I-DIC-Syndrome

I-DIC-syndrome - i-syndrome yokusakazwa kwe-intravascular coagulation - ukwephulwa kwe-hemostasis, ebonakala ngezinguquko kwi-coagulability yegazi. Ama-micro-clusters kanye nama-aggregate amangqamuzana egazi ayimbangela yokungasebenzi kahle kwezingcingo kanye nezinguquko ze-dystrophic ezingxenyeni, okuholela ekuthuthukiseni kwe-hypocoagulation, thrombocytopenia nokuphuma kwegazi.

Izimbangela zokuthuthukiswa kwe-DIC syndrome

I-DIC-syndrome ayisona isifo esihlukile futhi iqala ngokumelene nesimo sezinto ezilandelayo zokugula:

• izinqubo ze-septic ngesikhathi sokubeletha, ukukhipha isisu nokwelapha isikhathi eside kwezikebhe ezinkulu;
• ukuhlukumezeka kwemithwalo yegazi, izindonga zamasongo kanye ne-parenchyma yezitho zangaphakathi ngesikhathi sokungenelela kokuhlinzwa noma isisindo se-vascular prosthetics;
• ukwelashwa kwezidakamizwa nezinkinga zokubeletha, ukulethwa kokusebenza;
• izimo ezesabisayo, ezibangelwa ukulimala, isifo senhliziyo, isifo esibuhlungu kanye nezinye izifo;
• izifo zegazi ezinomdlavuza (myeloma, erythremia);
• Izakhiwo ezimbi emathangeni amaphaphu, i-prostate nama-pancreas;
• izifo ezizimele (lupus erythematosus, glomerulonephritis , vasculitis enegazi);
• i-hemolysis ngokushisa;
• izilonda ezinobuthi lapho inyoka inyoka ingena egazini;
• ukusetshenziswa kwesikhathi eside kwezidakamizwa ezithuthukisa i-blood clotting futhi kubangele ukwakheka kweplatelet.

Izimpawu ze-DIC syndrome

Umtholampilo we-DIC syndrome uhlotshaniswa nesifo esibangela lesi simo.

I-DIC-syndrome ebonakalayo ibonakala njengesimo sokuthuthumela esibangelwa ukwephulwa kwazo zonke izixhumanisi ze-hemostasis.

Nge-DVS-syndrome engapheli kukhona ukwanda kancane kancane emibonweni yemitholampilo ngezimpawu:

• hypovolemia (ukunciphisa umthamo wegazi emithanjeni yegazi);
• umonakalo wendikimba enesidumbu;
• ukuphazanyiswa kwezinqubo zokusebenzisa umzimba.

Ngesikhathi se-DIC-syndrome, lezi zigaba ziyi:

1. Esigabeni sokuqala, i-hypercoagulation kanye nokucwaswa kwama-platelets kwenzeka.
2. Esigabeni sesibili, kunezinguquko ekuguleni igazi (hypercoagulation noma hypocoagulation).
3. Esigabeni sesithathu, igazi liyeka ukuwa nhlobo.
4. Esigabeni sesine, imingcele ye-hemostatic ibe yinto evamile noma izinkinga ezenza kube nomphumela obulalayo.
5. Isigaba sesine kubhekwa njenge-permissive.

Ukuxilongwa kwe-ICE-syndrome

Ngokuvamile, ukuxilongwa kusekwe uphawu lokuqala lwe-DIC syndrome. Kodwa-ke, eziningana zezifo (isibonelo, ku-leukemia, lupus erythematosus), ukuxilongwa kunzima. Ezimweni ezinjalo, ukuxilongwa kwe-laboratory ukuhlolwa kwe-DIC syndrome kwenziwa, okuhlanganisa:

• ukutholakala kwamazinga okugaya igazi ;
• Ukuhlaziywa kwe-clot yegazi kanye ne-prothrombin isikhathi;
• ukutholakala kwephulwa ku-thromboelastogram;
• ukuhlolwa kwe-paracoagulation.

Ukwelashwa nokuvimbela isifo se-DIC

Ukwelashwa kwesifo se-DIC, njengombuso, kwenziwa enyunithi yokunakekelwa okujulile futhi kuhloswe ekuqedeni ama-clots egazi okwakhiwa, ukuvimbela ukwakheka kwegazi lamasha, nokubuyisela ukujikeleza kwegazi nokulawula i-hemostasis. Ngaphezu kwalokho, ukwelashwa okunamandla kwenziwa ukususa isiguli esimweni sokushaqeka, ukulwa namagciwane noma ezinye izindlela zokwelapha etiotropic kuvumela ukumelana nesimo esithathelwanayo. Iziguli zingase zibekwe i-anticoagulant, i-disaggregant, fibrinolytic kanye nokwelapha indawo.

Ku-ICE-syndrome engapheli, isibonelo, ezigulini ezingenalutho, indlela ye-plasmaphoresis iyasebenza. Iqukethe ukuthi isiguli sithathwa 600 ml we-plasma, esithatha indawo yamalungiselelo we-plasma efriziwe. Indlela okuhloselwe ukukhipha emzimbeni wengxenye yamaprotheni kanye nezixuku ze-immune, kanye nezici zokucubungula ezisebenzayo.

Ukuvimbela i-DIC syndrome ngokuyinhloko kugxile ekuqedeni izimbangela ezibangela ekuthuthukisweni kwayo. Phakathi kwezinyathelo zokuvimbela:

• ukungenelela kokuhlinzeka, okwenziwa ngendlela encane kakhulu;
• ukwelashwa okusezingeni eliphezulu kwamathumba;
• ukuvinjelwa kwezinyoka nezinyoka ezinamandla;
• Ukufakwa kwama-anticoagulants ekwelapheni kwezifo ezithathelwanayo, njll.