Yakadzika tsinga thrombosis

Yakadzika vein thrombosis (DVT) chiitiko chinoitika kana ropa rikaumbika mutsinga yakadzika mukati mechikamu chemuviri. Inonyanya kukanganisa tsinga hombe mugumbo rezasi uye chidya, asi inogona kuitika mune dzimwe tsinga dzakadzika, senge mumawoko nepagumbo.

DVT inonyanya kuwanikwa muvakuru vanopfuura makore makumi matanhatu.Asi inogona kuitika chero pazera. Kana jira rikatsemuka uye rofamba neropa, iro rinodaidzwa kuti embolism. Embolism inogona kunamatira mumidziyo yeropa muuropi, mapapu, moyo, kana imwe nzvimbo, zvichitungamira kukuvara kwakanyanya.

Kuvhara ropa kunogona kuumba kana chimwe chinhu chikanonoka kana kushandura kuyerera kweropa mutsinga. Njodzi zvinhu zvinosanganisira:

• Iyo pacemaker catheter iyo yakapfuudzwa kuburikidza neiyo tsinga mukati megura
• Kuzorora kwemubhedha kana kugara panzvimbo imwechete kwenguva refu, senge kufamba kwendiza
• Nhoroondo yemhuri yekuvhara ropa
• Kutsemuka muchiuno kana makumbo
• Kubereka mukati memwedzi mitanhatu yekupedzisira
• Kubata pamuviri
• Kufutisa
• Kuvhiya kwechangobva kuitika (kazhinji kacho hudyu, mabvi, kana kuvhiya kwechikadzi)
• Masero eropa akawandisa ari kugadzirwa nemongo wemapfupa, zvichikonzera kuti ropa rinyanye kupfuura zvakajairwa (polycythemia vera)
• Kuve nekugara (kwenguva refu) catheter muropa reropa

Ropa rinonyanya kuvhara munhu ane mamwe matambudziko kana kusagadzikana, senge:

• Gomarara
• Zvimwe zvinokanganisa autoimmune, senge lupus
• Kusvuta fodya
• Mamiriro ezvinhu anoita kuti zvinyanye kukura kuvhika kweropa
• Kutora estrogens kana mapiritsi ekudzivirira kuberekwa (iyi njodzi yakanyanya kukwira nekusvuta)

Kugara kwenguva yakareba kana uchifamba kunogona kuwedzera njodzi yeDVT. Izvi zvinonyanya kuitika kana iwe uine imwe kana yakawanda yezvinhu zvine njodzi zvakanyorwa pamusoro.

DVT inonyanya kukanganisa mitsipa mikuru mugumbo rezasi nehudyu, kazhinji kune rumwe rutivi rwemuviri. Iyo clot inogona kuvhara kuyerera kweropa uye kukonzera:

• Shanduko muganda reganda (kutsvuka)
• Kurwadziwa kwegumbo
• Kuzvimba kwegumbo (edema)
• Ganda rinonzwa kudziya kune iro bata

Mutapi wako wezvehutano achaita bvunzo dzepanyama. Bvunzo dzinogona kuratidza tsvuku, kuzvimba, kana gumbo nyoro.

Iyi miedzo miviri inowanzoitwa kutanga kuongorora DVT ndeiyi:

• D-dimer ropa bvunzo
• Doppler ultrasound bvunzo yenzvimbo yekunetseka

MRI yepelvic inogona kuitwa kana ropa rakavhara riri muchiuno, senge mushure mekubata pamuviri.

Kuongororwa kweropa kunogona kuitwa kuti utarise kana iwe uine mukana wakawanda wekuvhara ropa, kusanganisira:

• Yakagadziriswa protein C kuramba (kutarisa kweiyo Factor V Leiden mutation)
• Antithrombin III mazinga
• Antiphospholipid antibodies
• Yakazara kuverenga ropa (CBC)
• Genetic kuyedza kutsvaga shanduko dzinoita kuti iwe ugone kuwedzera maronda eropa, senge prothrombin G20210A mutation
• Lupus anticoagulant
• Mapuroteni C uye mapuroteni S mazinga

Anokupa anokupa mushonga wekutetepa ropa rako (inonzi anticoagulant). Izvi zvinochengetedza mamwe mavharo kubva pakuumba kana ekare kubva mukukura.

Heparin kazhinji ndiwo mushonga wekutanga waunogamuchira.

• Kana heparin ikapihwa kuburikidza nemutsinga (IV), unofanirwa kugara muchipatara. Zvisinei, vanhu vazhinji vanogona kurapwa vasina kugara muchipatara.
• Low molecular weight heparin inogona kupihwa jekiseni pasi peganda rako kamwe kana kaviri pazuva. Iwe ungangodaro usingade kugara muchipatara kwenguva yakareba, kana zvachose, kana iwe wakarairwa rudzi urwu rwe heparin.

Rumwe rudzi rwemushonga wekuonda-ropa unonzi warfarin (Coumadin kana Jantoven) unogona kutanga pamwe neheparin. Warfarin inotorwa nemuromo. Zvinotora mazuva akati wandei kuti ushande zvizere.

