Thola ulwazi mayelana nokujiya kwegazi lakho ngokuhlolwa kwe-D-Dimer!

Cishe uke wezwa ngalolu vivinyo olubizwa ngokuthi i-D-Dimer. Noma mhlawumbe udokotela wakho ukutshelile ukuthi ulwenze. Ngakho-ke, iyini i-D-Dimer? Kungani lolu vivinyo lubaluleke kangaka? Ake sixoxe ngakho konke lokhu ngokuningiliziwe, kalula kakhulu, namuhla. Ngizokuchaza ngendlela ongayiqonda.

Kuyini i-D-Dimer? Kalula nje...

Cabanga ngale ndlela: I-D-Dimer iyingcezu encane yeprotheni eyakheka lapho ihlule legazi lincibilika emzimbeni wakho. Ngokuvamile, uma ungenawo amahlule amaningi egazi akhiwa emzimbeni wakho, noma uma amahlule akhiwayo engancibiliki, cishe akukho D-Dimer egazini lakho. Noma ikhona ngamanani amancane kakhulu.

Manje, uma umphumela wakho wokuhlolwa kwe-D-Dimer ubonisa ukuthi ulungile noma uma izinga lakho le-D-Dimer liphakeme , kungase kubonise ukuthi unesifo sokujiya kwegazi. Kodwa-ke, akusho ukuthi unaleso simo . Futhi, ukuhlolwa kwe-D-Dimer kukodwa akukwazi ukukutshela ngqo ukuthi hlobo luni lwesimo sokujiya kwegazi onaso noma ukuthi i-clot yegazi ikuphi emzimbeni wakho. Kudingeka ukuhlolwa okwengeziwe ukuze kutholakale lokho.

Kwenzeka kanjani ngempela ukuthi igazi lijiye?

Ake siqale siqonde ukuthi iyini inqubo evamile yokujiya kwegazi. Eqinisweni, ukujiya kwegazi kuyinto ebaluleke kakhulu futhi ebalulekile. Uma ulimala, le nqubo iyasiza ekumiseni ukuphuma kwegazi okuningi. Cabanga nje, uma uthola ukulimala emthanjeni wegazi noma esicutshini bese uqala ukuphuma kwegazi, umzimba wakho uqala inqubo ebizwa ngokuthi "i-hemostasis". Yilokhu okunciphisa ukuphuma kwegazi futhi ekugcineni kwenze i-blood clot ukuze ikuyekise.

Phakathi nale nqubo "ye-hemostasis," umzimba wakho wenza imicu yeprotheni ebizwa ngokuthi "i-fibrin," eyakha i-mesh. Le mesh, kanye nohlobo lweseli olubizwa ngokuthi "i-platelet," kusiza ukugcina i-clot yegazi isendaweni yayo kuze kube yilapho inxeba liphola. La ma-clot ngezinye izikhathi angabonakala njengoqweqwe esikhumbeni sakho noma njengeqhubu ngaphansi kwesikhumba sakho.

Ngemva kokuba inxeba lakho selipholile, futhi umzimba wakho ungasadingi ihlule, umzimba wakho ukhiqiza i-enzyme ebizwa ngokuthi "i-plasmin" ukuze iphule ihlule libe yizicucu ezincane bese izisusa. Lezi zicucu zibizwa ngokuthi "imikhiqizo yokubola kwe-fibrin" noma "imikhiqizo yokuqhekeka kwe-fibrin". Enye yalezo zicucu ibizwa ngokuthi i-D-Dimer.

Kodwa-ke, uma unesifo sokujiya kwegazi, ungase ube namahlule ngisho noma ungenalo ukulimala. Noma, amahlule akhekile angase angancibiliki ngesikhathi esifanele. Kalula nje, inqubo yomzimba wakho yokujiya kwegazi ayisebenzi kahle. Lezi zinhlobo zamahlule egazi zingaba yingozi futhi zisongele nokuphila.

Ngakho-ke, izinga eliphezulu le-D-Dimer egazini lakho lingaba uphawu lokuthi umzimba wakho uyakha futhi uncibilikisa amahlule egazi kakhulu. Yingakho kuyisibonakaliso sesifo sokujiya kwegazi.

Iyini i-D-Dimer test esetshenziswayo ukuthola?

