Coagulogram ke ea eng mme e etsoa joang?

Litaba

• E etselitsoe eng
• E etsoa joang
• Liteko tsa Coagulogram
• 1. Nako ea ho tsoa mali (TS)
• 2.Nako ea Prothrombin (TP)
• 3.E butswe Karolo ea Thromboplastin Nako (APTT)
• Nako ea Thrombin (TT)
• 5. Bongata ba liplatelete

Coagulogram e tsamaellana le sehlopha sa liteko tsa mali tse kopiloeng ke ngaka ho lekola ts'ebetso ea ho koala mali, ho supa liphetoho life kapa life mme ka hona e bonts'a kalafo ea motho eo ho qoba mathata.

Teko ena e kopuoa haholo-holo pele ho ts'ebetso ea bongaka ho lekola kotsi ea mokuli ea ho tsoa mali nakong ea ts'ebetso, mohlala, mme e kenyelletsa nako ea ho tsoa mali, nako ea prothrombin, nako ea thromboplastin e sa sebetseng, nako ea thrombin le tlhahlobo ea palo ea liplatelete.

E etselitsoe eng

Coagulogram e bontšoa haholo pele ho ts'ebetso, empa e ka kopuoa hape ke ngaka ho fuputsa sesosa sa mafu a hematological le ho lekola kotsi ea thrombosis, haholo ho basali ba sebelisang lithibela-pelehi.

Ntle le moo, coagulogram e bonts'oa kamora ho longoa ke phoofolo e nang le chefo e ka kenang ts'ebetsong ea coagulation le ho beheng leihlo batho ba sebelisang li-anticoagulants, joalo ka Heparin le Warfarin. Tseba li-anticoagulants tse ling le hore na li bontšoa neng.

E etsoa joang

Coagulogram e tlameha ho etsoa le motho ea itima lijo lihora tse 2 ho isa ho tse 4 mme e na le pokello ea sampole ea mali e romeloang ho ea hlahlojoa, ntle le Nako ea ho Tšolla Mali (TS), e etsoang hona moo mme e na le ho shebella. nako ya ho tsoa madi ho emisa.

Ho bohlokoa hore pele tlhahlobo e etsoa, ​​ts'ebeliso ea lithethefatsi tsa anticoagulant ea tsebisoa, hobane e ka kena-kenana le sephetho kapa ea tsotelloa ha ho hlahlojoa, mohlala. Kahoo, ho bohlokoa ho fumana tataiso ho ngaka mabapi le ho emisoa ha ts'ebeliso ea lithethefatsi pele o etsa coagulogram.

Liteko tsa Coagulogram

Coagulogram e na le liteko tse ling tse lekolang boteng ba lintlha tsohle tse amehang ho hoamisa mali, ka hona, heestasis, e lumellanang le lits'ebetso tse etsahalang kahare ho methapo ea mali tse ikemiselitseng ho boloka mokelikeli oa mali molemong oa ho qoba popelo kapa ho tsoa madi. Utloisisa tsohle ka heestasis.

Litlhahlobo tsa mantlha tse teng ho coagulogram ke:

1. Nako ea ho tsoa mali (TS)

Hangata tlhatlhobo ena e kopuoa e le mokhoa oa ho tlatselletsa litlhahlobo tse ling mme ho bohlokoa ho bona phetoho efe kapa efe liplatelete mme e etsoa ka ho etsa lesoba le lenyenyane tsebeng, le lumellanang le mokhoa oa Duke, kapa ka ho seha letsoho le bitsoang mokhoa oa Ivy, ebe re bala nako eo mali a khaotsang ka eona.

Ho etsa mokhoa oa Ivy, khatello e sebelisoa letsohong la mokuli ebe ho etsoa leqeba le lenyane sebakeng seo. Tabeng ea mokhoa oa Duke, lesoba le tsebeng le entsoe ka lancet kapa pene e lahloang. Maemong ana ka bobeli, ho tsoa mali ho hlahlojoa metsotsoana e meng le e meng e 30 ho sebelisoa pampiri e sefang, e monyang mali setšeng. Teko e fela ha pampiri e sefa e se e sa monya mali.

