Indlela yokugaya igazi ibaluleke kakhulu empilweni. Uma isitsha segazi sibonakaliswe ukulimala, indlela ejwayelekile yokuvala i-clotting iqinisekisa ukuthi ukulahlekelwa kwegazi kuyonciphisa. Ngaphezu kwalokho, i-clot yegazi eyenza endaweni yokulimala inikeza isinyathelo sokuqala somzimba ekuphulukiseni ukulimala.
Kodwa-ke, uma i-clot yegazi ikhiqiza lapho kungenjalo, izinkinga ezinkulu zingabangela ngoba i-clot ingabangela umonakalo omkhulu egazini elinikeziwe (noma elivuthwe) yisitsha esivinjelwe.
Yingakho ukuhlonza i-clot yegazi-kungenzeka ngezobubili nokuhlolwa kwe-imaging-kubaluleke kakhulu.
Isikhathi Sokuthola I-Blood Clot
Ngokuvamile kubalulekile ukuxilonga ubukhona nendawo ye-thrombus noma i-embolus, izinhlobo ezimbili zezindwangu zamagazi, ngoba uhlobo olunalo lungcono kakhulu lokukhiqiza umonakalo wesikhumba. Ukwenza ukuhlonza okufanele kubalulekile ekumiseni ukwelashwa okuphumelelayo kakhulu.
Izimo ezivamile zokwelashwa ezivama kakhulu ngenxa ye-thrombus noma embolus zihlanganisa:
- I-stroke , okuvame ukubangelwa yi-thrombosis yezinye izifo ezithinta ubuchopho, noma i-embolus ehamba ebuchosheni (ngokuvamile ephuma enhliziyweni).
- Ukuhlasela kwenhliziyo , cishe njalo ngenxa yokuqubuka kwe- plaque ye- atherosclerotic , okubangela ukuba i-thrombus ifomu ngaphakathi kwe-artery coronary.
- I-thrombosis ejulile ye-vein (DVT) , i-clot eyenza kwenye yezinsana ezinkulu zomlenze, ithanga noma i-pelvis.
- I-pulmonary embolus , i-clot yegazi ehamba emaphashini, ngokuvamile ephuma e-thrombosis ejulile ye-vein.
- Ezinye izimo, kufaka phakathi i-thrombosis ye-vein enkulu eyenza isibindi (i-portal vein thrombosis), i-thrombosis ye-vein eveza izinso (i-veal thrombosis), kanye nokwakhiwa kwendwangu emlenzeni noma emlenzeni.
Ngayiphi yalezi zimo, ngaphambi kokuba ukwelashwa okuphumelelayo kungakhululwa kubalulekile ukukhombisa ngaphandle kokungabaza okucacile ukuthi i-clot yegazi empeleni ibangela inkinga.
Izivivinyo ze-Lab
Ukuhlolwa kwelabhu ukuxilonga i-clot yegazi kungahlola umsebenzi ongajwayelekile futhi unikeze izinkomba ezizosiza ekunciphiseni umzimba wakho phansi.
Ukuhlolwa kwegazi kwe-D-Dimer
Ukuhlolwa kwegazi kwe-D-dimer kuthola ukuthi ngabe kungekudala kube yizinga elingavamile lomsebenzi wokuqeda endaweni ethile ngaphakathi kwegazi. Lokhu kuvivinywa kuyasiza kakhulu ekusizeni odokotela ukuthi bangabe besaba ukuthi kungenzeka ukuthi i-DVT noma i-pulmonary embolus yenzeke.
Ama-Biomarker wezinhliziyo
Ama-biomarker we-cardiac asetshenziselwa ukuxilonga ukuhlaselwa kwenhliziyo. Lezi zivivinyo zegazi azixilisi ngokucophelela ama-clots egazi; kunalokho, bathola ukuthi kukhona yini ukulimala kwemisipha yenhliziyo-okuvame ukubangelwa i-plaque yamaphariyali ephukile, kanye nokubunjwa kwe-thrombosis elandelayo.
Ukuhlolwa kwezilingo
Udokotela wakho uzoyilungisa ukuhlolwa kwe-imaging okubheka ukuthi kuyadingeka ukuze kwenziwe ukuxilongwa okufanele. Buza udokotela wakho ukuthi yini ezohlolwa, bese uqinisekisa ukuthi ukhiphe noma yikuphi ukukhathazeka onakho mayelana nenqubo.