Odokotela bavame ukusebenzisa isivivinyo se-D-Dimer ukusiza ekuxilongeni inkinga yokujiya kwegazi. Izimo eziyinhloko zifaka:

• I-Deep Vein Thrombosis (DVT) noma i-Venous Thrombosis: Lokhu kwenzeka lapho kwakheka ihlule legazi emthanjeni ongaphakathi emzimbeni wakho. Leli hlule lingavimba ngokuphelele noma ngokwengxenye ukugeleza kwegazi emthanjeni. I-DVT ivame ukwenzeka emlenzeni ongezansi, ethangeni, noma enqulwini. Kodwa-ke, ingavela nakwezinye izingxenye zomzimba, njengengalo, ubuchopho, amathumbu, isibindi, noma izinso.
• I-Pulmonary Embolism (PE): Lokhu kwenzeka lapho ihlule legazi elakheke kwenye indawo emzimbeni (ngokuvamile emlenzeni noma engalweni) lihamba egazini bese lihlala emthanjeni wegazi emaphashini. Lesi yisimo esiyingozi kakhulu.
• Ukuqina Kwemithambo Yegazi Esakazekile (DIC): Kulesi simo, kwakheka amahlule amaningi egazi emzimbeni wakho . Lokhu kungalimaza izitho zomzimba futhi kubangele ezinye izinkinga ezinkulu. Ukuhlolwa kwe-D-Dimer akusetshenziselwa nje ukuxilonga i-DIC, kodwa futhi nokubona ukuthi ukwelashwa kwe-DIC kusebenza kahle kangakanani.
• Isifo sohlangothi: Kulesi simo, esisibiza nangokuthi “ihlule legazi ebuchosheni,” umthambo wegazi ebuchosheni uyavaleka noma uqhume.

Kungani ngidinga ukuhlolwa kwe-D-Dimer?

Uma unezimpawu zesimo sokujiya kwegazi, udokotela wakho angase akucele ukuhlolwa kwe-D-Dimer. Lezi izimpawu zezimo ezifana ne-`(DVT)`, `(PE)`, `(DIC)`, `(Stroke)` okukhulunywe ngazo ngenhla.

Esikhathini esiningi, ukuhlolwa kwe-D-Dimer kwenziwa ekamelweni lezimo eziphuthumayo noma esibhedlela.

Ziyini izimpawu ze-deep vein thrombosis (DVT)?

I-DVT ivame ukwenzeka emlenzeni noma engalweni yakho. Akuwona wonke umuntu onezimpawu. Kodwa-ke, ungase ube nezimpawu ezifana nalezi:

• Ukuvuvukala komlenze noma ingalo (ngezinye izikhathi kungazelelwe).
• Ubuhlungu noma ukuqaqamba kwemilenze (kungazwakala kuphela uma umi noma uhamba).
• Umuzwa ovuvukile nobuhlungu emlenzeni noma engalweni.
• Ukubomvu kwesikhumba noma ukushintsha kombala.
• Imithambo yegazi ngaphansi kwesikhumba ibonakala imikhulu kunokujwayelekile.

Uma unalezi zimpawu ze-`(DVT)`, noma ngabe awukho esibhedlela njengamanje, bona udokotela wakho ngokushesha okukhulu.

Ziyini izimpawu ze-pulmonary embolism (PE)?

Lesi yisimo esiphuthumayo. Izici ze-`(PE)` yilezi:

• Ukuphefumula okunzima ngokuzumayo (ukuphelelwa umoya) noma ukuphefumula ngokushesha.
• Ubuhlungu obukhulu esifubeni (ngokuvamile bube bubi kakhulu uma ukhwehlela noma uhamba).
• Ukuhlungu obusemhlane.
• Ukukhwehlela (ngezinye izikhathi kuba ne-phlegm enombala wegazi).
• Ukujuluka kakhulu kunokujwayelekile.
• Ukushaya kwenhliziyo okusheshayo (i-tachycardia).
• Ukuzizwa unesizungu noma ukuphelelwa yithemba.

Okubalulekile: Uma unalezi zimpawu ze-`(PE)`, kufanele ushayele u-911 noma uye egumbini lezimo eziphuthumayo eliseduze ngokushesha. Lokhu akufanele kubambezeleke.

Yiziphi izimpawu ze-dissembled intravascular coagulation (DIC)?

