Ukuvimbela isiteji sokusabalalisa i-thrombus

Akungabazeki ukuthi ukuthuthukiswa kwama-anticoagulants kuye kwakhuthaza ngokuqondile ukwelashwa kwe-DVT.Ukwelashwa kwe-Anticoagulant kungavimbela ukuvela kwe-thrombus, kuvimbele ukusakazeka kwe-thrombus, kusize u-autolysis we-thrombus kanye nokuvuselelwa kwe-lumen, kunciphise izimpawu, futhi kunciphise izehlakalo nokufa kwe-pulmonary embolism.Njengamanje, izidakamizwa ze-anticoagulant ikakhulukazi zifaka i-heparin, i-heparin yesisindo esiphansi samangqamuzana, i-warfarin, i-rivaroxaban ne-dabigatran.Ngayinye yale mithi inezinzuzo zayo kanye nokubi.Uma iqhathaniswa ne-heparin engahlukanisiwe, i-heparin enesisindo esiphansi se-molecular subcutaneous noma nge-intravenously inganciphisa kakhulu ukufa.Phakathi kwama-anticoagulant omlomo, i-warfarin isetshenziswa kabanzi ngenxa yenani layo eliphansi, umphumela onembile we-anticoagulant ngaphakathi kwebanga lokwelapha elisebenzayo (elidinga isilinganiso esijwayelekile samazwe ngamazwe ukuthi sibe phakathi kuka-2 no-3).Kodwa-ke, ngenxa yokuthi i-warfarin ithintwa kakhulu ukudla, kulula ukuba nezinkinga ezifana nokungaphumeleli kwe-anticoagulation nokopha, futhi kuyadingeka ukuqapha umsebenzi we-coagulation njalo.Eminyakeni yamuva, inani elikhulu lama-anticoagulants amasha livele embhedeni, njenge-rivaroxaban, i-dabigatran, i-apixaban, njll. umphumela we-anticoagulant unembile, izinkinga zokuphuma kwegazi ziyancipha, futhi asikho isidingo sokuphinda uhlole umsebenzi we-coagulation.

Njengamanje, ezinye izazi zisikisela ukuthi ukwelashwa kwezidakamizwa kungahlukaniswa ngezigaba ezimbili ngokusho kokuhlukaniswa kwesikhathi kwezinyanga ezingu-3: isigaba sokuqala sibizwa ngokuthi isigaba sokuqala sokwelapha esisebenzayo.Ikakhulukazi yenziwa phakathi nezinyanga ezi-3 ngemuva kokuqala kwe-dvt3, futhi isigaba sesibili sibizwa ngesigaba sokuvimbela ukuphindaphinda kokulandela, esenziwa ezinyangeni ezi-3 ngemuva kwesigaba sokuqala sokwelashwa.Imihlahlandlela ye-Accp9 iqale yancoma ama-anticoagulants omlomo amasha.Ohlelweni lweshumi lweziqondiso ze-American College of Chest Physicians (ACCP), umehluko omkhulu kunabo bonke kusukela esikhathini esidlule ukuthi ama-anticoagulant omlomo amasha (noac), njenge-factor Xa inhibitors (rivaroxaban, fondaparinux sodium, njll.) kanye ne-factor IIA inhibitors ( dabigatran, njll.) zisetshenziswa njengenketho yokuqala yokwelashwa kwe-VTE.Ukwelashwa kwe-Anticoagulant kunomphumela oqondile, kunciphisa kakhulu izinkinga zokopha, futhi akudingi ukuhlolwa kabusha kokusebenza kwe-coagulation.Iphinde ithuthukiswe ezigulini ezijwayelekile.Ama-anticoagulant amasha ngokuvamile angagwema ukuphinda kwe-DVT ku-80% ~ 92%.

Umkhawulo wokwelashwa kwe-anticoagulant kuphela ukuthi nakuba ukwelashwa kwe-anticoagulant kuvame ukusetshenziselwa ukunciphisa ukuphindaphinda kwe-thrombus nokuvikela ukusebenza kwe-valve ye-venous, akukwazi ukuhlakaza i-thrombus ngokushesha.Ukuzikhulula kwe-thrombus akuvamile ukubonwa ezigulini ezine-iliofemoral vein thrombosis, futhi i-thrombus esele ingaholela ekulimaleni kwe-valve ye-venous kanye nokuvinjelwa kwepheshana lokuphuma, okuyizizathu zezehlakalo eziphezulu ze-post thrombosis syndrome (PTS).Ucwaningo lokubheka ukwenzeka kwe-PTS ngemuva kokwelashwa kwe-anticoagulant ye-DVT lubonise ukuthi izehlakalo ze-PTS zazicishe zibe ngama-20% ~ 50%, izehlakalo zesilonda se-venous ezithweni ezingezansi zazingama-5% ~ 10%, kanti i-venous claudication yayingu-40% ngemva kweminyaka emi-5.Cishe i-15% yeziguli yayinezinkinga zokunyakaza, futhi izinga lempilo ye-100% yeziguli lehliswa ngamazinga ahlukahlukene.