Hemostasis - yog dab tsi? ua txhaum ntawm hemostasis

Muaj ntau ntawm peb yuav tsum tau muab mus soj ntsuam rau hemostasis. Yuav ua li cas yog nws thiab yog vim li cas koj yuav tau mus xyuas nws? Lo lus teb rau lo lus nug no yuav tsum pib nrog ib tug piav qhia seb peb circulatory system thiab dab tsi mechanisms yog ua tau hauj lwm nyob rau hauv nws.

Tus thawj muaj nuj nqi ntawm hemostasis

Ob peb cov neeg paub hais tias peb cov ntshav - nws tseem yog ib cov ntaub, tsuas ua kua. Nws muaj ntshav, nws yog cov cuab yeej ntawm cov kua caij, raws li zoo raws li cov ntshav liab, qe ntshav dawb thiab platelets, uas yog nyob rau hauv cov ntshav raws li nws raug tshem tawm. Tag nrho cov no tsis tu ncua txav raws loj thiab me me cov hlab ntsha, cov leeg thiab cov hlab ntsha nqa oxygen mus rau lub hlwb, lub hwj chim thiab kev ua tau zoo ib tug tswv tsev ntawm lwm yam kev khiav dej num. Xws li ib tug yooj yim to taub qauv ntawm peb circulatory system. Nws yog ib qho tseem ceeb hais tias cov ntshav yog txoj cai taub hau. Yog hais tias nws yog heev tuab, ntshav txhaws yog tsim. Conversely, yog hais ib yam nkaus thiab nyias nyias, tus neeg suffers los ntawm ntau los ntshav. Nws yuav ua rau peb cov ntshav nyob rau hauv zoo mob uas tsim los ntawm qhov xwm ntawm tus system, lub npe hu ua hemostasis. Yuav ua li cas hom ntawm system thiab dab tsi yog qhov mechanism ntawm nws cov hauj lwm?

Qhov thib ob muaj nuj nqi ntawm hemostasis

hemostatic system yog heev. Nyob rau hauv tas li ntawd mus tswj ib yam ntshav viscosity thiab fluidity, nws muab ib tug mob kho tau (siv ceev xwmphem los ntshav) rau tej qhov nqaij ntuag thiab lwm yam vascular raug mob. Cov phab ntsa ntawm lub yav tas yog tsim los ntawm cov peb khaubncaws sab nraud povtseg ntawm cov ntaub so ntswg, txhua tus uas ua ib tug luag hauj lwm los xyuas kom meej du tso cai ntawm lub ntshav los ntawm lub cev. Yog hais tias yog vim li cas, lub sam xeeb ntawm cov hlab phab ntsa yog tawg thiab ntshav rushes mus rau hauv cov kis, thiab ib tug txiv neej yuav qhib lub qhov los ntshav. Yuav kom tiv thaiv nws ua lub cev system ntawm cov ntshav coagulation, los yog hemostasis. Nws yog ntawm ob hom - thawj thiab.

Primary hemostasis: nws

Qhov no zoo ntawm tas los ntshav yog hu ua vascular-platelet hemostasis. Lub mechanism ntawm nws cov hauj lwm muaj nyob rau hauv yuav ua spasm ntawm lub puas txog ntsha, nws narrowing thiab txhaws "qhov khoob" platelets. Lub puas feem yog tsim ua kiav txhab, los ntshav nres. Cov neeg hais tias, "cov ntshav clotted." Rau cov neeg uas tsis muaj teeb meem nrog hemostasis, cov txheej txheem yuav siv sij hawm mus txog rau 3 feeb. Nws mechanism ntawm qhov kev txiav txim yog raws li nram no. Nyob rau cov phab ntsa hauv cov hlab nyob ze ntawm lub qhov txhab pib adhesion, piv txwv li deposition, adhesion ntawm platelets. Lawv zoo yuav ntau sib npaug, thiab nyob rau ntawm qhov chaw ntawm lub spikes tshwm sim thiab dab uas muab ib tug muaj zog daim ntawv cog lus nrog lwm yam platelets. Cov no ib tug tsevneeg lawv ua ke (aggregation), thiab yog tsim ntawm platelet plug. Nyob rau hauv 1 ml ntawm cov ntshav yuav tsum tau los ntawm 150 mus rau 300 txhiab noj qab nyob zoo platelet tseeb daim ntawv no. Txwv tsis pub txhaws txheej txheem yog disrupted.

