Ngaihtuah teh, i taksain thisen a chhuah lohna tura a pianpui mechanism chu a thunun theih loh thut a, chuta tang chuan a tawp vek a nih chuan eng nge thleng ang? I taksa pum puiah thisen zam te te a lo insiam a, chumi atana thil tul zawng zawng chu a bo vek tawh a, chutah chuan hliam tenau tak nei pawhin thisen i chhuak thei lo. Chu chu tunlaia kan sawi mek natna khirh tak tak, buaithlak tak tak zinga mi a ni , DIC (Disseminated Intravascular Coagulation) . Hei hi hming hlauhawm tak angin ri mah se, awlsam takin i hrethiam ang u.
DIC hi eng nge ni tak tak?
A awlsam zawngin sawi ila, DIC hi natna khirh tak a ni a, i thisen zam theihna a tichhe thei a ni. Thil thleng chu i taksa thisen zam (blotting system) chu a lo haywire vek a ni. Hetiang dinhmun hi stage lian pahnih ah a awm thei.
1. Stage 1 (Clot Formation Stage): Hetiang stage-ah hian i taksa pum puiah, i thisen kalna kawng chhungah thisen zam te tak te sang tam tak a lo awm tan thin . Heng clots siam tur hian platelet leh clotting factors tam tak kan hmang thin. Khawpui chhung zawnga kulh tenau tul lo tak siam nan cement block tam tak hman ang mai a ni. Hetiang hian heng thilte hi hmanral thuai a ni.
2. Stage 2 (Bleeding Stage): Tunah chuan taksain thisen zam nana a mamawh platelet leh protein a tlachham ta. Hetih lai hian hliam tenau tak pawhin thisen chhuah chu a titawp thei lo . Hei hi taksain thisen zam siamna atana mamawh “cement” a neih tawh loh vang a ni. Hei hian thunun theih loh khawpa thisen chhuak nasa tak a siam thin. Hei hi natna dinhmun hlauhawm ber a nih avangin enkawl vat a ngai a ni.
Pawimawh tak chu DIC hi a mah chauhin a thleng ngai lo. Damdawi lam natna khirh tak dang emaw, harsatna dang emaw avanga lo awm fo thin. Damdawi ina awm zinga 1% velin a awm nia sawi a ni.
Eng thilin nge DIC hi a thlen?
Kan sawi tawh ang khan DIC hi a hnuaia damdawi lam dinhmun (underlying medical condition) avanga lo awm a ni. A chhan hi natna hrang hrangah a inang lo. A tlangpuiin thil dang (e.g., bacterial toxins , tissue fragments chhia) thisen chhunga lut atanga tan a ni. A chhan berte han thlir ila.
| Chhan chi hrang hrang | Entirna leh sawifiahna |
|---|---|
| DIC rang (acute) lo awm chhan |
|
| Chronic DIC awm chhan te |
|
DIC natna lan chhuahna awm thei te chu engte nge ni?
I natna lan chhuah dan chu DIC condition hi a lo lang nghal (acute) emaw, zawi zawiin (chronic) emaw a lo awm tih ah a innghat.
Acute DIC natna lan chhuah dan
Chumi chhinchhiahna ber leh hlauhawm ber chu thunun theih loh thisen chhuah hi a ni.
- Surgery neihna hmun, IV hmun, hnar emaw, hmui atanga thisen chhuak tam lutuk.
- Chhan awm lovin taksa pum puiah hliam na tak tak a lo lang.
- Thisen chhuak.
- Thisen passing leh stool.
- Thluak, chaw ei kawng, taksa ruh, taksa peng hrang hranga thisen chhuak.
Chronic DIC natna lan chhuah dan
Hetiang chi-a hlauhawm ber chu thisen chhuahna a\angin a ni lo va, a tir lama thisen zam (blood clots) lo awm a ni. Heng thisen zamte hian a kal kual thei a, taksa peng pawimawh tak takah thisen kalna kawng a tikhawlo thei bawk.
- Organ failure: Thisen zam hian taksa peng pakhat, kal, thin emaw, lung emaw-a thisen kal a tikhawlo a nih chuan.
