1. Clinical aikace-aikace na jini coagulation ayyukan a cikin zuciya da kuma cerebrovascular cututtuka
A duk duniya, adadin mutanen da ke fama da cututtuka na zuciya da jijiyoyin jini yana da yawa, kuma yana nuna karuwa a kowace shekara.A cikin aikin asibiti, marasa lafiya na yau da kullun suna da ɗan gajeren lokacin farawa kuma suna tare da zubar da jini na cerebral, wanda ke yin mummunan tasiri akan hasashen kuma yana barazana ga lafiyar rayuwar marasa lafiya.
Akwai cututtuka da yawa na cututtukan zuciya da jijiyoyin jini, kuma abubuwan da ke tasiri su ma suna da rikitarwa.Tare da ci gaba da zurfafa bincike na asibiti akan coagulation, an gano cewa a cikin cututtukan zuciya da jijiyoyin jini, ana iya amfani da abubuwan haɗin gwiwa azaman abubuwan haɗari ga wannan cuta.Nazarin asibiti ya nuna cewa duka hanyoyin haɗin gwiwa na waje da na ciki na irin waɗannan marasa lafiya za su yi tasiri akan ganewar asali, kimantawa da tsinkayen irin waɗannan cututtukan.Sabili da haka, ƙima mai mahimmanci game da haɗarin coagulation na marasa lafiya yana da matukar mahimmanci ga marasa lafiya da cututtukan zuciya da jijiyoyin jini.mahimmanci.
2. Me ya sa ya kamata marasa lafiya da cututtukan zuciya da na cerebrovascular kula da alamun coagulation
Cututtukan zuciya da jijiyoyin jini cututtuka ne da ke yin illa ga lafiyar ɗan adam da rayuwa, tare da yawan mace-mace da yawan nakasa.
Ta hanyar gano aikin coagulation a cikin marasa lafiya da cututtukan zuciya da na jijiyoyin jini, yana yiwuwa a tantance ko mai haƙuri yana da jini da kuma haɗarin thrombosis na jini;a cikin aikin maganin rigakafin jijiyoyi na gaba, ana iya tantance tasirin anticoagulation kuma ana iya jagorantar magungunan asibiti don guje wa zubar jini.
1).Masu ciwon bugun jini
bugun jini na Cardioembolic wani bugun jini ne na ischemic wanda ke haifar da zubar da jini na cardiogenic da kuma daidaita jijiyoyin kwakwalwa masu dacewa, wanda ya kai kashi 14% zuwa 30% na dukkan shanyewar ischemic.Daga cikin su, bugun jini da ke da alaka da bugun jini yana da fiye da kashi 79% na duk bugun jini na zuciya, da bugun jini na zuciya ya fi tsanani, kuma ya kamata a gano da wuri kuma a shiga tsakani.Don ƙididdige haɗarin thrombosis da maganin maganin ƙwanƙwasawa na marasa lafiya, da kuma maganin maganin ƙwanƙwasa na asibiti yana buƙatar amfani da alamun coagulation don kimanta tasirin maganin ƙwanƙwasa da madaidaicin maganin rigakafin cutar don hana zubar jini.
Babban haɗari a cikin marasa lafiya tare da fibrillation na atrial shine thrombosis arterial, musamman kwakwalwar kwakwalwa.Shawarwarin rigakafin cututtukan zuciya don raunin ƙwayar cuta na biyu zuwa fibrillation na atrial:
1. Ba a ba da shawarar yin amfani da magungunan kashe qwari na yau da kullun ga marasa lafiya da ke fama da rauni mai tsanani ba.
2. A cikin marasa lafiya da aka yi wa thrombolysis, ba a ba da shawarar yin amfani da maganin rigakafi a cikin sa'o'i 24 ba.
3. Idan babu wasu abubuwan da suka hana su, kamar yanayin zubar jini, matsanancin ciwon hanta da koda, hawan jini> 180/100mmHg, da dai sauransu, za a iya la'akari da waɗannan sharuɗɗan zaɓin amfani da magungunan kashe qwari:
(1) Marasa lafiya da ciwon zuciya (irin su bawul na wucin gadi, fibrillation na wucin gadi, ciwon zuciya tare da mural thrombus, hagu na thrombosis na hagu, da dai sauransu) suna da wuyar samun bugun jini.
(2) Marasa lafiya tare da bugun jini na ischemic tare da raunin furotin C, ƙarancin furotin S, furotin C mai aiki da sauran marasa lafiya na thromboprone;marasa lafiya tare da bayyanar cututtuka na extracranial dissecting aneurysm;marasa lafiya tare da intracranial da intracranial artery stenosis.
(3) Marasa lafiya marasa lafiya da ke fama da ciwon kwakwalwa na iya amfani da heparin maras nauyi ko daidaitaccen kashi na LMWH don hana thrombosis mai zurfi da huhu.
2).Darajar sa ido kan coagulation index lokacin da aka yi amfani da magungunan anticoagulant
• PT: Aikin INR na dakin gwaje-gwaje yana da kyau kuma ana iya amfani dashi don jagorantar daidaita kashi na warfarin;tantance haɗarin zubar jini na rivaroxaban da edoxaban.
• APTT: Ana iya amfani da shi don tantance inganci da aminci na (matsakaicin allurai) heparin mara lahani da kuma kimanta haɗarin zubar da jini na dabigatran.
TT: Mai hankali ga dabigatran, ana amfani dashi don tabbatar da ragowar dabigatran a cikin jini.
• D-Dimer/FDP: Ana iya amfani da shi don kimanta tasirin warkewa na magungunan anticoagulant kamar warfarin da heparin;da kuma kimanta tasirin warkewa na magungunan thrombolytic kamar urokinase, streptokinase, da alteplase.
• AT-III: Ana iya amfani da shi don jagorantar tasirin magani na heparin, heparin low heparin, da fondaparinux, kuma don nuna ko ya zama dole don canza magungunan anticoagulants a cikin aikin asibiti.
3).Anticoagulation kafin da kuma bayan cardioversion na atrial fibrillation
Akwai haɗarin thromboembolism a lokacin cardioversion of atrial fibrillation, kuma maganin rigakafin da ya dace zai iya rage haɗarin thromboembolism.Ga marasa lafiya marasa kwanciyar hankali tare da fibrillation na atrial da ke buƙatar gaggawar bugun zuciya, farawar maganin hana daukar ciki bai kamata ya jinkirta cardioversion ba.Idan babu abin da ya hana, ya kamata a yi amfani da heparin ko ƙananan nauyin kwayoyin heparin ko NOAC da wuri-wuri, kuma ya kamata a yi cardioversion a lokaci guda.
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