Yuav ua li cas yog ob hemostasis

Glued platelets pib paim mus rau hauv cov ntshav active lom thiab tshuaj tshuaj yuav ua tau rau constriction ntawm cov hlab phab ntsa thiab lub tsim ntawm theem nrab irreversible tsevneeg. Ib txhij nrog platelet tau sawv tawm lub tseem ceeb tshaj plaws rau lub txhaws enzyme thrombin, uas nyob rau hauv lem muaj feem xyuam rau cov tsim ntawm fibrin protein. Lub fibers ntawm cov protein yog lub hauv paus ntawm ib tug ntshav los khov rau ntawd. Lawv tsim ib tug tsi ntawm network nyob rau hauv uas lub hma liab ntshav thiab ntshav dawb. Fibrin muab los ntawm lwm protein - fibrinogen. Yuav kom txiav txim rau qhov nyiaj ntawm cov ntshav, pub yus cov ntshav hemostasis. Yuav ua li cas yog nws - fibrinogen - thiab dab tsi yog nws tseem ceeb? Qhov no protein plays ib tug tseem ceeb luag hauj lwm nyob rau hauv cov ntshav txhaws. Nws tshaj ua thrombosis, thiab tsis muaj - hemorrhage. Cai yog los ntawm 1.5 mus 3.0 g / l fibrinogen. Yog hais tias nws yog ntau tshaj li 4.5 g / l, tej zaum yuav muaj ib tug tib neeg cov kab mob xws li kab mob ntsws, mob stroke, plawv nres, mob cancer, mob ntsws, kab mob khaub thuas, thiab ib tug xov tooj ntawm lwm yam tej yam kev mob, nrog rau mob loj heev kev kub nyhiab, kev phais, kev siv ntawm tej yam tshuaj. Tus nqi ntawm cov protein tsawg kawg yog 1.5 g / l ua mob npuas paug, DIC, kab mob siab, myeloid leukemia, toxemia, phais plab seem ntawm tus me nyuam, polycythemia, nab tom, B12 deficiency thiab vitamin C.

Qhov thib peb muaj nuj nqi ntawm hemostasis

Cov theem kawg ntawm lub qhov txhab kho - fibrinolysis, uas yog tseem lub luag hauj lwm rau hemostasis. Yuav ua li cas yog nws? Fibrinolysis yog kev puas tsuaj ntawm cov plugging ntshav los khov rau ntawd thiab restore ntshav txaus rau puas cov hlab ntsha. Los ntawm cov thawj vib nas this ntawm lub qhov txhab tom qab txheej txheem thiab pib ntawm ntshav nyob rau hauv ntshav tshuab txais enzyme plasminogen. Nws ua ib tug protein plasmin cleaving fibrin, thiab nrog nws, thiab ntshav los khov rau ntawd. Ntawm thrombus tsim thiab xaus yuav tsum muaj ib qhov nqi koj tshuav, uas muab hemostasis. Raws li koj tau pom, qhov no system yog heev tham. Tsis ua hauj lwm txawm nyob rau hauv qhov tsawg tshaj plaws ntawm nws cov link ua rau muaj kev cuam tshuam ntawm cov tag nrho lub saw thiab loj cov kab mob.

Kev ua txhaum ntawm hemostasis. Yuav ua li cas yog nws thiab yuav ua li cas qhia hais tias

Muaj cov nram qab no ua txhaum cai:

- nce ntshav (hypercoagulable) uas ua rau yus lub txawj tsim ntawm thrombi nyob rau hauv cov hlab ntsha, cov leeg, thiab hauv nruab nrog cev. Nws yog fraught nrog loj tej yam kev mob xws li mob stroke nyob rau ntawm ib thaum ntxov lub hnub nyoog, nquag ncuav me nyuam tau nyob rau hauv cov poj niam, lub hlwb tus kab mob (los ntawm thrombosis nyob rau hauv cov hlab ntsha ntawm lub paj hlwb), thiab lwm tus neeg.

- Txo ntshav (hypocoagulation), uas ua rau yus txawj los ntshav. Nws tshwm sim nyob rau hauv hemophilia, von Willebrand kab mob, ntshav platelet tsis muaj peev xwm los yog pathological kev hloov, daim siab tus kab mob, tsis txaus txhaws yam thrombocytopathia.

