Hoʻomaʻamaʻa intravascular coagulation (DIC)

ʻO ka coagulation intravaskular i hoʻolaha ʻia (DIC) kahi maʻi koʻikoʻi kahi e lilo ai nā protein i kaohi i ke kāpili ʻana o ke koko i lilo i overactive.

Ke hōʻeha ʻoe, hele nā ​​protein i ke koko e hana i nā clots koko i ka pūnaewele ʻeha e kōkua i ka hoʻōki ʻana i ke kahe ʻana o ke kahe. Inā lilo kēia mau protein i mea maʻamau i loko o ke kino, hiki iā ʻoe ke hoʻomohala iā DIC. ʻO ke kumu kumu ma muli o ka hoʻowahāwahā, maʻi, a i ʻole ka maʻi ʻaʻai.

I kekahi mau hihia o DIC, kū nā koko koko liʻiliʻi i nā kīʻaha koko. Hiki i kekahi o kēia mau ʻōpala ke kāpili i nā moku a ʻokiʻoki i ke kahe o ke koko maʻamau i nā meaola e like me ke ake, ka lolo, a me nā puʻupaʻa paha. Hiki i ka nele o ke kahe o ke koko ke hōʻeha a hōʻeha i nā kino.

I nā hihia ʻē aʻe o DIC, pau nā protein pūwili i kou koko. Ke hiki mai kēia, loaʻa paha iā ʻoe kahi makaʻu nui i ke kahe ʻana o ke kahe, ʻoiai mai kahi ʻeha liʻiliʻi a i ʻole ʻeha. Hiki paha iā ʻoe ke kahe i ka hoʻomaka koke (ma kāna iho). Hiki i ka maʻi ke hōʻemi i kāu mau hunaola ʻulaʻula olakino e haki a haki ke hele lākou i loko o nā moku liʻiliʻi i hoʻopiha ʻia me nā huʻa.

ʻO nā kumu pilikia no DIC me:

• ʻO ka hopena transfusion koko
• Ka maʻi ʻaʻai, ʻo ia hoʻi kekahi ʻano leukemia
• Hoʻonā o ka pancreas (pancreatitis)
• ʻO ka maʻi i ke koko, ʻo ia hoʻi e nā bacteria a i ʻole fungus
• Maʻi maʻi ate
• Nā pilikia o ka hāpai keiki (e like me ka placenta i waiho ʻia ma hope o ka lawe ʻana)
• ʻO ke kahakaha hou a anesthesia paha
• ʻO ka hōʻeha kino nui (e like me ka wela a me ke poʻo poʻo)
• Hemangioma nui (kahi kīʻaha koko i hana kūpono ʻole ʻia)

Pākuʻi ʻia paha nā ʻōuli o DIC i kekahi o kēia mau mea:

• Kahe, mai nā pūnaewele he nui i ke kino
• Huʻi koko
• ʻUpala
• E kulu i ke kaomi koko
• Pokole o ka hanu
• Huikau, nalo hoʻomanaʻo a i ʻole hoʻololi o ka lawena
• Fiva

Loaʻa paha iā ʻoe kekahi o nā hōʻike aʻe:

• Helu piha ke koko me ka hoʻāʻo ʻana o ke koko
• Wā thromboplastin manawa (PTT)
• Ka manawa Prothrombin (PT)
• Hōʻike koko Fibrinogen
• D-dimer

ʻAʻohe mālama kūikawā no DIC. ʻO ka pahuhopu e hoʻoholo a mālama i ke kumu kumu o DIC.

Pākuʻi ʻia paha nā hana kākoʻo:

• Nā transfusions o ka Plasma e pani i nā mea pili i ke koko inā nui ka nui o ke kahe ʻana.
• Lapaʻau lahilahi ke koko (heparin) i mea e pale aku ai i ke kāpili ʻana o ke koko inā he nui ka nui o ke kāpili ʻana.

Aia ka hopena i ka mea e hoʻokumu nei i kēia maʻi. Hiki i ka DIC ke hoʻoweliweli i ke ola.

Pākuʻi ʻia paha nā pilikia mai DIC:

• Kahena
• Kahe kahe o ke koko i nā lima, nā wāwae, a i ʻole nā ​​mea ola
• Hahau

E hele i ka lumi pilikia a kāhea paha iā 911 inā he kahe kou i kū ʻole.

E kiʻi koke i ka lāʻau no nā kūlana ʻike ʻia e lawe mai i kēia maʻi.

Hoʻohana coagulopathy; DIC

• Hoʻomaʻamaʻa koko
• ʻO Meningococcemia ma nā keiki bipi
• Huʻi koko

ʻO Levi M. Hoʻolahalaha i ka coagulation intravascular. I: Hoffman R, Benz EJ, Silberstein LE, et al, eds. Hematology: Nā Kumumanaʻo a me ka Hoʻomeheu. ʻEpekema 7 Piladelapia, PA: Elsevier; 2018: chap 139.

Napotilano M, Schmair AH, Kessler CM. Hoʻohui a me fibrinolysis. I: McPherson RA, Pincus MR, hua. ʻO kā Henry's Clinical Diagnosis a me Management e nā Laboratory Methods. 23rd Ed. St Louis, MO: Elsevier; 2017: chap 39.