Y Hypercoagulation Syndrome yog ib hom kab mob uas cuam tshuam rau cov ntshav txhaws. Tus kab mob tuaj yeem ua rau muaj kev ywj pheej lossis tsim tawm tsam keeb kwm yav dhau los ntawm concomitant defects. Feem ntau, tus kab mob yog nrog los ntawm ib tug neeg txoj kev nyiam ua cov ntshav txhaws. Nyob rau tib lub sijhawm, cov pob txha tsim yog xoob hauv nws cov qauv thiab tsis muaj elasticity.
Qee cov ntaub ntawv
Teeb meem nrog ntshav txhaws (coagulopathy) tuaj yeem yog ob qho tib si kab mob thiab lub cev. Tib neeg cov ntshav yog tsim los ntawm ntau hom kev tsim, nrog rau cov khoom ua kua. Raws li ib txwm muaj, cov kua dej muaj pes tsawg leeg yog sib npaug thiab muaj qhov sib piv ntawm hematocrit ntawm 4: 6 hauv kev pom zoo ntawm cov ntshav plasma. Yog tias qhov piv txwv no hloov mus rau cov khoom tsim, muaj cov ntshav thickening. Qhov tshwm sim no tuaj yeem yog vim qhov nce ntawm qhov ntim ntawm fibrinogen thiab prothrombin.
ntshav txhaws yog ib hom kev qhia ntawm lub cev cov lus teb rau cov ntshav tawm. Nrog rau kev raug mob tsawg kawg nkaus rau cov hlab ntsha, cov ntshav txhaws hauv cov ntshav, uas tau nrestxheej txheem dej ntws. Lub clotting Performance index tsis tas li thiab feem ntau yog nyob ntawm qhov xwm txheej ntawm lub cev. Hauv lwm lo lus, nws tuaj yeem hloov pauv mus thoob lub neej.
Ntse
Nyob rau hauv lub xeev ib txwm, los ntshav tom qab 3-4 feeb, thiab tom qab li 10-15 feeb cov ntshav txhaws tshwm sim. Yog tias qhov no tshwm sim ntau zaus, koj tuaj yeem xav tias muaj hypercoagulation syndrome. Raws li ICD-10, cov kab mob no tau muab rau tus lej D65.
Tus mob no suav tias yog qhov txaus ntshai heev vim tias nws tuaj yeem ua rau cov hlab ntsha varicose, thrombosis, mob stroke, plawv nres thiab lwm yam kev puas tsuaj rau lub cev. Vim cov ntshav tuab dhau lawm, lub cev tau ntsib qhov tsis muaj oxygen, tiv thaiv qhov kev mob tshwm sim thiab kev ua haujlwm tsis zoo. Tsis tas li ntawd, qhov tshwm sim ntawm cov ntshav txhaws nce ntau.
ICD-10 code rau hypercoagulation syndrome - D65.
Kev tshwm sim
Raws li kev ntsuas kev kho mob, kev kis mob ntawm tus kab mob no nce mus txog 5-10 tus neeg rau 100 txhiab tus neeg. Txoj kev loj hlob ntawm pathology nyob rau hauv ib ntus tsis tu ncua yog cuam tshuam nrog kev pheej hmoo siab ntawm tus kab mob.
Kev ua txhaum cai tshwm sim tawm tsam keeb kwm yav dhau los ntawm qhov tau txais thiab qhov txawv txav hauv lub cev. Feem ntau, nws yog qhov tseeb vim yog kev mob sab nraud: txhua yam kab mob, kev tswj tsis tau cov tshuaj muaj zog, tsis muaj cov kab mob thiab cov vitamins, tsis ua raws li kev haus dej haus cawv thiab ntau yam.
Yog vim li casPathology
Hypercoagulation syndrome feem ntau tsis muaj cov tsos mob tshwm sim. Feem ntau, cov neeg mob yws yws ntawm cov mob migraine nquag, nkees nkees, lethargy.
