Te Tukanga Pupuri Toto me ngā Take Whakaawe
Ko te toto totoka, e mōhiotia ana ko te toto totoka, he tukanga tinana nui e ārai ana i te toto nui ina whara te pūnaha toto. Kei roto i tēnei tikanga uaua he raupapa o ngā mahi e arahi ana ki te hurihanga o ngā wāhanga toto wai hei totoka totoka, e hiri ana i ngā patunga, ā, e taea ai te tīmata te whakatikatika kiko. Ka rukuhia e tēnei tuhinga te tukanga taipitopito o te toto totoka, ngā kaitākaro matua e whai wāhi ana, me ngā āhuatanga rerekē ka pā ki tēnei tikanga nui.
Te Tukanga Pupuri Toto: He Tirohanga Whānui mō te Hipanga-i-te-Hipanga
He maha ngā wāhanga e whakaahuahia ana te tukanga toto totoka, tae atu ki te pupuhi o ngā uaua toto, te hanganga o te mono pereti toto, me te rerenga toto totoka.
1. Te Āwhiowhio o ngā Uaua
Ko te urupare tuatahi ki te whara o ngā oko toto ko te vasoconstriction, arā, te whakawhāiti i ngā oko toto. Ka āwhina tēnei pupuhi o ngā oko toto ki te whakaiti i te rere o te toto ki te wāhi e pāngia ana, ka whakaiti i te ngaronga o te toto. Ko ngā pūtau uaua maeneene i roto i ngā pakitara o ngā oko toto te take matua, ā, ka taea te whakaoho mā te whara tika, mā ngā tohu matū rānei e tukuna ana mai i ngā pūtau endothelial me ngā platelets.
2. Te Hanganga o te Mono Peretā
Ina pakaru ngā oko toto, ka pakaru ngā pūtau endothelial e whakarārangi ana i ngā pakitara o ngā oko toto, ka kitea te collagen kei raro me ētahi atu kiko subendothelial. Ko ngā platelets, he kongakonga pūtau iti e rere ana i roto i te toto, ka piri ki ēnei kiko kua kitea. Ka āwhinahia tēnei piri e te von Willebrand factor, he pūmua e mahi ana hei piriti i waenga i ngā platelets me te collagen.
I te piritanga, ka whakahohehia ngā pereti toto, ka tukuna ngā kirikiri kei roto ngā matū maha, pērā i te ADP (adenosine diphosphate), te thromboxane A2, me te serotonin. Ka whakanuia e ēnei matū te urupare whakahohenga pereti toto, ka kohia ētahi atu pereti toto ki te wāhi ka piri tahi, ka hanga he mono pereti toto rangitahi.
3. Te Puku Whakapūpū
I te hanganga o te mono pereti toto, ka tīmatahia te rerenga toto totoka, he raupapa o ngā tauhohenga whākōkī, hei whakau i te mono mā te whakamahi i te mata fibrin. Ko te tikanga, kua wehea tēnei rerenga toto ki ngā ara o roto me ngā ara o waho, e tūtaki ana i runga i te ara kotahi.
– Ara ā-roto: Ka whakahohehia e te kino o te uaua toto tonu, ka uru atu ki tēnei ara te whakahohenga o ngā momo take toto totoka, tae atu ki ngā take XII, XI, IX, me VIII. I te aroaro o ngā katote konupūmā me ngā phospholipid, ka hangaia he matatini e whakahohe ana i te take
– Ara o Waho: Nā te whara o waho, ko tēnei ara e uru ana ki te tukunga o te tauwehe kiko (TF) mai i ngā kiko kua pakaru. Ka taunekeneke te tauwehe kiko me te tauwehe VII hei hanga i tētahi matatini e whakahohe tika ana i te tauwehe
– Ara Noa: Mā ngā ara ā-roto me ngā ara ā-waho ka whakahohehia te take X, ka honoa ki te take V, ngā katote konupūmā, me ngā phospholipid hei hanga i te matatini prothrombinase. Ka hurihia e tēnei matatini te prothrombin (take II) hei thrombin (take IIa). Kātahi ka whai wāhi nui te thrombin ki te huri i te fibrinogen, he pūmua plasma wairewa, hei miro fibrin kore wairewa e whatu ana i roto i te mono pereti, ka hanga he totoka pumau.
4. Te Tangohanga me te Whakatika i te Totoka
Kia oti te hanga o te kupenga fibrin, ka tīmata te mimiti o te toto totoka ki te whakawhāiti i roto i tētahi tukanga e mōhiotia ana ko te whakahokinga toto totoka. Kei roto i ngā pereti toto te actin me te myosin, arā, ngā pūmua mimiti e āwhina ana ki te kukume i ngā taha o te patunga kia piri tahi, ka whakaiti i te rahi o te wāhi kua pakaru, ka āwhina hoki i te whakatikatika kiko.
5. Fibrinolysis
Kia ora rawa te oko toto, me tango te toto totoka. Ko te fibrinolysis te tukanga e pakaru ai te toto totoka, e whakarewaina ai. Ko te plasminogen, he whākōkī kore mahi e whakauruhia ana ki roto i te toto totoka i te wā e hangaia ana, ka whakahohehia hei plasmin e te kaiwhakaoho plasminogen kiko (tPA). Kātahi ka nakunaku te plasmin i te fibrin ka whakarewa i te toto totoka.
