, a tlem hle nachungin, he heparin hian kan taksaah thisen zam tam zawk a siam thei a, platelet a ti tlem thei bawk. Chu chu `Heparin-Induced Thrombocytopenia` emaw `(HIT)` emaw kan tih chu a ni. Ngaihtuah buai suh, hei hi a buaithlak deuhin a lang thei a, mahse awlsam takin han sawi ila.
Heparin hi eng nge ni? Engvangin nge HIT hi a lo awm?
A awlsam zawngin heparin hi
anticoagulant (thisen tithianghlimtu) a ni. Kan thisen kalna kawnga
thisen zam (blood clots) a lo awm loh nan hman a ni . Doctor-te chuan operation lian tak hnuah emaw, thisen zam lo awm tawh chu tihthianghlim nan emaw an pe thin. Mahse, a tlem hle a, heparin hi mi thenkhat hnena pek a nih chuan a chhiatna a thlen thei a ni. Hei hi kan
immune system hian heparin nen a inzawm sual a, kan platelet ngei pawh a tichak a ni. Platelets hi cell chi khat a ni a, kan thisen chhuah titawp theitu a ni. Chuvangin, hetianga platelets te hi activate a nih chuan thisen zam siamna tur tihtawp ai chuan
a tul lovah thisen zam (thrombosis) an siam tan thin . Chutih rual chuan platelet pawh a tlahniam chak hle (thrombocytopenia). Hei vang hian he natna hi `Heparin-Induced Thrombocytopenia and Thrombosis (HITT)` an ti \hin.
Ngaihtuah teh, thisen zam venna atana damdawi pek hian thisen zam a tipung ang a, platelet a ti tlem ang tih hi thil mak deuh a ni lawm ni? Mahse a thleng thei tho.
HIT hi chi hnih lian tak a awm a.
Doctor-te chuan he `(HIT)` dinhmun hi chi hnih ah an then a: 1.
HIT I (Type 1): Hetiang a nih chuan heparin i tan atanga ni hmasa berah i platelet level chu a tlahniam deuh a, mahse ni engemaw zat chhungin a pangngaiin a lo kir leh thin.
This is not a dangerous condition , leh thisen zam hlauhawmna a awm lo va, chuvangin enkawlna bik a ngai lo. 2.
HIT II (Type 2): Hei hi kan ngaihtuah ngai chi a ni. Chutiang a nih chuan kan immune system hian heparin chhanna atan platelets a tichak a ni. Hei hian platelet level a ti tlahniam a,
thisen zam na tak a awm theihna a awm bawk . A tlangpuiin `(HIT)` kan sawi hian he chi hlauhawm tak `(HIT II)` an tih hi kan sawi fo thin.
He HIT hi tute nge nei tam zawk?
Heparin hmangtu tu pawhin, a dose emaw, a hman hun chhung emaw pawh nise, he natna hi a nei thei a ni. Mahse,
hmeichhia kum 40 chunglam te chuan an vei tam zawk tih hmuhchhuah a ni. Doctor-te chuan engvangin nge mi thenkhatin heparin lakah hetiang reaction hi an neih a, thenkhatin an neih loh chhan chiang takin an la hre lo. Hei
Thil awm dan tlangpui a ni lo. He ``(HIT)`` natna hi mi tlemte, 5% vel, ni li aia tam heparin ei thinte zingah a awm thin. HIT natna lanchhuahna chu engte nge ni? Engtin nge kan hriat chian?
Heparin i ei a nih chuan i doctor chuan i thisena cell awm zat, a bik takin platelet awm zat a enfiah fo ang. Platelet count hniam hi HIT chhinchhiahna hmasa ber a ni thei. HIT vei zinga a chanve vel chuan thisen zam thar an nei thin. Hei hi kea deep vein thrombosis (DVT) emaw, pulmonary embolism (PE) emaw a ni thei. Heng symptoms te hi en reng ang che: Chu bâkah, heparin injection i tihna hmunah hian natna, hliam emaw, vun rawng emaw i hmu thei bawk. A pawimawh ber: Heparin i ei a, heng symptoms te hi i neih chuan emergency doctor pan nghal rawh. Hei hi tihkhawtlai tur thil a ni lo.
Engtikah nge HIT hi a lo awm?
A tam zawkah chuan heparin hman tan atanga ni nga atanga kar hnih chhungin natna lan chhuah dan a intan thin. Mahse, hun dangah pawh an awm thei bawk:- Early-onset HIT: Hei hi heparin hman tan atanga ni khat atanga ni thum chhungin a thleng thei. Hei hi heparin i hman tawh chuan (a tlangpuiin thla thum chhungin) a thleng tam zawk. Tichuan, i taksa chuan heparin chu a "hriat reng" a, a dotu antibody a siam a, rang taka chhan let turin a inpeih ta a ni.
- Refractory HIT: Hetiang dinhmun hi heparin tihtawp a nih hnuah pawh kar tam tak chhung a awm thei.
