Thrombophilia - ntoni na? Thrombophilia: Oonobangela, Iimpawu, diagnosis and Treatment

Imo susceptibility umzimba ukuba thrombosis semithambo, nto leyo ibuya futhi ube indawo eyahlukileyo, ebizwa thrombophilia. Isifo isenokuba yemfuza okanye lufundiwe. Unobangela sifo amaninzi kakhulu ekunqandeni igazi. Ngokwezonyango, isifo ukuze babonise iindidi thrombosis kwiindawo ezahlukeneyo. Thrombophilia kakhulu kwande kubemi kwaye yenzeka ngeendlela ezahlukeneyo. Isifo kufuna unyango ngamayeza okanye iindlela yotyando.

Thrombophilia: ntoni na?

Pathology ibhekisa izifo kwinkqubo yegazi, wabonakaliswa utyekelo thrombosis kunye hemostatic ukuphazamiseka. thrombosis nezolo Multiple kwi thrombophilia isenokuba kuba sisiphumo trauma, utyando, ntshikilelo ngokwasemzimbeni, okanye ngethuba lokukhulelwa. Condition kuyingozi kuba oko kungakhokelela kubunzima ezifana Embolism yemiphunga, stroke, iposi engabalulekanga, deep vein thrombosis. Kudla Iifom oluphambili ziyabulala.

Uphando, isifo kunye nonyango thrombophilia inxaxheba kwiindawo ezininzi yamayeza. Haematology ufunda iimpawu negazi, phlebology - Uxilongo kunye nonyango lwe thrombosis ye imithambo, ukususa egazi igazi inxaxheba oogqirha yegazi. thrombus owabumba kubangela ukuphazamiseka yokumpompoza kwegazi oqhelekileyo, nto leyo sikhatshwa uphuhliso iimeko eziyingozi ekunzima ukunyanga. Ekuhambeni kwexesha ukuthintela le ngxaki, kufuneka avavanywe athile ukuba igazi ekunqandeni. Ummiselo kumabhinqa, umzekelo, igazi lwemithambo yimizuzu 5-10.

oonobangela

Izinto ezibangela uphuhliso izifo, bambalwa. Phantse wonke umntu nazo nezifo ezifana thrombophilia. Yintoni na imeko eyingozi, izigulane ezininzi ngamanye amaxesha ayazi noyena uze ucele uncedo kunokuba emva kwexesha. Kukho uludwe lwezizathu ezinokuthi zibe negalelo kuphuhliso ngezifo.

thrombophilia sofuzo (okanye genetic) yenzeka ngenxa yofuzo ukuya sifo. Ekusukeni izifo ngaphambili igazi (thrombocytosis, erythremia, antiphospholipid syndrome) Kwakhona ibe isizathu lwalo lokukhawulelana nophuhliso. imibandela eyingozi ziquka yegazi, umhlaza, fibrillation atrial, imithambo varicose, kunye nezifo sokuhlasela. Amathuba isenzeko ukunyuka thrombophilia emva ukufa icala okanye intliziyo ukuhlasela. Xa zone ingozi leyo, izigulane abatyebe kakhulu, ukhokela uhleli ungenzi nto, uphuza hormone, musani ukudla ngaphambili ubunzima yokwenzakala kakhulu okanye uqhaqho. Esemncinane esi sifo kunqabile, oko kudla kwenzeka kubantu abadala. Ukuthintela isifo okanye imeko singaqalisi, kucetyiswa ukususela amaxesha ngamaxesha ukuba uluphumelele uvavanyo ukuze thrombophilia.

picture clinical

obubonakala lwezonyango kwezifo esibonakala ukunyuka anencasa ixesha nomsinga, izigulane zange ngoko nangoko uqaphele utshintsho kubume bentlalo, yaye musa ukwenza naziphi na izikhalazo. parameters yemigaqo ukuxilonga thrombophilia, umfanekiso lwezonyango eneenkcukacha kwezinye iimeko, oko kwenzeka kwiminyaka nje embalwa kamva. iimpawu Bright kunokwenzeka xa ihlwili kuye kwasekwa. Ubungakanani kwimiqobo ye sayo isitya kunye zalapha ekhaya kwabo thrombus kuchaphazela ubuzaza iimpawu.

thrombosis emithanjeni, nto leyo ibangwa egazi igazi sayo olujikeleza yesingqengqelo esimbaxa, sikhatshwe ukuyilwa thrombus kwi mithambo iimpahla ngumkhaya, ukufa intrauterine ezingekazalwa, ukuphuphuma ezininzi, ukuhlaselwa insufficiency etsolo coronary, stroke kobuchopho.

thrombosis lwemithambo of kweqondo asezantsi iimpawu zonyango azibonakalisa ngohlobo utshintsho trophic ulusu, ukufukuka kakhulu kweqondo asezantsi, ukubonakala intlungu, imvakalelo ubunzima eziphelweni asezantsi.

