Ob qhov kev tshawb fawb tseem ceeb ntawm cov ntshav coagulation, qhib ib nrab thromboplastin lub sij hawm (APTT) thiab lub sij hawm prothrombin (PT), ob leeg pab txiav txim seb qhov ua rau coagulation txawv txav.
Txhawm rau kom cov ntshav nyob hauv lub xeev ua kua, lub cev yuav tsum ua kom muaj txiaj ntsig zoo.Circulating ntshav muaj ob yam ntshav, procoagulant, uas txhawb cov ntshav coagulation, thiab anticoagulant, uas inhibits coagulation, tswj cov ntshav khiav.Txawm li cas los xij, thaum cov hlab ntsha puas thiab qhov sib npaug yog cuam tshuam, procoagulant sau rau hauv qhov chaw puas thiab cov ntshav txhaws pib.Cov txheej txheem ntawm cov ntshav coagulation yog ib qho txuas-los ntawm-txuas, thiab nws tuaj yeem qhib tau los ntawm ob lub tshuab coagulation nyob rau hauv parallel, intrinsic lossis extrinsic.Lub kaw lus endogenous yog qhib thaum cov ntshav hu collagen los yog puas endothelium.Lub extrinsic system yog qhib thaum cov ntaub so ntswg puas tso tawm tej coagulation tshuaj xws li thromboplastin.Qhov kawg txoj kev ntawm ob lub tshuab ua rau lub condensation apex.Thaum cov txheej txheem coagulation no, txawm hais tias nws tshwm sim sai sai, ob qhov kev kuaj mob tseem ceeb, qhib lub sijhawm thromboplastin ib nrab (APTT) thiab lub sijhawm prothrombin (PT), tuaj yeem ua tau.Ua cov kev ntsuam xyuas no yuav pab ua kom muaj txiaj ntsig zoo ntawm txhua qhov coagulation txawv txav.

 

1. APTT qhia li cas?

Qhov kev ntsuam xyuas APTT ntsuam xyuas txoj hauv kev endogenous thiab kev coagulation.Tshwj xeeb, nws ntsuas nws siv sijhawm ntev npaum li cas rau cov qauv ntshav los tsim cov fibrin clot nrog ntxiv ntawm cov tshuaj nquag (calcium) thiab phospholipids.Ntau rhiab heev thiab sai dua ib nrab ntawm thromboplastin lub sij hawm.APTT feem ntau yog siv los saib xyuas kev kho mob nrog daim siab violet.

Txhua chav kuaj muaj nws tus nqi APTT ib txwm, tab sis feem ntau yog li ntawm 16 txog 40 vib nas this.Lub sij hawm ntev yuav qhia tau tias qhov tsis txaus ntawm qhov thib plaub ntawm txoj kev endogenous, Xia lossis yam, lossis qhov tsis txaus I, V lossis X ntawm txoj hauv kev.Cov neeg mob uas tsis muaj vitamin K tsis txaus, kab mob siab, lossis tshaj tawm cov kab mob hauv cov hlab ntshav coagulopathy yuav ncua APTT.Qee yam tshuaj - tshuaj tua kab mob, tshuaj tua kab mob, tshuaj tua kab mob, tshuaj yeeb tshuaj, lossis tshuaj aspirin tuaj yeem ua rau APTT ntev.

Kev txo qis APTT tuaj yeem tshwm sim los ntawm qhov mob hnyav, mob hnyav (tshwj tsis yog mob qog noj ntshav siab) thiab qee qhov kev kho tshuaj suav nrog tshuaj tiv thaiv kab mob, tshuaj tiv thaiv kab mob, kev npaj digitalis, thiab lwm yam.

2. PT qhia dab tsi?

PT assay ntsuam xyuas cov txheej txheem extrinsic thiab feem ntau clotting pathways.Rau kev saib xyuas kev kho mob nrog anticoagulants.Qhov kev ntsuam xyuas no ntsuas lub sij hawm nws siv rau cov ntshav plasma tom qab ntxiv cov ntaub so ntswg thiab calcium rau cov ntshav.Qhov ib txwm muaj rau PT yog 11 txog 16 vib nas this.Kev ncua ntev ntawm PT yuav qhia tau tias qhov tsis txaus ntawm thrombin profibrinogen lossis yam V, W lossis X.

Cov neeg mob ntuav, raws plab, noj zaub ntsuab ntsuab, cawv lossis tshuaj tua kab mob ntev, tshuaj tiv thaiv kab mob, tshuaj tiv thaiv qhov ncauj, tshuaj yeeb, thiab tshuaj aspirin ntau tuaj yeem ua rau PT.Qib qis PT kuj tuaj yeem tshwm sim los ntawm cov tshuaj tiv thaiv kab mob barbiturates, antacids, lossis vitamin K.

Yog hais tias tus neeg mob tus PT ntev tshaj 40 vib nas this, intramuscular vitamin K los yog tshiab-dried plasma yuav tsum tau.Txheeb xyuas tus neeg mob lub sijhawm los ntshav, tshuaj xyuas nws lub paj hlwb, thiab kuaj ntshav occult hauv cov zis thiab quav.

 

3. Piav cov txiaj ntsig

Ib tus neeg mob uas muaj cov coagulation txawv txav feem ntau xav tau ob qhov kev sim, APTT thiab PT, thiab nws yuav xav kom koj txhais cov txiaj ntsig no, dhau sijhawm cov kev sim no, thiab thaum kawg npaj nws txoj kev kho mob.