Likarolo tsa coagulation nakong ea bokhachane


Mongoli: Mohlahlami   

Nakong ea kemolo e tloaelehileng, tlhahiso ea pelo ea eketseha 'me ho hanyetsa peripheral ho fokotseha ha lilemo tsa boimana li ntse li eketseha.Ka kakaretso ho lumeloa hore tlhahiso ea pelo e qala ho eketseha libeke tse 8 ho isa ho tse 10 tsa bokhachane, 'me e fihla tlhōrō ea libeke tse 32 ho isa ho tse 34 tsa bokhachane, e leng 30% ho ea ho 45% e phahameng ho feta ea ba sa ima,' me e boloka boemo bona ho fihlela. phano.Ho fokotseha ha peripheral vascular resistance ho fokotsa khatello ea mali, 'me khatello ea mali ea diastolic e fokotseha haholo,' me phapang ea khatello ea pelo ea eketseha.Ho tloha libekeng tse 6 ho isa ho tse 10 tsa boimana, palo ea mali ea bakhachane e eketseha ka keketseho ea nako ea bokhachane, 'me e eketseha ka hoo e ka bang 40% qetellong ea bokhachane, empa keketseho ea plasma ea mali e feta hōle palo ea lisele tse khubelu tsa mali, plasma. e eketseha ka 40% ho isa ho 50%, 'me lisele tse khubelu tsa mali li eketseha ka 10% ho ea ho 15%.Ka hona, nakong ea bokhachane bo tloaelehileng, mali a hlapolloa, a bonahatsoa e le ho fokotseha ha viscosity ea mali, ho fokotseha ha hematocrit, le ho eketseha ha tekanyo ea erythrocyte sedimentation [1].

Lintho tse kopanyang mali Ⅱ, Ⅴ, VII, Ⅷ, IX, le Ⅹ kaofela lia eketseha nakong ea bokhachane, 'me li ka fihla linakong tse 1.5 ho isa ho tse 2.0 tse tloaelehileng nakong ea bokhachane le bohareng, le mesebetsi ea coagulation factor Ⅺ le  e fokotseha.Fibrinopeptide A, fibrinopeptide B, thrombinogen, platelet factor Ⅳ le fibrinogen e ile ea eketseha haholo, ha antithrombin Ⅲ le protheine C le protheine S li fokotsehile.Nakong ea bokhachane, nako ea prothrombin le nako ea prothrombin e sebetsang e khutsufatsoa, ​​​​'me boemo ba plasma fibrinogen bo eketseha haholo, bo ka nyolohelang ho 4-6 g/L trimester ea boraro, e leng hoo e ka bang 50% e phahameng ho feta ea ba sa imang. nako.Ho phaella moo, plasminogen e ile ea eketseha, nako ea ho qhibiliha ha euglobulin e ile ea lelefala, 'me liphetoho tsa coagulation-anticoagulation li ile tsa etsa hore' mele o be boemong ba hypercoagulable, e neng e le molemo ho hemostasis e sebetsang ka mor'a ho phatloha ha placenta nakong ea mosebetsi.Ho feta moo, mabaka a mang a hypercoagulable nakong ea bokhachane a kenyelletsa keketseho ea kakaretso ea k'holeseterole, phospholipids le triacylglycerol maling, androgen le progesterone e hlahisoang ke placenta e fokotsa phello ea li-inhibitors tse itseng tsa mali a coagulation, placenta, decidua ea uterine le mahe.Ho ba teng ha lintho tsa thromboplastin, joalo-joalo, ho ka khothalletsa mali hore a be boemong ba hypercoagulable, 'me phetoho ena e mpefala le ho eketseha ha nako ea bokhachane.Hypercoagulation e itekanetseng ke mokhoa oa tšireletso oa 'mele, o leng molemo ho boloka fibrin e kenngoa ka har'a methapo, lebota la uterine le placental villi, ho thusa ho boloka botšepehi ba placenta le ho theha thrombus ka lebaka la ho hlobola, le ho nolofatsa hemostasis e potlakileng nakong le ka mor'a ho pepa., ke mokhoa oa bohlokoa oa ho thibela ho tsoa ha mali ka mor'a ho pepa.Ka nako e ts'oanang, ts'ebetso ea bobeli ea fibrinolytic e qala ho tlosa thrombus ka har'a methapo ea mali ea popelo le venous sinuses le ho potlakisa ho nchafatsoa le ho lokisoa ha endometrium.

Leha ho le joalo, boemo ba hypercoagulable le bona bo ka baka mathata a mangata a pelehi.Lilemong tsa morao tjena, liphuputso li fumane hore basali ba bangata ba bakhachane ba na le bothata ba ho ba le thrombosis.Boemo bona ba lefu la thromboembolism ho basali ba bakhachane ka lebaka la bofokoli ba liphatsa tsa lefutso kapa maemo a kotsi a fumanoeng joalo ka liprotheine tsa anticoagulant, lintlha tsa coagulation le liprotheine tsa fibrinolytic li bitsoa thrombosis.(thrombophilia), e tsejoang hape e le boemo ba prothrombotic.Boemo bona ba prothrombotic ha bo hlile bo lebisa ho lefu la thrombotic, empa bo ka lebisa liphellong tse mpe tsa bokhachane ka lebaka la ho se leka-lekane ha mekhoa ea coagulation-anticoagulation kapa ts'ebetso ea fibrinolytic, microthrombosis ea methapo ea mali ea uterine kapa villus, e bakang ho senyeha ha placental kapa esita le infarction, joalo ka Preeclampsia. , placenta abruption, placental infarction, disseminated intravascular coagulation (DIC), thibelo ea khōlo ea lesea, ho senyeheloa khafetsa, ho tsoala lesea le shoeleng le ho tsoaloa pele ho nako, joalo-joalo, ho ka lebisa lefung la bakhachane le ba pelehi maemong a matla.