Physiological hemostasis yog ib qho ntawm cov kev tiv thaiv tseem ceeb ntawm lub cev.Thaum cov hlab ntsha puas ntsoog, ntawm ib sab, nws yuav tsum tau tsim ib lub hemostatic ntsaws sai kom tsis txhob poob ntshav;Ntawm qhov tod tes, nws yog ib qho tsim nyog los txwv cov lus teb hemostatic rau qhov puas tsuaj thiab tswj cov kua dej hauv cov hlab ntsha hauv cov hlab ntsha.Yog li, physiological hemostasis yog qhov tshwm sim ntawm ntau yam thiab cov txheej txheem sib cuam tshuam los tswj kom muaj qhov sib npaug.Clinically, cov quav mos feem ntau siv los puncture lub taub hau lossis ntiv tes kom tso cai rau cov ntshav ntws tawm, thiab tom qab ntawd ntsuas lub sijhawm los ntshav.Lub sijhawm no yog hu ua lub sijhawm los ntshav (lub sijhawm los ntshav), thiab tib neeg ib txwm tsis pub dhau 9 feeb (tus qauv qauv).Lub sijhawm los ntshav ntev tuaj yeem cuam tshuam txog lub xeev ntawm lub cev hemostatic muaj nuj nqi.Thaum lub physiological hemostatic muaj nuj nqi tsis muaj zog, hemorrhage nyhav tshwm sim, thiab cov kab mob hemorrhagic tshwm sim;Thaum lub overactivation ntawm lub physiological hemostatic muaj nuj nqi tuaj yeem ua rau pathological thrombosis.

Basic txheej txheem ntawm physiological hemostasis
Cov txheej txheem hemostasis ntawm lub cev feem ntau suav nrog peb txheej txheem: vasoconstriction, platelet thrombus tsim thiab ntshav coagulation.

1 Vasoconstriction Physiological hemostasis yog thawj zaug tshwm sim raws li kev cog lus ntawm cov hlab ntsha puas thiab cov hlab ntsha me me nyob ze, uas txo cov ntshav hauv zos thiab muaj txiaj ntsig zoo los txo lossis tiv thaiv los ntshav.Qhov ua rau vasoconstriction suav nrog peb yam hauv qab no: ① Kev raug mob stimulus reflex ua rau vasoconstriction;② Kev puas tsuaj rau cov phab ntsa vascular ua rau lub zos vascular myogenic contraction;③ Platelets adhering rau qhov raug mob tso tawm 5-HT, TXA₂, thiab lwm yam rau constrict cov hlab ntsha.tshuaj uas ua rau vasoconstriction.

2 Tsim cov platelet-wise hemostatic thrombus Tom qab cov hlab ntsha raug mob, vim yog raug ntawm subendothelial collagen, ib tug me me ntawm platelets ua raws li subendothelial collagen li 1-2 vib nas this, uas yog thawj kauj ruam nyob rau hauv lub tsim ntawm hemostatic thrombus.Los ntawm adhesion ntawm platelets, qhov chaw raug mob tuaj yeem "qhia tau", yog li ntawd lub hemostatic plug tuaj yeem muab tso rau kom raug.Adhered platelets ntxiv ua kom platelet signaling txoj hauv kev los qhib platelets thiab tso endogenous ADP thiab TXA₂, uas nyob rau hauv lem qhib lwm platelets nyob rau hauv cov ntshav, nrhiav neeg platelets ntxiv rau ib leeg thiab ua rau irreversible aggregation;Cov qe ntshav liab puas hauv zos tso tawm ADP thiab hauv zos Cov thrombin tsim tawm thaum lub sijhawm coagulation tuaj yeem ua rau cov platelets ntws los ze ntawm lub qhov txhab txuas ntxiv mus txuas ntxiv thiab sib sau ua ke ntawm cov platelets uas tau ua raws thiab kho rau subendothelial collagen, thiab thaum kawg tsim cov platelet hemostatic ntsaws rau. thaiv lub qhov txhab thiab ua tiav hemostasis ua ntej, tseem hu ua thawj hemostasis (irsthemostasis).Thawj hemostasis feem ntau yog nyob ntawm vasoconstriction thiab tsim ntawm platelet hemostatic plug.Tsis tas li ntawd, kev txo qis ntawm PGI₂ thiab TSIS MUAJ ntau lawm hauv cov hlab ntsha endothelium puas tseem muaj txiaj ntsig zoo rau kev sib sau ntawm cov platelets.

3 Cov ntshav coagulation Cov hlab ntsha puas tuaj yeem ua rau cov ntshav coagulation system, thiab cov ntshav coagulation hauv zos tshwm sim sai, yog li cov fibrinogen soluble hauv plasma hloov mus rau hauv insoluble fibrin, thiab interwoven rau hauv lub network kom ntxiv dag zog rau lub hemostatic plug, uas yog hu ua theem nrab. hemostasis (thib ob hemostasis) hemostasis) (Daim duab 3-6).Thaum kawg, cov ntaub so ntswg hauv zos proliferates thiab loj hlob mus rau hauv cov ntshav txhaws kom ua tiav hemostasis mus tas li.

Physiological hemostasis tau muab faib ua peb txheej txheem: vasoconstriction, platelet thrombus tsim, thiab ntshav coagulation, tab sis peb cov txheej txheem no tshwm sim ua ntu zus thiab sib tshooj, thiab muaj kev sib raug zoo rau ib leeg.Platelet adhesion yog ib qho yooj yim kom ua tiav tsuas yog thaum cov ntshav ntws qeeb los ntawm vasoconstriction;S-HT thiab TXA2 tso tawm tom qab platelet activation tuaj yeem txhawb vasoconstriction.Activated platelets muab ib qho chaw phospholipid rau kev ua kom cov coagulation yam thaum lub sij hawm cov ntshav coagulation.Muaj ntau ntau yam coagulation uas khi rau saum npoo ntawm platelets, thiab platelets tseem tuaj yeem tso cov coagulation yam xws li fibrinogen, yog li ua kom cov txheej txheem coagulation sai heev.Cov thrombin tsim thaum lub sij hawm cov ntshav coagulation tuaj yeem ntxiv dag zog rau kev ua kom cov platelets.Tsis tas li ntawd, kev cog lus ntawm platelets hauv cov ntshav txhaws tuaj yeem ua rau cov ntshav txhaws rov qab thiab nyem tawm cov ntshav hauv nws, ua rau cov ntshav txhaws ntau dua thiab khov kho qhov qhib ntawm cov hlab ntsha.Yog li ntawd, peb txheej txheem ntawm physiological hemostasis txhawb ib leeg, kom lub cev hemostasis tuaj yeem ua tiav raws sijhawm thiab nrawm.Vim tias platelets muaj feem cuam tshuam nrog peb qhov txuas hauv cov txheej txheem physiological hemostasis, platelets ua lub luag haujlwm tseem ceeb hauv cov txheej txheem physiological hemostasis.Lub sij hawm los ntshav yog ncua ntev thaum platelets raug txo los yog txo qis kev ua haujlwm.