Izifundo ezimbini ezibalulekileyo zokujiya kwegazi, i-activated partial thromboplastin time (APTT) kunye ne-prothrombin time (PT), zombini zinceda ekuchongeni unobangela wokujiya kwegazi okungaqhelekanga.
Ukuze igazi lihlale likwimeko yolwelo, umzimba kufuneka wenze isenzo sokulinganisela esithambileyo. Igazi elijikelezayo liqulathe izinto ezimbini zegazi, i-procoagulant, ekhuthaza ukujiya kwegazi, kunye ne-anticoagulant, ethintela ukujiya kwegazi, ukugcina ukuhamba kwegazi. Nangona kunjalo, xa umthambo wegazi wonakele kwaye ibhalansi iphazamisekile, i-procoagulant iqokelelana kwindawo eyonakeleyo kwaye igazi liqala ukujiya. Inkqubo yokujiya kwegazi yi-link-by-link, kwaye ingasetyenziswa ziinkqubo ezimbini zokujiya ngokulinganayo, ngaphakathi okanye ngaphandle. Inkqubo ye-endogenous iyasebenza xa igazi lidibana ne-collagen okanye i-endothelium eyonakeleyo. Inkqubo ye-extrinsic iyasebenza xa izicubu ezonakeleyo zikhupha izinto ezithile zokujiya ezifana ne-thromboplastin. Indlela yokugqibela eqhelekileyo yeenkqubo ezimbini ezikhokelela kwi-condensation apex. Xa le nkqubo yokujiya, nangona ibonakala ngathi yeyo nangoko, iimvavanyo ezimbini ezibalulekileyo zokuxilonga, ixesha elisebenzayo le-thromboplastin (APTT) kunye nexesha le-prothrombin (PT), zinokwenziwa. Ukwenza ezi mvavanyo kunceda ukwenza uxilongo olucacileyo lwazo zonke iingxaki zokujiya kwegazi.

 

1. Ibonisa ntoni i-APTT?

Uvavanyo lwe-APTT luvavanya iindlela zokwaluphala kwegazi ezisuka emzimbeni ukuya emzimbeni neziqhelekileyo. Ngokukodwa, lulinganisa ixesha elithathwayo ukuba isampuli yegazi yenze i-fibrin clot ngokongeza into esebenzayo (i-calcium) kunye ne-phospholipids. Ikhawuleza ngakumbi kwaye ikhawuleza kunexesha le-thromboplastin elingaphelelanga. I-APTT idla ngokusetyenziswa ukujonga unyango nge-liver violet.

Ilabhoratri nganye inexabiso layo eliqhelekileyo le-APTT, kodwa ngokubanzi isusela kwimizuzwana eli-16 ukuya kwengama-40. Ixesha elide linokubonisa ukungasebenzi kakuhle kwecandelo lesine lendlela engapheliyo, i-Xia okanye i-factor, okanye i-deficient factor I, V okanye i-X yendlela eqhelekileyo. Izigulana eziswele i-vitamin K, isifo sesibindi, okanye i-disseminated intravascular coagulopathy ziya kuyindisa i-APTT. Amayeza athile—amayeza okubulala iintsholongwane, amayeza okubulala iintsholongwane, amayeza okubulala iintsholongwane, amayeza okubulala iintsholongwane, amayeza okubulala iintsholongwane, okanye i-aspirin nawo anokwandisa i-APTT.

Ukuncipha kwe-APTT kunokubangelwa kukopha kakhulu, izilonda ezinkulu (ngaphandle komhlaza wesibindi) kunye nonyango oluthile lwamayeza kuquka ii-antihistamines, ii-antacids, amalungiselelo e-digitalis, njl.

2. Ibonisa ntoni i-PT?

Uvavanyo lwe-PT luvavanya iindlela zokuqhekeka kwegazi zangaphandle nezesiqhelo. Ukujonga unyango olusebenzisa amayeza okubulala igazi. Olu vavanyo lulinganisa ixesha elithathwayo ukuze i-plasma ijike emva kokongezwa kwe-tissue factor kunye ne-calcium kwisampulu yegazi. Uluhlu oluqhelekileyo lwe-PT yimizuzwana eli-11 ukuya kweli-16. Ukwandiswa kwe-PT kunokubonisa ukunqongophala kwe-thrombin profibrinogen okanye i-factor V, W okanye i-X.

Izigulana ezihlanzayo, ezirhudayo, ezitya imifuno eluhlaza, ezisebenzisa utywala okanye unyango olude lwee-antibiotics, ezisebenzisa amayeza okulwa noxinzelelo lwegazi, ezisebenzisa amayeza okulwa nokuqina kwegazi, ezisebenzisa ii-narcotics, kunye needosi ezininzi ze-aspirin nazo zinokulibazisa ixesha elide i-PT. I-PT ekumgangatho ophantsi inokubangelwa zii-antihistamine barbiturates, ii-antacids, okanye i-vitamin K.

Ukuba i-PT yesigulana idlula imizuzwana engama-40, kuya kufuneka i-vitamin K emithanjeni okanye i-plasma eqandisiweyo eyomileyo. Hlola ukopha kwesigulana rhoqo, ujonge imeko yaso yemithambo-luvo, kwaye wenze uvavanyo lwegazi olungaqhelekanga kumchamo nakwindle.

 

3. Cacisa iziphumo

Isigulana esine-coagulation engaqhelekanga sidla ngokufuna iimvavanyo ezimbini, i-APTT kunye ne-PT, kwaye siya kufuna ukuba utolike ezi ziphumo, uphumelele ezi vavanyo zexesha, kwaye ekugqibeleni ulungiselele unyango lwaso.