ʻO ka hemostasis physiological kekahi o nā mea pale nui o ke kino.I ka wā e pōʻino ai ke kīʻaha koko, ma ka ʻaoʻao hoʻokahi, pono e hana koke i kahi plug hemostatic e pale ai i ke kahe koko;ma ka ʻaoʻao ʻē aʻe, pono e kaupalena i ka pane hemostatic i ka ʻāpana i hōʻino ʻia a mālama i ke kūlana wai o ke koko i loko o nā kīʻaha koko systemic.No laila, ʻo ka hemostasis physiological ka hopena o nā ʻano mea like ʻole a me nā mīkini e launa pū ana e mālama i kahi kaulike pololei.ʻO ka maʻi maʻi, hoʻohana pinepine ʻia nā nila liʻiliʻi e hou i ka ʻuala pepeiao a i ʻole nā ​​manamana lima e hiki ai ke kahe maoli ke koko, a laila e ana i ka lōʻihi o ke kahe ʻana.Ua kapa ʻia kēia manawa he bleeding time (bleeding time), a ʻaʻole ʻoi aku ka nui o nā kānaka maʻamau ma mua o 9 mau minuke (meʻa hana).Hiki i ka lōʻihi o ke kahe koko ke hōʻike i ke kūlana o ka hana hemostatic physiological.Ke hoʻonāwaliwaliʻia ka hana hemostatic physiological, hele mai ka hemorrhage, a hiki mai nā maʻi hemorrhagic;ʻoiai ka overactivation o ka hana hemostatic physiological hiki ke alakaʻi i ka thrombosis pathological.

Kaʻina kumu o ka hemostasis physiological
ʻO ke kaʻina hana hemostasis physiological he ʻekolu mau kaʻina: vasoconstriction, platelet thrombus formation a me ke koko coagulation.

1 Vasoconstriction Hōʻike mua ʻia ka hemostasis physiological ma ke ʻano he ʻoki ʻana o ke kīʻaha koko i hōʻino ʻia a me nā kīʻaha koko liʻiliʻi kokoke, e hōʻemi ana i ke kahe koko kūloko a he mea pono e hōʻemi a pale i ke koko.ʻO nā kumu o ka vasoconstriction e pili ana i kēia mau ʻano ʻekolu: ① ʻO ka hoʻoulu ʻana i ka hōʻeha ʻeha ke kumu o ka vasoconstriction;② ʻO ka pōʻino o ka pā vascular ke kumu o ka hoʻohaʻahaʻa myogenic kūloko;③ ʻO nā platelets e pili ana i ka hōʻeha e hoʻokuʻu i ka 5-HT, TXA₂, a me nā mea ʻē aʻe e hoʻopaʻa i nā kīʻaha koko.nā mea e hoʻoulu ai i ka vasoconstriction.

2 Ka hoʻokumu ʻana o ka thrombus hemostatic platelet-wise Ma hope o ka hōʻeha ʻana i ka moku koko, ma muli o ka ʻike ʻana o ka subendothelial collagen, kahi liʻiliʻi o nā platelets e pili ana i ka subendothelial collagen i loko o 1-2 kekona, ʻo ia ka hana mua i ka hoʻokumu ʻana o ka thrombus hemostatic.Ma o ka hoʻopili ʻana o nā platelets, hiki ke "ʻike ʻia" ka wahi ʻeha, i hiki ke hoʻonohonoho pono ʻia ka plug hemostatic.Hoʻoulu hou nā platelets i nā ala hōʻailona platelet e hoʻōla i nā platelets a hoʻokuʻu i ka endogenous ADP a me TXA₂, ka mea e hoʻāla ai i nā platelets ʻē aʻe i loko o ke koko, e kiʻi hou i nā platelets e pili i kekahi i kekahi a hoʻoulu i ka hoʻohui ʻana;ʻO ka thrombin i hana ʻia i ka wā o ka coagulation hiki ke hana i nā platelets e kahe ana ma kahi kokoke i ka ʻeha e hoʻopili mau a hōʻiliʻili i nā platelets i hoʻopili ʻia a hoʻopaʻa ʻia i ka subendothelial collagen, a hoʻokumu i kahi platelet hemostatic plug e ālai i ka ʻeha a loaʻa ka hemostasis mua, ʻike ʻia hoʻi he hemostasis mua (irsthemostasis).ʻO ka hemostasis mua e pili ana i ka vasoconstriction a me ka hoʻokumu ʻana o ka platelet hemostatic plug.Eia kekahi, ʻo ka hōʻemi ʻana o ka hana PGI₂ a me NO i ka endothelium vascular i hōʻino ʻia he mea maikaʻi hoʻi i ka hoʻohui ʻana o nā platelets.

3 ʻO ke koko coagulation Hiki i nā kīʻaha koko i hōʻino ʻia ke hoʻoikaika i ka ʻōnaehana coagulation koko, a hiki koke ka coagulation koko kūloko, i hoʻololi ʻia ka fibrinogen soluble i loko o ka plasma i fibrin insoluble, a hoʻopili ʻia i loko o kahi pūnaewele e hoʻoikaika ai i ka plug hemostatic, i kapa ʻia ʻo ke lua. hemostasis (ke koko lua) hemostasis) (Figure 3-6).ʻO ka hope, hoʻonui ka ʻiʻo fibrous kūloko a ulu i loko o ke koko koko e loaʻa ai ka hemostasis mau.

Hoʻokaʻawale ʻia ka hemostasis physiological i ʻekolu mau kaʻina: vasoconstriction, platelet thrombus formation, a me ke koko coagulation, akā ʻo kēia mau kaʻina hana ʻekolu e hana kūleʻa a hoʻopaʻa kekahi i kekahi, a pili pono kekahi i kekahi.He mea maʻalahi ka hoʻopili ʻana i ka platelet i ka wā e hoʻolohi ʻia ke kahe koko e ka vasoconstriction;ʻO S-HT a me TXA2 i hoʻokuʻu ʻia ma hope o ka hoʻoulu ʻana o ka platelet hiki ke hāpai i ka vasoconstriction.Hāʻawi nā platelets i hoʻāla ʻia i kahi phospholipid surface no ka hoʻāla ʻana o nā mea coagulation i ka wā o ka coagulation koko.Nui nā kumu coagulation i hoʻopaʻa ʻia i ka ʻili o nā platelets, a hiki i nā platelets ke hoʻokuʻu i nā mea coagulation e like me fibrinogen, a laila e hoʻolōʻihi i ka hana coagulation.Hiki i ka thrombin i hana ʻia i ka wā coagulation koko ke hoʻoikaika i ka hoʻōla ʻana o nā platelets.Eia kekahi, ʻo ka hoʻohaʻahaʻa ʻana o nā platelets i loko o ke koko e hiki ai ke hoʻihoʻi i ke koko a hoʻopaʻa i ka serum i loko, e hoʻoikaika i ke koko a hoʻopaʻa paʻa i ka wehe ʻana o ke kīʻaha koko.No laila, hoʻoikaika nā kaʻina hana ʻekolu o ka hemostasis physiological i kekahi i kekahi, i hiki ke hoʻokō ʻia ka hemostasis physiological i ka manawa a me ka wikiwiki.Ma muli o ka pili pili ʻana o nā platelets i nā loulou ʻekolu i ke kaʻina hana hemostasis physiological, pāʻani nui nā platelets i ka hana hemostasis physiological.Hoʻoloihi ʻia ka manawa koko ke hoʻemi ʻia nā platelets a hoʻemi ʻia ka hana.