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Что такое коагулограмма и для чего сдают этот анализ Перейти к контенту
Здоровье самое ценное, что есть у человека. Очень часто под действием различных факторов оно «подрывается», и хорошо, если для его восстановления достаточно пройти курс терапии. Но нередки случаи, когда человеку требуется хирургическая помощь. Перед такой важной процедурой в обязательном порядке больному делают коагулограмму. С этим термином знакомы также беременные женщины, которым приходится три раза на протяжении всего вынашивания прибегать к этому исследованию.
Удивительно, но есть люди, которые даже не слышали этот термин и тем более не знаю, что это значит. Данная статья детально ознакомит с данным исследованием, расскажет о его особенностях, расшифровке и как правильно к нему подготовиться.
Коагулограмма что это за анализ Кровеносная система считается одной из важных в человеческом организме, а развёрнутая коагулограмма представляет собой лабораторное исследование системы свёртываемости кровяной жидкости. Такая процедура позволяет обнаружить происходящие в организме нарушения, а именно сбой гемостаза, который в ответе за поддержку крови в жидком, т.е. нормальном её состоянии. Помимо этого, гемостаз отвечает за свёртываемость, что позволяет остановить кровь во время кровопотери.
Патология этой системе может привести к серьёзным негативным последствиям, вплоть до летального исхода. Так, даже небольшой порез провоцирует сильную потерю крови, такое наблюдается при сниженной свёртываемости. При нарушении возможно и образования тромбоза, из-за сгущения крови, что в свою очередь приводит к инфаркту, инсульту. Это происходит при повышенной свёртываемости.
Опасность проблемы заключается в том, что она не проявляет себя никак, а обнаружиться может при оперировании или во время родовой деятельности. А это является угрозой для жизни.
Показания к проведению коагулограммы В медицине немало ситуаций, когда врачам нужно знать особенность свёртываемости крови пациента, среди часто встречающихся следующие:
перед плановой операцией; при склонности к образованию тромбов ; перед назначением лечебной терапии, в основе которой лежит приём антикоагулянтов. Данные медицинские средства оказывают угнетающее воздействие на свёртываемость кровяной жидкости; когда имеют место быть гестоз, варикоз, заболевания печени, различных геморрагических недугов; при диагностике сердечно-сосудистых заболеваний; когда произошёл инфаркт, инсульт; при наличии кровоизлияния, которое невозможно остановить, и оно имеет неизвестную этиологию; во время беременности коагулограмма является обязательной. Коагулограмма при планировании беременности Коагулограмма при беременности необходима для осуществления контроля за состоянием здоровья матери. Такой анализ проводится каждый триместр. Стоит отметить, что в этот период времени у женщины наблюдается незначительное повышение свёртываемости кровяной жидкости. Этому имеется объяснение. Так, организм пытается защититься от потери крови.
С помощью данного исследования предотвращается следующее:
образование тромб в венах конечностей; выкидыш; отслойка плаценты.
Сколько дней делается коагулограмма Многих людей интересует, сколько дней делается коагулограмма. Сотрудникам лаборатории требуется как минимум один день, чтобы выполнить подсчёт количественных показателей анализа . Обычно срок зависит от оборудования, которое используется лабораторией. Если необходима транспортировка материала, это ещё дополнительные несколько дней. Но чаще всего пациенту выдают результат исследования через два дня.
Подготовка к исследованию Чтобы подготовиться к анализу, нужно придерживаться следующих требований:
Процедура выполняется натощак, поэтому пациенту нужно отказаться от трапезы за 8-12 часов до проведения анализа. Рекомендуется накануне вечером покушать что-то легкоусвояемое. Под запретом алкогольные напитки, жареная, солёная, копчёная пища и консервации. За пару часов до сдачи биоматериала нужно не пить чай, кофе и соки, разрешается только вода. За 25 минут до процедуры нужно выпить один стакан очищенной воды. В день забора крови нужно воздерживаться от физической нагрузки, стрессовых ситуаций, переутомления, нервного перенапряжения. Также перед исследованием следует сообщить лечащему врачу о принимаемых препаратах, если такие имеются. Особенно это важно при приёме антикоагулянтов, так как они могут негативно сказаться на результате исследования. Обычно в этом случае врач на некоторое время советует воздержаться от употребления данных препаратов.
Как сдать коагулограмму Важно также ознакомиться с информацией, как происходит сдача коагулограммы. Её делают утром. Врачи предупреждают, что очень важно накануне хорошо выспаться, а при процедуре принять горизонтальное положение. К особенностям анализа относят:
сбор биоматериала выполняется с помощью сухого шприца или вакуумной системы; для процедуры нет нужды в применении жгута; используется игла, которая характеризуется широким просветом; медицинский работник осуществляет манипуляции с аккуратностью для того, чтобы не повредить вену пациента. Если все же произойдёт повреждение, тогда вместе с кровяной жидкостью в анализ попадает тканевой тромбопластин. Это в свою очередь искажает достоверность обследования; используется две пробирки, которые заполняют кровью, но исследуется лишь одна; в лабораторную ёмкость добавляют цитрат натрия. Коагулограмму можно сделать в любой клинической больнице, при наличии в ней специального оборудования. Результат анализа пациент получит через пару дней.