- Delayed onset HIT: Hei hi heparin enkawlna tihtawp a nih hnuah a thleng thin. A tlangpuiin damdawi ei chawlhsan ni nga emaw a aia rei emaw a lo awm thin.
Eng thilin nge he HIT hi a thlen tak tak?
`HIT` hi damdawi heparin hian kan platelet-a protein pakhat `PF4` (Platelet Factor 4) a binding hian a lo awm thin. He heparin leh `PF4` te hi an inzawm khawm a, `Heparin-PF4 complex` an siam ta a ni. Kan taksaa `Heparin-PF4 complex` kan hmuh hian kan immune system a buai a, a dotu antibody a siam tan ta a ni. Heng antibodies te hi kal in chu `Heparin-PF4 complex` ah chuan an inzawm khawm thin. Chuta tang chuan a intan vek a ni. Heng antibodies te hi an inzawm meuh chuan platelet te chu a thawk nghal a, thisen zam a siam tan ta a ni. Chutiang chuan thisen zam siamtu platelet atang hian `PF4` tam zawk a chhuak thin. Tichuan chu `PF4` lo thleng thar pawh chuan heparin nen a inzawm a, `Heparin-PF4 complex` tam zawk a siam ta a ni. Antibodies te chu an lo kir leh a, an inzawm leh a, thisen zam tam zawk a lo awm... Hei hi chain reaction ang maiin a kal zel a ni. Heng thisen zam siamna zawng zawng avang hian taksaa platelet awmte chu a hmang zo thuai thin. Chuvang chuan platelet level a tlahniam ta a ni. Hetianga thisen zam tam lutuk avang hian thisen zam lian tak tak, nunna atana hlauhawm tak tak a lo awm thei a, kan thisen kalna kawng leh thisen kalna kawngte a tikhawlo thei a ni. HIT vei theihna tur risk factors te chu engte nge ni?
HIT vei theihna tipungtu thil engemaw zat a awm a:- I gender: Hmeichhia hian HIT an vei tam zawk.
- Heparin hman chi: Zirna thenkhatah chuan HIT vei theihna hi heparin i ei chi hrang hrang a zirin a danglam thei niin an sawi. Entirnan, low-molecular-weight heparin ai chuan unfractionated heparin hman hian a hlauhawmna a tihziaawm thei tih finfiahna engemaw zat a awm. Mahse, hemi chungchangah hian zirchianna tam zawk neih a ngai a ni.
- Operation hnua heparin ei: Operation hnua thisen zam venna atana heparin ei thinte hian thisen zam awm tawh enkawlna atana ei thinte aiin HIT an vei tam zawk. He hlauhawmna hi ruh lam operation, thinlung surgery, leh cardiopulmonary bypass hnuah a sang hle a ni.
Engtin nge HIT hi hmuhchhuah a nih? (Diagnosis) tih a ni.
Thisen test engemaw zat hmangin HIT i vei em tih hriat theih a ni:- Platelet levels: Hei hian i platelet count a hniam em tih a enfiah thei (thrombocytopenia).
- Clot formation: Thisen test-ah i thisen a clot em tih a hriat theih.
- PF4 antibody levels: I thisena PF4 antibodies awm zat hian i immune system hian platelet a tichak em tih a hril thei a ni. He antibody test hian HIT a awm tih a nemnghet a ni.
I doctor chuan i kea thisen zam (DVT) a awm leh awm loh enfiah turin ultrasound a ti thei bawk. I dinhmun azirin, i kut ang chi hmun dangah thisen zam a awm leh awm loh enfiah turin test an ti thei bawk. Mahse, he antibody test result hi a lo let leh theih nan hun engemaw chen a duh avangin doctor-te chuan enkawl tan hmain a lo let leh hun an nghak lo. HIT hi enkawl loh chuan thihna thlen thei dinhmun a nih avangin, HIT i vei theihna tur a zirin enkawl dan tur a ni. He "4Ts test" hi eng nge ni?
`4Ts test` hi scoring system a ni a, `HIT` i neih theihna tur a chhut chhuak a ni. Antibody test result nghah ngai lovin enkawlna i tan theihna tura i mamawh information a pe a ni. Doctor chuan heng thil palite hi score (0 atanga 2 thleng) a pe a:- Thrombocytopenia (platelet count hniam): I platelet count hi engzat nge a hniam?
- Timing (heparin a chhan hun): Engtik lai khan nge i platelet level a tlahniam?
- Thrombosis (thisen chhuak): Thisen zawrh chhinchhiahna a awm em?
- oA chhan dang: I platelet count hniam chhan hi heparin tih loh chhan dang a awm thei ang em?
Score a san poh leh `HIT` i neih theihna chance a sang zawk. HIT enkawl dan tur chu engte nge ni?
