01. Te mōhio tuatahi ki te D-dimer, FDP

1. Ko te FDP te kupu whānui mō ngā hua pirau o te fibrin me te fibrinogen i raro i te mahi a te plasmin, e whakaata ana i te taumata fibrinolytic whānui o te tinana;

2. Ko te D-dimer he hua pakaru motuhake o te fibrin honohono-whiti i raro i te mahi a te plasmin, ā, ko te pikinga o tōna taumata e tohu ana i te noho o te hyperfibrinolysis tuarua;

02. Te whakamahinga haumanu o te D-dimer me te FDP

Kaua e whakaurua te totohu o roto i ngā uaua (kei roto i te VTE te DVT, te PE)

Ka taea e te tika o te whakakorenga kino o te D-dimer o te toto toto hohonu (DVT) te eke ki te 98%-100%.

Ka taea te whakamahi i te tātaritanga D-dimer hei whakakore i te thrombosis uaua

♦Te hiranga o te tautuhi i te DIC

1. He tukanga pathophysiological uaua te DIC, ā, he mate toto-toto kino kua riro mai. He tere te tīmatanga o te nuinga o ngā DIC, he uaua te mate, he tere te whanaketanga, he uaua te tautuhi mate, ā, he morearea te putanga mai o te mate. Ki te kore e tautuhi wawetia, e rongoatia paitia, he maha ngā wā ka tūpono te ora o te tūroro;

2. Ka taea e te D-dimer te whakaata i te kaha o te DIC ki tētahi taumata, ka taea te whakamahi i te FDP hei aroturuki i te whanaketanga o te mate i muri i te whakaūnga o te tātaritanga, ā, ka āwhina te antithrombin (AT) ki te mārama ki te kaha o te mate me te whai huatanga o te maimoatanga heparin. Ko te whakakotahitanga o te D-dimer, te FDP me te whakamātautau AT kua noho hei tohu pai rawa atu mō te tātaritanga o te DIC.

♦Te hiranga o ngā pukupuku kino

1. He hononga tata ngā pukupuku kino ki te koretake o te mahi hemostasis. Ahakoa he pukupuku totoka kino, he leukemia rānei, ka pāngia ngā tūroro e te āhua totoka nui, te thrombosis rānei. Ko te adenocarcinoma e uaua ana ki te thrombosis te mea tino noa;

2. He mea tika kia whakanuia ko te totohu toto he tohu tōmua pea o te pukupuku. Mō ngā tūroro he totohu toto hohonu kāore e kite i ngā āhuatanga mōrearea o te totohu toto, tera pea he pukupuku kei roto.

♦Te hiranga haumanu o ētahi atu mate

1. Te aroturuki i te rongoā thrombolytic

I te wā e rongoatia ana, ki te kore e ranea te nui o te rongoā whakaheke toto, ā, kāore anō kia memeha katoa te thrombus, ka mau tonu te taumata teitei o te D-dimer me te FDP i muri i te taenga ki tōna taumata teitei; i te mea ka nui rawa te rongoā whakaheke toto ka piki ake te mōrearea o te toto.

2. Te hiranga o te maimoatanga heparin ngota iti i muri i te pokanga

He maha ngā wā ka rongoatia ngā tūroro e whara ana/pokanga ki te ārai i ngā rongoā ārai toto.

Ko te horopeta taketake o te heparin ngota iti ko te 2850IU/rā, engari ki te mea ko te taumata D-dimer o te tūroro he 2ug/ml i te 4 o ngā rā i muri i te pokanga, ka taea te whakanui ake i te horopeta ki te 2 ngā wā i te rā.

3. Te tapahi koi o te aorta (AAD)

Ko te AAD tētahi o ngā tino take o te matenga ohorere o ngā tūroro. Mā te tautuhi me te maimoatanga wawe ka taea te whakaiti i te mate o ngā tūroro me ngā mōrearea hauora.

Ko te tikanga pea mō te pikinga o te D-dimer i roto i te AAD: I muri i te pakaru o te paparanga waenga o te pakitara o te oko toto aorta nā ngā take maha, ka pakaru te pakitara o te oko toto, ka uru te toto ki roto, ki waho hoki, ka hanga he "kōhao teka", nā te toto pono me te toto teka i roto i te kōhao. He rerekētanga nui te tere o te rere, ā, he puhoi te tere o te rere i roto i te kōhao teka, ka ngāwari te puta o te thrombosis, ka whakahohehia te pūnaha fibrinolytic, ā, i te mutunga ka whakatairanga i te pikinga o te taumata D-dimer.

03. Ngā āhuatanga e pā ana ki te D-dimer me te FDP

1. Ngā āhuatanga ā-tinana

Teitei: He rerekētanga nui kei waenganui i te tau, ngā wāhine hāpu, te whakakori tinana kaha, me te paheketanga.

2. Te pānga o te mate

Teitei: te whiu o te roro, te rongoā thrombolytic, te mate kino, te sepsis, te gangrene kiko, te preeclampsia, te hypothyroidism, te mate ate kino, te sarcoidosis.

3. Te Hyperlipidemia me ngā pānga o te inu waipiro

Teitei: ngā kaiinu;

Whakaitihia: te hyperlipidemia.

4. Ngā pānga o te rongoā

Teitei: heparin, ngā rongoā antihypertensive, urokinase, streptokinase me te staphylokinase;

Te whakaiti: ngā ārai hapūtanga ā-waha me te estrogen.
04. Whakarāpopototanga

He haumaru, he māmā, he tere, he ohanga, ā, he tino tairongo te kitenga i te D-dimer me te FDP. Ka rerekē ngā nekehanga o ngā huringa o ngā mate manawa, ngā mate ate, ngā mate roro, te toto toto tiketike i puta mai i te hāputanga, me te pre-eclampsia i roto i ēnei e rua. He mea nui kia aromatawaihia te kaha o te mate, kia aroturukihia te whanaketanga me te huringa o te mate, me te aromatawai i te matapae o te hua whakaora.