Mezentealny thrombosis isisu lwenzeka xa kukho igazi ihlwili kweli lizwe iimpahla mesenteric i ekhatshwa iimpawu ezifana evakalala ilindle, ukugabha, isicaphucaphu, imela-ebukhali intlungu.

Xa hepatic vein thrombosis hydrothorax kuphuhliswa (Budd-Chiari syndrome), ascites, nokudumba kodonga akudala esiswini kunye iziphelo asezantsi, ukugabha amanyala kunye neentlungu ibinamandla kulo mmandla epigastric.

thrombophilia hematogenous

Thromboses kuchaphazela imeko eludongeni semithambo, alwenze ngayo kunye nokunciphisa ukuxhathisa, ukuba wehlise ukuhamba kwegazi kunye nophuhliso nezinye izifo hemodynamic ezihlobene ne ukutshintsha viscosity kunye amahlwili. karhulumente Thrombophilic kwiimeko ezininzi enxulumene ukubakhona kwezifo ezinemigca ezifana yegazi, ukwenzakala intimal semithambo, vasculitis toxigenic, omzimba okanye imvelaphi esosulelayo. thromboembolism Multiple elikhala inokuba ngenxa yeenguqu iimpawu igazi ngokwayo, enika ilungelo lokuthetha malunga nesifo igama "thrombophilia hematogenous." ezimbi enxulumene nophuhliso utyekelo omzimba ukuphuhlisa thrombosis, okubangelwa ezingaqhelekanga e coagulation, nokuphazamiseka hemostatic igazi isakhono.

Thrombophilia hematogenous unemvelaphi kunokuba iziphene okanye lufundiwe. Kwi indlela engundoqo cell ukuba izifo ezo zibangelwa: amaxesha conjugated thrombogenic, kwekhono zegazi, fibrinolysis kakuhle, inhibition, engaqhelekanga okanye nokuqhwalela coagulation ilahleko enkulu anticoagulant nokomzimba. Ukongeza, omnye ikude kuphuhliso ngenxa yeziphumo iziyobisi okanye ungenelelo zonyango thrombophilia iatrogenic.

thrombophilia zamafa

Chaza thrombosis azalwa okanye ilifa kunokuba ibe sisiseko wabonakala bezonyango zilandelayo: thrombosis besebancinane, amatyala thrombosis of pulmonary, mesenteric, nemilenze imbali yosapho, isiqephu sokuqala thrombosis nezolo lwemithambo phambi kweminyaka engama-30 ubudala, thrombosis ngexesha lokukhulelwa ekuqaleni, ukungaphili thrombotic. thrombophilia ilifa okanye yemfuza uzimisele emva kokuba uxilongo olubanzi izigulane kuba ingozi kubunzima thrombophilic.

uhlobo azalwa ngayo esi sifo enemo eyahlukileyo. Xa lokufunyaniswa kwesifo kuthathelwa ingqalelo abamakishi yemfuza ukuba thrombophilia. Eyona nto yokuqala igalelo kuphuhliso lwesifo - yofuzo. Kulo mzekelo, isifo ingabi kungekho iimeko engabangela indlela yophuhliso lwayo. Le yesibini - le ukuguquka zofuzo ngexesha kuphuhliso osandul. Ngonyuka landa mvanje imiba yoxinaniso ezibhentsisa kuguquka sofuzo. Phakathi kwabo, abo eyenziwa yimisebenzi yabantu: ezikhutshwayo imitha, ukusetyenziswa kwezithako ukutya, namayeza afanelekileyo, ungcoliseko lokusingqongileyo (iikhemikhali indlu, izibaso, iyeza lokubulala izitshabalalisi) iintlekele ezenziwe ngabantu. Kunzima ukuqikelela iimeko phantsi apho gene kunokuba modifiable, ngoko mutagenesis ke kuthathwa ukuba yinkqubo random, olwenzeka iyodwa kwaye ukukwazi ukutshintsha iimpawu njengelifa.

