Pamene uli ndi pakati, mayi amakuuza iwe kuti utenge mayesero ambiri: choyenera, chimene amayi onse oyembekezera ayenera kutenga mzere wina, ndi zina - ngati akufunikira. Kuwongolera pa nthawi ya mimba ndi imodzi mwa mayesero ovomerezeka. Chitani kamodzi mu trimester (zosavuta kunena, kamodzi pa miyezi itatu). Koma ngati mayi atalembedwa pambuyo pa sabata la 12 la mimba, ndiye kuti padzakhala maphunziro awiriwa: nthawi yomweyo mayiyo atalembedwa komanso asanapite kuzimayi - pa masabata 30.
Kuwonjezera pamenepo, kufufuza pa coagulogram panthawi yomwe mayiyo ali ndi mimba kumaperekedwa pambuyo pa chithandizo, ngati munalibe vutoli, komanso musanabadwe, ngati mutapatsidwa gawo lachilombo. Magazi pa coagulogram pamene ali ndi mimba imatengedwanso, monga kusanthula zamagulu - kuchokera mitsempha ndi m'mimba yopanda kanthu.
Kodi magazi a coagulogram amasonyeza chiyani?
Zizindikiro zazikulu za munthu wathanzi coagulogram:
Nthawi yotseka - mphindi 5-10;- nthawi yowonjezeredwa (ATS) - 50 - 70 masekondi;
- nthawi yowonjezera ya thromboplastin (APTT) - masekondi 24 mpaka 35;
- prothrombin index - 80 - 120%;
- zomwe zili ndi fibrinogen - 2 - 4 g / l;
- nthawi yotsitsa - masekondi 11 mpaka 17.8;
- Mavitamini otchedwa monomer complex (RNMC) - 4 mg / 100 ml;
- Ntchito ya fibrinolytic - 183 - 263 mphindi;
- trombotest - IV - V digiri;
- fibrinogen - 5.9 - 11.7 μmol / l;
- fibrinogen B - zoipa;
- plasma kulekerera ndi heparin - mphindi 3 mpaka 11;
- Kutuluka kwa Duroku mpaka mphindi 4;
- kubwezeretsa magazi - 44 - 65%;
- nthawi yowonjezeredwa kwa plasma (VPR) ndi masekondi 60 mpaka 120.
Bwanji osintha zotsatira za coagulation panthawi yoyembekezera?
Zisonyezero za kugwidwa pakati pa mimba nthawi zambiri zimakhala zosiyana, chifukwa thupi likukonzekera kubereka kumeneku, kuti magazi asatayika nthawi yayitali, ndipo magazi amayamba kuthamanga mofulumira. Izi zimawoneka ngakhale ndi coagulogram yosavuta, pamene chiwerengero cha mapulogalamu okhawo amatsimikiziridwa - zigawo za magazi zomwe zimapangidwa kuchokera ku thrombus (nthawi zambiri chiwerengero chawo chimakhala cha 150 mpaka 400 x 109 / L), nthawi yotseka (5-10 mphindi malinga ndi njira), fibrinogen ndi prothrombin index.
Magazi a coagulability amachulukitsa thupi, ndipo izi zikuwonekera polemba zizindikiro zina:
- fibrinogen - mapuloteni omwe amapangidwa ndi fibrin m'magazi - m'kati mwa magawo atatu a mimba ya mimba kuchuluka kwake kumakula kuchokera 2 mpaka 4 mpaka 6 g / l;
- pulogalamu ya prothrombin ya amayi apakati sayenera kusiyana ndi kafukufuku wamba: prothrombin - mapuloteni a plasma a m'magazi, omwe amapangidwira pang'onopang'ono - chiwerengero chikukwera ngati chiwonongeko cha msanga chisanafike chikuchitika.
Nchifukwa chiyani amapereka coagulogram yochulukirapo pa nthawi ya mimba?
Mu ma laboratories ena mwakamodzi kapena kupatuka ku chizolowezi chosavuta kapena coagulogram coagulogram yowonjezereka pamene mimba yatha. Koma chitsogozo cha coagulogram yapaderadera chimapangidwira zizindikiro zenizeni: ndi mimba yambiri , oyambirira komanso mochedwa mimba gestosis, intrauterine fetal imfa, matenda olowa mwazi, mbiri yakale ya kusabereka, kupitako padera.
Nthawi yowonjezera ya thromboplastin (APTT) imasonyeza kukhalapo kwa zinthu zowonongeka, popanda zomwe sizingatheke kupanga magazi. Amayi oyembekezera amfupikitsidwa kwa masekondi 17 mpaka 20 (thrombus kuchokera fibrinogen ndi thandizo lawo amapangidwa mofulumira). Lupus anticoagulant sayenera kukhalapo m'mimba mwa amayi omwe ali ndi pakati, koma imawoneka mu matenda omwe amadzimva okhaokha komanso mochedwa toxicosis ya mimba, kupezeka kwake kumabweretsa kuwonjezeka kwa APTT. Nthawi ya Thrombin (masentimita 11 mpaka 18) amayi oyembekezera amakula mpaka 18 - 25 masekondi. Nthawi ino ndi gawo lomalizira la kutseka kwa magazi, pamene nsonga za fibrin zimapangidwa kuchokera ku fibrinogen pansi pochitidwa ndi thrombin (coagulation factor).
Ndi chiyani chomwe chimaletsa kusintha kwa coagulogram pathupi?
Ngati magawo a coagulogram ndi osiyana ndi ozolowereka, ndiye choyamba, tiyenera kumvetsetsa mbali iyi kusintha: magazi coagulation akuwonjezeka kapena, pang'onopang'ono, amachepetsanso. Ndipo chitani bwino kuposa katswiri. Zoonadi, kuchepa kwa coagulation mphamvu ya magazi kungakhale chifukwa cha kusamutsidwa msanga kwa placenta ndi kuchepa kwa magazi: zosungira zogwirizanitsa magazi zimakhala zatha ndipo matenda a coagulation, omwe ndi oopsa kwa amayi, akhoza kuyamba. Ndipo kuwonjezeka kwa magazi kumatulutsa mtundu wina wa thrombosis.