Imwe kirasi yevanocheka ropa inoshanda zvakasiyana newarfarin. Mienzaniso yeiyi kirasi yemishonga, inonzi yakananga muromo anticoagulants (DOAC), inosanganisira rivaroxaban powder (Xarelto), apixaban (Eliquis), dabigatran (Pradax), uye edoxaban (Savaysa). Iyi mishonga inoshanda nenzira yakafanana kune heparin uye inogona kushandiswa ipapo ipapo panzvimbo yeparparin. Wako mupi achasarudza kuti ndeupi mushonga wakakukodzera.

Iwe unogonotora ropa rakaonda kwemwedzi mitatu. Vamwe vanhu vanozvitora kwenguva yakareba, kana kunyangwe kwehupenyu hwavo hwese, zvinoenderana nenjodzi yavo yekumwe hove.

Paunenge uchitora mushonga wekutetepa ropa, uri mukana wekubuda ropa, kunyangwe kubva pane zvawagara uchiita. Kana iwe uri kutora ropa rakatetepa kumba:

• Tora mushonga nenzira yakatarwa nemupi wako.
• Kumbira mupi kuti chii chaunofanira kuita kana ukarasikirwa neipi.
• Tora kuongororwa kweropa sekurairwa kwako nemupi wako kuti uve nechokwadi chekuti uri kutora iro chairo dosi. Iyi bvunzo inowanzo kudikanwa newarfarin.
• Dzidza kutora mimwe mishonga uye nguva yekudya.
• Tsvaga maitiro ekutarisa matambudziko anokonzerwa nemushonga.

Muzviitiko zvisingawanzoitika, ungangoda kuvhiyiwa pachinzvimbo chekuwedzera kana anticoagulants. Kuvhiya kunogona kusanganisira:

• Kuisa firita mutsinga huru yemuviri kudzivirira kuvhara kweropa kubva pakuenda kumapapu
• Kubvisa kuwanda kweropa kubva mutsinga kana kujekesa mishonga yekuvhara-kuvhara

Tevedzera chero mimwe mirairo iwe yaunopihwa kuti ubate yako DVT.

DVT inowanzoenda pasina dambudziko, asi mamiriro acho anogona kudzoka. Zviratidzo zvinogona kuoneka ipapo kana iwe ungasazvikudziridze kwe1 kana anopfuura makore mushure. Kupfeka kumanikidza masokisi mukati uye mushure meDVT kunogona kubatsira kudzivirira dambudziko iri.

Zvinetso zveDVT zvinogona kusanganisira:

• Inouraya pulmonary embolism (kuwanda kweropa pachidya kunowanzoita kupunzika nekufamba kuenda kumapapu pane kuwanda kweropa mugumbo rezasi kana zvimwe zvikamu zvemuviri)
• Kugara uchirwadziwa uye kuzvimba (post-phlebitic kana post-thrombotic syndrome)
• Varicose tsinga
• Zvisiri-kurapa maronda (zvisingawanzoitika)
• Shanduko muganda reganda

Fonera mupiki wako kana iwe uine zviratidzo zveDVT.

Enda kuimba yekukurumidzira kana kufonera iyo yemuno emergency emergency (se911) kana uine DVT uye iwe uchikura:

• Kurwadziwa pachifuva
• Kukosora ropa
• Kunetseka kufema
• Kufenda
• Kurasikirwa kwekuziva
• Zvimwe zviratidzo zvakakomba

Kuchengetedza DVT:

• Fambisa makumbo ako kazhinji mukati merwendo rurefu rwekufamba nendege, kufamba kwemotokari, uye mamwe mamiriro ezvinhu awakagara kana kurara pasi kwenguva yakareba.
• Tora mishonga yekuchera ropa yaunopihwa nemupi wako.
• USASVIRA. Taura nemupi wako kana iwe uchida rubatsiro kurega.

DVT; Ropa rakavhara mumakumbo; Thromboembolism; Post-phlebitic chirwere; Post-thrombotic chirwere; Hupenyu - DVT

• Yakadzika tsinga thrombosis - kubuda
• Kutora warfarin (Coumadin, Jantoven) - chii chekubvunza chiremba wako
• Kutora warfarin (Coumadin)

• Yakadzika venous thrombosis - iliofemoral
• Tsinga dzakadzika
• Ropa rekuvhara ropa
• Tsinga dzakadzika
• Venous thrombosis - akateedzana

Kearon C, Akl EA, Ornelas J, et al. Antithrombotic kurapa kweVTE chirwere: CHEST nhungamiro uye nyanzvi pani mushumo. Chest. 2016; 149 (2): 315-352. PMID: 26867832 pubmed.ncbi.nlm.nih.gov/26867832/.

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Lockhart ME, Umphrey HR, Weber TM, Robbin ML. Peripheral midziyo. Mu: Rumack CM, Levine D, eds. Kuongorora Ultrasound. 5 ed. Philadelphia, PA: Elsevier; 2018: chitsiko 27.

Siegal D, Lim W. Venous thromboembolism. Muna: Hoffman R, Benz EJ, Silberstein LE, et al, eds. Hematology: Basic Misimboti uye Maitiro. 7th ed. Philadelphia, PA: Elsevier; 2018: chitsiko 142.