Tuab Ntshav (hypercoagulability)

Zoo Siab

• Cov tsos mob ntawm cov ntshav tuab yog dab tsi?
• Dab tsi ua kom muaj cov ntshav tuab?
• Yuav kuaj ntshav li cas?
• Yuav kho tus mob cov ntshav tuab li cas?
• Polycythemia vera
• Kho rau cov mob uas cuam tshuam rau cov ntshav txhaws
• Qhov teebmeem hnyav rau cov ntshav tuab yog dabtsi?
• Dab tsi yog qhov tshwm sim rau tus mob no?

Cov ntshav tuab yog dabtsi?

Thaum ib tug neeg cov ntshav yuav zoo li tsis sib thooj, nws ua los ntawm kev sib txuas ntawm cov hlwb sib txawv, cov protein, thiab cov ntshav txhaws, lossis cov tshuaj uas txhaws khov.

Xws li ntau yam hauv lub cev, cov ntshav cia siab rau kev tshuav nyiaj li cas los tuav qhov xwm yeem. Yog tias qhov qog ntawm cov protein thiab cov hlwb ua lub luag haujlwm ntawm cov ntshav thiab ntshav khov, koj cov ntshav yuav dhau los. Qhov no paub zoo li hypercoagulability.

Ntau yam ua rau cov ntshav tuab tuaj, xws li:

• tshaj cov ntshav hauv cov ntshav ncig
• cov kab mob uas cuam tshuam ntshav txhaws
• tshaj cov ntshav txhaws cov protein nyob rau hauv cov ntshav

Vim tias nws muaj ntau yam ua rau cov ntshav tuab, cov kws kho mob tsis muaj cov ntsiab lus txhais ntawm cov ntshav tuab. Lawv hloov txhais nws los ntawm txhua qhov mob uas ua rau muaj ntshav tuab.

Cov ntshav txhaws ua rau cov ntshav tuab ua qhov tsawg. Qee qhov tshwj xeeb tshaj plaws suav nrog qhov tseem ceeb V Leiden, uas kwv yees li 3 txog 7 feem pua ​​ntawm cov neeg dav dav muaj. Qhov xwm txheej no tsis tau txhais hais tias ib tus neeg cov ntshav yuav tuab heev, tab sis lawv yog qhov uas ua rau muaj ntshav tuab.

Ntawm txhua tus neeg uas muaj ntshav txhaws nyob rau hauv lawv cov leeg, tsawg dua 15 feem pua ​​yog los ntawm cov mob uas ua rau cov ntshav tuab.

Cov tsos mob ntawm cov ntshav tuab yog dab tsi?

Coob tus tsis muaj cov tsos mob ntshav tuab txog thaum lawv muaj ntshav txhaws. Cov ntshav txhaws feem ntau tshwm sim hauv tib neeg cov leeg ntshav, uas tuaj yeem ua rau mob thiab cuam tshuam ncig ncig thiab thaj chaw hauv thaj chaw uas txhaws ntshav txhaws.

Qee tus paub tias lawv tsev neeg muaj keeb kwm ntshav txhaws. Qhov no yuav txhawb kom lawv mus soj ntsuam teeb meem ntshav txhaws ua ntej tshwm sim.

Muaj cov qe ntshav ntau yuav ua rau muaj ntau cov tsos mob. Piv txwv ntawm cov no suav nrog:

• qhov muag plooj
• kiv taub hau
• doog yooj yim
• ntev li ntawm kev coj khaub ncaws
• mob gout
• mob taub hau
• ntshav siab
• khaus tawv
• tsis muaj lub zog
• txog siav

Yog tias koj muaj cov tsos mob no, koj yuav tsum ntsib koj tus kws kho mob kom kuaj ntshav tuab:

• muaj ntshav txhaws ntawm qhov tsis paub keeb kwm
• muaj kev rov mob ntshav ntxiv tsis paub yog vim li cas
• ntsib kev xeeb tub tsis zoo ib yam dab tsi (poob ntau tshaj peb thawj zaug cev xeeb tub)

Koj tus kws kho mob yuav hais kom kuaj ntshav ntau yam yog tias koj muaj cov tsos mob no ntxiv rau tsev neeg keeb kwm cov ntshav tuab.

Dab tsi ua kom muaj cov ntshav tuab?

