Noʻonoʻo: Ma lalo o nā kūlana physiological maʻamau

1. No ke aha i hui ʻole ai ke koko e kahe ana i loko o nā kīʻaha koko?

2. No ke aha e hiki ai i ka ipu koko i poino ke hooki i ke koko?

Me nā nīnau ma luna, hoʻomaka mākou i kēia lā!

Ma lalo o nā kūlana physiological maʻamau, kahe ke koko i loko o nā kīʻaha koko o ke kanaka a ʻaʻole e kahe i waho o nā kīʻaha koko e hoʻokahe koko, ʻaʻole hoʻi e coagulate i loko o nā kīʻaha koko a hoʻoulu i ka thrombosis.ʻO ke kumu nui ʻo ke kino o ke kanaka he paʻakikī a maikaʻi hoʻi ka hemostasis a me nā hana anticoagulant.Ke ʻano ʻino kēia hana, e pilikia ke kino o ke kanaka i ke koko a i ʻole ka thrombosis.

1. Hemostasis kaʻina

Ua ʻike mākou a pau ʻo ke kaʻina hana o ka hemostasis i loko o ke kino o ke kanaka ʻo ia ka mua o ka hoʻopaʻa ʻana o nā kīʻaha koko, a laila ka adhesion, aggregation a me ka hoʻokuʻu ʻana o nā mea like ʻole procoagulant o nā platelets e hana i ka palapala palapalapala emboli.Kapa ʻia kēia kaʻina hana he hemostasis hoʻokahi.

Eia nō naʻe, ʻoi aku ka mea nui, hoʻāla ia i ka ʻōnaehana coagulation, hoʻokumu i kahi pūnaewele fibrin, a hoʻokumu i kahi thrombus paʻa.Kapa ʻia kēia kaʻina hana he hemostasis lua.

2.Coagulation hana

ʻO ka coagulation koko kahi kaʻina e hoʻāla ʻia ai nā mea coagulation ma kekahi ʻano e hoʻopuka ai i ka thrombin, a ma hope ua hoʻololi ʻia ka fibrinogen i fibrin.Hiki ke hoʻokaʻawale ʻia ke kaʻina hana coagulation i ʻekolu mau ʻanuʻu kumu: ka hoʻokumu ʻana o ka paʻakikī prothrombinase, ka hoʻoulu ʻana o ka thrombin a me ka hana ʻana o ka fibrin.

ʻO nā kumu coagulation ka inoa hui o nā mea i pili pono i ka coagulation koko i loko o ka plasma a me nā kiko.I kēia manawa, he 12 coagulation factor i kapa ʻia e like me ka helu Roma, ʻo ia hoʻi nā kumu coagulation Ⅰ~XⅢ (ʻaʻole i manaʻo hou ʻia ʻo VI ma ke ʻano he kumu coagulation kūʻokoʻa), koe wale no Ⅳ Aia ma ke ʻano ionic, a ʻo ke koena he mau protein.Pono ka hana o Ⅱ, Ⅶ, Ⅸ, a me Ⅹ i ke komo ʻana o VitK.

E like me nā ʻano like ʻole o ka hoʻomaka ʻana a me nā kumu coagulation e pili ana, hiki ke hoʻokaʻawale ʻia nā ala no ka hoʻomohala ʻana i nā complexes prothrombinase i nā ala coagulation endogenous a me nā ala coagulation exogenous.

ʻO ke ala hoʻokaʻawale koko endogenous (hoʻohana maʻamau APTT ho'āʻo) ʻo ia hoʻi, ʻo nā mea āpau i pili i ka coagulation koko mai ke koko mai, ka mea maʻamau e hoʻomaka ʻia e ka hoʻopili ʻana o ke koko me ka ʻili o ke kino haole i hoʻopiʻi maikaʻi ʻia (e like me ke aniani, kaolin, collagen. , etc.);ʻO ke kaʻina hana coagulation i hoʻomaka ʻia e ka ʻike ʻana i ka mea kiko kiko i kapa ʻia ʻo ke ala coagulation exogenous (hoʻohana maʻamau ʻo PT).

Ke noho nei ke kino i kahi kūlana pathological, hiki i ka endotoxin bacteria, hoʻopiha i ka C5a, nā paʻakikī immune, tumor necrosis factor, a me nā mea ʻē aʻe hiki ke hoʻoulu i nā cell endothelial vascular a me nā monocytes e hōʻike i ka mea kiko, a laila e hoʻomaka i ke kaʻina coagulation, e hoʻopiʻi i ka intravascular coagulation (DIC).

3. ʻO ka hana anticoagulation

a.Pūnaehana antithrombin (AT, HC-Ⅱ)

b.Pūnaehana Pūmua C (PC, PS, TM)

c.ʻO ka mea hoʻopaneʻe ala ala ala (TFPI)

Hana: E hōʻemi i ka hoʻokumu ʻana o ka fibrin a hoʻemi i ka pae hoʻāla o nā mea coagulation like ʻole.

4.Fibrinolytic mechanical

Ke hoʻohui ʻia ke koko, hoʻāla ʻia ʻo PLG i PL ma lalo o ka hana a t-PA a i ʻole u-PA, e hoʻoikaika ana i ka hoʻoheheʻe ʻana o ka fibrin a hana i nā huahana degradation fibrin (proto) (FDP), a hoʻohaʻahaʻa ʻia ka fibrin cross-linked ma ke ʻano he huahana kikoʻī.Kāhea ʻia ʻo D-Dimer. ʻO ka hoʻoulu ʻana o ka ʻōnaehana fibrinolytic i māhele nui ʻia i ke ala hoʻāla i loko, ke ala hoʻāla waho a me ke ala hoʻāla waho.

ʻO ke ala hoʻonā i loko: ʻO ia ke ala o PL i hoʻokumu ʻia e ka cleavage o PLG e ke ala coagulation endogenous, ʻo ia ke kumu kumu o ka fibrinolysis lua. ʻO ka PLG e hana i ka PL, ʻo ia ke kumu kumu o ka fibrinolysis mua. ʻO ke ala hoʻāla ʻana: nā lāʻau thrombolytic e like me SK, UK a me t-PA i komo i ke kino o ke kanaka mai waho o ka honua hiki ke hoʻāla iā PLG i PL, ʻo ia ke kumu kumu o thrombolytic therapy.

ʻO kaʻoiaʻiʻo, he paʻakikī nā hana e pili ana i ka coagulation, anticoagulation, a me nā ʻōnaehana fibrinolysis, a he nui nā hoʻokolohua hoʻokolohua e pili ana, akā ʻo ka mea e pono ai mākou e hoʻolohe nui i ke koena ikaika ma waena o nā ʻōnaehana, ʻaʻole hiki ke ikaika a ʻoi aku paha. nāwaliwali.