thrombophilia ilifa Kwakhona ngenxa noshowo okanye ukuguquka genomic zofuzo ilifa kwizizukulwana zangaphambili. Kukho elibekwe imeko gene izifo: sofuzo okanye lubalaseleyo. Kwimeko yesibini, le leengxaki bonisa ngokwayo kuzo zonke iimeko.

thrombophilia ezifunyenwe

Ifa kuphela kodwa imvelaphi ezifunyenwe ukuze esi sifo. Esi sigulane asikwazi nokuxilonga syndrome antiphospholipid (APS). Kwaba njalo kwiimeko ezininzi kuziveza yafumana thrombophilia. Yintoni na, yintoni na indlela yophuhliso yayo, nendlela ukulwa nalo?

Antiphospholipid syndrome imbaxa uphawu ehlanganisa iinkcukacha elebhu kunye nemiqondiso clinical. Isifo kunye zizigulo zemithambo, thrombocytopenia omzimba, foetal ilahleko syndrome, lwemithambo kunye umfutho thrombosis. Nika uhlobo APS: lokuqala, lesibini ezinkulu; ongakhetha serological: seronegative kunye seropositive. kuvela Syndrome nxamnye neoplastic, ezosulelayo, samathambo okanye izifo komzimba okanye ngenxa yokunganyamezelani iziyobisi.

Development APS esinxulunyaniswa kunye neemeko ezifana ezingaqhelekanga ezifana neoplasm onobungozi (umhlaza, isifo zegazi, leukemia), usulelo (mycoplasmosis,-HIV, negcushuwa), ukujikeleziswa nazimpawu Afa, ukusilela ezondeleyo kwezintso, izifo kwemithambo peripheral kunye kwemithambo yenhliziyo, isifo sesibindi, izifo nokuqina tissue, kunye nezifo samathambo (isifo Crohn kaThixo, vasculitis systemic, SLE).

Thrombophilia ekukhulelweni

Ngexa lokukhulelwa, thrombophilia yemfuza okanye ilifa rhoqo esizibonakalisa okokuqala. Oku kubangelwa ikakhulu yokufika leyesithathu, wesangqa ukujikeleziswa placental okuye phezu kwegazi ye umthwalo owongezelelweyo. Formation of egazi igazi nayo inegalelo eziliqela iinkalo isangqa placental. Ngumkhaya akukho emithanjeni, ingena igazi sikanina ukusuka imithambo, ngoko ayahamba na villi chorionic, iqukuqela kungena imfesane yosana.

Kaloku umzimba yomfazi okhulelweyo zibandakanya ukwanda igazi ekunqandeni, leyo kunciphisa ukopha phakathi kweenkonzo okanye xa kuthe kwakho iingxaki ezifana abruption isisu kunye placental. Oku kunegalelo nengozi yokuba amahlwili egazi, kwaye kubo kukho ingozi. Ukuba bathe abekiwe sibuphethe ngezitya yegazi ezikhokelela ngumkhaya, izondlo, hypoxia kwenzeka yokumisa kwemali olungekazalwa. Kuxhomekeka kwinqanaba odla kwemithambo yegazi kunye nenani egazi kwegazi, ukuze ilandelwe iingxaki kakhulu, ukuzalwa ngaphambi kwexesha, kwesisu, ebunayo ukukhulelwa, malformations okanye ukufa ezingekazalwa, insufficiency fetoplacental, abruption placental. zibonakale, ngokuqhelekileyo emva kweeveki ezili-10. Xa ixesha yokuqala thrombophilia xa ukhulelwe kunqabile kakhulu. Ukuba sifo emva kweeveki ezingama-30, ngoko ke siphela kwiimeko ezininzi, abruption placental, insufficiency placental okanye yokukhulelwa kakhulu. Kwi yoviwo ugqirha kufuneka sinikele ingqalelo igazi ekunqandeni, izinga abafazi "kwi" nto leyo yahluke kancinane ukusuka umgangatho.