Cov xwm txheej uas ua rau muaj cov ntshav tuab tuaj yeem tau txais los ntawm cov noob nqaij yav dhau los lossis tom qab ntawd, zoo li feem ntau muaj cov qog nqaij hlav. Hauv qab no yog cov qauv me me ntawm ntau yam mob uas tuaj yeem ua rau ntshav tuab:

• mob qog noj ntshav
• lupus, uas ua rau koj lub cev tsim cov tshuaj tiv thaiv kev ua kom rov ua haujlwm, uas tuaj yeem ua rau txhaws
• kev hloov pauv hauv yam V
• polycythemia vera, uas ua rau koj lub cev ua kom cov qe ntshav liab ntau dhau, uas ua rau cov ntshav tuab
• protein C tsis txaus
• protein S tsis txaus
• prothrombin 20210 hloov pauv
• haus luam yeeb, uas tuaj yeem ua rau cov nqaij mos ua kom puas tsuaj nrog rau kev txo qis ntawm cov khoom uas txo cov ntshav txhaws

Nws yog ib qho tseem ceeb kom to taub tias tej yam kev mob uas ua rau ntshav tuab, thiab qee zaum cov ntshav txhaws, tsis yog tib txoj kev txhaws ntshav txhaws.

Piv txwv li, ib tus neeg yuav muaj lub plawv nres vim tias lawv cov ntshav tau chwv cov quav hniav hauv lawv cov hlab ntsha, uas ua rau txhaws. Cov uas tsis muaj ntshav khiav mus los yooj yim dua rau cov ntshav txhaws vim lawv cov ntshav tsis txav mus rau hauv lawv lub cev ib yam nkaus. Qhov no tsis yog vim cov ntshav tuab. Hloov pauv, cov hlab ntsha thiab cov leeg ntawm cov neeg no tau puas, yog li ntshav tsis tuaj yeem txav ceev li qub.

Yuav kuaj ntshav li cas?

Koj tus kws kho mob yuav pib kuaj mob los ntawm kev noj koj li keeb kwm kho mob. Lawv yuav nug txog cov tsos mob uas koj yuav ntsib nrog keeb kwm kev noj qab haus huv.

Koj tus kws kho mob yuav xaj kuaj ntshav, tab sis feem ntau ua ntu zus. Cov laj thawj rau qhov no yog tias ntau ntawm cov kev kuaj rau cov ntshav tuab yog kim heev thiab muaj tseeb. Yog li lawv yuav pib nrog kev sim ntau dua, thiab tom qab ntawd xaj ntau yam ntxiv yog tias tsim nyog.

Ib qho piv txwv ntawm cov kev ntsuas ntshav siv yog tias koj tus kws kho mob xav tias koj yuav muaj cov ntshav tuab xws li:

• Ua kom tiav cov ntshav suav: Kev kuaj ntshav no yog kuaj xyuas seb puas muaj cov qe ntshav liab thiab ntshav khov hauv ntshav. Cov qib ntshav siab ntau thiab hematocrit yuav qhia tau tias muaj qhov mob zoo li polycythemia vera.
• Kev ua kom muaj protein ntau C: Qhov kev ntsuam xyuas no rau qhov muaj tshwm sim V Leiden.
• Prothrombin G20210A kev hloov pauv: Qhov no txiav txim siab muaj cov antithrombin, protein C, lossis protein S ua haujlwm tsis zoo.
• Antithrombin, protein C, lossis protein S qib ua haujlwm: Qhov no tuaj yeem lees paub cov muaj lupus anticoagulants.

Lub Cleveland Lub Tsev Kho Mob pom zoo tias kev kuaj ntshav tuab yog tsawg kawg yog plaub mus rau rau lub lim tiam tom qab koj muaj ntshav txhaws. Kev soj ntsuam sai dua tuaj yeem ua rau muaj qhov tsis tseeb-vim yog qhov muaj qhov tshwm sim ntawm cov ntshav hauv cov ntshav los ntawm ntshav khov.

Yuav kho tus mob cov ntshav tuab li cas?

Cov kev khomob rau cov ntshav tuab yog nyob ntawm qhov pib vim li cas.

Polycythemia vera

Thaum cov kws kho mob tuaj yeem kho tsis tau polycythemia vera, lawv tuaj yeem pom zoo cov kev kho mob txhawm rau txhim kho cov ntshav txaus. Kev tawm dag zog hauv lub cev tuaj yeem pab txhawb kev ua kom ntshav txaus hauv koj lub cev. Lwm cov kauj ruam yuav tsum muaj:

• nquag ncab, tshwj xeeb ntawm koj ob txhais ceg thiab taw los txhawb cov ntshav khiav
• hnav khaub ncaws tiv thaiv, tshwj xeeb rau koj txhais tes thiab taw, thaum lub caij ntuj no
• zam qhov kub tshaj plaws
• nyob hydrated thiab haus dej kom ntau
• noj cov hmoov txhuv nplej siab los ntawm kev ntxiv ib nrab-lub thawv ntawm cov hmoov txhuv nplej rau sov so dej sov, uas tuaj yeem nplij cov tawv nqaij ntau dhau los nrog polycythemia vera.

