Cov txiaj ntsig ntawm kev kuaj ntshav tso cai rau peb los txiav txim lub xeev ntawm lub cev tiv thaiv kab mob, kab mob plawv thiab lwm yam kab ke ntawm tib neeg lub cev. Yog li, thrombocytopenia yog tus cwj pwm los ntawm qib qis ntawm platelets hauv cov ntshav, spontaneous hemorrhages nyob rau hauv cov pob qij txha thiab hauv nruab nrog cev, mob hematomas. Tsis muaj peev xwm ntawm platelet hlwb cuam tshuam qhov tsim ntawm hemostatic plug uas rov ua kom muaj kev ncaj ncees ntawm cov hlab ntsha puas. Yog tias qhov tsis xws luag uas tau tshwm sim tsis yog "sau" hauv lub sijhawm, txawm tias qhov kev txiav txim siab feem ntau tuaj yeem ua rau muaj qhov tshwm sim loj heev.
Lub ntsiab ntawm qhov teeb meem
Platelets yog cov qauv uas tsis yog-nuclear ntawm qhov tsis sib xws oval lossis puag ncig. Lawv raug tsim los ntawm kev faib tawm ntawm cov cytoplasm los ntawm megakaryocytes (polyploid pob txha pob txha loj heev). Sab nraud, cov qe ntshav zoo ib yam li cov disks tiaj tus nrog txoj kab uas hla ntawm 2-4 microns. Platelets nyob rau hauv cov ntshav plasmaNtau tshaj 12 hnub, tom qab ntawd rhuav tshem ntawm tus po, daim siab thiab hloov los ntawm cov tshiab.
Platelets ua haujlwm hemostatic. Nyob rau hauv cov ntaub ntawv ntawm cov neeg kho tshuab raug mob, lawv tso mus rau ib tug kaum os xov zoo li txheej txheem, uas tshaj qhov luaj li cas ntawm lub cell nws tus kheej los ntawm 5-10 lub sij hawm. Cov platelets yog loj heev xa mus rau qhov chaw ntawm lub rupture ntawm lub nkoj thiab, nrog kev pab los ntawm pseudopodia, yog txuas mus rau nws phab ntsa, nruj nreem nias rau ib leeg. Tom qab ntawd, α-granules nrog kev loj hlob zoo (PDGF) raug tso tawm, nws yog cov proteins uas pib cov txheej txheem ntawm kev tsim cov ntaub so ntswg puas. Kev txo qis hauv platelet ntau lawm hauv cov pob txha liab hloov cov rheological zog ntawm cov ntshav, nws dhau los ua nyias, thiab muaj teeb meem nrog kev los ntshav.
Reference values
Qib platelets yog xam nyob rau hauv ntau txhiab ib 1 microliter ntawm lub cev kua. Lawv qhov concentration nyob ntawm lub hnub nyoog, poj niam txiv neej ntawm tus neeg mob, lub caij ntawm lub xyoo thiab txawm tias lub sijhawm ntawm hnub. Nyob rau lub caij nplooj ntoo hlav thiab hmo ntuj, cov ntsiab lus ntawm platelets hauv cov ntshav plasma nce mus txog qhov qis qis ntawm cov qauv.
Ib qib qis ntawm platelets hauv cov ntshav ntawm poj niam, txiv neej lossis menyuam yaus qhia tias thrombocytopenia, thaum muaj kev sib txuas ntxiv ntawm cov khoom tsim qhia txog kev txhim kho ntawm thrombocytosis. Cov kab mob hematopoietic ntawm cov menyuam yug tshiab thiab cov menyuam yaus txog ib xyoos tsis ruaj khov: cov hlwb liab nquag tsim thiab tuag sai. Nrog lub hnub nyoog, cov kev ntsuas hemodynamic ntawm cov ntshav khiav tau rov qab los thiab kev tsim cov platelets poob qis. Raws li qee cov ntaub ntawv, qib platelet rau cov poj niam hauvtxoj hauj lwm yuav raug txo kom 100 txhiab U / μl. Thaum lub sij hawm cev xeeb tub, qhov taw qhia yog 75 -220 txhiab U / mkl.
Symptomatics
Thaum xub thawj, thrombocytopenia zoo li asymptomatic thiab protracted. Tus kws kho mob hematologist uas tsim nyog yuav xav tias muaj kev ua txhaum cai raws li cov cim qhia dav dav ntawm ntshav qab zib hauv lub cev: pallor ntawm daim tawv nqaij, ua tsis taus pa, palpitations, tsis muaj zog, kiv taub hau, mus txog qhov tsis nco qab.
