Habka xinjirta dhiiggu aad ayuu muhiim u yahay nolosha. Marka marinnada dhiigga ay waxyeelo soo gaadhay, mishiinka caadiga ah ee xinjirta ayaa xaqiijiya in dhiig-luminta ay xadidan tahay. Intaas waxaa sii dheer, xinjirowga dhiigga ee ka muuqda goobta dhaawaca wuxuu ku siinayaa tallaabada ugu horreysa ee jidhka si loo bogsado dhaawaca.
Si kastaba ha noqotee, haddii xinjirowga dhiigu uu soo baxo marka aysan ahayn, dhibaatooyinka dhabta ahi waxay keeni karaan sababtoo ah xinjirku wuxuu dhaawici karaa dhaawaca culus ee ku yimaadda weelka la keeno (ama miiray) markabka xiran.
Tani waa sababta ciladeynta dhiig-xinjir ufudud oo suurtagal ah labadaba shaybaarka iyo imtixaanka sawir-qaadashada - waa mid muhiim ah.
Goorta la Baarayo Xinjirta Dhiiga
Waxaa badanaa muhim ah in la ogaado joogitaanka iyo meesha uu ku yaalo xuubka ama xuubka 'embolus', laba nooc oo xinjiro dhiig ah, sababtoo ah nooc kasta wuxuu leeyahay awood weyn oo wax soo saara dhaawaca unugyada. Samaynta baaritaanka saxda ah waa mid muhiim u ah sameynta daaweynta ugu waxtar badan.
Xaalado caafimaad oo caadi ah oo badanaa badanaa waxaa sabab u ah labada xabbad ee loo yaqaan "thrombus ama embolus"
- Stroke , kaas oo badanaa keena xinjir dhiig oo halbowlaha ah oo maskaxda siinaya, ama embolus oo maskaxda u socda (maskax ahaan).
- Weerarka wadnaha , kaas oo had iyo jeer had iyo jeer sabab u ah dillaac ka mid ah huurada atherosclerotic , taasoo keenta xinjir udeed si loo sameeyo gudaha halbowlaha wadnaha.
- Deep venous thrombosis (DVT) , xinjir oo ka sameysan mid ka mid ah xididdada waaweyn ee lugta, bowdada ama miskaha.
- Pulmonary embolus , waa xinjir dhiig oo u socdaalay sanbabada, badanaa ka yimaada xinjir dhiig oo xidid.
- Xaalado kale, oo ay ku jiraan xinjirowga xididada ugu weyn ee beerka ka soo baxa (portal vagin thrombosis), xinjirowga xididka dhiigga ee xannuunka kelyaha (xuubka xinjirowga xinjirowga), iyo embolization xinjir gacmaha ama lugta.
Xaaladahan midkoodna, ka hor intaan waxtarka daaweyn la qaadan karin waxaa muhiim ah in la muujiyo shaki macquul ah oo ah in xinjirta dhiigga ay dhab ahaantii keento dhibaatada.
Baaritaanada sheybaarka
Imtixaanka shaybaarka ee lagu ogaanayo xinjir dhiig ayaa tijaabin kara dhaqdhaqaaq aan caadi ahayn oo soo bandhigo tilmaamo kaa caawin doona jirkaaga yareynta xanuunkaaga.
Baaritaanka D-Dimer D-Dimer
Baaritaanka dhiigga ee D-dimer-ka ayaa ogaanaya haddii ay dhowaan aheyd heer aan caadi ahayn oo ka mid ah hawlaha xinjirta meelo ka mid ah dhiigga. Baaritaankaan ayaa ah midka ugu faa'iido badan ee ka caawinaya dhakhaatiirta inay shakiyaan tuhunka ah in DVT ama embolus pulmonary embolus uu dhacay.
Biomarkers ee wadnaha
Biomarkers ayaa loo isticmaalaa in lagu ogaado cudurka wadnaha. Tijaabooyinka dhiigaagu si adag u ma ogaan karaan xinjiro dhiig; Hase yeeshee, waxay ogaadaan in uu jirey muruqa wadnaha-taas oo had iyo goor uu keeno hargab dillaacsan oo loo yaqaan 'coronary artery plaque', oo ay la socoto qaabka ku xiga ee dhiig-baxa.
Imtixaanada Imtixaanka
Dhakhtarkaagu wuxuu amri doonaa tijaabooyinka sawirada isaga ama iyada oo u arko lagama maarmaanka u ah samaynta baadhitaan haboon. Weydiiso dhakhtarkaaga waxa imtixaanku muujin doono, oo hubi inaad soo gudbiso wixii welwel ah ee aad ka qabto nidaamka.