Ngā Take e Pā Ana ki te Pupuhi Toto
He maha ngā āhuatanga ka pā ki te whai huatanga me te whaihua o te tukanga toto totoka. Ka taea e ēnei āhuatanga te noho mai i roto i te tinana, te noho mai rānei i waho, e ahu mai ana i ngā pūtake o waho.
1. Nga Tikanga Ira
Ka pā kino pea ētahi mate ira ki te tukanga toto totoka. Hei tauira, ko te hemophilia he mate ira e kore e whai kiko, e ngaro rānei ngā mea totoka motuhake (pērā i te mea VIII, IX rānei), ka roa ai te toto. Ko te Mea V Leiden tētahi atu mate ira e whakanui ake ai te whakarerekētanga o te mea V i te mōrearea o te toto totoka rerekē (thrombosis).
2. Ngā Take Kai
He mea nui te Huaora K mō te hanga i ētahi āhuatanga toto totoka, tae atu ki ngā āhuatanga II, VII, IX, me te X. Ka taea e te korenga o te Huaora K, e puta mai ana i te kai koretake, i ngā āhuatanga mimiti kore rānei, te whakararu i te tukanga toto totoka. Hei tāpiri, he mea nui te nui o te konupūmā, nā te mea he mahi nui tā tēnei kohuke i roto i ngā taahiraa maha o te rerenga toto totoka.
3. Nga rongoa
Ka taea e ngā rongoā maha te awe i te toto totoka. Ka whakamahia ngā rongoā ārai totoka pēnei i te warfarin me te heparin hei ārai i te hanganga totoka i roto i ngā tūroro e mōrearea ana ki te thrombosis. Ka mahi te Warfarin mā te aukati i ngā mea totoka e whakawhirinaki ana ki te huaora K, i te mea ka whakarei ake te heparin i te mahi a te antithrombin III, he pūmua e whakakore ana i te thrombin me ētahi atu mea totoka. I tetahi atu taha, ka taea e ngā rongoā anti-inflammatory kore-steroidal (NSAID) pēnei i te aspirin te aukati i te mahi pereti toto me te whakaiti i te hanganga totoka.
4. Tauira Tikanga
Ka pā nui pea ngā momo āhua noho ki te toto totoka. Hei tauira, e mōhiotia ana te kai paipa ka whakanui ake i te kohikohinga o ngā pereti toto me te whakatairanga i te āhua pro-thrombotic. Ka taea hoki e te momonatanga me te noho noa te whakanui ake i te mōrearea o te hanganga toto totoka nā te maha o ngā taurite koretake o te pākia me te homoni. I tētahi atu taha, ko te mahi ā-tinana auau e hono ana ki te hauora o ngā oko toto me te whakaiti i te mōrearea o te toto totoka.
5. Nga Tikanga Hauora
He maha ngā āhuatanga hauora ka pā ki te toto totoka. Hei tauira, ka taea e te mate ate te whakararu i te hanga o ngā mea totoka, nā te mea ko te ate te wāhi matua o tā rātou hanga. Ko ngā mate pēnei i te totoka totoka whānui (DIC) ka uru ki te whakahohenga rerekē o te rerenga totoka, ka arahi ki te hanganga totoka whānui me te toto i muri mai nā te whakahekenga o ngā mea totoka. Heoi anō, ka taea hoki e te mate pukupuku me ētahi mate te whakarerekē i ngā ara totoka, ka whai wāhi ki te āhua totoka nui.
6. Te pakeke me te Ira tangata
Ka pā te pakeketanga ki te kaha o te toto totoka; tera pea ka nui ake te mōrearea o te hunga kaumātua ki te toto totoka nā te huringa o te hanganga toto me te pumau o ngā oko toto. Ka pā hoki ngā huringa homoni, inā koa i roto i ngā wāhine, ki te toto totoka. Hei tauira, ko te whakamahinga o te rongoā whakakapinga homoni, te whakamahi rānei i ngā ārai hapūtanga ka piki ake te mōrearea o te toto totoka, i te wā e hono ana te hapūtanga ki te āhua totoka nui hei ārai i te toto nui i te wā whānau.
Opaniraa
He tikanga tiaki nui te toto totoka e ārai ana i te toto nui, ā, e āhei ai te whakaora tika i te patunga. Kei roto i tēnei he raupapa o ngā mahi kua taunga pai, tae atu ki te pupuhi o ngā oko toto, te hanganga o te mono pereti toto, me te rerenga totoka. He maha ngā āhuatanga o roto me waho, pērā i te ira, te kai, ngā rongoā, ngā kōwhiringa momo noho, ngā āhuatanga hauora, te tau, me te ira tangata, ka taea te awe nui i tēnei tukanga uaua. He mea nui te mārama ki ēnei āhuatanga hei whakahaere me te ārai i ngā mate totoka, ā, mā reira ka whakarei ake i te hauora me te oranga whānui.