Tsawg platelets hauv cov ntshav manifest:
- Nyob li qub, muaj kua muag ntswg.
- Petechial rash.
- Periodontosis.
- Ntawm qhov nqaij tawv ntawm lub cev yam tsis muaj laj thawj.
- Ntshav streaks thaum tso zis lossis tso quav.
- Nyob rau poj niam txiv neej.
Raws li txoj cai, petechial hemorrhages yog nyob rau ntawm lub hauv siab, plab, sab sauv thiab sab qis. Kev nce hauv cov qog nqaij hlav hauv tsev menyuam qee zaum nrog cov mob subfebrile. Nrog thrombocytopenia, kev hloov pauv ntawm cov mis leukocyte mus rau sab laug yog pom, qhov muaj pes tsawg leeg ntawm erythrocytes txo qis, thaum lub concentration ntawm reticulocytes tsis tu ncua nce.
Causal factors
Thrombocytopenia tuaj yeem txhim kho raws li kev ywj pheej pathology lossis qhia tias muaj lwm yam kab mob (ob leeg tau txais thiab keeb kwm yav dhau los). Feem ntau, platelet hypoaggregation yog txuam nrog kev mob hauv lawv cov synthesis lossis qib siab ntawm kev puas tsuaj ntawm cov qe ntshav. Cov teeb meem ntshav txhaws tshwm sim tawm tsam keeb kwm ntawm lub cev tsis muaj zog, vitamin B12 tsis txaus thiabfolic acid.
Qib platelets poob qis dua qib uas tau txais vim yog cov kab mob hauv qab no:
- Hormonal tsis ua haujlwm.
- kab mob siab ntev, mob leukemia.
- Kev ua haujlwm ntawm tus po.
- kab mob (rheumatoid mob caj dab, dermatomyositis, lupus erythematosus).
- ARI, kab mob kis rau menyuam yaus (qhua pias, kab mob qhua pias, rubella).
- raug hluav taws xob lossis ua rau muaj kuab lom ntau hauv lub cev.
Congenital thrombocytopenia tau txais los ntawm lub hauv paus recessive, tus kab mob yog tshwm sim los ntawm cov qauv ntawm cov hlwb, lawv tsis muaj zog. Tsis tshua muaj, cov ntshav qis qis hauv menyuam yaus yog txuam nrog Bernard-Soulier syndrome, May-Hegglin anomaly, lossis kev qhia txog tshuaj tiv thaiv MMR (mob qhua pias, rubella, mumps). Cov pab pawg muaj kev pheej hmoo suav nrog cov neeg muaj kev rog rog, kev quav yeeb tshuaj lossis haus dej cawv ntev. Muaj ib hom kab mob idiopathic, qhov twg nws tsis tuaj yeem txiav txim siab qhov ua rau qis qis ntawm platelets hauv cov ntshav.
YFalse thrombocytopenia
Cov txiaj ntsig tsis zoo yuav cuam tshuam txog tus kheej tus yam ntxwv ntawm tus neeg mob lossis qhia txog kev npaj tsis raug rau CBC. Qhov kub thiab txias kuj tseem cuam tshuam rau kev sib sau ntawm lub cev uas tsis yog-nuclear. Lub sijhawm ntau dhau tom qab kuaj ntshav, qhov kev pheej hmoo siab dua ntawm kev muaj pseudothrombocytopenia. Tsawg platelets hauv cov ntshav thaum cev xeeb tub yog vim qhov hloov pauv hormonal nyob rau hauv lub cev ntawm leej niam leej niam thiab feem ntau pom ze rau hnub yug.
Thrombocytopenia provoked los ntawm qee cov tshuaj tua kab mob, diuretics, NSAIDs, narcotic analgesics. Cov npe ntawm cov ntshav thinners nrov yog coj los ntawm Aspirin, Piracetam, Voltaren, Ibuprofen. Tom qab txiav tawm lossis hloov cov tshuaj antiplatelet nrog rau daim ntawv zoo dua, thrombocytopenia daws ntawm nws tus kheej.
