Kazhinji, iyo thrombophilia inomiririra chimiro chakatemwa kana kuti chakawanikwa apo ropa rinoita kugwamba zviri nyore, zvichikonzera zviitiko zvakakomba zve thrombotic kana, panguva yekuzvitakura, matambudziko ekudzivirira ane ngozi.
Iri boka rekupedzisira rinosanganisira vakanonoka kukura kwe fetal, gestational hypertensive disorders, kuputika kwe placenta y kubvisirwa pamuviri. Iyi predisposition inowedzerwa kune mamiriro e hypercoagulability yenguva yekuzvitakura.
Ndiani anofanira kuongororwa?
Iko kutsvaga kwekuchinja kunotungamira kune deep vein thrombosis inofanira kuitwa kunze kwepamuviri, nokuti kazhinji inovhara imwe mamiriro ezvinhu akajairika, nokudaro kusarudza kuongororwa kwenhema.
Kazhinji, madzimai achavhenekwa vanenge vari vaya vakamboitwa zviitiko zvakakomba zve thrombotic, kubviswa kwepamuviri kunoramba kuchiitika, kutadza kukura kwechibereko, kufa kwemwana mudumbu, gestational hypertension, uye kubvongodzwa kwechibereko.
Varwere ava, chaizvoizvo, vanotsanangurwa se "symptomatic." Chekupedzisira, zvisinei nekuvepo kwezviratidzo zvakanyorwa pamusoro, pane chiratidzo chekuita kuongorora zvakare kune avo vakadzi vasina zviratidzo, asi vanoziva zvakadzama zviitiko zvethromboembolic kana vanoziva nezve thrombophilia.
Ndeapi maedzo uye ndeapi marapirwo anoitwa muzviitiko zvekufungidzirwa thrombosis panguva yekuzvitakura
Miedzo yekuona thrombophilia nepamuviri Ndizvo:
- coagulation factor V kudzidza,
- antithrombin,
- protein C,
- protein S,
- kuramba kune activated protein C,
- G20210A prothrombin mutation,
- Homocysteine antiphospholipid antibodies.
Kurapa inoiswa pasi-density heparin Peso molecular. Iyo chete inosarudzika ndeye yakasarudzika hyperhomocystinemia inobatsira kubva folic acid. Kana yasarudzwa kupindira mune zvemishonga, kurapwa kunofanira kutangwa nekukurumidza sezvinobvira panguva yekuzvitakura uye kuenderera mberi kwemavhiki matanhatu mushure mekusununguka.
Kuwedzera ngozi ye thrombosis
Njodzi ine hukama yekukudziridza tsinga yakadzika uye / kana pelvic vein thrombosis panguva uye pakarepo mushure mekuita pamuviri ndeye 5 kusvika ku6 nguva yakakwirira kupfuura yevakadzi vasina pamuviri. Dhiyabhorosi pamusoro pehuwandu hwe thrombosis yakasiyana zvikuru kubva kune imwe neimwe, sezvo maitiro ekuongorora chinangwa, akadai sephlebography kana radioactive fibrinogen tests, anowanzoshandiswa chete nekuvanzika kukuru pamuviri. Chii chimwe, zviratidzo zvekiriniki zve thrombosis hazvina kuvimbika zvachose uye kazhinji zvakaoma kusiyanisa pakati pepamusoro thrombophlebitis uye yakadzika thrombosis.
Iyo yakanyanya kuitika ye thrombosis pamuviri kunoitika mune yechipiri trimester yekuzvitakura. Gumbo rekuruboshwe rinobatwa zvakanyanya kakawanda kupfuura rekurudyi, pamwe nekuti iyo iliac artery yekurudyi inomanikidza kuruboshwe iliac tsinga, ichipfuura nayo.
