Ọkpụkpụ ọbara na-ekekọta usoro dị ezigbo mkpa ná ndụ. Mgbe mmerụ ahụ mebiri arịa ọbara, usoro ikuku clotting na-eme ka o doo anya na ọbara ga-ejedebe. Ọzọkwa, ọbara ahụ na-emepụta na saịtị nke mmerụ ahụ na-enye nzọụkwụ mbụ nke ahụ ahụ iji gwọọ mmerụ ahụ.
Otú ọ dị, ọ bụrụ na akpụkọ ọbara na-emepụta mgbe ọ na-ekwesịghị, nnukwu nsogbu nwere ike ịpụta n'ihi na clot nwere ike imebi ihe dị egwu nke arịa ahụ (ma ọ bụ drained) site na akpa ahụ.
Nke a bụ ihe mere ịchọta ọnya ọbara-nke ga-ekwe omume na nyocha abụọ na nyocha nke ima-dị oke mkpa.
Mgbe iji chọpụta ncha ọbara
Ọ na-adịkarị mkpa ịchọpụta ọnụnọ na ọnọdụ nke thrombus ma ọ bụ ihe mkpuchi, ụdị nkedo ọbara abụọ, n'ihi na ụdị ọ bụla nwere nnukwu ohere nke imebi anụ ahụ. Ime nchọpụta ziri ezi dị oké mkpa iji guzobe ọgwụgwọ kasị dị irè.
Ọnọdụ ọgwụgwọ zuru oke bụ nke na-abụkarị n'ihi ma ọ bụ thrombus ma ọ bụ ihe eji eme ihe gụnyere:
- Ihe ojoo , nke a na-emekarị site na thrombosis nke otu n'ime akwara ndị na-enye ụbụrụ, ma ọ bụ ihe mgbagwoju anya nke na-aga ụbụrụ (ọtụtụ mgbe site na obi).
- Mgbu obi , bụ nke fọrọ nke nta ka ọ bụrụ mgbe nile n'ihi nkwụsị nke ihe oyiyi atherosclerotic , nke na-eme ka thrombus na-etolite n'ime akwara coronary.
- Mkpụrụ obi thrombosis dị omimi (DVT) , akpụkpọ ụkwụ nke na-etolite n'otu n'ime ụbụrụ ukwu nke ụkwụ, apata ma ọ bụ pelvis.
- Ngwongwo nke Pulmonary , akpịkọ ọbara nke na-agafe na ngụgụ, na-esitekarị na thrombosis dị omimi.
- Ọnọdụ ndị ọzọ, gụnyere thrombosis nke isi vein nke na-agbaju umeji (veal thrombosis), thrombosis nke vein nke na-ebute akụrụ (renal vein thrombosis), na ịmepụta akpụkpọ ụkwụ na ogwe aka ma ọ bụ ụkwụ.
Na nke ọ bụla n'ime ọnọdụ ndị a, tupu enwee ike inye ọgwụgwọ dị irè, ọ dị mkpa igosi na ọ bụghị ihe ezi uche dị na ya na eriri ọbara na-akpata nsogbu ahụ.
Nyocha ụlọ
Nyocha ụlọ nyocha maka ịchọọpụta ọnya ọbara nwere ike ịnwale maka ọrụ na-adịghị mma ma na-enye ihe ngosi nke ga-enyere gị aka nyochaa nyocha gị.
D-Dimer Ọbara Ọbara
Nyocha ọbara nke D-dimer na-achọpụta ma ọ dị na nso nso a bụ ọkwa dịgasị iche nke clotting ọrụ n'ime ọbara. Nnwale a bụ ihe kasị baa uru n'inyere ndị dọkịta aka ka ha chee na ntinye DVT ma ọ bụ ihe mgbagwoju anya.
Cardiac Biomarkers
A na -eji ndị na- emepụta ihe na Cardiac chọpụta ọnyá obi. Nnyocha ọbara ndị a adịghị achọpụtacha ọnyá ọbara; kama nke ahụ, ha na-achọpụta ma mmebi ahụ ọkpụkpụ obi dị-nke fọrọ nke nta ka ọ bụrụ mgbe ọkpụkpụ a na-agbanye akwara akwara na-akpata, tinyere nchịkọta thrombosis sochirinụ.
