1. Amfani da ayyukan daidaita jini a cikin cututtukan zuciya da jijiyoyin jini
A duk duniya, adadin mutanen da ke fama da cututtukan zuciya da jijiyoyin jini yana da yawa, kuma yana nuna karuwar yanayin kowace shekara. A aikin asibiti, marasa lafiya da aka saba da su suna da ɗan gajeren lokacin farawa kuma suna tare da zubar jini a kwakwalwa, wanda hakan ke shafar hasashen kuma yana barazana ga lafiyar marasa lafiya.
Akwai cututtuka da yawa na cututtukan zuciya da jijiyoyin jini, kuma abubuwan da ke tasiri a cikinsu suma suna da matuƙar rikitarwa. Tare da ci gaba da zurfafa bincike a asibiti kan coagulation, an gano cewa a cikin cututtukan zuciya da jijiyoyin jini, ana iya amfani da abubuwan coagulation a matsayin abubuwan da ke haifar da wannan cuta. Nazarin asibiti ya nuna cewa hanyoyin coagulation na waje da na ciki na irin waɗannan marasa lafiya za su yi tasiri kan ganewar asali, kimantawa da kuma hasashen irin waɗannan cututtuka. Saboda haka, cikakken kimanta haɗarin coagulation na marasa lafiya yana da matuƙar muhimmanci ga marasa lafiya da ke fama da cututtukan zuciya da jijiyoyin jini.
2. Me yasa marasa lafiya da cututtukan zuciya da jijiyoyin jini ya kamata su kula da alamun ɗigon jini
Cututtukan zuciya da jijiyoyin jini cututtuka ne da ke barazana ga lafiyar ɗan adam da rayuwarta, tare da yawan mace-mace da kuma yawan nakasa.
Ta hanyar gano aikin coagulation a cikin marasa lafiya da cututtukan zuciya da jijiyoyin jini, ana iya tantance ko majiyyaci yana da zubar jini da kuma haɗarin thrombosis na jijiyoyin jini; a cikin tsarin maganin coagulation na gaba, ana iya tantance tasirin anticoagulation kuma ana iya jagorantar magunguna na asibiti don guje wa zubar jini.
1) Marasa lafiya da ke fama da bugun jini
Ciwon zuciya da jijiyoyin jini (cardioembolic stroke) wani bugun jini ne da ke faruwa sakamakon zubar jini a zuciya da kuma toshe hanyoyin jini masu dacewa, wanda ya kai kashi 14% zuwa 30% na dukkan bugun jini na ischemic. Daga cikinsu, bugun jini da ke da alaƙa da atrial fibrillation ya kai fiye da kashi 79% na dukkan bugun jini na cardioembolic, kuma bugun jini na cardioembolic ya fi tsanani, kuma ya kamata a gano shi da wuri kuma a yi aiki da shi sosai. Don tantance haɗarin thrombosis da maganin hana zubar jini ga marasa lafiya, da kuma maganin hana zubar jini, ya kamata a yi amfani da alamun hana zubar jini don tantance tasirin hana zubar jini da kuma magungunan hana zubar jini na musamman don hana zubar jini.
Babban haɗarin da ke tattare da masu fama da matsalar atrial fibrillation shine thrombosis na jijiyoyin jini, musamman embolism na cerebral embolism. Shawarwarin hana zubar jini ga bugun kwakwalwa wanda ya biyo bayan atrial fibrillation:
1. Ba a ba da shawarar a yi amfani da magungunan rage kitse nan take ga marasa lafiya da ke fama da bugun zuciya mai tsanani ba.
2. Ga marasa lafiya da aka yi wa magani da thrombolysis, ba a ba da shawarar a yi amfani da magungunan hana zubar jini cikin awanni 24 ba.
3. Idan babu wasu abubuwan da ke hana zubar jini kamar yadda ake zubar jini, cututtukan hanta da koda masu tsanani, hawan jini sama da 180/100mmHg, da sauransu, ana iya ɗaukar waɗannan yanayi a matsayin amfani da magungunan hana zubar jini ta hanyar zaɓe:
(1) Marasa lafiya da ke fama da bugun zuciya (kamar bawul ɗin roba, fibrillation na atrial, bugun zuciya mai toshewar jijiyoyin jini, bugun zuciya na atrial na hagu, da sauransu) suna iya sake kamuwa da bugun jini.
(2) Marasa lafiya da ke fama da bugun jini na ischemic tare da ƙarancin furotin C, ƙarancin furotin S, juriyar furotin C mai aiki da sauran marasa lafiya masu thrombosis; marasa lafiya da ke fama da alamun cutar aneurysm ta hanyar rarrabawa daga kwakwalwa; marasa lafiya da ke fama da stenosis na jijiyoyin jini a cikin kwakwalwa da kuma a cikin kwakwalwa.
(3) Marasa lafiya da ke kwance a gado waɗanda ke fama da bugun kwakwalwa za su iya amfani da ƙaramin maganin heparin ko kuma maganin LMWH mai dacewa don hana thrombosis na jijiyoyin jini da kuma bugun zuciya na huhu.
2). Darajar sa ido kan ma'aunin coagulation lokacin da ake amfani da magungunan hana zubar jini
• PT: Aikin INR na dakin gwaje-gwaje yana da kyau kuma ana iya amfani da shi don jagorantar daidaita adadin warfarin; tantance haɗarin zubar jini na rivaroxaban da edoxaban.
• APTT: Ana iya amfani da shi don tantance inganci da amincin (matsakaicin allurai) marasa rarrabuwar heparin da kuma tantance haɗarin zubar jini na dabigatran ta hanyar inganci.
• TT: Mai saurin kamuwa da dabigatran, wanda ake amfani da shi don tabbatar da ragowar dabigatran a cikin jini.
• D-Dimer/FDP: Ana iya amfani da shi don tantance tasirin maganin magungunan hana zubar jini kamar warfarin da heparin; da kuma kimanta tasirin maganin thrombolytic kamar urokinase, streptokinase, da alteplase.
• AT-III: Ana iya amfani da shi don jagorantar tasirin maganin heparin, heparin mai ƙarancin nauyin ƙwayoyin halitta, da fondaparinux, da kuma nuna ko ya zama dole a canza magungunan hana ɗaukar ciki a aikin asibiti.
3) Maganin hana zubar jini kafin da kuma bayan bugun zuciya na atrial fibrillation
Akwai haɗarin thromboembolism yayin bugun zuciya na atrial fibrillation, kuma maganin hana zubar jini mai dacewa na iya rage haɗarin thromboembolism. Ga marasa lafiya marasa kwanciyar hankali na hemodynamics waɗanda ke da atrial fibrillation waɗanda ke buƙatar gaggawar bugun zuciya, fara maganin hana zubar jini bai kamata ya jinkirta bugun zuciya ba. Idan babu wata hanyar hana zubar jini, ya kamata a yi amfani da heparin ko ƙananan nauyin ƙwayoyin halitta ko NOAC da wuri-wuri, kuma a yi aikin bugun zuciya a lokaci guda.
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