Pathogenesis ye thrombosis pamuviri
Izvo zvitatu zvepathogenic zvinhu zveVirchow's triad zvakare zvinogadzirisa kuonekwa kwethrombosis pamuviri:
- kuchinja mukuyerera kweropa
- kuchinja mukugadzirwa kweropa
- vascular integrity
Thrombosis pamuviri inogona kubva kukanganisa mukufamba kweropa kwakajairika mumigumo yakaderera, inokonzerwa nekuvharirwa kwe venous kudzoka nechibereko chiri kukura.
Ngozi ye thrombosis inowedzerwa nekukanganiswa kunoenderana kweiyo coagulation system, sezvo yakawedzera yakawedzera mu synthesis yezvinhu coagulation uye maplatelet inowanzoonekwa.
Kunyanya, panogona kunge paine chiratidzo kuwedzera fibrinogen mazinga mazinga akaenzana akapetwa kaviri (400 - 650 mg/dL) panguva yekuzvitakura. Mukuwedzera, kuderera kwezvinhu zve fibrinolysis system kunoonekwa zvakare.
La tsinga yakadzika uye pelvic vein thrombosis inocherechedzwa mushure mekuita Kesariya inokwana kusvika 3-8% pasina anticoagulant prophylaxis, kureva kuti, ivo vane 4-8 nguva yakawanda kupfuura mushure mekusununguka kwemukadzi. Chiyero chekufa (kufa) nekuda kwe embolism kunoenderana ne2-3% uye saka yakapetwa ka10 kupfuura iyo yekuzvitakura.
Chikonzero chacho chinogona kurangarirwa kukuvara kwekuvhiya kumidziyo uye tishu, nekuvapo kukuru kwe thromboplastic zvinhu mukutenderera. Vakadzi vanogadzira hutachiona hwezvikamu zve periuterine zvezvikepe zvakanyanya panjodzi.
Ko thrombophlebitis inogona kurapwa sei?
La thrombophlebitis Iko kuzvimba kwepamusoro kunoonekwa neakakosha frequency pamwe neakanyanya uye mashoma saphenous tsinga. Semitemo yakawanda, mavhavha maduku uye kushamwaridzana kwavo hakuwanzoitiki mumitsipa yakadzika, nekuda kwekugadziriswa kwevheji uye anatomy yevhavha.
Kurapa kunosanganisira zviyero zvemuviri zvemunharaunda, kureva, masitokisi ekumanikidza uye kuunganidza varwere.
Compression therapy inofarira kushanda kwetsandanyama kupomba mumakumbo uye, saka, iyo venous return, iyo inodzivirira kufambira mberi kwethrombosis.
Prevención
Epidemiologically yakaratidza njodzi ine chekuita nekuonekwa kwe thrombosis panguva yekuzvitakura uye mumashure mekukurumidza ndeiyi:
- mukadzi ane pamuviri pakuchembera
- zviitiko zvekare zve thromboembolic
- obesidad
- chiutsi
- varicose veins
- chikamu chekutanga cheKesariya
Vakadzi vane pamuviri vari panjodzi ye thromboembolic complications vanofanira kunyoreswa nekukurumidza sezvinobvira.
Mukuwedzera kune muviri prophylaxis (kumanikidza zvipfeko) uye physiotherapyZvichienderana nekuoma kwengozi, pharmacological antithrombotic prophylaxis inogona kudiwa.
La yakaderera molecular uremu heparin (semuenzaniso, Fragmin P kana fraxiparin) inowanzoshandiswa nekuti yakachengeteka uye iri nyore kushandisa. Mishonga iyi inopihwa kamwe chete pazuva nejekiseni rakafanozadzwa.
hypercoagulability pamuviri
Huwandu hwese hwekuzvarwa uye hwakawanikwa zvirwere zvinotungamira kune yakakwira chiitiko che thromboembolic matambudziko muhupenyu hwakajairika uye, saka, zvakanyanya pakubata pamuviri.
Mukuwedzera pakurapwa kwechirwere chinokonzera, kunyanya kunyatsodzivirira mumuviri uye pharmacological kudzivirira thrombosis inodiwa panguva yekuzvitakura.