Izimpawu ze-DIC zingafaka:

• Izinsini eziphuma igazi.
• Ukucanuzela kwenhliziyo kanye/noma ukuhlanza.
• Ubuhlungu obukhulu bemisipha kanye nobuhlungu besisu.
• Ukudlikizela.
• Ukuphuma komchamo okuncane kunokujwayelekile.

Uma usuvele utholakale une-DIC futhi uthola ukwelashwa, udokotela wakho angase akucele ukuhlolwa kwe-D-Dimer njalo ukuze ahlole ukuthi ukwelashwa kwakho kusebenza kahle yini.

Ziyini izimpawu zesifo sohlangothi?

Ukukhubazeka nakho kuyisimo esiphuthumayo. Izimpawu yilezi:

• Ukungazweli noma ubuthakathaka bobuso, ingalo, noma umlenze (ikakhulukazi ohlangothini olulodwa lomzimba).
• Ukudideka okungazelelwe, ubunzima bokukhuluma, noma ubunzima bokuqonda lokho okushiwo othile.
• Ubunzima bokubona ngokuzumayo ngeso elilodwa noma womabili.
• Ubunzima obungazelelwe bokuhamba.
• Ukuzungeza okungazelelwe, ukulahlekelwa ibhalansi, noma ukulahlekelwa ukuhambisana.
• Ikhanda elibuhlungu elivela ngokuzumayo ngaphandle kwesizathu.

Okubaluleke kakhulu: Uma wena noma omunye umuntu eba nalezi zimpawu zesifo sohlangothi , kufanele ushayele u-911 noma uye esibhedlela esiseduze ngokushesha. Isikhathi sibaluleke kakhulu.

Ubani owenza ukuhlolwa kwe-D-Dimer? Kwenziwa kanjani?

Ngokuvamile, udokotela we-phlebotomist wenza ukudonsa igazi, okuhlanganisa nokuhlolwa kwe-D-Dimer. Kodwa-ke, noma yimuphi uchwepheshe wezempilo oqeqeshwe ukudonsa igazi angakwenza. Isampula yakho yegazi ibe isithunyelwa elabhorethri. Lapho, usosayensi welabhorethri yezokwelapha ulungisa isampula bese eyihlola emishinini ebizwa ngokuthi ama-analyzer.

Ingabe kukhona engikudingayo ngaphambi kokuhlolwa?

Cha, awudingi ukwenza noma yini ekhethekile ngaphambi kokuhlolwa kwe-D-Dimer. Ungaphila impilo evamile.

Kwenzekani ngesikhathi sokuhlolwa?

I-D-Dimer ukuhlolwa kwegazi. Ngakho-ke uma uthatha isampula yegazi, nazi izinto ezenzekayo:

• Uzohlala esihlalweni noma ulele embhedeni. Isisebenzi sezempilo sizobe sesibheka izingalo zakho bese sithola umthambo olula wokukhipha igazi kuwo. Ngokuvamile, ungaphakathi kwengalo yakho, ngemuva nje kwendololwane yakho.
• Uma kutholakala umthambo, uyahlanzwa futhi uhlanzwe ngamagciwane.
• Ngemuva kwalokho kufakwa inaliti encane emthanjeni wakho bese kuthathwa isampula yegazi. Lokhu kuzozwakala njengokulunywa yintuthwane encane.
• Ngemva kokufaka inaliti, igazi elincane lizoqongelela epayipini lokuhlola.
• Ngemva kokuthathwa igazi elanele ukuze kuhlolwe, inaliti iyasuswa bese kufakwa ucezu lukakotini noma i-gauze bese lubanjwa ukuze kumiswe ukopha.
• Bese kufakwa iplasta endaweni bese umsebenzi usuphelile.

Le nqubo yonke ivame ukuthatha imizuzu engaphansi kwemihlanu. Ishesha kakhulu.

Kwenzekani ngemva kokuhlolwa?

Ngemva kokuthathwa kwesampula yegazi lakho, lithunyelwa elabhorethri. Uma imiphumela yokuhlolwa isifikile, udokotela wakho uzokutshela imiphumela.

Ingabe zikhona izingozi ngokuhlolwa kwe-D-Dimer?

