Ob txoj kev tshawb nrhiav tseem ceeb txog kev coagulation ntshav, lub sijhawm ua haujlwm ib nrab thromboplastin (APTT) thiab lub sijhawm prothrombin (PT), ob qho tib si pab txiav txim siab qhov ua rau muaj kev tsis sib xws ntawm cov ntshav coagulation.
Yuav kom cov ntshav nyob rau hauv ib qho kua, lub cev yuav tsum ua ib qho kev sib npaug zoo. Cov ntshav ncig muaj ob lub Cheebtsam ntawm cov ntshav, procoagulant, uas txhawb nqa cov ntshav coagulation, thiab anticoagulant, uas inhibits coagulation, kom tswj cov ntshav ntws. Txawm li cas los xij, thaum cov hlab ntsha raug puas tsuaj thiab qhov sib npaug raug cuam tshuam, procoagulant sau rau hauv thaj chaw raug puas tsuaj thiab cov ntshav coagulation pib. Cov txheej txheem ntawm cov ntshav coagulation yog ib qho txuas-los-txuas, thiab nws tuaj yeem ua haujlwm los ntawm ob lub tshuab coagulation hauv parallel, intrinsic lossis extrinsic. Lub kaw lus endogenous raug ua haujlwm thaum cov ntshav sib cuag collagen lossis endothelium puas tsuaj. Lub kaw lus extrinsic raug ua haujlwm thaum cov ntaub so ntswg puas tsuaj tso tawm qee yam coagulation tshuaj xws li thromboplastin. Txoj kev kawg ntawm ob lub tshuab ua rau lub condensation apex. Thaum cov txheej txheem coagulation no, txawm hais tias nws zoo li yog instantaneous, ob qho kev kuaj mob tseem ceeb, qhib ib feem thromboplastin lub sijhawm (APTT) thiab prothrombin lub sijhawm (PT), tuaj yeem ua tau. Ua cov kev xeem no pab ua kom muaj kev kuaj mob tseem ceeb ntawm txhua qhov kev coagulation tsis zoo.

 

1. APTT qhia txog dab tsi?

Qhov kev ntsuam xyuas APTT soj ntsuam cov txheej txheem coagulation endogenous thiab cov txheej txheem coagulation. Tshwj xeeb, nws ntsuas seb nws siv sijhawm ntev npaum li cas rau cov qauv ntshav los tsim cov fibrin clot nrog kev ntxiv cov tshuaj nquag (calcium) thiab phospholipids. Rhiab dua thiab sai dua li lub sijhawm thromboplastin ib nrab. APTT feem ntau siv los saib xyuas kev kho mob nrog daim siab violet.

Txhua lub chaw kuaj mob muaj nws tus nqi APTT ib txwm muaj, tab sis feem ntau nws kav ntev li ntawm 16 txog 40 vib nas this. Lub sijhawm ntev yuav qhia tau tias qhov tsis txaus ntawm qhov chaw thib plaub ntawm txoj kev endogenous, Xia lossis factor, lossis qhov tsis txaus factor I, V lossis X ntawm txoj kev sib koom ua ke. Cov neeg mob uas tsis muaj vitamin K txaus, kab mob siab, lossis cov kab mob intravascular coagulopathy yuav ua rau APTT ntev dua. Qee cov tshuaj - tshuaj tua kab mob, tshuaj anticoagulants, tshuaj narcotics, tshuaj narcotics, lossis aspirin kuj tuaj yeem ua rau APTT ntev dua.

Qhov txo qis ntawm APTT tuaj yeem tshwm sim los ntawm kev los ntshav sai sai, cov qhov txhab loj (tsis yog mob qog noj ntshav hauv siab) thiab qee yam kev kho mob suav nrog cov tshuaj antihistamines, antacids, digitalis preparations, thiab lwm yam.

2. PT qhia dab tsi?

Qhov kev ntsuam xyuas PT soj ntsuam cov kev mob ntawm sab nraud thiab cov kev mob uas tshwm sim. Rau kev saib xyuas kev kho mob nrog cov tshuaj anticoagulants. Qhov kev xeem no ntsuas lub sijhawm uas nws siv rau cov ntshav kom ntshav khov tom qab ntxiv cov ntaub so ntswg thiab calcium rau hauv cov qauv ntshav. Ib qho ntau thiab tsawg rau PT yog 11 txog 16 vib nas this. Kev ncua sijhawm ntawm PT yuav qhia txog qhov tsis txaus ntawm thrombin profibrinogen lossis factor V, W lossis X.

Cov neeg mob uas ntuav, raws plab, noj zaub ntsuab nplooj, haus dej cawv lossis siv tshuaj tua kab mob ntev, tshuaj tiv thaiv ntshav siab, tshuaj tiv thaiv ntshav khov hauv qhov ncauj, tshuaj yeeb, thiab tshuaj aspirin ntau kuj tuaj yeem ua rau PT ntev. PT qib qis kuj tuaj yeem tshwm sim los ntawm antihistamine barbiturates, antacids, lossis vitamin K.

Yog tias tus neeg mob lub sijhawm PT tshaj 40 vib nas this, yuav tsum tau txhaj tshuaj vitamin K rau hauv cov leeg lossis cov ntshav khov qhuav tshiab. Soj ntsuam tus neeg mob cov ntshav tsis tu ncua, xyuas nws lub paj hlwb, thiab kuaj cov ntshav zais hauv cov zis thiab cov quav.

 

3. Piav qhia txog cov txiaj ntsig

Feem ntau tus neeg mob uas muaj cov ntshav txhaws tsis zoo yuav tsum tau ob qho kev kuaj, APTT thiab PT, thiab nws yuav xav kom koj txhais cov txiaj ntsig no, dhau cov kev kuaj sijhawm no, thiab thaum kawg npaj nws txoj kev kho mob.