Ka sephetho sa TS, ho a khonahala ho hlahloba hemostasis le ho ba teng kapa ho ba sieo ha von Willebrand factor, e leng ntho e teng liplateletseng tse nang le karolo ea bohlokoa ts'ebetsong ea ho koala mali.Le ha tlhahlobo ena e le molemo ho fumaneng liphetoho ho hemostasis, e ka baka pherekano haholoholo ho bana, joalo ka ha tlhahlobo e ka etsoa ka ho phunya lesoba tsebeng.

Tsela ea ho utloisisa sephetho: Kamora ho cheka sekoti, ngaka kapa setsebi se ikarabellang bakeng sa tlhahlobo se bala nako eo mali a hoamanang le ho lekola ka pampiri ea sefa e monyang mali sebakeng seo. Ha pampiri e sefa e se e sa monya mali, tlhahlobo e emisoa. Haeba tlhahlobo e entsoe ka mokhoa oa Ivy, e leng letsoho, nako e tloaelehileng ea ho tsoa mali e pakeng tsa metsotso e 6 le 9. Tabeng ea mokhoa oa Duke, e leng oa tsebe, nako e tloaelehileng ea ho tsoa mali e pakeng tsa metsotso e 1 le 3.

Ha nako e le telele ho feta nako ea ts'upiso, ho thoe tekong e atolositsoeng ea TS, ho bonts'a hore ts'ebetso ea ho hoama e nkile nako e teletsana ho feta e tloaelehileng, e kanna ea supa lefu la von Willebrand, ts'ebeliso ea lithethefatsi tsa anticoagulant kapa thrombocytopenia, mohlala. Tseba lisosa tse kholo tsa thrombocytopenia.

2.Nako ea Prothrombin (TP)

Prothrombin, eo hape e tsejoang e le Coagulation Factor II, ke protheine e ts'oaroang nakong ea ts'ebetso ea coagulation mme mosebetsi oa eona ke ho khothaletsa phetoho ea fibrinogen ka fibrin, ho theha polaka ea bobeli kapa e hlakileng ea platelet.

Teko ena e ikemiselitse ho netefatsa tšebetso ea tsela ea `` coagulation '' e tsoang kantle ho naha, hobane e na le tekolo ea nako eo mali a e nkang ho theha buffer ea bobeli kamora ho pepesetsoa ke calcium thromboplastin, e leng reagent e sebelisitsoeng tekong.

Tsela ea ho utloisisa sephetho: Tlas'a maemo a tloaelehileng, kamora ho kopana le mali le calcium thromboplastin, tsela ea extrinsic ea ts'oaroa, ka ts'ebetso ea lintlha tsa VII le X tsa coagulation mme, ka lebaka leo, factor II, e leng prothrombin, e khothalletsang phetoho ea Fibrinogen ho Fibrin, e emisa ho tsoa mali. Ts'ebetso ena hangata e nka pakeng tsa metsotsoana e 10 ho isa ho e 14.

Leha ho le joalo, maemong a mang coagulogram e lemoha PT e holisitsoeng, ho bolelang hore ts'ebetso ea prothrombin e etsahala ka nako e telele ho feta e tloaelehileng. Litekanyetso tse eketsehileng tsa PT hangata li etsahala ha li-anticoagulants li sebelisoa, khaello ea vithamine K, khaello ea factor VII le mathata a sebete, mohlala, kaha prothrombin e hlahisoa sebeteng.

Maemong a sa tloaelehang, PT e ka fokotseha, joalo ka ts'ebetsong ea tšebeliso ea livithamine K kapa lipilisi tsa thibelo ea bokhachane le estrogen. Utloisisa ho eketsehileng ka sephetho sa teko ea Prothrombin Time.

3.E butswe Karolo ea Thromboplastin Nako (APTT)

Teko ena e boetse e sebelisetsoa ho lekola hemostasis, leha ho le joalo e lumella ho ba teng kapa ho ba sieo ha lintlha tsa coagulation tse teng tseleng e kahare ea phallo ea coagulation ho netefatsoa.