- DIC, nyob rau hauv uas muaj ob hom ntawm coagulation.

Yuav kom txiav txim qhov ua rau ntawm kev txawv txav nyob rau hauv cov ntshav txhaws, siv hemostasiogram (coagulation), los yog hemostasis tsom xam. Yuav ua li cas yog nws? Qhov no tsom xam yog tau rau cev xeeb tub cov poj niam, cov neeg mob ua ntej phais, cov neeg txom nyem los ntawm cov kab mob ntawm lub plawv thiab cov hlab ntsha, raws li zoo raws li cov neeg mob uas txawv txav ntawm cov ntshav txhaws. Coagulation yog puag, uas txiav txim hematocrit, hemoglobin, tus xov tooj ntawm tag nrho cov ntshav yam thiab ib tug xov tooj ntawm lwm yam kev ntsuas. Qhov thib ob hom ntawm coagulation - ncua, kom taw mas cov neeg uas muaj ntshav txawv txav thiab cev xeeb tub.

Hormonal hemostasis raws li ib tug txoj kev ntawm kev kho mob

Ib txhia poj niam muaj coj khaub irregularities, ua rau hnyav heev los ntshav. Yuav kom daws tau qhov teeb meem no, siv ib tug hormonal hemostasis. Yuav ua li cas yog nws? Cov qauv no yog thov rau cov kev kho mob ntawm cov tub ntxhais cov poj niam, uas yog cais cov kab mob xws li fibroids, ntawm zes qe menyuam hlav, endometriosis. Muaj peb txoj kev hormonal hemostasis - cov tshuaj no, progestin thiab mixed. Estrogen yog tshuaj tshuaj intramuscularly. Thawj ob los yog peb hnub lawv ua txhua txhua 2.5-3 lub sij hawm. Nyob rau hauv lub nram qab no hnub, lub koob tshuaj yog poob. Tom qab siv ceev xwmphem qhov los ntshav yog hloov los ntawm estrogens thiab progestins rau kev kho nrog hormonal agents. Progestogen txoj kev yog siv thaum tus neeg mob tsis muaj ntshav liab txaus, decompensated mob npuas paug. Nws lub hom phiaj - tsim ib theem ntawm cov tshuaj hormones nyob rau hauv uas lub dag zog yuam yog tsis lees txais endotherm carpeted uterine kab noj hniav. Yog sib npaug rau cov qauv no yuav tau mus thov hCG hemostasis siv gonadotropin.

Hemostasis thaum lub sij hawm cev xeeb tub

Cev xeeb tub ua rau ntau cov kev hloov nyob rau hauv ib tug poj niam lub cev. Ib tug ntawm lawv - nce nyob rau hauv lub xov tooj ntawm platelets thiab, raws li ib tug tshwm sim, lub viscosity ntawm cov ntshav. Qhov no yog ib qho physiological txheej txheem, tshwm sim los ntawm cov kev npaj rau lub yavtom ntej kab genera. Txawm li cas los, Yog hais tias ntau dhau heev lawm yog tsim platelets, ib tug yuav hais lus ntawm thrombophilia, ib tug mob uas ua rau yus mus rau tsim ntawm txhaws nyob rau hauv cov hlab ntsha. Thrombophilia yog txiav ntawm cev xeeb tub, me nyuam hauv plab kev loj hlob ruamqauj, toxemia thiab lwm yam teeb meem. Nws yog yog li ntawd kiag li tsim nyog los ua kev ntsuam xyuas rau hemostasis thaum lub sij hawm cev xeeb tub. Qhov no txhais li cas thiab thaum peb yuav tsum tau ua li cas? Qhov tseeb tiag mas, yog hais tias qhov kev soj ntsuam tuav ua ntej conception los mus tiv thaiv cov teeb meem ntawm nqa ib tug me nyuam. Qhov no tsom xam yog nqa tawm mus rau 14 ntsiab lus, thiab muab ib tug muaj tseeb duab ntawm lub xeev ntawm cov ntshav. Yog hais tias lub kuaj abnormality, tus kws kho mob yuav muab tshuaj rau cov tshuaj. Tab sis qhov no yog tsis tsim nyog. Tej zaum nws yog txaus kev soj xyuas tus muaj zog ntawm qhov hloov tus nqi.