Ukucindezela kwe-Ultrasound
Ukuhlolwa kwe-ultrasound ukucindezela kuyisimo esingavumelekile esingasetshenziswa embhedeni ovame ukuwusizo ekuhloleni i-DVT.
V / Q Scan
I-scanning perfusion scan (V / Q scan) wuhlolo ngokusebenzisa idayisi e-radioactive ukuhlola ukugeleza kwegazi emaphashini, ukubona ukuthi isitsha segazi sepulmonary sivinjelwe yi-pulmonary embolus.
I-CT Scan
I-CT scan iyindlela yokusebenzisa i-x-ray engabonisa inani elimangalisayo lemininingwane ye-anatomiki. I-CT scan isebenza ngokukhethekile ekuqinisekiseni ukuthi ukushaywa komzimba kubangelwa yi-embolus noma i-thrombus, futhi ngokuvamile kuvame ukuhlolwa okuqala ekuhloleni ukushaywa. I-CT scan ingaba usizo kakhulu ekuqinisekiseni i-pulmonary embolus.
I-MRI Scan
Njengama-CT scan, ukuhlolwa kwe-MRI kungasetshenziswa ukuthola ama-clots ngaphakathi kwemithwalo yegazi. Lezi zivivinyo zilukhuni kakhulu ukwenza ngaphezu kokuhlola kwe-CT, ngakho-ke uma isikhathi sisesisindo sokuqala se-CT sisebenza njalo.
Angiography noma Venography
Lawa amasu okugcoba lapho idayi ijozwa khona emzimbeni wegazi lapho kukhonjelwa khona i-clot futhi x-ray ithathwa ukuze ibone i-clot.
I-angiography yama-pulmonary ingasetshenziselwa ukuxilonga i-pulmonary embolus; i-venography ukuze ihlolwe i-DVT. Ngenxa yokutholakala kwe-CT nokuhlola kwe-MRI, lezi zivivinyo ezingavamile ziyadingeka ukuze zihlolwe ngokuphindaphindiwe kakhulu kunalokho ezazisendulo ukuze zihlolwe i-thrombus noma i-embolus.
I-Echocardiography
Ama-Echocardiograms asetshenziselwa iziguli eziye zaba nemigomo ethinta umshini-ikakhulukazi kubantu abaye bahlaselwa isisu. Ukuze ungene emthini, cishe zonke izimo ukuqubuzana kuzodingeka kuvele ngaphakathi kwenhliziyo noma ukuhamba ngenhliziyo.
I-echocardiogram ingakwazi ukubona i-thrombus eyenziwe enhliziyweni (ngokuvamile e-atrium kwesokunxele kumuntu one -fibrillation ye-atrial , noma e-ventricle engakwesokunxele kumuntu one- cardiomyopathy ekhuphuke kakhulu). I-echocardiogram ingathola futhi izinkinga zenhliziyo ezingavumela ukuthi ama-embolus ahambisane nenhliziyo, njenge- patent foramen ovale .
> Imithombo:
> Fields JM, Davis J, Girson L, et al. I-Transthoracic Echocardiography Ukuthola Ukuxilongwa Kwama-Pulmonary Embolism: Ukubuyekezwa Okuhlelekile Nama-Analysis. J Am Soc Echocardiogr 2017; 30: 714. doi: 10.1016 / j.echo.2017.03.004.
> Gibson NS, Schellong SM, Kheir DY, et al. Ukuphepha Nokuzwela Kwezinkambiso Zikabili Zama-Ultrasound Ezigulini Ezine-Thrombosis Ebonakalayo Emtholampilo Ekhulelwe Ngomtholampilo: Isifundo Sokuphathwa Okubhekayo. J Thromb Haemost 2009; 7: 2035. doi: 10.1016 / j.echo.2017.03.004.
> Stein PD, Yaekoub AY, uMatta F, et al. Isixazululo se-Pulmonary Embolism On Ct Pulmonary Angiography. I-Ajr Am J Roentgenol 2010; 194: 1263. doi: 10.2214 / AJR.09.3410.
> Weitz JI, Fredenburgh JC, Eikelboom JW. Isivivinyo Kuqukethwe: D-Dimer. J Am Coll Cardiol 2017; 70: 2411. doi: 10.2214 / AJR.09.3410.