Ukuhlolwa kwegazi kuyindlela evamile kakhulu futhi edingekayo yokuhlolwa kwezokwelapha. Izingozi zokuhlolwa kwegazi ziphansi kakhulu. Ungase uzizwe ubuhlungu noma ulimale kancane lapho igazi likhishwe khona. Kodwa lokho kuzophela ngokushesha. Ngakho-ke akukho okufanele ukhathazeke ngakho.

Isho ukuthini imiphumela yokuhlolwa kwe-D-Dimer?

Umbiko wokuhlolwa kwegazi, ngisho nombiko wokuhlolwa kwe-D-Dimer, uvame ukuqukethe ulwazi olufana nalolu:

• Igama lokuhlolwa kwegazi, noma lokho okulinganiswe egazini lakho.
• Inombolo noma isilinganiso somphumela wokuhlolwa kwegazi lakho.
• Ububanzi obujwayelekile balolo vivinyo.
• Ulwazi olukhombisa ukuthi umphumela wakho ujwayelekile, awujwayelekile, uphezulu, uphansi, muhle, noma mubi.

Iyini imiphumela evamile ye-D-Dimer?

Kunezindlela ezahlukene zokuhlola amazinga akho e-D-Dimer egazini lakho. Ngakho-ke, akukho luhlu olujwayelekile oluthi "leli izinga elijwayelekile." Umbiko wakho webhulebhu uzofaka ulwazi olubonisa ukuthi izinga lakho le-D-Dimer lijwayelekile, liphansi, liphezulu, lihle, noma libi.

Uma umbiko wakho webhulebhu uthi izinga lakho le-D-Dimer liphansi, libi, noma lijwayelekile , cishe kusho ukuthi awunayo inkinga yokujiya kwegazi.

Uma utholakale une-Disseminated Intravascular Coagulation (DIC) futhi uthola ukwelashwa, izinga elijwayelekile noma eliphansi le-D-Dimer egazini lakho lisho ukuthi ukwelashwa kwakho cishe kusebenza kahle.

Kusho ukuthini ukuthi umphumela we-D-Dimer ephezulu usho ukuthini?

Uma imiphumela yakho ikhombisa ukuthi amazinga akho e-D-Dimer egazini aphakeme kunokuvamile , kungasho ukuthi unesifo sokujiya kwegazi. Kodwa-ke, njengoba ngishilo ekuqaleni, ukuhlolwa kwe-D-Dimer kukodwa akukwazi ukukutshela kahle ukuthi yisiphi isimo sokujiya kwegazi ongase ube naso noma ukuthi amajikijolo egazi akuphi emzimbeni wakho.

Uma utholakale une-Disseminated Intravascular Coagulation (DIC) futhi uthola ukwelashwa, izinga eliphezulu le-D-Dimer egazini lakho lingasho ukuthi ukwelashwa kwakho akusebenzanga kahle.

Kodwa-ke, kunezimo lapho amazinga e-D-Dimer angakhuphuka khona ngisho nangaphandle kwesifo sokujiya kwegazi. Ezinye izizathu ezenza amazinga e-D-Dimer abe phezulu kunokuvamile zifaka:

• Ukukhulelwa.
• Isifo senhliziyo.
• Ukuhlinzwa kwamuva nje.
• Ingozi noma ukulimala emzimbeni (ukuhlukumezeka).
• Ukutheleleka.

Futhi, amazinga e-D-Dimer avame ukwanda njengoba ukhula. Uma unesifo esifana ne-rheumatoid arthritis, ungathola imiphumela engalungile.

Ngakho-ke, uma imiphumela yakho ibonisa ukuthi amazinga akho e-D-Dimer awajwayelekile, udokotela wakho cishe uzoyala ukuhlolwa kwegazi okwengeziwe kanye/noma ukuhlolwa kwezithombe ukuze kutholakale ukuthi une-HIV.

Ngizoyazi nini imiphumela yokuhlolwa kwe-D-Dimer?

Odokotela bavame uku-oda ukuhlolwa kwe-D-Dimer ezimweni eziphuthumayo, ngoba amahlule egazi angaba yingozi empilweni. Uma wenza lokhu kuhlolwa esimeni esiphuthumayo, udokotela wakho cishe uzothola imiphumela zingakapheli amahora ambalwa.