Cov kws kho mob pom zoo faib cov kab mob ua rau lub hauv paus thiab kis tau.
qeb kawg suav nrog:
- tus cwj pwm phem;
- rog thiab phaus ntxiv;
- hnub nyoog hloov pauv;
- xeeb tub;
- noj tshuaj tiv thaiv qhov ncauj;
- Yhormone replacement therapy;
- siab ntau cov roj cholesterol hauv cov ntshav;
- kev cuam tshuam kev phais, lossis theej, lub txaj ntev so tom qab lawv;
- ua kom tsis muaj zog lub cev;
- lub cev qhuav dej hnyav;
- hnyav hlau lom;
- hypothermia;
- microbial invasions;
- tshuaj thiab thermal hlawv;
- tsis muaj Omega-3 fatty acids.
Raws li qhov ua rau yug me nyuam, cov no suav nrog kev nchuav menyuam uas tsis tau piav qhia, tsev neeg keeb kwm ntawm thrombophilia, ntshav txhaws ua ntej hnub nyoog 40.
Lwm yam yuav tsum tau ua ua ntej rau kev txhim kho
Hypercoagulation syndrome feem ntau muaj tus cwj pwm innate, tab sis nws tuaj yeem txhim kho zoo tiv thaiv keeb kwm yav dhau los ntawm cov xwm txheej sab nraud. Muaj ntau ntau yam uas qhov tsos mob ntawm tus kab mob tsis suav nrog:
- protracted neurosis thiab kev ntxhov siab;
- vascular puas;
- oncology;
- erythremia;
- antiphospholipidSyndrome;
- kab mob zoo;
- plasma tiv tauj nrog txawv teb chaws;
- hematogenous thrombophilia;
- impressive hemangiomas;
- postpartum thiab cev xeeb tub;
- kab mob autoimmune - lupus erythematosus, aplastic anemia, thrombocytopenic purpura;
- atherosclerosis ntawm coronary hlab ntsha;
- ntshav los ntawm plab hnyuv;
- siv cov tshuaj estrogen rau menopausal;
- siv tshuaj tiv thaiv yug menyuam;
- synthetic plawv valve thiab hemodialysis.
Pathology tuaj yeem tshwm sim los ntawm ntau yam hauv ib zaug. Kev kho mob ntawm hypercoagulable syndrome feem ntau nyob ntawm qhov ua rau nws tshwm sim.
Risk Factor
Muaj qee yam mob uas ua rau mob los ntshav. Pathology tuaj yeem tshwm sim los ntawm ntau yam mob:
- Tsis muaj dej, lub cev qhuav dej. Ntshav yog kwv yees li 85% kua, thaum ntshav ntshav yog 90%. Txo cov ntsuas no entails ib tug logical thickening. Nws yog ib qho tsim nyog yuav tau xyuam xim tshwj xeeb rau kev haus dej haus cawv hauv lub caij sov. Nws yog ib qho tseem ceeb heev uas yuav tsum tau ntxiv cov dej tseg thaum lub cev tawm dag zog.
- Fermentopathy yog ib yam kab mob uas cuam tshuam nrog kev tsis muaj enzymes zaub mov lossis ua txhaum ntawm lawv txoj haujlwm. Qhov mob no ua rau cov zaub mov tsis tuaj yeem tawg tag, tso cov khoom pov tseg uas tsis tau ua tiav nkag mus rau hauv cov hlab ntsha, ua rau cov zaub mov tuab.
- khoom noj tsis zoo. Ntau cov khoom noj muaj cov protein tshwj xeeb inhibitors uas tsim cov tebchaw nrog cov proteinases hauv cov hnyuv. Qhov no ua rau kev ua haujlwm tsis zoo hauv kev zom zaub mov thiab nqus cov protein. Cov amino acids nyoos raug xa mus rau hauv cov hlab ntsha thiab cuam tshuam nrog nws cov ntshav txhaws. Pathology tej zaum yuav yog vim overeating ntawm carbohydrates, qab zib thiab fructose.
- Tsis muaj cov zaub mov thiab cov vitamins. Cov dej-soluble vitamins yog tsim nyog rau kev tsim cov enzymes. Lawv qhov tsis txaus provokes kev zom zaub mov tsis zoo thiab, vim li ntawd, hypercoagulability.
- Kev ua siab phem. Txhua hnub, lub cev tsim tawm kwv yees li 15-20 g ntawm cov ntshav cov protein ua lub luag haujlwm rau kev thauj mus los thiab kev tswj hwm kev ua haujlwm. Kev sib txawv hauv biosynthesis ua rau muaj kev hloov pauv hauv cov ntshav.