Enkawlna hmasa ber chu heparin ei kha tihtawp nghal a ni. Tichuan, thisen tithianghlimtu damdawi dang hmangin i inthlak ang. Heparin i chawlhsan hnu ni engemaw zat chhungin i platelet count a pung leh tur a ni. Chumi hma chuan i doctor chuan thisen zam a lo awm loh nan damdawi dang a pe mai thei. Heparin aiah hian damdawi chi hrang hrang hman theih a awm a:- ``Thrombin inhibitor dik tak'' (entir nan `argatroban', `bivalirudin') .
- `Fondaparinux` tih a ni
- `Direct oral anticoagulants` (thisen thisen zam venna damdawi, ka atanga direct a ei theih)
I platelet level a normal leh tawh a, HIT vanga thisen zam theihna a liam tawh chuan i doctor chuan thisen tithianghlimtu damdawi dang, warfarin ang chi hmangin a thlak thei che a ni. HIT hi kan veng thei ang em?
HIT venna tur hian engmah tih theih a awm lo tak zet a ni. Mahse, i doctor-in i platelet level a enfiah fo chuan heparin avanga harsatna lo thleng thei chu a tiziaawm thei a ni. HIT i neih chuan eng nge beisei tur?
Heparin-Induced Thrombocytopenia (HIT) hi natna khirh tak a ni a, enkawl vat loh chuan thihna thlen thei a ni. Kut leh kea thisen zam lian tak takte chuan chu taksa pengte chu hun rei tak chhung a tichhe thei a ni. Thisen zam, taksa peng lian (major organs) tichhe thei hian thihna a thlen thei a ni. Vanneihthlak takin HIT chungchanga hriatna a pun zel avang leh enkawlna kawng tha zawk a awm avangin damchhuahna pawh nasa takin a tha chho ta a ni. Thisen zam na tak tak a lo awm hmaa hriat hmasak hi thil tha tak chhuahna kawng pawimawh tak a ni.I doctor chuan HIT chhinchhiahna, platelet count hniam ang chi a hmuh chuan thisen zam hlauhawm tak awm theihna tur damdawi a pe thei a ni. Engtin nge ka in enkawl ang?
I platelet level enfiah tur leh thisen zam i neih loh nan doctor i hmuh fo a ngai dawn a ni. Chu bakah, i doctor chuan heparin atanga anticoagulant thar a thlak hunah side effect awm thei (mi thenkhat thisen chhuah ang chi) a hre bawk ang. Hetih lai hian i damdawi ei tur a tih ang anga ei a pawimawh hle. Thisen zam i la nei lo a nih pawhin thla khat tal non-heparin anticoagulant i ei a ngai dawn a ni. Thisen zam i neih tawh chuan rei zawk i ei a ngai mai thei. Mahni in enkawl dan tha ber chu nakin lawka enkawltu doctor tu pawh hnenah he harsatna hi i nei tawh tih hrilh hi a ni. `HIT` i neih tawh chuan heparin hi i ei leh tawh ngai lovang.
Heparin i ei laiin i taksaah danglamna i hmu a nih chuan emergency doctor pan nghal rawh. Heparin-Induced Thrombocytopenia (HIT) hi natna awm lo tak a ni a, mahse thisen zam chhinchhiahna eng pawh hi a pawi lutuk a, ngaihthah theih a ni lo. Enkawlna tel lo chuan HIT hian thihna a thlen thei a ni. Enkawlna a awm chuan i platelet level chu a normal leh tur a ni a, thisen zam i neih theihna pawh a tlahniam tur a ni. Hmalam pan zelin heparin ai chuan damdawi hman tur tha ber chungchang i doctor nen sawiho rawh. Take-Home Thuchah hnuhnung ber
- Heparin hi thisen zam vengtu damdawi pawimawh tak ni mahse, natna khirh tak `Heparin-Induced Thrombocytopenia (HIT).` tih hi a thlen tam lo hle
- Hetiang dinhmunah hian thil thleng chu thisen zam venna ai chuan thisen zam siamna a pung a, platelet a tlem phah a ni.
- I ke/kut hring, natna, rilru na, leh thawk harsa tih ang chi symptoms te chu fimkhur rawh. Hengte hi i hriat chian chuan Doctor pan nghal rawh.
- `HIT` tih hmuhchhuah a nih chuan tih hmasak ber tur chu heparin hi tihtawp a ni. Tichuan thisen tihthianghlimna damdawi dang i hman a ngai dawn a ni.
- `HIT` i neih tawh chuan i medical record zawng zawngah ziak vek la, nakin lawka doctor i hmuh apiang hrilh rawh. Heparin hi pek leh tawh ngai lo tur a ni.
He thu hi i tan a tangkai ngei ka beisei. Hrisel takin awm rawh! Heparin, Thrombocytopenia, Thisen zam, Platelets, Anticoagulant, HIT, Side effect, Thisen zam, Platelets, Heparin, Side effects te hi a awm thei
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