ekuxilongweni

Wabonakala kwezonyango thrombosis naqiniswa ekliniki usebenzisa laboratory (cytological, kwemichiza, yemfuza, coagulologic) kunye nobuchule zomculo. Imbonakalo kunye nemeko umzimba qwalasela kuyakrokreleka thrombosis lwemithambo (ukudumba). Zombini lwemithambo kunye emithanjeni kunye iintlungu rhoqo ngokucindezela ukuqunjelwa. Ngamanye amaxesha lobushushu lesikhumba (lwemithambo) kwandisa kummandla lizwe. Lwemithambo thrombosis isahlulo kufutshane thrombus elifana neli ukuncipha lobushushu, cyanosis (cyanosis), iintlungu elibukhali. Ezi mpawu - ezi markers yokuqala thrombophilia, nto leyo isizathu esibalulekileyo sokuba kutyelela yincutshe.

Ngqo esibhedlele wayeqhuba isifundo ngokucokisekileyo isigulane. Qiniseka ukuba athathe uvavanyo ngenxa thrombophilia, wenze ultrasound imithambo (imisela uhlobo, ubungakanani kunye nendawo ihlwili legazi), ukwenza umahluko arteriography kunye venography, okuvumela ukunika baphande owakhiwe kweenkqubo thrombotic. Kwakhona, ukusetyenziswa radiographic, iindlela radioisotopic, uhlalutyo yemfuza polymorphisms, nokumisela uyondelelwano lwee- homocysteine.

unyango

Umbuzo wokoyisa sifo kwenzeka kwabo ezijongene unesifo thrombophilia. Yintoni na nendlela yokujongana nabo ukuze uphephe nemiphumo eyingozi? unyango sifo kufuneka comprehensive nokubandakanya inxaxheba koogqirha of amakhono ezahlukeneyo: utyando semithambo, phlebology segazi. Ngelo kwinqanaba lokuqala kuyimfuneko ukufunda iindlela etiopathogenic zophuhliso sifo. iziphumo ezincumisayo yonyango enokulindelwa kuphela emva nokuphelisa ingcambu. Enye into ebalulekileyo unyango na ukutya, nto leyo ukuphelisa ukutya cholesterol aphezulu, umda okunamafutha kunye nokutya eqhotsiweyo. Kuyanconywa ukuba aquke kwizidlo leziqhamo owomileyo, iziqhamo kunye nemifuno, imifuno fresh.

unyango Drug iquka antiplatelet esiwusebenzisayo, nto leyo zincediswe ukusetyenziswa igazi unyango anticoagulation, gemodelyutsiey. Kwezinye iimeko kuyimfuneko ukwenza ukutofelwa plasma entsha frozen obudibene heparinization. Ukwenziwa kwezilungiso therapy esimiselweyo kwifomu ilifa, apho kungenxa ukuswela antithrombin III.

thrombophilia Easy (uvavanyo lwegazi kuya kunceda ukuqinisekisa imilo), liphathwe ne plasma lyophilized (emthanjeni) okanye owomileyo plasma lomnikelo. Ngeendlela kakhulu kusetyenziswa amachiza fibrinolytic lwenziwa isitya occluded usebenzisa catheter. Xa lokufunyaniswa unyango thrombophilia kufuneka individualised nezintsonkothileyo, ukuqinisekisa recovery olukhawulezayo kakuhle.

ukuvimbela

Ukuze ukuba kufuneka aginye kule sifo kakhulu okanye iingxaki zawo, amanyathelo othintelo ukuthintela oku kufuneka kube njalo. Izigulane thrombophilia kukhethwa bamthwala plasma igazi ngeedosi eliphantsi kunye neziyobisi ongama "lweeHedfowuni". Nomonde for prophylaxis kufuneka amisele amayeza ukomeleza udonga nemithambo ( "Trental" "papaverine" efakwa ngomlomo).

Kuba nokuthintela kunye nokunyanga thrombophilia Kucetyiswa ukuba usebenzise amayeza iintsomi, ezifana kwezityalo ezingamayeza. Ngoko ke, ukuba ukunciphisa umsebenzi zegazi kuya kunceda cranberry iti okanye incindi yomdiliya. igazi Rarefy ngokusebenzisa tincture lembewu Sophora Japanese. Ngaphezu koko, kungakuhle ukuba ukwenza ukutya ekunene, hambani ngakumbi kwi umoya ancame nemikhwa emibi.