Nhau

Dambudziko rePasi Pose reVenous Thromboembolism (VTE)

Venous Thromboembolism (VTE), musanganiswa unouraya weDeep Vein Thrombosis (DVT) nePulmonary Embolism (PE), unouraya vanhu vanodarika 840,000 pasi rose gore rega rega—zvakaenzana nerufu rumwe chete mumasekonzi makumi matatu nemanomwe ega ega. Zvinotoshamisa ndezvekuti, 60% yezviitiko zveVTE zvinoitika panguva yekurara muchipatara, zvichiita kuti ive iyo inonyanya kukonzera kufa muchipatara kusina kurongwa. MuChina, kuwanda kweVTE kuri kuramba kuchiwedzera, kusvika pa14.2 pavanhu 100,000 muna 2021, nevanhu vanopfuura 200,000 vane chirwere ichi. Kubva kuvarwere vakwegura mushure mekuvhiyiwa kusvika kune vafambi vebhizinesi vari mundege refu, njodzi dzethrombosis dzinogona kuvanda chinyararire—chiyeuchidzo chakajeka chehunhu hweVTE hwakaipa uye kupararira kwayo kwakapararira.

I. Ndiani Ari Panjodzi? Kutsvaga Mapoka Ane Ngozi Yakawanda

Vanhu vanotevera vanoda kungwarira zvakanyanya:

1. "Vakafa Vasingaonekwe" Vanogara Pamwe Chete
   Kugara kwenguva refu (>maawa mana) kunononotsa kufamba kweropa zvakanyanya. Semuenzaniso, mumwe mugadziri wepurogiramu anonzi Zhang akatanga kuzvimba makumbo kamwe kamwe mushure mekushanda kwenguva yakareba uye akaonekwa aine DVT—mugumisiro wekugara kwetsinga muropa.

2. Mapoka Engozi dzeIatrogenic

   • Varwere Vanovhiyiwa: Varwere vanotsiva nhengo mushure mekuvhiyiwa vanosangana nenjodzi ye40% yeVTE vasina kudzivirira kuungana kweropa.
   • Varwere veGomarara: Rufu runokonzerwa neVTE runoumba 9% yerufu rwese rwegomarara. Murwere wegomarara remapapu anonzi Li, uyo asina kurapwa panguva imwe chete panguva yechemotherapy, akarwara nePE—nyaya yekunyevera.
   • Vakadzi Vane Mimba: Kuchinja kwemahormone uye kudzvanywa kwetsinga dzeropa muchibereko kwakaita kuti mukadzi ane pamuviri anonzi Liu anzwe kupererwa nemhepo kamwe kamwe mumwedzi mitatu yake yechitatu yekuzvitakura, izvo zvakazosimbiswa kuti ndiye PE.

3. Varwere Vane Zvirwere Zvisingaperi Vane Njodzi Dzakawedzerwa
   Kuwanda kweropa muvanhu vakafuta uye vane chirwere cheshuga, pamwe chete nekudzikira kwesimba remwoyo muvanhu vane chirwere chemwoyo, zvinoita kuti ropa ritange kuyerera zvakanaka.

Yambiro Yakakosha: Tsvaga rubatsiro rwechiremba nekukurumidza kana gumbo rako rakazvimba kamwe kamwe, kurwadziwa kwechipfuva pamwe nekudzipwa, kana kubuda ropa mumuviri—izvi zvinotora nguva.

II. Sisitimu Yekudzivirira Yematanho: Kubva Pakuvamba Kuenda Pakudzivirira Kwakarurama

1. Kudzivirira Kwekutanga: "Mantra yeMashoko Matatu" yekudzivirira Thrombosis
   • Kufamba-famba: Ita maminetsi makumi matatu ekufamba-famba kana kushambira zuva nezuva. Kune vashandi vemuhofisi, ita maekisesaizi ekupomba makumbo (masekondi gumi e dorsiflexion + masekondi gumi e plantarflexion, inodzokororwa kwemaminitsi mashanu) maawa maviri ega ega. Dhipatimendi revanamukoti rePeking Union Medical College Hospital rakaona kuti izvi zvinowedzera kuyerera kweropa remakumbo epasi ne37%.
   • Mvura: Inwa kapu imwe chete yemvura inodziya paunomuka, usati warara, uye panguva yekumuka husiku (huwandu hwe1,500–2,500 mL/zuva). Chiremba wemwoyo Dr. Wang anowanzo kurudzira varwere kuti: "Kapu imwe chete yemvura inogona kuderedza chikamu chimwe mugumi chenjodzi yako ye thrombosis."
   • Idya: Idya salmon (yakapfuma mu Ω-3 inodzivirira kuzvimba), hanyanisi (quercetin inodzivirira kuungana kwemaplatelet), uye fungus nhema (polysaccharides inoderedza kusimba kweropa).
2. Kudzivirira Michina: Kufambisa Kuyerera Kweropa Nezvishandiso Zvekunze
   • Masiketi Akapedza Kudzidza (GCS): Mukadzi ane pamuviri anonzi Chen aipfeka GCS kubva pavhiki rechi20 repamuviri kusvika pakusununguka, zvichidzivirira tsinga dzakakuvara uye DVT.
   • Kumanikidzwa Kwepfungwa Kwenguva Pneumatic (IPC): Varwere vemapfupa mushure mekuvhiyiwa vachishandisa IPC vakaona kudzikira kwengozi yeDVT ne40%.
3. Kudzivirira Mishonga: Kutarisira Kudzivirira Kubuda Kweropa Zvakasimba
   Zvichibva paCaprini Score:

