Tangoganizirani, chingachitike n’chiyani ngati njira yachibadwa ya thupi lanu yoletsa kutuluka magazi mwadzidzidzi italephera kulamulira kenako n’kusiya kwathunthu? Magazi ochepa anaundana m’thupi lanu lonse, zonse zofunika pa magaziwo zitatha, kenako simungathe kuletsa kutuluka magazi ngakhale mutavulala pang’ono. Imeneyi ndi imodzi mwa matenda oopsa kwambiri komanso ovuta omwe tikukamba lero , DIC (Disseminated Intravascular Coagulation) . Ngakhale kuti izi zikumveka ngati dzina loopsa, tiyeni timvetse mosavuta.
Kodi DIC ndi chiyani kwenikweni?
Mwachidule, DIC ndi matenda oopsa omwe amakhudza mphamvu ya magazi anu yoti amange magazi. Chomwe chimachitika ndichakuti njira yotsekereza magazi m'thupi lanu imasokonekera kwathunthu. Matendawa amatha kuchitika m'magawo awiri akuluakulu.
1. Gawo 1 (Gawo Lopanga Magazi Oundana): Mu gawoli, magazi ambiri amayamba kuumba m'thupi lanu lonse, mkati mwa mitsempha yanu yamagazi . Kuti tipange magazi oundanawa, timagwiritsa ntchito ma platelet ambiri ndi zinthu zoundana. Zili ngati kugwiritsa ntchito mabuloko ambiri a simenti kumanga makoma ang'onoang'ono osafunikira mumzinda wonse. Mwanjira imeneyi, zinthuzi zimagwiritsidwa ntchito mwachangu.
2. Gawo 2 (Gawo Lotuluka Magazi): Tsopano, thupi latha ma platelet ndi mapuloteni ofunikira kuti magazi aundane. Pakadali pano, ngakhale kuvulala pang'ono sikungathe kuletsa kutuluka magazi . Izi zili choncho chifukwa thupi sililinso ndi "simenti" yofunikira kuti magazi aundane. Izi zimayambitsa kutuluka magazi ambiri mosalamulirika. Iyi ndi gawo loopsa kwambiri la matendawa ndipo limafuna chithandizo chachangu.
Chofunika kwambiri n'chakuti, DIC siimachitika yokha. Nthawi zonse imachitika chifukwa cha matenda ena aakulu kapena mavuto ena. Akuti imachitika mwa odwala pafupifupi 1% omwe ali m'chipatala.
Kodi chimayambitsa DIC ndi chiyani?
Monga tanenera kale, DIC imayamba chifukwa cha matenda enaake. Choyambitsa matenda chimasiyana malinga ndi matenda. Nthawi zambiri imayamba ndi chinthu chachilendo (monga poizoni wa bakiteriya , zidutswa za minofu yowonongeka) zomwe zimalowa m'magazi. Tiyeni tiwone zomwe zimayambitsa.
| Mtundu wa chifukwa | Zitsanzo ndi mafotokozedwe |
|---|---|
| Zifukwa za DIC yadzidzidzi (yoopsa) |
|
| Zifukwa za DIC Yosatha |
|
Kodi zizindikiro za DIC zingachitike ndi ziti?
Zizindikiro zomwe mumakumana nazo zimadalira ngati vuto la DIC limabwera mwadzidzidzi (mwadzidzidzi) kapena pang'onopang'ono (losatha).
Zizindikiro za DIC Yoopsa
Chizindikiro chachikulu komanso choopsa kwambiri cha izi ndi kutuluka magazi kosalamulirika.
- Kutuluka magazi ambiri kuchokera pamalo ochitira opaleshoni, malo ochitira opaleshoni, mphuno, kapena m'kamwa.
- Mabala akuonekera thupi lonse popanda chifukwa.
- Kusanza magazi.
- Kutulutsa magazi ndi ndowe.
- Kutuluka magazi mu ubongo, m'mimba, m'minofu, kapena m'mabowo a thupi.
Zizindikiro za DIC Yosatha
Ngozi yaikulu yamtunduwu si kutuluka magazi, koma ndi magazi oundana omwe amapangika kumayambiriro. Magazi oundanawa amatha kuyenda ndikutseka mitsempha yamagazi m'ziwalo zofunika kwambiri.
- Kulephera kwa ziwalo: Ngati magazi kuundana atseka kuyenda kwa magazi kupita ku ziwalo monga impso, chiwindi, kapena mapapo.
