Indlela yokuqhawula ingenye yezona zinto zibaluleke kakhulu kwaye ziyinkimbinkimbi zeenkqubo ze-physiologic. Igazi kufuneka lihambe ngokukhululekile kwimithambo yegazi ukuze kugcinwe ubomi. Kodwa ukuba isitya segazi sixinzelelekile, igazi kufuneka livale ukuze kuthintela ubomi ekuphumeni. Ngaloo ndlela, igazi kufuneka linikeze inkqubo enokusetyenziswa ngokukhawuleza-kwaye leyo ingafumaneka kwiindawo zokumisa ukuhamba kwegazi.
Le nkqubo ibizwa ngokuba yindlela yokucima.
Ukunyanga okanye ukuthintela i-blood clotting engafanelekanga, oogqirha kufuneka baqonde iinkalo ezininzi ze-clotting mechanism. Inqaku elilandelayo lilula kakhulu kodwa lenzelwe ukunika ingqiqo eyintloko malunga nendlela ezininzi izilwanyana ezisetyenziselwa ukuphatha iingxaki zokuqhawula, kunye nesiseko esithile sokuvavanya unyango lwakho ugqirha unokukunikezela.
Igazi livale njani?
Kukho iinkalo ezimbini ezibalulekileyo zendlela yokuqhawula: iiplatelets , kunye ne-thrombin system.
Iiplatelets zizinto ezincinci zamaselula, ezenziwe kwintsipho yethambo , ezihamba ngegazi elilindele ukukhupha ingxaki yokuphucula. Xa kuphuma ukuphuma kwegazi, ukutshintsha kweekhemikhali kushintshela umgangatho weplatelet ukwenzela ukuba ibe "inamathele." Iiplatelet ezinamanzi kuthiwa "zenziwe". "Ezi iplatelets ezisebenzayo ziqala ukunamathela eludongeni lwesitya segazi kwisiza sokukhupha, kunye komnye nomnye.
Ngemizuzu embalwa, iiplatelet ezinamathele zenza into ebizwa ngokuthi "i-clot emhlophe." (Iqoqo leeplatelets libonakala limhlophe kwiso.)
Inkqubo ye-thrombin iqukethe amaprotheni amaninzi egazi, xa kuphuma igazi, kusebenze. Iiprotheni zokuqhawula ezisebenzayo zibandakanya i-cascade yeempendulo zamakhemikhali ekugqibeleni zivelise into ebizwa ngokuba yi-fibrin.
I-Fibrin inokucingwa njengomtya omude, onamathele. UFibrin unamathele eludongeni lwentsimbi ebonakalayo, ehlanganisana kunye nokwenza i-web-like complex strands. Iiseli zegazi ezibomvu zibanjwa kwiwebhu, kwaye kuthiwa "i-clot ebomvu" ikhona.
Iphulo legazi elivuthiweyo liqukethe iiplatelets kunye ne-fibrin strands, kunye neeseli ezibomvu zegazi. Imida ye-fibrin idibanisa iiplatelet kunye, kwaye "ekugqibeleni imisa" i-clot ukuze yomelele.
Kwiimitha zeetriyri, indlela yokuqhawula ngokuyinhloko ixhomekeke kwiiplatelet. Kwiimvini, indlela yokuqhawula ngokuyinhloko ixhomekeke kwinkqubo yokuthintela. Kodwa ngokwenene, zombini iiplatelet kunye ne-thrombin zibandakanyeka, kwizinga elinye okanye kwelinye, kuwo onke ama-blood clotting.
Indlela yokuCima ingenza njani iingxaki?
Inkqubo yokucima, njengezo zonke iinkqubo eziyinkimbinkimbi ze-physologic, zivelisa iingxaki.
Kucacile ukuba, nokuba iiplatelets okanye inkqubo ye-thrombin ayisebenzi kakuhle, iziphawuliso zokuphuma kwegazi ezingavamile zingenzeka. Ukubalwa kweplatelet ephantsi kungenzeka nge- chemotherapy , umzekelo, okanye nge- leukemia . Izifo ezininzi zofuzo, kuquka i- hemophilia , zingabangela ukuba inkqubo ye-thrombin ibe yimpumelelo. Naliphi na le miqathango inokubangela iingxaki ezinkulu zokuphuma kwegazi.
Indlela yokucima ingabangela ukuba ama-clots enze apho angenza khona ingozi, imeko ebizwa ngokuba yi-thrombosis.
I-thrombosis inokuvela kwintsimbi ye-coronary (okanye umzobo wengqondo) xa i-palros athelclerotic iyaqhekeka Le ngxube ye-arterial ingavimbela ukuhamba kwegazi kwaye ivelise umonakalo entliziyweni ( intliziyo yesifo ) okanye kwingqondo (i-stroke).
Amaqhekeza angaqhelekanga anokufumaneka nakwiimvini, ngokuqhelekileyo imilenze yomlenze, ukuvelisa imeko ebizwa ngokuba yi- thrombosis eninzi, okanye i-DVT . Amaqhekeza angamaqhekeza angaphula (embolize) aze ahambe emiphakeni, ebangela ukuba yingozi imeko ebizwa ngokuba yi- pulmonary embolus .
Ngoko ke inkqubo yokuqhawula ngokuqhelekileyo iyimfuneko yokukhusela ukuphuma kwegazi ngokugqithiseleyo nokugqithisa ngokugqithiseleyo.
Ukutywala kwegazi okungavumelekanga kungenziwa njani?
Ukuphuma kwegazi okubangelwa yintlupheko yeplatelet kuvame ukuphathwa ngophethiloli weplatelet ngelixa kubangelwa ingxaki yeplatelet.
Ukuphazamiseka kwenkqubo ye-thrombin inokuthi iguqulwe, okwethutyana, kunye ne-plasma infusion (ebeka endaweni yokulahleka okanye ukungasebenzi kakubi).
Izidakamizwa ezijolise ekumiseni ukwakheka kwegazi zingabhekiswa kumsebenzi wokuvimbela iplatelet, okanye inkqubo ye-thrombin. Nangona zonke iinkatho zokwelapha eziye zenzelwe ukuvimbela ama-blood clots zineempembelelo zabo eziyimiphumo emibi, enye ingxaki eqhelekileyo kuzo zonke ezi zonyango ziphuma ngegazi. Zonke mazizisebenzise ngokulumkeleka okufanelekileyo.
ILizwi
Ukusebenza ngokuqhelekileyo kwenkqubo yokucima igazi kubalulekile ebomini. Ngaphandle kokuba i-clotting mechanism isebenza ngaphakathi kwimiqathango yayo eqhelekileyo, ingcipheko, nokuba kuphuma igazi elingaphezulu, okanye ifom yegazi apho kungenakufuneka kwenziwe khona, kubonakalise izitho ezibalulekileyo.
Unyango lwe-clotting inability, ngoko, luphawu olubaluleke kakhulu lwezonyango.
> Imithombo:
> I-Brass LF. UkuThutha kunye nokuSebenza kwePlatelet. I-Chest 2003; 124: 18S.
> Furie B, Furie BC. Iinkqubo zeFrombus Formation. N Engl J Med 2008; 359: 938.
> Goldhaber SZ. Iingxaki zobungozi be-Thromboembolism ye-Venous. J Am Coll Cardiol 2010; 56: 1.