Koj tus kws kho mob yuav qhia cov kev kho mob hu ua phlebotomy, qhov uas lawv ntxig txoj leeg (IV) rau hauv cov leeg ntshav kom tshem qee qhov ntshav.

Muaj ntau txoj kev kho mob pab tshem qee yam ntawm koj lub cev hlau, uas tuaj yeem txo cov ntshav tawm.

Muaj qee zaus, thaum muaj tus mob ua rau mob hnyav, xws li kev puas tsuaj rau hauv nruab nrog cev, koj tus kws kho mob yuav pom zoo kom siv cov tshuaj kho mob. Piv txwv ntawm cov no suav nrog hydroxyurea (Droxia) thiab interferon-alpha. Cov no pab ua kom koj txoj hlab ntsha tsis txhob tsim cov qe ntshav ntau dhau. Raws li qhov tshwm sim, koj cov ntshav ua tsawg dua tuab.

Kho rau cov mob uas cuam tshuam rau cov ntshav txhaws

Yog tias koj muaj tus kab mob uas ua rau ntshav txhaws sai (xws li hloov pauv V), koj tus kws kho mob yuav pom zoo qee yam kev kho mob hauv qab no:

• Antiplatelet Kev Kho: Qhov no suav nrog kev noj tshuaj uas tiv thaiv cov ntshav ua lub luag haujlwm ua ntshav txhaws, hu ua platelets, ntawm kev lo ua ke kom dhau los ua txhaws. Piv txwv ntawm cov no tuaj yeem suav cov tshuaj aspirin (Bufferin).
• Anticoagulation txoj kev kho: Qhov no suav nrog kev noj tshuaj uas siv los tiv thaiv cov ntshav txhaws, xws li warfarin (Coumadin).

Txawm li cas los xij, ntau tus neeg uas muaj mob uas tuaj yeem ua rau lawv cov ntshav tuab tsis tuaj yeem ntsib ntshav txhaws. Vim li no, koj tus kws kho mob yuav kuaj ntshav tuab, tseem tsis tau sau ntawv yuav tshuaj rau koj noj tsis tu ncua tshwj tsis yog lawv ntseeg tias koj muaj kev pheej hmoo txhawm rau txhaws ntshav.

Yog tias koj muaj feem ntau ntshav txhaws, koj yuav tsum koom nrog kev ntsuas kev coj ua hauv lub neej kom txo lawv txoj hauv kev. Cov no suav nrog:

• tsis haus luam yeeb
• koom ua ub no hauv lub cev
• siv ntau lub sijhawm los ncab thiab taug kev thaum mus kev deb ntawm dav hlau lossis hauv tsheb
• nyob hydrated

Qhov teebmeem hnyav rau cov ntshav tuab yog dabtsi?

Yog tias koj muaj cov ntshav tuab, koj yuav muaj feem ntau mob ntshav txhaws, hauv koj cov leeg thiab cov hlab ntsha. Cov ntshav txhaws hauv koj cov hlab ntsha yuav cuam tshuam rau cov ntshav ntws mus rau thaj chaw tseem ceeb ntawm koj lub cev. Yog tias tsis muaj ntshav txaus, cov nqaij yuav tsis muaj sia nyob. Yog koj xav tias koj muaj feem ntshav khov, nrhiav kev kho mob sai.

Ib qho kev phom sij tshaj plaws ntawm cov ntshav tuab yog mob ntsws pulmonary emboli, uas yog cov ntshav txhaws uas thaiv ib lossis ntau ntawm cov hlab ntshav ntsig hauv lub ntsws. Vim li ntawd, lub ntsws tsis tuaj yeem txais cov ntshav oxygenated. Cov tsos mob ntawm tus mob no suav nrog ua pa siav, mob hauv siab, thiab hnoos uas yuav muaj ntshav. Koj yuav tsum nrhiav kev kho mob maj nrawm yog tias koj xav tias koj muaj mob ntsws txhaws.

Dab tsi yog qhov tshwm sim rau tus mob no?

Raws li Cleveland Lub Chaw Kho Mob, tam sim no tsis muaj ntaub ntawv qhia tias cov ntshav tuab cuam tshuam txog kev muaj sia nyob ntev. Txawm li cas los xij, yog tias koj tsev neeg muaj keeb kwm ntawm tus mob, koj yuav tsum tau sab laj nrog koj tus kws kho mob txog cov kev pheej hmoo txaus ntshai.