Ntawm lwm yam, tus mob tuaj yeem cuam tshuam nrog kev muaj kab mob hauv lub cev, ua haujlwm siab ntawm tus po lossis raug mob rau cov hlab ntsha.
Cov tsos mob ntawm hypercoagulation syndrome
Thaum cev xeeb tub, pathology tuaj yeem tshwm sim nws tus kheej nrog cov duab qhia pom. Tab sis hauv lwm tus neeg, nce viscosity yuav tsis muaj qhov tshwm sim tshwj xeeb. Muaj tseeb tiag, muaj ntau qhov sib txawv uas tuaj yeem pab kom xav tias muaj tus kab mob. Cov tsos mob muaj xws li:
- kiv taub hau nrog me ntsis poob ntawm kev sib koom tes;
- qaug zog, qaug zog;
- mob migraines;
- muscle tsis muaj zog;
- nausea, faintness;
- insomnia;
- muaj teeb meem ntev;
- xiav ntawm daim tawv nqaij thiabmucous daim nyias nyias, lawv nce dryness;
- txias taw, hnov qhov hnyav thiab mob ntawm caj dab;
- cuam tshuam kev hnov qab ntawm ob txhais ceg thiab caj npab, loog, kub hnyiab;
- siab txias susceptibility;
- mob hauv cheeb tsam ntawm lub plawv - tingling, arrhythmia, ua tsis taus pa;
- -muaj kev ntxhov siab, kev ntxhov siab, cuam tshuam;
- kev tsis pom kev thiab hnov lus, qhov tsos ntawm tinnitus;
- qhov muag kub, kua muag;
- nce qib hemoglobin;
- khaw los ntshav ntawm qhov txhab, txiav, khawb;
- -nchuav menyuam, ua tsis tau cuaj hlis;
- frequent yawning.
Tag nrho cov cim piav qhia yuav tsum tau kuaj xyuas kom zoo. Tom qab kev sim thiab ntsuas ntsuas, tus kws tshaj lij tuaj yeem txheeb xyuas cov kab mob.
Hypercoagulation syndrome thaum cev xeeb tub
Cov ntshav tuab hauv niam lub siab tuaj yeem piav qhia los ntawm cov caj ces lossis cuam tshuam ntawm cov xwm txheej sab nraud. Thaum cev xeeb tub, hypercoagulation syndrome tshwm sim tawm tsam keeb kwm ntawm kev thauj cov noob rau thrombophilia, rog rog, tsis muaj vascular laus, lub cev tsis muaj zog, lub cev qhuav dej, kev ntxhov siab, overheating lossis hypothermia.
Qhov muaj cov xwm txheej zoo li no tsis tas yuav qhia txog kev xeeb tub nyuaj. Tus me nyuam lub cev ntawm tus poj niam, nws yooj yim dua rau nws nrog ntau yam teeb meem thiab qhov tsis tshua muaj tus mob.
Code rau hypercoagulation syndrome hauv cov poj niam cev xeeb tub raws li ICD-10 - D65.
Ntau cov ntshav viscosity tuaj yeem ua raurau ntau yam teeb meem:
- ncua kev loj hlob ntawm embryonic;
- preeclampsia;
- tus menyuam hauv plab tuag;
- regressive cev xeeb tub;
- cuam tshuam txhua lub sijhawm;
- placental abruption, txawv txav los ntshav;
- ntshav poob thaum yug menyuam;
- placental insufficiency.
Txhawm rau tiv thaiv qhov tshwm sim, koj yuav tsum npaj koj cev xeeb tub kom raug. Yog tias muaj cov tsos mob ntawm hypercoagulability, nws yuav tsum tau noj kev tiv thaiv txawm tias ua ntej xeeb tub. Txawm hais tias muaj kev hloov pauv me me, nws zoo li yuav muaj qhov muaj peev xwm puv thiab yug me nyuam ib txwm muaj. Nyob rau hauv cov ntaub ntawv loj ntawm hypercoagulation syndrome nyob rau hauv cov poj niam cev xeeb tub, leej niam expectant yuav tau txais kev kho mob tshwj xeeb.