- Stroke: Thisen zam in thluaka thisen kalna kawng a block chuan.
- Heart attack: Heart a thisen pe chhuaktu thisen kalna kawng a inkharkhip chuan.
- Deep Vein Thromboembolism (DVT): Ke emaw kut emaw vein chhungah thisen zam a lo awm a, chu hmunah chuan a hring a, a na bawk.
- Thâwk harsa: Thisen zam chu lungah a kal chuan.
A châng chuan, slow-onset DIC hian symptom a nei lo thei bawk. Tin, a ruala hmun inzawm lo pathum (e.g., hnar thisen chhuak, hmui, leh zun) atanga thisen chhuah hi DIC chhinchhiahna a ni thei bawk.
DIC enkawl dan tur chu engte nge ni?
DIC chungchangah hian doctor-te thil tih hmasak ber leh pawimawh ber chu DIC thlentu damdawi lam dinhmun (underlying medical condition) enkawl hi a ni. Entirnan, DIC hi infection (sepsis) avanga lo awm a nih chuan chu infection atan chuan antibiotics pek a ni ang.
Hei bakah hian DIC avanga natna lan chhuah dan control nan enkawlna pek a ni bawk.
- Plasma transfusions: Thisen hloh tam lutuk a awm tawh chuan thisen plasma pek a ni a, chu chu thisen zam tura protein (clotting factors) mamawh thlak nan a ni.
- Platelet transfusion: Hengte hi thisen chhuah avanga platelet tlahniam tawhte siam that leh nan pek thin a ni.
- Oxygen therapy: Thisen zam avanga taksa peng pakhata thisen supply a tihbuai chuan chu taksa peng chu a chhiat loh nan oxygen pek a ni.
- Anticoagulation damdawi: Thisen tithianghlimtu heparin ang chi hi hman theih a ni. I ngaihtuah mai thei, “Wow, engvangin nge thisen chhuak tawh tu emaw hian thisen tihthianghlimna damdawi tam zawk a mamawh ang ?” Hengte hi fimkhur takin hman a ni. Thisen zam hlauhawm zawk siam a nih loh nan pek an ni a, a bik takin chronic DIC-ah emaw, natna bul tan tirh lamah emaw an pe thin. Hei hi i doctor chauhin thutlukna a siam theih a ni.
Acute DIC hi medical emergency a ni. Hospital-a intensive care unit (ICU) emaw emergency treatment unit (ETU)-a enkawl a ngai a ni. Mahse lungngai suh, a tam zawkah chuan operation emaw nau neih lai emaw hian hetiang hi a thleng thin a, medical team pawh i bulah an awm nghal vek bawk.
Damdawi in i chhuahsan hnuah pawh i doctor chuan a enkawl chhunzawm zel ang che a, DIC avanga damdawi lam dinhmun leh harsatna awm thei te chu a enkawl chhunzawm zel ang che.
Take-Home Thuchah a ni
- DIC hi amah chauha lo awm ve ve a ni lo. Damdawi lam natna khirh tak dang (e.g. sepsis, cancer, trauma na tak) avanga harsatna a ni fo thin.
- Hetianga thil thleng chu a hmasa berah chuan taksa pum puiah a tul lovah thisen zam a lo awm a, chutah chuan thisen zam tur thil mamawh chu a tawp a, chu chuan thunun theih loh thisen a chhuah tir thin.
- Treatment hian DIC thlentu underlying condition enkawl a ngaih pawimawh ber a, chubakah symptoms enkawl a ni bawk.
- I taksa hmun hrang hrang atanga chhan hriat loha thisen chhuak nghal emaw, hliam na tak emaw i neih chuan, a bik takin natna khirh tak dang i neih chuan doctor hmu nghal la, a nih loh leh damdawi in hnai ber Emergency Department (ETU)-ah kal nghal rawh.
DIC, Disseminated Intravascular Coagulation, Thisen zam, Thisen chhuah, Thisen chhuah, Sepsis, A lan chhuah dan te
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