- Kutsekeka kwa magazi: Ngati magazi oundana atseka mtsempha wamagazi muubongo.
- Matenda a mtima: Ngati mtsempha wamagazi wopereka magazi kumtima watsekeka.
- Kutsekeka kwa Mitsempha Yaikulu (DVT): Magazi amaundana mkati mwa mitsempha ya miyendo kapena manja, zomwe zimapangitsa kutupa ndi kupweteka m'malo amenewo.
- Kuvuta kupuma: Ngati magazi oundana apita ku mapapo.
Nthawi zina, DIC yomwe imayamba pang'onopang'ono singayambitse zizindikiro zilizonse. Komanso, kutuluka magazi kuchokera m'malo atatu osagwirizana nthawi imodzi (monga kutuluka magazi m'mphuno, m'kamwa, ndi mkodzo) kungakhale chizindikiro cha DIC.
Kodi mankhwala a DIC ndi ati?
Chinthu choyamba komanso chofunikira kwambiri chomwe madokotala amachita pa nkhani ya DIC ndikuchiza matenda omwe amayambitsa DIC. Mwachitsanzo, ngati DIC yayamba chifukwa cha matenda (sepsis), maantibayotiki adzaperekedwa pa matendawa.
Kuphatikiza apo, chithandizo chimaperekedwanso kuti chichepetse zizindikiro zomwe zimayambitsidwa ndi DIC.
- Kuika magazi m'magazi: Ngati magazi atayika kwambiri, magazi amaperekedwa kuti alowe m'malo mwa mapuloteni (zinthu zoundana) zomwe zimafunika kuti magazi aziundana.
- Kuika magazi m'maselo: Izi zimaperekedwa kuti zibwezeretse chiwerengero cha maselo omwe achepa chifukwa cha kutuluka magazi.
- Chithandizo cha okosijeni: Ngati magazi akupita ku chiwalo cha munthu asokonekera chifukwa cha magazi kuundana, mpweya umaperekedwa kuti chiwalocho chisawonongeke.
- Mankhwala oletsa magazi kuundana: Mankhwala ochepetsa magazi monga heparin angagwiritsidwe ntchito. Mwina mukudzifunsa kuti, “Chifukwa chiyani munthu amene akutuluka magazi kale amafunikira mankhwala ochepetsa magazi?” Mankhwalawa amagwiritsidwa ntchito mosamala kwambiri. Amaperekedwa kuti apewe kupangika kwa magazi oundana kwambiri, makamaka mu DIC yosatha kapena kumayambiriro kwa matendawa. Ichi ndi chisankho chomwe dokotala wanu yekha ndi amene angapange.
Matenda a DIC owopsa ndi matenda adzidzidzi. Amafunika chithandizo m'chipinda chosamalira odwala kwambiri (ICU) kapena chipinda chothandizira odwala mwadzidzidzi (ETU). Koma musadandaule, nthawi zambiri izi zimachitika panthawi ya opaleshoni kapena kubereka, ndipo gulu lachipatala limakhala nanu pomwepo.
Mukatuluka kuchipatala, dokotala wanu adzapitiriza kukuyang'anirani ndikuyang'anirani matenda aliwonse omwe amabwera chifukwa cha DIC.
Uthenga Wopita Nawo Kunyumba
- DIC si matenda omwe amabwera okha. Nthawi zonse amakhala vuto la matenda ena aakulu (monga sepsis, khansa, kuvulala kwambiri).
- Chomwe chimachitika pankhaniyi ndi chakuti choyamba, magazi amaundana mosafunikira m'thupi lonse, kenako zinthu zofunika kuti magazi amaundana zimatuluka, zomwe zimapangitsa kuti magazi azituluka mosalamulirika.
- Chithandizo chimayang'ana kwambiri pa kuchiza matenda omwe amayambitsa DIC, komanso kuthana ndi zizindikiro.
- Ngati mukumva kutuluka magazi mwadzidzidzi kapena kuvulala kwambiri m'malo osiyanasiyana a thupi lanu popanda chifukwa chomveka, makamaka ngati muli ndi matenda ena aakulu, onani dokotala wanu nthawi yomweyo kapena pitani ku Dipatimenti Yothandiza Pangozi (ETU) ya chipatala chapafupi.
DIC, Kugawanika kwa Mitsempha Yamagazi, Kuundana kwa Magazi, Kutuluka Magazi, Kutuluka Magazi, Sepsis, Zizindikiro
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