Txoj Kev Tshuaj Kho Mob
Kev kho mob tactics rau thrombocytopenia nyob ntawm qhov etiology ntawm tus kab mob thiab qhov hnyav ntawm kev kho mob tshwm sim. Yog tias qhov ua rau qis qis ntawm platelets hauv cov ntshav yog cov kab mob sib kis, cov tshuaj tua kab mob tau sau tseg. Lub qhov ntswg muaj zog yuav pab kom tsis txhob muaj tus kws kho mob ENT, lub tsev menyuam los ntshav - tus kws kho mob gynecologist, yog tias tsim nyog, kev phais mob, hu rau tus kws phais mob plab. Megaloblastic anemia yog kho nrog folic acid thiab vitamin B12. Corticosteroids, koob tshuaj ntau ntawm immunoglobulin ntse tua cov kab mob autoimmune.
Hemostatic tshuaj xws li "Dicynone" lossis "Aminocaproic acid" nce lub zog ntawm phab ntsa capillary, txhawb kev tsim cov thromboplastin hauv qhov txhab. Los ntawm txoj kev, tus paub zoo hemostatic tus neeg sawv cev "Vikasol" yog tsis zoo nyob rau hauv thrombocytopenia thiab tej zaum yuav ua rau tus neeg mob tus mob. "Ascorutin", "Kurantil" qeeb cov ntshav khiav hauv cov hlab ntsha tawg, yog li tiv thaiv hemorrhage. Hauv kev kho mob ntawm cov neeg mob hnub nyoog tshaj 45 xyoos, antigonadotropic capsules tau ua pov thawj lawv tus kheej zoo -Danazol. Kev noj tshuaj yuav tsum tau pom zoo nrog koj tus kws kho mob.
ntsuas ntsuas tseem ceeb
Los ntawm qhov pom ntawm kev kuaj mob hauv chav kuaj, qib ntawm platelets, tsis tshaj 30 txhiab units / μl, yog qhov tseem ceeb. Hauv qhov no, kev hloov pauv ntawm platelet concentrate yog qhia. Yog tias txoj kev tshawb nrhiav caj ces pom tau tias muaj cov kab mob pathology, tus neeg mob yuav xav tau kev hloov cov pob txha pob txha. Kev kho mob ntawm cov mob hnyav ntawm thrombocytopenia yog ua los ntawm splenectomy. Txoj kev phais yog hais txog kev tshem tawm tag nrho lossis ib nrab ntawm tus po.
Plasmapheresis qee zaum siv nrog kev kho tshuaj hormonal rau platelets tsawg. Lub essence ntawm txoj kev yog los ntxuav lub cev ntawm cov tshuaj tiv thaiv rau nws tus kheej platelet hlwb. 2-4 zaug yog txaus coj tus neeg mob tawm ntawm lub xeev txaus ntshai. Yog tias thrombocytopenia nrog los ntshav hnyav, kev hloov ntshav yog qhov tseem ceeb.
Dej kua txob extract thiab infusion ntawm nettle nplooj pab ntxiv dag zog rau cov hlab ntsha, normalize lub permeability ntawm phab ntsa capillary. Cov txiv hmab txiv ntoo ntawm qus strawberries, chokeberry, qus sawv muaj hemostatic zog. Nrog rau qib qis ntawm cov platelets hauv cov ntshav, cov kws kho mob ib txwm pom zoo kom noj ib lub decoction ntawm yarrow, tshuaj verbena, chicory, rue lossis plantain. Eleutherococcus, echinacea extract, Suav magnolia vine, aloe, qej, walnuts, marjoram thiab lwm yam immunomodulating nroj tsuag muaj kev ntseeg siab nce kev tiv thaiv.
Muaj ntau yam zaub mov noj tshuaj zoo:
- Hemostatic collection. Cov khoom muaj xws li 20 g ntawm chamomile paj, 40 g ntawm peppermint, 40 g ntawm shepherd lub hnab. Rau thrombocytopenia, ncuav 300 ml ntawm boiling dej tshaj 1 tbsp. l. raw cov ntaub ntawv thiab muab tso rau hauv ib da dej (15 feeb). Tom qab ntawd tshem lub saucepan los ntawm tshav kub, nws cov ntsiab lus yuav tsum tau txias thiab lim los ntawm 2-3-txheej gauze napkin los yog lim. Haus 100 ml ntawm kev kho mob ob zaug ib hnub.
- Decoction ntawm currant nplooj. Ncuav lub crushed nplooj nrog ib liter ntawm dej kub. Nrog rau qhov tsis muaj platelets hauv cov ntshav, cov khoom siv raw yog boiled rau 2-3 feeb los ntawm lub sijhawm boiling, ces cov kua yog poured rau hauv ib lub thermos. Ntxiv txiv qaub thiab zib mu mus saj. Tom qab 3 teev, cov dej haus yog npaj txhij, noj 200 ml ntawm cov khoom ob peb zaug ib hnub twg. Tsis zoo li cawv tinctures, lub decoction zoo ntxuav lub cev ntawm co toxins, kho anemia thiab los ntshav cov pos hniav, thiab relieves insomnia.
