DIC-Syndrome

Matenda a DIC - matenda ofalitsidwa ndi intravascular coagulation - kuphwanya hemostasis, yomwe imadziwika ndi kusintha kwa magazi coagulability. Maselo ang'onoang'ono omwe amachititsa maselo ndi magulu a maselo amagazi ndi omwe amachititsa kusagwiritsidwa ntchito kwa tizilombo toyambitsa matenda ndi kusintha kwa ziwalo mu ziwalo, zomwe zimayambitsa chitukuko cha hypocoagulation, thrombocytopenia ndi magazi.

Zifukwa za chitukuko cha matenda a DIC

Matenda a DIC si matenda osiyana ndipo amayamba kutsutsana ndi zotsatirazi:

• njira zapakati pa kubala, kuchotsa mimba ndi catheterization yaitali ya zombo zazikulu;
• kupwetekedwa kwa mitsempha ya mitsempha, makoma amphamvu ndi parenchyma ya ziwalo zenizeni panthawi yopanga opaleshoni kapena ma prosthetics;
• Kugonjetsedwa ndi matenda opatsirana pogonana komanso mazira a amayi, yobereka;
• mikhalidwe yoopsya, chifukwa cha kuvulala, matenda, kupweteketsa mtima ndi mavuto ena;
• Matenda a khansa (myeloma, erythremia);
• Zopweteka zopangidwa m'mapapo, mapuloteni ndi zikondamoyo;
• Matenda okhaokha (lupus erythematosus, glomerulonephritis , magazi oopsa);
• hemolysis ndi zotentha;
• zilonda za poizoni pamene njoka ya njoka imalowa magazi;
• kugwiritsa ntchito mankhwala osokoneza bongo kwa nthawi yaitali.

Zizindikiro za matenda a DIC

Chipatala cha matenda a DIC chikugwirizana ndi matenda omwe amachititsa vutoli.

Matenda owopsa a DIC amadziwonetsera ngati dziko loopsya loperewera chifukwa cha kuphwanya maulumikizano onse a hemostasis.

Ndi matenda aakulu a DVS ali ndi kuwonjezeka pang'onopang'ono mawonetseredwe a chipatala ndi zizindikiro:

• hypovolemia (kuchepetsa magazi mu mitsempha ya magazi);
• kuwonongeka kwa thupi;
• kusokoneza kwa njira zamagetsi.

Pakati pa matenda a DIC, magawowa ndi awa:

1. Pachiyambi choyamba, kugwiritsira ntchito mankhwala ozunguza bongo komanso kusakanikirana kwa mapaleletiti kumachitika.
2. Mu gawo lachiwiri, pali kusintha kwa magazi clotting (hypercoagulation kapena hypocoagulation).
3. Gawo lachitatu, magazi amatha kugwa konse.
4. Mu gawo lachinai, maseŵero a hemostatic mwina amawoneka kapena zovuta zimayambitsa zotsatira zake.
5. Gawo lachinai likutengedwa ngati lololedwa.

Kuzindikira matenda a ICE

Kawirikawiri, matendawa amakhazikitsidwa pachizindikiro choyamba cha matenda a DIC. Komabe, mu matenda ambiri (mwachitsanzo, mu khansa ya m'magazi, lupus erythematosus), matendawa ndi ovuta. Zikatero, matenda opatsirana a DIC akuchitika, kuphatikizapo:

• kudziwika kwa malire a magazi ;
• Kusanthula kwa magazi ndi prothrombin nthawi;
• kuzindikira kwa kuphwanya mu thromboelastogram;
• mayesero a paracoagulation.

Kuchiza ndi kupewa matenda a DIC

Kuchiza kwa matenda a DIC, monga lamulo, kumachitika mu chipinda cholandirira kwambiri ndipo cholinga chake ndi kuthetsa magazi omwe amapangidwa, kuteteza mapangidwe atsopano a magazi, komanso kubwezeretsa kuyendetsa magazi ndi kuyang'anira hemostasis. Kuonjezera apo, mankhwala opatsirana amachititsa kuchotsa wodwalayo kudziko loopsya, Antibacteria kapena mankhwala ena otchulidwa ndi etiotropic amalola kuti asamane ndi matenda opatsirana. Odwala akhoza kuuzidwa antiticoagulant, disaggregant, fibrinolytic ndi mankhwala othandizira.

Mwachitsanzo, pa matenda a ICE-syndrome, odwala omwe alibe chidziwitso cha chiberekero, njira ya plasmaphoresis imathandiza. Zimaphatikizapo kuti wodwalayo amatengedwa 600ml ya plasma, yomwe imalowetsedwa ndi kukonzekera mazira a pulasitiki atsopano. Njira cholinga chochotsa thupi la gawo limodzi la mapuloteni ndi magulu a chitetezo cha mthupi, kuphatikizapo zinthu zowonongeka.

Kupewa Matenda a DIC makamaka cholinga cha kuthetsa zifukwa zomwe zimapangitsa kuti chitukukocho chikule. Zina mwazitsulo:

• opaleshoni yothandizira, yochitidwa ndi njira yovuta kwambiri;
• mankhwala apamwamba a zotupa;
• kupewa njoka ndi njoka yoopsa;
• Kuphatikizidwa kwa anticoagulants kuchipatala cha matenda opatsirana, ndi zina zotero.