Hangata APTT e bohlokoa ho lekola bakuli ba sebelisang Heparin, e leng anticoagulant, kapa ba nang le mathata ka ho koala mali, ho ba molemo ho khetholla liphetoho tse amanang le lintho tse hoamisa.

Tekong ena, sampole ea mali a bokelletsoeng e pepesetsoa li-reagents, ebe ho latela nako eo e e nkang hore mali a koalehe.

Tsela ea ho utloisisa sephetho: Tlas'a maemo a tloaelehileng, APTT ke metsotsoana e 21 ho isa ho e 32. Leha ho le joalo, ha motho a sebelisa li-anticoagulants, joalo ka heparin, kapa a haelloa ke lintlha tse itseng tsa tsela e kahare, joalo ka lintlha tsa XII, XI kapa VIII le IX, tse supang haemophilia, nako hangata e telele ho feta nako ea ts'upiso ., ho bonts'oa tlhahlobong ea hore APTT e atolositsoe.

Nako ea Thrombin (TT)

Nako ea thrombin e tsamaellana le nako e hlokahalang ea hore leqhoa le thehoe kamora ho eketsoa ha thrombin, e leng eona ntho e hlokahalang ea ho koala bakeng sa ts'ebetso ea fibrinogen ka fibrin, e netefatsang botsitso ba lehloa.

Teko ena e hlokolosi haholo 'me e etsoa ka ho eketsa thrombin maemong a tlase maling a mali, nako ea ho honyela e susumetsoa ke palo ea fibrinogen e teng lero la mali.

Tsela ea ho utloisisa sephetho: Ka tloaelo kamora ho kenyelletsoa ha thrombin le lero la mali, lera le hlaha pakeng tsa metsotsoana e 14 le 21, hona ho nkuoa e le boleng ba litšupiso, bo ka fapana ho latela laboratori eo tlhahlobo e etsoang ho eona.

TT e nkuoa e le telele ha motho a sebelisa li-anticoagulants, a hlahisa lihlahisoa tsa ho senyeha ha fibrin, a na le factor XIII kapa khaello ea fibrinogen, mohlala.

5. Bongata ba liplatelete

Liplatelete ke likhechana tsa lisele tse teng maling tse phethang karolo ea bohlokoa ho hemostasis, hobane li na le lintlha tsa bohlokoa molemong oa ho koala, joalo ka von Willebrand factor.

Ha ho na le leqeba la lisele, liplatelete li ea kapele moo ho nang le kotsi, ka sepheo sa ho thusa ts'ebetsong ea mali. Li-platelet tse sebelisitsoeng li ikamahanya le endothelium ea sekepe se lemetseng ka lebaka la von Willebrand factor ebe ba fetola sebopeho sa eona le ho lokolla lintho ho li-plasma ho bokella liplatelete tse ngata sebakeng sa kotsi mme ka hona ba theha polaka ea mantlha ea platelet.

Kahoo, ho hlahloba palo ea liplatelete ho bohlokoa ho coagulogram kaha e lumella ngaka ho tseba hore na ho na le phetoho ts'ebetsong ea heestasis ea mantlha, e khothaletsa kalafo e ikhethileng.

Tsela ea ho utloisisa sephetho: Palo e tloaelehileng ea liplatelete maling e pakeng tsa 150000 le 450000 / mm³. Litekanyetso tse tlase ho boleng ba litšupiso li bonts'itsoe tlhahlobong e le thrombocytopenia, e bonts'ang hore ho na le lipalo tsa mali tse potolohang tse fokolang, tse ka lebisang mathateng a ho koala mali, a ratang ho tsoa mali, ntle le ho khona ho bonts'a khaello ea phepo e nepahetseng, liphetoho masapong mohlala, moko kapa tšoaetso.

Melao ea boitšoaro e kaholimo ho moo ho buuoang ka eona e bitsoa thrombocytosis, e ka fella ka coagulation e fetelletseng, e ka etsahalang ka lebaka la mekhoa ea bophelo, joalo ka ho tsuba kapa joala, ka mohlala, kapa ka lebaka la maemo a kulisang, joalo ka khaello ea mali ea anemia, lefu la myeloproliferative le leukemia , ka mohlala. Ithute ka lisosa tse ling tsa kholo ea platelet.