Uma une-D-Dimer test ukuze ubone ukuthi ukwelashwa kwakho kusebenza kahle kangakanani ngenkathi welashwa ngesimo sokujiya kwegazi, cishe uzothola imiphumela zingakapheli izinsuku ezimbili zebhizinisi.

Kwenzekani ngokulandelayo? Uma imiphumela ingajwayelekile...

Uma imiphumela yakho yokuhlolwa kwe-D-Dimer ingajwayelekile, udokotela wakho angase akucele ukuhlolwa okukodwa noma ngaphezulu kwezithombe ukuze anqume ukuthi unesifo sokujiya kwegazi futhi, uma kunjalo, ukuthi amahlule akuphi. Lokhu kuhlolwa kufaka phakathi:

• I-Doppler ultrasound: Lokhu kusebenzisa amaza omsindo ukudala izithombe zemithambo yakho (imithambo yegazi).
• I-computed tomography (CT) angiography: Kulolu vivinyo, udokotela ufaka idayi ekhethekile komunye wemithambo yakho. Lokhu kwenza imithambo yegazi yakho ibonakale emshinini we-X-ray okhethekile.
• Ukuskena komoya wokungenisa umoya emaphashini (V/Q): Lokhu kuhilela ukuskena komoya wokungenisa umoya (V), okulinganisa ukuthi umoya ugeleza kanjani emaphashini akho, kanye nokuskena komoya wokungenisa umoya (Q), okubheka ukuthi igazi ligeleza kuphi emaphashini akho. Kuzo zombili iziskena, inani elincane lezinto eziyingozi ezisebenzisa imisebe liyasetshenziswa ukusiza isiskena sibone ukuthi umoya negazi kuhamba kahle kangakanani emaphashini akho.

Kufanele ngimbone nini udokotela?

Uma unezimpawu zesifo sohlangothi noma i-pulmonary embolism (PE), shayela u-911 ngokushesha noma uye egumbini lezimo eziphuthumayo eliseduze. Ungalibali.

Uma unezimpawu zokuqhekeka kwegazi emthanjeni ojulile (i-Deep Vein Thrombosis - DVT), bona udokotela wakho ngokushesha okukhulu.

Yiziphi izici ezibangela ukuqhekeka kwegazi?

Izici eziyingozi ezingaba nomthelela ekwakhekeni kwe-blood clot okungalungile noma okungavamile zifaka:

• Ukuhlinzwa okukhulu noma ukulimala okukhulu ngokomzimba (ukuhlukumezeka).
• Ukuhlala endaweni eyodwa isikhathi eside (isibonelo, ukuhlala ohambweni olude, noma ukuhlala embhedeni isikhathi eside).
• Ukuthatha amaphilisi okuvimbela inzalo noma ukwelashwa kokufaka esikhundleni sama-hormone.
• Ukukhulelwa noma ukubeletha kwakamuva.
• Ukuba nomlando womndeni wokujiya kwegazi, noma ukuba nesimo esithile sezokwelapha njengesifo se-Factor V Leiden, i-Antiphospholipid syndrome, noma i-Polycythemia vera.
• Ukuba nohlobo oluthile lomdlavuza.
• Ukuqubuka kwesifo seCoronavirus sika-2019 (i-COVID-19).
• Ukuba nokukhuluphala ngokweqile.
• Ukubhema.

Okokugcina, izinto okufanele uzikhumbule (Umyalezo Wokuya Ekhaya)

Kuvamile ukuzizwa wesaba futhi ukhathazekile uma uthola umphumela wokuhlolwa ongajwayelekile. Kodwa khumbula, umphumela wokuhlolwa we-D-Dimer ophakeme akusho ukuthi unesifo sokujiya kwegazi. Uma imiphumela yakho ibonisa ukuthi izinga lakho le-D-Dimer liphezulu, udokotela wakho cishe uzoyala ukuhlolwa okwengeziwe ukuze athole ukuxilongwa.

Uma unemibuzo, ungesabi ukubuza udokotela wakho. Odokotela bakhona ukuzokusiza. Bazokuchazela konke.

Ngiyethemba ukuthi lolu lwazi luwusizo kuwe. Hlala uphilile!

I- D-Dimer, ukujiya kwegazi, ukuhlolwa kwegazi, i-DVT, i-PE, i-Stroke, i-DIC, ukujiya kwegazi