Nnyocha Echiche
Dọkịta gị ga-enye gị ihe nyocha nke ihe osise nke ọ na-ewere dị mkpa maka ịme nchọpụta kwesịrị ekwesị. Jụọ dọkịta gị ihe ule ga-ekpughe, hụkwa na ị ga-ebute nchegbu ị nwere banyere usoro ahụ.
Mkpakọ Ultrasound
Ihe nyocha nke ultrasound compression bụ ule na-enweghị nhụjuanya nke a ga-arụ na akwa akwa nke na-abakarị uru n'ịchọpụta DVT.
V / Q Iṅomi
Ihe ntanye nke ventilashion (V / Q scan) bụ ule na-eji redioactive na-acha ọbara ọbara iji nyochaa ọbara na ngụgụ, iji chọpụta ma ọ bụ ihe mgbagwoju anya na-egbochi ọbara ọbara.
CT Iṅomi
CT scan bụ ihe ọmụma x-ray kọmputa nke nwere ike igosi oke ọnụọgụ nke anatomic. CT scan bụ karịsịa bara uru iji kwenye na ọrịa strok sitere na embolbus ma ọ bụ thrombus, ọ bụkwa mgbe mbụ a na-eji nyochaa ọrịa strok. Nyocha CT nwekwara ike inye aka n'igosi ihe eji eme ihe.
MRI Iṅomi
Dị ka CT na-enyocha, a na-enyocha MRI iji chọpụta nkedo n'ime arịa ọbara. Ule ndị a na-esiri ike karịa ịrụ ọrụ karịa ka CT na-enyocha, n'ihi ya, mgbe oge bụ ihe dị mkpa CT scans na-ejikarị arụ ọrụ.
Angiography ma ọ bụ ihe ọhụụ
Ihe ndị a bụ usoro nchịkwa nke a na-etinye ọgwụ n'ime mmiri n'ime ụgbọ mmiri ebe a na-enyo enyo na a na-ewere ụzarị ọkụ iji chọpụta clot.
Enwere ike iji ihe eji eme ihe n'usoro pulmonary iji chọpụta ihe mgbagwoju anya; ihe omimi iji chọpụta DVT. N'ihi nyocha nke CT na nyocha MRI, a na-achọ nlele ndị a na-emenye ụjọ maka ihe nchọpụta diagnostic ọtụtụ ugboro karịa ka ha na-eme n'oge gara aga iji chọpụta ihe ngọngọ ma ọ bụ ihe ọkpụkpụ.
Echocardiography
Echocardiograms na -ejikarị ya eme ihe n'ọrịa ndị nwere ụdị ihe na-emetụta ụbụrụ-karịsịa na ndị mmadụ nwere ọrịa strok. Iji banye n'ime ikuku, n'ihe fọrọ nke nta ka ọ bụrụ ihe ọ bụla, ihe ọ bụla ga-esite n'ime obi ma ọ bụ ịgagharị n'obi.
Echocardiogram ahụ nwere ike ịchọpụta thrombs nke dị n'ime obi (dịka n'aka ekpe ekpe na onye nwere ihe nkedo , ma ọ bụ n'aka ekpe ekpe na onye nwere ọrịa cardiomyopathy siri ike). Echocardiogram nwekwara ike ịchọpụta nsogbu obi nke nwere ike ikwe ka ihe eji eme ihe iji gbanye obi, dịka oval patrol breramen .
> Isi mmalite:
> Ubi JM, Davis J, Girson L, et al. Ihe Echocardiography Transthoracic Maka Ịchọpụta Embolism Pulmonary: A Review System and Meta-Analysis. J Am Soc Echocardiogr 2017; 30: 714. Echiche: 10.1016 / j.echo.2017.03.004.
> Gibson NS, Schellong SM, Kheir DY, et al. Nchebe na Mmetụta nke Abụọ Ultrasound Strategies In patients with Clinically Expected Deep Venous Thrombosis: Ọdịnihu na-atụle Ọmụmụ Ihe. J Thromb Haemost 2009; 7: 2035. Echiche: 10.1016 / j.echo.2017.03.004.
> Stein PD, Yaekoub AY, Matta F, et al. Mkpebi nke Embolism On Ct Pulmonary Angiography. Ajr Am J Roentgenol 2010; 194: 1263. Echiche: 10.2214 / AJR.09.3410.
> Weitz JI, Fredenburgh JC, Eikelboom JW. Ule Ule: D-Dimer. J Am Coll Cardiol 2017; 70: 2411. Echiche: 10.2214 / AJR.09.3410.