Izifundo ezimbili ezibalulekile zokuhlanganisa igazi, isikhathi se-activated partial thromboplastin (APTT) kanye nesikhathi se-prothrombin (PT), zombili zisiza ekunqumeni imbangela yokuphazamiseka kokuhlanganisa igazi.
Ukuze igazi lihlale lisesimweni soketshezi, umzimba kumele wenze isenzo sokulinganisela esibucayi. Igazi elijikelezayo liqukethe izingxenye ezimbili zegazi, i-procoagulant, ekhuthaza ukujiya kwegazi, kanye ne-anticoagulant, evimbela ukujiya kwegazi, ukuze kugcinwe ukugeleza kwegazi. Kodwa-ke, lapho umthambo wegazi wonakele futhi ibhalansi iphazamiseka, i-procoagulant iyaqoqana endaweni eyonakele bese kuqala ukujiya kwegazi. Inqubo yokujiya kwegazi iyisixhumanisi-nge-link, futhi ingasetshenziswa yinoma yiziphi izinhlelo ezimbili zokujiya ezihambisanayo, ezingaphakathi noma ezingaphandle. Uhlelo lwe-endogenous luyasebenza lapho igazi lithinta i-collagen noma i-endothelium eyonakele. Uhlelo lwe-extrinsic luyasebenza lapho izicubu ezonakele zikhipha izinto ezithile zokujiya njenge-thromboplastin. Indlela yokugcina evamile yezinhlelo ezimbili eziholela ekujiya kwegazi. Lapho le nqubo yokujiya kwegazi, nakuba ibonakala sengathi ishesha, kungenziwa izivivinyo ezimbili ezibalulekile zokuxilonga, isikhathi se-thromboplastin esisebenzayo (APTT) kanye nesikhathi se-prothrombin (PT). Ukwenza lezi zivivinyo kusiza ukwenza ukuxilongwa okubalulekile kwazo zonke izinkinga zokujiya kwegazi.

 

1. I-APTT ibonisani?

Ukuhlolwa kwe-APTT kuhlola izindlela zokwakheka kwegazi ezivamile nezivamile. Ngokukhethekile, kulinganisa ukuthi kuthatha isikhathi esingakanani ukuthi isampula yegazi yakhe i-fibrin clot ngokufakwa kwesithako esisebenzayo (i-calcium) kanye ne-phospholipids. Kuzwela kakhulu futhi kuyashesha kunesikhathi se-thromboplastin esingaphelele. I-APTT ivame ukusetshenziselwa ukuqapha ukwelashwa nge-liver violet.

Ilabhorethri ngayinye inenani layo elijwayelekile le-APTT, kodwa ngokuvamile lisukela kumasekhondi angu-16 kuya kwangu-40. Isikhathi eside singase sibonise ukungasebenzi kahle kwesizinda sesine sendlela engokwemvelo, i-Xia noma i-factor, noma i-deficiency factor I, V noma i-X yendlela evamile. Iziguli ezinesifo se-vitamin K, isifo sesibindi, noma i-disseminated intravascular coagulopathy zizokwandisa i-APTT. Imithi ethile—ama-antibiotic, ama-anticoagulants, ama-narcotic, ama-narcotic, noma i-aspirin nayo ingandisa i-APTT.

Ukwehla kwe-APTT kungabangelwa ukopha okukhulu, izilonda ezinkulu (ngaphandle komdlavuza wesibindi) kanye nokwelashwa ngemithi ethile okuhlanganisa ama-antihistamine, ama-antacid, amalungiselelo e-digitalis, njll.

2. I-PT ibonisani?

Ukuhlolwa kwe-PT kuhlola izindlela zokujiya kwangaphandle kanye nezindlela ezivamile zokujiya kwamangqamuzana. Ukuze kuqashwe ukwelashwa ngama-anticoagulants. Lokhu kuhlolwa kulinganisa isikhathi esithathwayo ukuze i-plasma ijiye ngemva kokufakwa kwe-tissue factor kanye ne-calcium kusampula yegazi. Ububanzi obujwayelekile obujwayelekile be-PT bungamasekhondi angu-11 kuya kwangu-16. Ukwelulwa kwe-PT kungabonisa ukuntuleka kwe-thrombin profibrinogen noma i-factor V, W noma X.

Iziguli ezinokuhlanza, uhudo, ukudla imifino eluhlaza, ukwelashwa ngotshwala noma ngama-antibiotic isikhathi eside, imithi yokunciphisa umfutho wegazi, imithi yomlomo yokunciphisa ukugabha kwegazi, imithi yokwelapha izidakamizwa, kanye nemithamo emikhulu ye-aspirin nakho kungandisa isikhathi se-PT. I-PT esezingeni eliphansi ingabangelwa ama-antihistamine barbiturates, ama-antacid, noma i-vitamin K.

Uma i-PT yesiguli idlula imizuzwana engama-40, kuzodingeka i-vitamin K emisipheni noma i-plasma eqandisiwe eyomisiwe. Hlola njalo ukopha kwesiguli, hlola isimo sakhe sezinzwa, bese wenza ukuhlolwa kwegazi okungavamile emchameni nasendle.

 

3. Chaza imiphumela

Isiguli esinokukhubazeka okungajwayelekile sivame ukudinga ukuhlolwa okubili, i-APTT kanye ne-PT, futhi sizodinga ukuthi uchaze le miphumela, uphumelele kulezi zivivinyo zesikhathi, bese ekugcineni uhlela ukwelashwa kwaso.