Ultrasound Compression
Imtixaanka ultrasound ee isku dhafan waa tijaabo aan la-baadhin oo lagu samayn karo sariirta oo inta badan aad u faa'iido badan oo lagu ogaanayo DVT.
V / Q Scan
Baadhitaan nalalka hawo leh (V / Q scan) waa tijaabo iyada oo la isticmaalayo dheeh shucaac ah si loo eego socodka dhiigga ee sanbabada, si loo ogaado in xididada dhiigga ee sambabada ay xannibeen embolus pulmonary ah.
CT Scan
Baadhitaanka CT-ga waa farsamo raajo oo kombiyuutar ah oo muujin kara qadar fara badan oo faahfaahin ah. Baaritaanka CT-ga wuxuu si gaar ah uga faa'iideysan karaa xaqiijinta in istaroog ku dhacay ay keentay embolus ama trombus, badanaaba waa tijaabada ugu horreysa ee lagu isticmaalo baaritaanka istaroogga. Baadhitaanka CT-ga sidoo kale wuxuu noqon karaa mid waxtar leh oo ku saabsan xaqiijinta sambabada sambabada.
Sawirka MRI
Sida baaritaanka CT, baaritaannada MRI waxaa loo isticmaali karaa in lagu ogaado xinjirta gudaha xididdada dhiigga. Imtixaannadani waa kuwo si tartiib tartiib ah u shaqeynaya marka la eegayo CT scans, markaa waqtiga asalkoodu yahay Baadhitaano CT waxaa badanaa la shaqeeyaa.
Angiography ama Vienography
Kuwani waa farsamooyinka cathetering taas oo dheeha lagu duro xididdada dhiigga halka xinjirta laga shakiyo iyo raajo loo qaado si loo ogaado xinjirta.
Cudurka 'Pulmonary Angiography' ayaa loo isticmaali karaa si loo ogaado sambabarka sambabada; venography si loo ogaado DVT. Thanks to helitaanka CT scans iyo baaritaanada MRI, baaritaanada murgacashada ayaa loo baahan yahay ujeedooyinka ogaanshaha baaritaanka inta badan ka hor intaanay horay u joogin si loo ogaado caloolxumo ama embolus.
Echocardiography
Echocardiograms waxaa badanaa loo adeegsadaa bukaanada kuwaas oo ku jiray maadada 'embolisms' oo saameynaya xidid-gaar ahaan dadka ku dhacay stroke embolic. Si aad u heshid halbowlaha, kiis kasta oo ka mid ah embolism waa inuu ka yimaadaa wadnaha gudihiisa ama u socdaalaya wadnaha.
Echocardiogram wuxuu ogaan karaa xinjirta wadnaha ku sameysma (sida caadiga ah ee bidixda bidix ee qofka ku leh fibrillada atrial , ama qotodheerka bidix ee qofka qaba kiniiniga wadnaha ee dila ). Echocardiogram wuxuu kaloo ogaan karaa dhibaatooyinka wadnaha kaas oo u oggolaan kara in embolus uu wadnahay wadnaha, sida sheyga loo yaqaan 'patent foramen ovale' .
> Ilo:
> Beeraha JM, Davis J, Girson L, et al. Transthoracic Echocardiography For Diagnosing Embolism Pulmonary: Dib u habeyn nidaamsan iyo Meta-falanqaynta. J Am Soc Echocardiogr 2017; 30: 714. doi: 10.1016 / joeco.2017.03.004.
> Gibson NS, Schellong SM, Kheir DY, iyo al. Badbaadada iyo Dareenka Laba Xeeladaha Ultrasound ee Bukaanada Iyadoo La Xakameynayo Cudurka Dabaysha ee Dheecaanka ah ee Daacuunka ah: Daraasadda Maaraynta Hawlgabka. J Thromb Haemost 2009; 7: 2035. doi: 10.1016 / joeco.2017.03.004.
> Stein PD, Yaekoub AY, Matta F, iyo al. Xallinta Ammaanka Pulmonary Embolism on Ct Pulmonary Angiography. Ajr Am J Roentgenol 2010; 194: 1263. doi: 10.2214 / AJR.09.3410.
> Weitz JI, Fredenburgh JC, Eikelboom JW. Tijaabada A Waxyaabaha ku jira: D-Dimer. J Am Coll Cardiol 2017; 70: 2411. doi: 10.2214 / AJR.09.3410.