VIDEO Расшифровка результатов Показатели коагулограммы помогают дать представление о состоянии здоровья пациента, сюда входит:
Время свёртывания кровяной жидкости. Для этого из вены берут биоматериал в объеме 2 мл., который после делится на две равные части и разливается по стерильным пробиркам, в них не должны находиться стабилизирующие элементы. Далее потребуется имитация температуры тела человека. Здесь прибегают к водяной бане, а время засекают с помощью секундомера, при этом ёмкости должны быть немного под наклоном. Следующим этапом является изучение процесса образования сгустка и засекается время, когда это начинается. Вычисляют среднее время для данной процедуры образования в двух ёмкостях. Здесь нормой считается – 5-10 сек. Увеличение нормы (более 15 сек.) говорит о наличии дефицита витамина С, фермента протромбиназа и фибриногена. Существует и упрощенный способ исследования, при котором применяется одна ёмкость, но здесь имеется риск получить недостоверные результаты. Ретракция. Во время данного метода осуществляется определение степени сжатия кровяного сгустка. Нормой принято считать – 40-95%. Снижается показатель на фоне тромбоцитопении, а увеличивается при анемии . Протромбиновый индекс. Алгоритм проведения процедуры тот же, как и в первом показателе. Единственным отличием является добавление в пробирки хлористого кальция, а также раствора тромбопластина. Нормой будет считаться значение 12-20 сек. При её увеличении врачи указывают на наличие у больного проблем с образованием протромбиназы, фибриногена и протромбина. А это в свою очередь говорит о наличии авитаминоза, дисбактериоза и печёночного недуга. Тромботест. Позволяет определить имеется ли в крови у пациента фибриноген, а также его качество. Показатель считается в норме при результате – 4-5 степень тромботеста. Фибриноген. Основой исследования является процедура перенесения фибринных нитей на фильтры. В норме показатель на уровне 5,9-11,7 мкмоль/л. При снижении значения можно утверждать о наличии у больного печёночного недуга или различных патологий. Когда в результате получено увеличение нормы, возможно, имеются инфекционные или воспалительные заболевания, лейкоз. Время плазменной рекальцификации. Соединяя хлористый кальций и плазму в соотношении 2:1 и ставя ёмкость на водяную баню, сотрудники лаборатории выявляют время образования сгустка. Такие действия проделывают три раза, а после считают среднее время данных исследований. У здорового человека нормой считается 1-2 мин. Снижение показателя возникает по причине гиперкоагуляционных свойств кровяной жидкости, а увеличение из-за тромбоцитопении, недостаточности плазменных факторов свёртываемости, а также когда в крови имеется медицинский препарат, относящийся к гепаринам. АЧТВ. Данный показатель представляет собой активированное частичное тромбопластиновое время, с его помощью выявляют недостаточность плазменных факторов. Во время анализа используют фосфолипиды, его нормой является значение — 35-55 сек. Если произошло увеличение значения, это указывает на дефицит факторов свёртываемости, которые имеет врождённый характер, а если снижение – повышенный риск появления тромбоза . Фибринолитическая активность. С помощью этого показателя оценивается способность кровяной жидкости растворять тромбы. Нормой является 183-263 мин. При снижении значения можно говорить о наличии повышенной кровоточивости. Толерантность плазмы к гепарину. Во время анализа обращают внимание на быстроту формирования сгустка фибрина, при этом в пробирки добавляют гепарин. Считается, что если на этот процесс уходит 7-15 мин., то это норма. Когда наблюдается увеличение значения, возможно, у пациента есть заболевание печени, а при снижении значения предполагается наличие гиперкоагуляции.
Помимо перечисленных показателей добавляют и другие, обычно в этом есть необходимость для более точной диагностики при имеющихся подозрениях на какой-либо недуг. Среди них может быть:
Протеин С. Данный белок является одним из самых важных, его нормой для взрослого человека является – 70-140%. Такой показатель выявляет патологии при беременности, недуги печени, онкологические заболевания, сепсис, тромбозы и прочее. РФМК – представляет собой остатки тромбов, которые имели небольшие размеры. Увеличение показателя свидетельствует о сгущении крови, происходящих патологических процессах в организме больного, наличии ДВС-синдрома. Что касается нормы, у здорового человека эта отрицательное значение, т.е. при исследовании в крови не должен быть обнаружен фибрин. Антитромбин. Представляет собой белок, помогающий не только образовывать, но и уничтожать тромбы. МНО . Этот показатель позволяет контролировать лечение больного с помощью противосвёртывающих медицинских препаратов. Когда показатель повышен это может говорить о склонности к кровопотерям, а когда снижен – существует риск развития тромбоза.Д-димер. Данное белковое вещество является продуктом распада фибринов. Норма на уровне 0-500 нг/мл. Он указывает на повышение тромбоза при увеличении его значений. Волчаночный антикоагулянт. При данном анализе выявляют антитела, такой показатель всегда должен равнять нулю, а если полученные значения «ушли» от нормы, в организме пациента развиваются аутоиммунные болезни. Для точного «прочтения» результатов анализа следует обращаться только к специалисту.
Благодаря такому анализу, как коагулограмма, существует возможность выявления заболеваний сердца, печени, почек и других органов. Берегите свое здоровье, ведь оно бесценно!
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