- Sesame oil. Cov roj yog tsim los ntawm cov noob noob hnav tshiab los ntawm kev nias txias. Cov khoom ntuj ua kom ntshav txhaws, muaj cov tshuaj antioxidant. Noj 1 tbsp txhua hnub. l. sesame oil.
Cov hau kev no yuav tsis tiv thaiv kev puas tsuaj loj ntawm cov platelets lossis kho cov kab mob autoimmune. Lwm txoj kev tshuaj yog tsim nyog los siv rau kev tiv thaiv ntawm anemia. Cov kev kho neeg mob maj mam thiab tsis muaj kev phiv tshwm sim txhawb kev sib sau ntawm cov platelets, rov ua kom lub zog tsim nyog los tawm tsam thrombocytopenia.
Kev noj haus
Khoom noj khoom hausKev noj zaub mov uas tsis tshua muaj platelets hauv cov ntshav yuav tsum suav nrog cov khoom noj uas yooj yim digestible protein, vitamins, micro- thiab macroelements. Freshly squeezed kua txiv los ntawm strawberries, raspberries, txiv apples los yog dub radish yuav coj invaluable txiaj ntsim. Ib qho txiaj ntsig zoo yog kev siv cov khoom noj uas muaj vitamin B12 thiab folic acid (legumes, nqaij nyug siab, cheese, tshuaj ntsuab, zaub qhwv, apricots.) Rau thrombocytopenia, muab kev nyiam rau chav cutlets los ntawm ntses lossis zaub, nqaij hau, ci txiv hmab txiv ntoo.
Cov khoom noj phom sij suav nrog cov nqaij haus luam yeeb, zaub qhwv, khoom noj, khoom noj ceev thiab khoom noj yooj yim. Cov zaub mov ntsim thiab kub heev, uas ua rau lub qhov txhab ntawm lub plab zom mov, yog txwv tsis pub. Nws yog ib advisable mus ua noj porridge nrog dej los yog mis nyuj; es tsis txhob ntawm qab zib, ntxiv zib mu, txiv hmab txiv ntoo thiab berries. Cov cawv muaj zog ua rau qeeb ntawm cov platelets hauv cov pob txha thiab ua rau cov hlwb uas twb muaj lawm, uas yog vim li cas platelets tsawg hauv cov ntshav feem ntau cuam tshuam nrog cov cwj pwm phem.
Yuav ua li cas tiv thaiv kev ua txhaum
Nrog thrombocytopenia, nws raug nquahu kom tsis txhob muaj kev sib tw kis las, tab sis kuj muaj kev ua si sab nraum zoov. Hiking nyob rau hauv cov huab cua ntshiab, ntawm qhov tsis tooj, yuav pab kom zoo siab, saturate lub hlwb nrog oxygen. Cov neeg mob uas muaj kev pheej hmoo yuav tsum paub tias pes tsawg platelet suav txhais tau li cas thiab yuav ua li cas tiv thaiv kev txhim kho hemorrhagic syndrome. Tsis txhob noj tshuaj thiab zaub mov uas ua rau cov ntshav nyias. Tsis txhob overcool, them nyiaj rau kev tiv thaivkab mob thiab kis kab mob. Thrombocytopenia yog ib qho laj thawj kom tshem tau cawv thiab haus luam yeeb.
In xaus
Thaum nyob rau hauv ib puag ncig txawv teb chaws rau lub cev, cov ntshav pib sai sai, yog li tso tseg cov ntshav. Nws yog platelets uas ua lub luag haujlwm txiav txim siab hauv kev kho cov ntaub so ntswg puas. Cov kab me me ntawm megakaryocytes conscientiously ua ib tug hemostatic muaj nuj nqi, ua rau kom lub hlwb tsis kam mus rau qhov kev txiav txim ntawm pathogens. Qib qis ntawm platelets hauv cov ntshav hauv cov txiv neej, poj niam, thiab menyuam yaus yuav tsum tau kho kho raws sijhawm. Ib qho kev ncua ntev, yam tsis muaj exaggeration, tuaj yeem ua rau tus neeg mob nws lub neej. Saib xyuas!
