DIC-syndrome - lefu la ho arolelana intravascular coagulation - tlhekefetso ea hemostasis, e khetholloang ke liphetoho tsa mali coagulability. Li-micro-clusters le lihlopha tsa metsoako ea mali ke sesosa sa ho se sebetse ha microcirculation le liphetoho tsa dystrophic lithong, tse lebisang tlhokomelong ea hypocoagulation, thrombocytopenia le mali.
Lisosa tsa nts'etso-pele ea lefu la DIC
DIC-syndrome ha e na lefu le fapaneng 'me e fetoha ka lebaka la maemo a latelang a ho kula:
- mekhoa ea septic nakong ea ho pepa, ho ntša mpa ea phekolo ea meriana le kathetherising e telele ea likepe tse khōlō;
- ho sithabela ha methapo ea mali, marako a vascular le parenchyma ea litho tsa ka hare nakong ea ho kenngoa ha likokoana-hloko kapa likokoana-hloko tsa mesifa;
- phekolo ea mafu a ho folisa le a basali, phepelo ea ts'ebetso;
- maemo a tsosang, a bakoang ke ho tsoa likotsi, lefu la pelo, tšenyo ea mali le mathata a mang;
- maloetse a tšoaetsoang ke mali (myeloma, erythremia);
- Litlhahiso tse mpe maling a matšoafo, sehlahisoa sa malapa le lik'hamphani;
- maloetse a li-autommune (lupus erythematosus, glomerulonephritis , hemorrhagic vasculitis);
- hemolysis le ho chesa;
- likokoanyana tse chefo ha boea ba noha bo kenella mali;
- tšebeliso ea nako e telele ea lithethefatsi tse ntlafatsang mali ho koala le ho etsa hore sebopeho se entsoe.
Matšoao a lefu la DIC
Tleliniki ea lefu la DIC e amana le lefu le bakang boemo bona.
Lefu la boloetse ba DIC-syndrome le iponahatsa e le boemo bo tšosang bo bakiloeng ke tlōlo ea lihlopha tsohle tsa hemostasis.
Ka boloetse bo sa feleng ba DVS ho na le keketseho e fokolang litšoantšong tsa tleliniking ka lipontšo:
- hypovolemia (ho fokotseha ha molumo oa mali meleng ea mali);
- tšenyo e mpe ea 'mele;
- litšitiso tsa mekhoa ea metsolic.
Nakong ea DIC-syndrome, mekhahlelo ena ke:
- Karolong ea pele, ho hlahisa li-platelet le li-platelet li hlahisa li-platelet.
- Karolong ea bobeli, ho na le liphetoho ho thibela mali (hypercoagulation kapa hypocoagulation).
- Karolong ea boraro, mali a khaotsa ho oela ho hang.
- Karolong ea bone, mekhoa ea hemostatic e tloaelehileng kapa ea mathata e etsa hore ho be le liphello tse bolaeang.
- Karolo ea bone e nkoa e le tumello ea tumello.
Tlhahlobo ea ICE-syndrome
Ka makhetlo a mangata, lefu lena le fumanoa ka letšoao la pele la lefu la DIC. Leha ho le joalo, ka maloetse a mangata (mohlala, ka kankere ea mali, lupus erythematosus), ho hlahlojoa ke ntho e thata. Maemong a joalo, ho hlahlojoa ha laboratori ea lefu la DIC ho etsoa, e akarelletsang:
- ho fumanoa ha likhahla tsa mali ;
- tlhahlobo ea mali ea mali le prothrombin nako;
- ho lemoha tlōlo ho thromboelastogram;
- litlhahlobo tsa lipatlisiso.
Kalafo le thibelo ea lefu la DIC
Kalafo ea lefu la DIC, e le molao, e etsoa lefapheng la tlhokomelo e matla 'me e reretsoe ho felisa maqeba a mali a thehiloeng, ho thibela ho thehoa ha mali a macha, le ho tsosolosa phekolo ea mali le ho laola hemostasis. Ho phaella moo, phekolo e matla e etsoang ho tlosa mokuli ho tswa ho boemo ba ts'oaetso, phekolo ea meriana ea lefuba kapa etiotropic e lumella ho hanela sebōpeho se tšoaetsanoang. Bakuli ba ka 'na ba laeloa anticoagulant, disaggregant, fibrinolytic le phekolo ea phekolo.
Ka mohlala, ka ICE-syndrome e sa foleng, ho bakuli ba nang le ho se sebetse ha lesea, mokhoa oa plasmaphoresis oa atleha. E na le taba ea hore mokuli o nkiloe 600 ml ea plasma, e nkeloa sebaka ke litokisetso tsa lero la pula e nang le lero le lerootho. Mokhoa
Ho thibela lefu la DIC ho reretsoe ho felisa lisosa tse tlatsetsang tsoelo-pele ea eona. Har'a mehato e thibelang:
- ho kenella ka ho buoa, ho tsamaisoa ke mokhoa o fokolang haholo;
- phekolo e phahameng ea li-tumor;
- thibelo ea linoha tsa noha le chefo e matla;
- Ho kenngoa ha anticoagulants ho phekolo ea maloetse a tšoaetsanoang, joalo-joalo.