Diagnosis
Yog tias xav tias tus kab mob no, tus kws kho mob tshwj xeeb yuav tsum tau kuaj xyuas tus mob anamnesis, tshuaj xyuas qhov xwm txheej ntawm tus neeg mob cov tsos mob thiab kev tsis txaus siab, qhov muaj qhov nchuav menyuam thiab cov caj ces. Tom qab ntawd kev sim kuaj tau ua tiav txhawm rau txhawm rau kuaj ntshav viscosity:
- kuaj ntshav dav dav txhawm rau txiav txim siab tus naj npawb ntawm cov khoom tsim, hemoglobin concentration;
- coagulogram kom tau txais cov ntaub ntawv hais txog lub xeev ntawm hemostasis system, qib ntawm coagulation, lub sijhawm los ntshav;
- qhib lub sijhawm thromboplastin los ntsuas qhov ua tau zoo ntawm txoj hauv kev txhaws.
Txhawm rau txiav txim siab txog lub xeev ntawm cov kabmob hauv nruab nrog cev thiab cov hlab ntsha, ib qho kev kuaj mob ntxiv ntawm hypercoagulation syndrome yog ua tiav:
- doppler ultrasound;
- MRI, ultrasound;
- phlebography.
Ntawm lwm yam, tus kws kho mob yuav tsum sib txawv cov kab mob no los ntawm DIC, kab mob hemolytic uremic thiab qog nqaij hlav malignant.
Kev kho cov poj niam cev xeeb tub
Yog tias muaj qhov sib txawv loj hauv lub cev hemostasis thaum cev xeeb tub, tus poj niam tau muab tshuaj tiv thaiv coagulants: Fragmin, Heparin, Warfarin. Cov tshuaj tau txhaj rau hauv qab ntawm daim tawv nqaij, chav kawm ntawm kev kho yuav siv li 10 hnub. Tom qab kev kho mob, hemostasiogram yog qhov yuav tsum tau ua.
Ntxiv rau, cov tshuaj tiv thaiv kab mob tuaj yeem raug sau: Cardiomagnyl, Thrombo ACC, acetylsalicylic acid.
Nws yog ib qho tseem ceeb sib npaug rau kev noj zaub mov. Txhawm rau txo cov ntshav viscosity thaum cev xeeb tub, nws raug nquahu kom noj cov zaub mov uas muaj vitamin E. Cov tais diav yuav tsum tau boiled, stewed los yog steamed. Kev noj zaub mov yuav tsum muaj zaub, khoom noj siv mis, ntses thiab nqaij.
Tab sis koj yuav tsum tso cov khoom qab zib, pickled, kaus poom, khoom noj rog, muffins, dej qab zib, qos yaj ywm thiab cawv.
Drug therapy
Hauv hypercoagulation, yuav tsum tau siv tshuaj los tiv thaiv cov ntshav txhaws thiab cov ntshav nyias. Cov neeg mob feem ntau raug tshuaj:
- tshuaj tiv thaiv kab mob - "Trombo ACC", "Acetylsalicylic acid", "Cardiomagnyl";
- tshuaj tiv thaiv coagulants - "Heparin", "Warfarin","Fragmin";
- fibrinolytics - Fortelizin, Thromboflux, Streptaza;
- Vitamin C, E thiab P;
- antispasmodics - "Papaverine", "No-shpa", "Spazmalgon";
- tshuaj tiv thaiv kab mob - "Indomethacin", "Ibuklin";
- tshuaj vascular - "Kurantil", "Pentoxifylline";
- yog tias kuaj pom muaj kab mob, tshuaj tua kab mob - Gordoks, Cefazolin, Azithromycin, Kontrykal;
- cov tshuaj steroid yog xav tau rau cov kab mob autoimmune - Dexamethasone, Prednisolone.
Yog tias tus neeg mob muaj tus mob paraneoplastic hypercoagulation syndrome - ib qho kab mob uas tau tshwm sim tawm tsam keeb kwm ntawm cov qog nqaij hlav, kev phais yog ua. Hauv qhov xwm txheej hnyav, kev qhia txog cov tshuaj crystalloid thiab colloid, kev hloov pauv ntawm cov ntshav pub dawb yuav raug qhia.
