01. Ukujwayelana kokuqala no-D-dimer, i-FDP

1. I-FDP yigama elijwayelekile lemikhiqizo eyahlukahlukene yokuwohloka kwe-fibrin kanye ne-fibrinogen ngaphansi kwesenzo se-plasmin, esibonisa kakhulu izinga le-fibrinolytic lomzimba;

2. I-D-dimer iwumkhiqizo othize wokuwohloka kwe-fibrin exhumene ne-cross-linked ngaphansi kwesenzo se-plasmin, futhi ukwanda kwezinga layo kubonisa ukuba khona kwe-hyperfibrinolysis yesibili;

02. Ukusetshenziswa kwezokwelapha kwe-D-dimer kanye ne-FDP

Khipha i-venous thrombosis (i-VTE ifaka phakathi i-DVT, i-PE)

Ukunemba kokukhishwa kwe-D-dimer negative kwe-deep vein thrombosis (DVT) kungafinyelela ku-98%-100%

Ukutholwa kwe-D-dimer kungasetshenziswa ukuqeda i-venous thrombosis

♦Ukubaluleka ekuxilongweni kwe-DIC

1. I-DIC inqubo eyinkimbinkimbi ye-pathophysiological kanye ne-severe acquired clinical thrombo-hemorrhagic syndrome. Iningi lama-DIC liqala ngokushesha, linesifo esiyinkimbinkimbi, likhula ngokushesha, lithola ukuxilongwa okunzima, futhi libikezela okuyingozi. Uma lingatholakali kusenesikhathi futhi lelashwe ngempumelelo, livame ukufaka impilo yesiguli engozini;

2. I-D-dimer ingabonisa ubukhali be-DIC ngezinga elithile, i-FDP ingasetshenziswa ukuqapha intuthuko yesifo ngemva kokuqinisekiswa kokuxilongwa, kanti i-antithrombin (AT) isiza ukuqonda ubukhali besifo kanye nokusebenza kahle kokwelashwa kwe-heparin. Ukuhlanganiswa kokuhlolwa kwe-D-dimer, i-FDP kanye ne-AT sekuyindlela engcono kakhulu yokuxilonga i-DIC.

♦Ukubaluleka kwamathumba abulalayo

1. Izimila eziyingozi zihlobene kakhulu nokungasebenzi kahle kwe-hemostasis. Kungakhathaliseki ukuthi izimila eziqinile noma i-leukemia zinjani, iziguli zizoba nesimo esibi kakhulu sokujiya kwegazi noma i-thrombosis. I-Adenocarcinoma eyinkimbinkimbi yi-thrombosis iyona evame kakhulu;

2. Kuhle ukugcizelela ukuthi i-thrombosis ingaba uphawu lokuqala lwesimila. Ezigulini ezine-thrombosis yemithambo ejulile ezihluleka ukubona izici eziyingozi ze-thrombosis yokopha, kungenzeka ukuthi kukhona isimila esingaba khona.

♦Ukubaluleka komtholampilo kwezinye izifo

1. Ukuqapha ukwelashwa kwemithi ye-thrombolytic

Ngesikhathi sokwelashwa, uma inani lomuthi we-thrombolytic linganele futhi i-thrombus ingancibiliki ngokuphelele, i-D-dimer ne-FDP zizohlala zisezingeni eliphezulu ngemva kokufinyelela esicongweni; kuyilapho umuthi we-thrombolytic omningi uzokwandisa ingozi yokopha.

2. Ukubaluleka kokwelashwa kwe-heparin yama-molecule amancane ngemva kokuhlinzwa

Iziguli ezihlukunyezwe/ezihlinzwe zivame ukwelashwa nge-anticoagulant prophylaxis.

Ngokuvamile, umthamo oyisisekelo we-heparin encane yama-molecule ngu-2850IU/ngosuku, kodwa uma izinga le-D-dimer lesiguli lingu-2ug/ml ngosuku lwesine ngemva kokuhlinzwa, umthamo ungandiswa ube izikhathi ezimbili ngosuku.

3. Ukusikwa kwe-aorta okubukhali (i-AAD)

I-AAD iyimbangela evamile yokufa ngokuzumayo ezigulini. Ukuxilongwa kusenesikhathi kanye nokwelashwa kunganciphisa izinga lokufa kweziguli futhi kunciphise izingozi zezokwelapha.

Indlela engaba khona yokwanda kwe-D-dimer ku-AAD: Ngemva kokuba ungqimba oluphakathi lodonga lwemithambo ye-aorta lonakele ngenxa yezizathu ezahlukahlukene, udonga lwemithambo luyaqhuma, okubangela ukuba igazi lingene ezingxeni zangaphakathi nezangaphandle ukuze kwakheke "umgodi wamanga", ngenxa yegazi langempela nelamanga emgodini Kukhona umehluko omkhulu ngesivinini sokugeleza, futhi isivinini sokugeleza emgodini wamanga sihamba kancane, okungabangela kalula i-thrombosis, kubangele ukuthi uhlelo lwe-fibrinolytic lusebenze, futhi ekugcineni kukhuthaze ukwanda kwezinga le-D-dimer.

03. Izici ezithinta i-D-dimer kanye ne-FDP

1. Izici zomzimba

Kuphakanyisiwe: Kunomehluko omkhulu ngokweminyaka, abesifazane abakhulelwe, ukuzivocavoca okunzima, kanye nokuya esikhathini.

2. Umthelela wesifo

Okuphakanyisiwe: isifo sohlangothi lwe-cerebrovascular, ukwelashwa nge-thrombolytic, ukutheleleka okukhulu, i-sepsis, i-tissue gangrene, i-preeclampsia, i-hypothyroidism, isifo sesibindi esibi, i-sarcoidosis.

3. I-Hyperlipidemia kanye nemiphumela yokuphuza

Okuphakanyisiwe: abaphuzayo;

Yehlisa: i-hyperlipidemia.

4. Imiphumela yezidakamizwa

Okuphakanyisiwe: i-heparin, imithi yokunciphisa umfutho wegazi, i-urokinase, i-streptokinase kanye ne-staphylokinase;

Ukuncipha: izithibela-nzalo eziphuzwa ngomlomo kanye ne-estrogen.
04. Isifinyezo

Ukutholwa kwe-D-dimer kanye ne-FDP kuphephile, kulula, kuyashesha, kuyabiza, futhi kuyazwela kakhulu. Zombili zizoba namazinga ahlukahlukene ezinguquko ezifweni zenhliziyo, isifo sesibindi, isifo semithambo yegazi, umfutho wegazi ophakeme obangelwa ukukhulelwa, kanye ne-pre-eclampsia. Kubalulekile ukwahlulela ubucayi besifo, ukuqapha intuthuko kanye noshintsho lwesifo, kanye nokuhlola ukubikezela komphumela wokwelapha.