ʻElua mau haʻawina hoʻopaʻa koko koʻikoʻi, ka manawa thromboplastin ʻāpana i hoʻāla ʻia (APTT) a me ka manawa prothrombin (PT), kōkua ʻelua i ka hoʻoholo ʻana i ke kumu o nā mea ʻino o ka coagulation.
No ka mālama ʻana i ke koko i loko o kahi ʻano wai，Pono ke kino e hana i kahi hana kaulike maʻalahi.Loaʻa i ke koko kaapuni ʻelua ʻāpana koko, ka procoagulant, ka mea e hoʻoikaika i ka coagulation koko, a me ka anticoagulant, ka mea e pale ai i ka coagulation, e mālama i ke kahe koko.Eia nō naʻe, i ka wā e pōʻino ai ke kīʻaha koko a hoʻopilikia ʻia ke koena, e hōʻiliʻili ka procoagulant i ka wahi i poino a hoʻomaka ke koko.ʻO ke kaʻina hana o ka coagulation koko he loulou-by-link, a hiki ke hoʻoikaika ʻia e nā ʻōnaehana coagulation ʻelua i ka like, intrinsic a extrinsic paha.Hoʻohana ʻia ka ʻōnaehana endogenous i ka wā e pili ai ke koko i ka collagen a i ʻole endothelium pōʻino.Hoʻohana ʻia ka ʻōnaehana extrinsic i ka wā e hoʻokuʻu ai ka ʻiʻo ʻino i kekahi mau mea coagulation e like me ka thromboplastin.ʻO ke ala maʻamau hope loa o nā ʻōnaehana ʻelua e alakaʻi ana i ka piko condensation.Ke hana ʻia kēia kaʻina coagulation, ʻoiai he mea hikiwawe, hiki ke hana ʻia ʻelua mau hoʻokolohua diagnostic nui, ka manawa thromboplastin ʻāpana (APTT) a me ka manawa prothrombin (PT), hiki ke hana.ʻO ka hana ʻana i kēia mau hoʻāʻo e kōkua i ka hana ʻana i kahi hōʻailona nui o nā mea ʻino a pau o ka coagulation.

 

1. He aha ka APTT e hōʻike ai?

Hoʻopili ka APTT assay i nā ala coagulation endogenous a maʻamau.ʻO ke kikoʻī, e ana ʻo ia i ka lōʻihi o kahi laʻana koko e hana ai i kahi fibrin clot me ka hoʻohui ʻana i kahi mea hana (calcium) a me nā phospholipids.ʻOi aku ka maʻalahi a me ka wikiwiki ma mua o ka manawa thromboplastin hapa.Hoʻohana pinepine ʻia ʻo APTT no ka nānā ʻana i ka mālama ʻana me ka violet ate.

Loaʻa i kēlā me kēia keʻena keʻena kāna waiwai APTT maʻamau, akā maʻamau mai 16 a 40 kekona.Hiki i ka manawa lōʻihi ke hōʻike i ka lawa ʻole o ka ʻehā o ke ala hope, Xia a i ʻole kumu, a i ʻole kumu hemahema I, V a i ʻole X o ke ala maʻamau.ʻO ka poʻe maʻi me ka nele o ka huaora K, ka maʻi ate, a i ʻole ka hoʻolaha ʻana o ka coagulopathy intravascular e hoʻolōʻihi i ka APTT.Hiki ke hooloihi i ka APTT kekahi mau lāʻau lapaʻau—antibiotic, anticoagulants, narcotics, narcotics, a aspirin.

Hiki ke hoʻemi ʻia ka APTT ma muli o ke koko nui, nā ʻeha nui (ma waho aʻe o ka maʻi maʻi ate) a me kekahi mau lāʻau lapaʻau me nā antihistamines, antacids, digitalis preparations, etc.

2. He aha ka PT e hōʻike ai?

Hoʻopili ka PT assay i nā ala clotting extrinsic a maʻamau.No ka nānā ʻana i ka mālama ʻana me nā anticoagulants.ʻO kēia hoʻāʻo e ana i ka manawa e hoʻopili ai ka plasma ma hope o ka hoʻohui ʻana o ka mea kiko a me ka calcium i kahi laʻana koko.ʻO ka laulā maʻamau maʻamau no PT he 11 a 16 kekona.Hiki i ka hoʻolōʻihi ʻana o PT ke hōʻike i kahi hemahema o ka thrombin profibrinogen a i ʻole ka helu V, W a i ʻole X.

ʻO ka poʻe maʻi me ka luaʻi, ka maʻi maʻi, ka ʻai ʻana i nā lau lau ʻōmaʻomaʻo, ka waiʻona a i ʻole ka lāʻau antibiotic lōʻihi, antihypertensives, anticoagulants waha, narcotics, a me ka nui o ka aspirin hiki ke hoʻolōʻihi i ka PT.Hiki ke hoʻokumu ʻia ka PT haʻahaʻa haʻahaʻa e ka antihistamine barbiturates, antacids, a i ʻole ka huaora K.

Inā ʻoi aku ka PT o ka mea maʻi ma mua o 40 kekona, e koi ʻia ka intramuscular vitamin K a i ʻole ka plasma hau maloʻo hou.E nānā i kēlā me kēia manawa i ke koko o ka mea maʻi, e nānā i kona kūlana neurological, a hana i nā hoʻāʻo koko huna i ka mimi a me nā feces.

 

3. E wehewehe i nā hopena

ʻO ka mea maʻi me ka coagulation maʻamau e pono i ʻelua mau hoʻokolohua, APTT a me PT, a pono ʻo ia iā ʻoe e wehewehe i kēia mau hopena, e hele i kēia mau hoʻokolohua manawa, a hoʻonohonoho hope i kāna lapaʻau.