Ukuthintela i-thrombus kwinqanaba lokusabalalisa

Akungabazeki ukuba uphuhliso lwe-anticoagulants lukhuthaze ngokuthe ngqo unyango lwe-DVT.Unyango lwe-Anticoagulant lunokuthintela ukwenzeka kwe-thrombus, luthintele ukusasazeka kwe-thrombus, luququzelele i-autolysis ye-thrombus kunye nokuvuselelwa kwe-lumen, ukunciphisa iimpawu, kunye nokunciphisa iziganeko kunye nokufa kwe-pulmonary embolism.Okwangoku, iziyobisi ze-anticoagulant ziquka i-heparin, i-heparin ye-molecular ephantsi, i-warfarin, i-rivaroxaban kunye ne-dabigatran.Ngalinye kula mayeza lineengenelo kunye nokungona kwalo.Xa kuthelekiswa ne-heparin engaxutywanga, i-heparin ephantsi ye-molecular weight subcutaneously okanye nge-intravenously inokunciphisa kakhulu ukufa.Phakathi kwe-anticoagulants yomlomo, i-warfarin isetyenziswa ngokubanzi ngenxa yexabiso layo eliphantsi, isiphumo esichanekileyo se-anticoagulant ngaphakathi kwoluhlu lonyango olusebenzayo (oludinga umlinganiselo wamazwe ngamazwe osemgangathweni ukuba ube phakathi kwe-2 kunye ne-3).Nangona kunjalo, ngenxa yokuba i-warfarin ichaphazeleka kakhulu kukutya, kulula ukuba neengxaki ezifana nokungonelanga kwe-anticoagulation kunye nokuphuma kwegazi, kwaye kuyimfuneko ukubeka iliso kwi-coagulation umsebenzi rhoqo.Kwiminyaka yakutshanje, inani elikhulu lama-anticoagulants amatsha avele ebhedeni, njenge-rivaroxaban, i-dabigatran, i-apixaban, njl njl. Umphumo we-anticoagulant uchanekile, iingxaki zokuphuma kwegazi ziyancipha, kwaye akukho mfuneko yokuphinda uhlolisise umsebenzi we-coagulation.

Okwangoku, abanye abaphengululi bacebisa ukuba unyango lweziyobisi lunokwahlulwa lube ngamanqanaba amabini ngokwexesha lokwahlula iinyanga ezi-3: isigaba sokuqala sibizwa ngokuba yinqanaba lokuqala lonyango olusebenzayo.Ikakhulu iqhutywa kwiinyanga ezi-3 emva kokuqala kokuqala kwe-dvt3, kwaye inqanaba lesibini libizwa ngokuba linqanaba lokuthintela ukuphindaphinda, eliqhutywa kwiinyanga ezi-3 emva kwenqanaba lokuqala lonyango.Izikhokelo ze-Accp9 ziqale zandulula ii-anticoagulants zomlomo ezintsha.Kwi-10th edition ye-American College of Chest Physicians (ACCP) izikhokelo, umehluko omkhulu kwixesha elidlulileyo kukuba i-anticoagulants yomlomo omtsha (noac), njenge-factor Xa inhibitors (rivaroxaban, fondaparinux sodium, njl.) kunye ne-factor IIA inhibitors ( dabigatran, njl) zisetyenziswa njengokhetho lokuqala lonyango lwe-VTE.Unyango lwe-Anticoagulant lunempembelelo eqinisekileyo, lunciphisa kakhulu iingxaki zokuphuma kwegazi, kwaye alufuni ukuphinda kuhlolwe umsebenzi we-coagulation.Iyakhuthazwa ngakumbi kwizigulana eziqhelekileyo.Ama-anticoagulants amatsha anokuphepha ngokubanzi ukuphindaphinda kwe-DVT kwi-80% ~ 92%.

Ukunciphisa unyango lwe-anticoagulant yodwa kukuba nangona unyango lwe-anticoagulant luhlala lusetyenziselwa ukunciphisa ukuphindaphinda kwe-thrombus kunye nokukhusela umsebenzi we-valve ye-venous, ayikwazi ukunyibilikisa i-thrombus ngokukhawuleza.Ukuzicoca ngokwakho i-thrombus kunqabile ukubonwa kwizigulane ezine-iliofemoral vein thrombosis, kunye ne-thrombus eshiyekileyo inokukhokelela kumonakalo wevalve ye-venous kunye nokuphazamiseka kwendlela yokuphuma, ezi zizathu zeziganeko eziphezulu ze-post thrombosis syndrome (PTS).Uphononongo lokuqwalasela ukwenzeka kwe-PTS emva kokuba unyango lwe-anticoagulant ye-DVT lubonise ukuba iziganeko ze-PTS zazimalunga ne-20% ~ 50%, iziganeko ze-venous ulcer zamalungu angaphantsi zazingama-5% ~ 10%, kwaye iziganeko ze-venous claudication yi-40% emva kweminyaka emi-5.Ngokumalunga ne-15% yezigulane zineengxaki zokunyakaza, kwaye umgangatho wobomi be-100% yezigulane zancitshiswa kwiidigri ezahlukeneyo.