ʻElua mau haʻawina koʻikoʻi o ke coagulation koko, ʻo ka manawa thromboplastin hapa i hoʻāla ʻia (APTT) a me ka manawa prothrombin (PT), e kōkua i ka hoʻoholo ʻana i ke kumu o nā ʻano coagulation.
No ka mālama ʻana i ke koko i loko o kahi wai, pono ke kino e hana i kahi hana kaulike akahele. Loaʻa i ke koko kaʻapuni ʻelua mau ʻāpana koko, ʻo ka procoagulant, ka mea e hoʻoulu ai i ke kāpili ʻana o ke koko, a me ka anticoagulant, ka mea e kāohi ai i ke kāpili ʻana, e mālama i ke kahe o ke koko. Eia nō naʻe, ke hōʻino ʻia kahi kīʻaha koko a hoʻopilikia ʻia ke kaulike, hōʻiliʻili ka procoagulant ma kahi i hōʻino ʻia a hoʻomaka ke kāpili ʻana o ke koko. ʻO ke kaʻina hana o ke kāpili ʻana o ke koko he loulou-ma-loulou, a hiki ke hoʻāla ʻia e kekahi ʻōnaehana kāpili ʻelua ma ke ʻano like, intrinsic a extrinsic paha. Hoʻāla ʻia ka ʻōnaehana endogenous ke hoʻopili ke koko i ka collagen a i ʻole ka endothelium i hōʻino ʻia. Hoʻāla ʻia ka ʻōnaehana extrinsic ke hoʻokuʻu nā ʻiʻo i hōʻino ʻia i kekahi mau mea kāpili e like me ka thromboplastin. ʻO ke ala maʻamau hope loa o nā ʻōnaehana ʻelua e alakaʻi ana i ka condensation apex. Ke ʻike ʻia kēia kaʻina hana kāpili ʻana, ʻoiai ke ʻano koke, ʻelua mau hoʻokolohua diagnostic koʻikoʻi, ka manawa thromboplastin hapa i hoʻāla ʻia (APTT) a me ka manawa prothrombin (PT), hiki ke hana ʻia. ʻO ka hana ʻana i kēia mau hoʻokolohua e kōkua i ka hana ʻana i kahi hōʻailona koʻikoʻi o nā ʻano coagulation āpau.

 

1. He aha ka mea e hōʻike ai ʻo APTT?

Loiloi ka hoʻāʻo APTT i nā ala coagulation endogenous a me nā ala maʻamau. ʻO ke kikoʻī, ana ia i ka lōʻihi o ka manawa e hana ai kahi hāpana koko i kahi clot fibrin me ka hoʻohui ʻana o kahi mea hana (calcium) a me nā phospholipids. ʻOi aku ka maʻalahi a me ka wikiwiki ma mua o ka manawa thromboplastin hapa. Hoʻohana pinepine ʻia ka APTT e nānā i ka mālama ʻana me ka violet ake.

Loaʻa i kēlā me kēia keʻena hoʻokolohua kona waiwai APTT maʻamau, akā ma ke ʻano laulā mai 16 a 40 kekona. ʻO ka manawa lōʻihi e hōʻike paha i ka lawa ʻole o ka ʻāpana ʻehā o ke ala endogenous, Xia a i ʻole factor, a i ʻole factor hemahema I, V a i ʻole X o ke ala maʻamau. ʻO nā maʻi me ka nele o ka huaora K, ka maʻi akepaʻa, a i ʻole ka disseminated intravascular coagulopathy e hoʻolōʻihi i ka APTT. ʻO kekahi mau lāʻau lapaʻau—nā antibiotics, anticoagulants, narcotics, narcotics, a i ʻole aspirin hiki ke hoʻolōʻihi i ka APTT.

Hiki i ka emi ʻana o ka APTT ke hopena mai ke kahe koko nui, nā ʻeha nui (koe wale nō ke kanesa o ke akepaʻa) a me kekahi mau lāʻau lapaʻau e like me nā antihistamines, antacids, nā hoʻomākaukau digitalis, a pēlā aku.

2. He aha ka mea a PT e hōʻike nei?

Loiloi ka hoʻāʻo PT i nā ala clotting extrinsic a me nā ala clotting maʻamau. No ka nānā ʻana i ka mālama ʻana me nā anticoagulants. Ana kēia hoʻāʻo i ka manawa e pono ai no ka plasma e clot ma hope o ka hoʻohui ʻana o ka tissue factor a me ka calcium i kahi hāpana koko. ʻO kahi pae maʻamau maʻamau no PT he 11 a 16 kekona. ʻO ka hoʻolōʻihi ʻana o ka PT e hōʻike paha i ka nele o ka thrombin profibrinogen a i ʻole ka factor V, W a i ʻole X.

ʻO nā maʻi me ka luaʻi ʻana, ka maʻi palahēhē, ka ʻai ʻana i nā lau ʻōmaʻomaʻo, ka waiʻona a i ʻole ka lāʻau antibiotic lōʻihi, nā antihypertensives, nā anticoagulants waha, nā narcotics, a me nā dosis nui o ka aspirin hiki ke hoʻolōʻihi i ka PT. Hiki ke hana ʻia ka PT haʻahaʻa e nā antihistamine barbiturates, antacids, a i ʻole ka huaora K.

Inā ʻoi aku ka PT o ka mea maʻi ma mua o 40 kekona, pono ka huaora K intramuscular a i ʻole ka plasma hau maloʻo hou. E loiloi i ke kahe koko o ka mea maʻi i kēlā me kēia manawa, e nānā i kona kūlana neurological, a hana i nā hoʻokolohua koko huna i loko o ka mimi a me nā feces.

 

3. E wehewehe i nā hopena

ʻO ka maʻamau, pono i ka mea maʻi me ka coagulation abnormal ʻelua mau hoʻokolohua, APTT a me PT, a pono ʻo ia iā ʻoe e wehewehe i kēia mau hopena, e hala i kēia mau hoʻokolohua manawa, a laila e hoʻonohonoho i kāna lāʻau lapaʻau.