   Danho reNjodzi	Vanhu Vakajairika	Nzira yekudzivirira
   Yakaderera (0–2)	Varwere vechidiki vanovhiyiwa zvishoma	Kukurumidza kuunganidza vanhu + IPC
   Zviri pakati nepakati (3–4)	Varwere vanovhiyiwa zvikuru neLaparoscopic	Enoxaparin 40 mg/zuva + IPC
   Yakakwira (≥5)	Varwere vane gomarara rehudyu/vanorwara negomarara repamusoro	Rivaroxaban 10 mg/zuva + IPC (kuwedzera kwemavhiki mana kune varwere vegomarara)

Yambiro Yekusadzivirira Kubuda Kweropa: Mishonga inorwisa ropa haibvumidzwe kana ropa richibuda mumuviri kana kuti maplatelet ari pasi pe50×10⁹/L. Kudzivirira nekushandisa michina kwakachengeteka mumamiriro ezvinhu akadaro.

III. Mapoka Akakosha: Nzira Dzakasiyana Dzekudzivirira

1. Varwere veGomarara
   Ongorora njodzi uchishandisa muenzaniso weKhomana: Murwere wegomarara remapapu anonzi Wang ane mamakisi ≥4 anodiwa pazuva neheparin ine huremu hushoma hwemamorekuru. Kuyedzwa kwebhaibheri kwePEVB (96.8% sensitivity) kunogonesa kuziva varwere vane njodzi huru nekukurumidza.

2. Vakadzi vane Mimba
   Warfarin haibvumidzwe (njodzi yeteratogenic)! Chinja ushandise enoxaparin, sezvakaratidzwa nemukadzi ane pamuviri anonzi Liu uyo ​​akabereka zvakachengeteka mushure mekusaita ropa kusvika mavhiki matanhatu mushure mekusununguka. Kubereka mwana neCesarean kana kufuta zvakanyanya/zera rekuberekwa rinoda kuti ropa ridzimwe ropa ridzimwe nguva ridzimwe nguva.

3. Varwere veMafupa
   Kurapa ropa kunofanira kuramba kuchiitwa mushure memazuva ≥14 ekudzorera chiuno uye mazuva 35 ekutyoka chiuno. Murwere anonzi Zhang akaonekwa nePE mushure mekurega chiuno nguva isati yakwana—chidzidzo chekutevedzera.

IV. 2025 China Guidelines Updates: Kufambira Mberi Kwebudiriro

1. Tekinoroji Yekuongorora Nekukurumidza
   Westlake University's Fast-DetectGPT inowana kururama kwe90% mukuona zvinyorwa zvakagadzirwa neAI, ichishanda nekukurumidza ka340—ichibatsira majenari mukuseta zvinyorwa zveAI zvisina kunaka.

2. Maitiro Ekurapa Akavandudzwa

   • Kutanga kwe "catastrophic PTE" (systolic BP <90 mmHg + SpO₂ <90%), zvichikonzera kupindira kwechikwata chePERT chemarudzi akawanda.
   • Kuderedzwa kwemuyero weapixaban kunokurudzirwa kune kutadza kushanda kweitsvo (eGFR 15–29 mL/min).

V. Chiito Chekubatana: Kubvisa Thrombosis Kuburikidza Nekubatana Kwese

1. Masangano Ehutano
   Kupedza Caprini kuwana mamakisi mukati memaawa makumi maviri nemana mushure mekubvumidzwa kune vese vari muchipatara. Peking Union Medical College Hospital yakaderedza kuwanda kweVTE ne52% mushure mekushandisa nzira iyi.

2. Kuzvitonga Kweveruzhinji
   Kudzikiswa kwehuremu ne5% muvanhu vane BMI >30 kunoderedza njodzi ye thrombosis ne20%! Kurega kusvuta uye kudzora glycemic control (HbA1c <7%) zvakakosha.

3. Kusvikika Kwetekinoroji
   Skena makodhi kuti uwane dzidziso dzekurovedza muviri dzepombi yegumbo. Masevhisi ekurenda michina yeIPC ikozvino anofukidza maguta mazana maviri.

Shoko Guru: VTE inzira inodziviririka uye inodzorwa ye "kuuraya chinyararire." Tanga nekurovedza muviri kwako kunotevera kwepombi yegumbo. Tanga negirazi rako rinotevera remvura. Ramba ropa richiyerera zvakasununguka

Mareferensi

1. Hurumende yeYantai Municipal. (2024).Dzidzo yehutano pamusoro peThromboembolism yeVhena.
2. Nhungamiro dzeChinese dzekudzivirira nekurapa chirwere cheThrombotic(2025).
3. Chinese Academy of Sciences Institute of Physics and Chemistry. (2025).Kufambira Mberi Kutsva mukufanotaura Njodzi yeVTE kune Varwere veCancer.
4. Dzidzo Yehutano Hweveruzhinji. (2024).Kudzivirira Kwekutanga Kwevanhu Vane Njodzi Yakanyanya yeVTE.
5. Yunivhesiti yeWestlake. (2025).Mushumo weUnyanzvi weGPT Unokurumidza Kuonekwa.