Litaba

Kotsi ea Lefatše ea Venous Thromboembolism (VTE)

Venous Thromboembolism (VTE), motsoako o bolaeang oa Deep Vein Thrombosis (DVT) le Pulmonary Embolism (PE), e bolela hore batho ba fetang 840,000 ba phela lefatšeng ka bophara selemo se seng le se seng—e leng se lekanang le lefu le le leng metsotsoana e meng le e meng e 37. Ho makatsang le ho feta, 60% ea liketsahalo tsa VTE li etsahala nakong ea ho kena sepetlele, e leng se etsang hore e be sesosa se ka sehloohong sa lefu le sa reroang la sepetlele. Chaena, ketsahalo ea VTE e ntse e eketseha, e fihla ho 14.2 ho baahi ba 100,000 ka 2021, ka linyeoe tse fetang 200,000 tse feletseng. Ho tloha ho bakuli ba tsofetseng ka mor'a ho buuoa ho ea ho baeti ba khoebo ka lifofane tse nkang nako e telele, likotsi tsa thrombotic li ka lalla ka khutso - khopotso e hlakileng ea tlhaho e bolotsana ea VTE le ho ata hohle.

I. Ke Mang ea Kotsing? Ho tlaleha Lihlopha tse Kotsing e Phahameng

Batho ba latelang ba hloka tlhokomelo e eketsehileng:

1. "Bahlaseluoa ba sa Bonahaleng" ba lutseng fatše
   Ho lula nako e telele (> lihora tse 4) ho liehisa phallo ea mali haholo. Ka mohlala, moqapi e mong ea bitsoang Zhang o ile a ruruha leoto ka tšohanyetso ka mor'a ho sebetsa lihora tse eketsehileng tse latellanang 'me ho ile ha fumanoa hore o na le DVT—e leng phello ea khale ea venous stasis.

2. Lihlopha tsa Kotsi tsa Iatrogenic

   • Bakuli ba Buoang: Bakuli ba ka morao-manonyeletso ba tobana le kotsi ea 40% VTE ntle le prophylactic anticoagulation.
   • Bakuli ba Kankere: Mafu a amanang le VTE a etsa karolo ea 9 lekholong ea batho bohle ba shoang ke mofetše. Mokuli oa mofetše oa matšoafo ea bitsoang Li, ea sa kang a fumana anticoagulation ka nako e le 'ngoe nakong ea chemotherapy, o ile a inehela ho PE - pale ea tlhokomeliso.
   • Basali ba Bakhachane: Liphetoho tsa li-hormone le khatello ea popelo ea methapo ea mali e lebisitse ho mosali oa moimana ea bitsoang Liu ho ba le dyspnea ea tšohanyetso trimester ea hae ea boraro, e ileng ea tiisoa hamorao e le PE.

3. Bakuli ba Mafu a sa Feleng ba nang le Likotsi tse Atolositsoeng
   Ho ba le viscosity e phahameng ea mali ho batho ba batenya le ba nang le lefu la tsoekere, hammoho le ho fokotseha ha pelo ho bakuli ba nang le lefu la pelo, ho baka sebaka se nonneng sa thrombosis.

Tlhokomeliso e Bohlokoa: Batla tlhokomelo ea meriana hang-hang bakeng sa ho ruruha ha leoto le le leng ka lehlakoreng le leng, bohloko ba sefuba ka ho bipetsana, kapa hemoptysis - ena ke peiso khahlanong le nako.

II. Tiered Defense System: Ho tloha ho Motheo ho ea ho Precision Prevention

1. Thibelo ea Motheo: "Mantra ea Mantsoe a Mararo" bakeng sa Thibelo ea Thrombosis
   • Tsamaea: Nka metsotso e 30 ho tsamaea ka potlako kapa ho sesa letsatsi le letsatsi. Bakeng sa basebetsi ba ofisi, etsa boikoetliso ba pompo ea maqaqailana (metsotsoana e 10 ea dorsiflexion + metsotsoana e 10 ea plantarflexion, e phetoa metsotso e 5) lihora tse ling le tse ling tse peli. Lefapha la baoki la Peking Union Medical College Hospital le fumane hore sena se eketsa phallo ea mali ea maoto le matsoho ka 37%.
   • Hydrate: Noa kopi e le 'ngoe ea metsi a futhumetseng ha u tsoha, pele u robala, le nakong ea ho tsoha bosiu (kakaretso ea 1,500-2,500 mL / letsatsi). Setsebi sa lefu la pelo Dr. Wang hangata se eletsa bakuli: "Komiki e le 'ngoe ea metsi e ka fokotsa karolo ea leshome ea kotsi ea thrombosis."
   • Eja: Sebelisa salmon (e ruileng ka anti-inflammatory Ω-3), eiee (quercetin e thibela platelet aggregation), le fungus e ntšo (polysaccharides e fokotsa viscosity ea mali).
2. Thibelo ea Mechini: Ho Khanna Phallo ea Mali ka Lisebelisoa tsa Kantle
   • Graduated Compression Stockings (GCS): Mosali oa moimana ea bitsoang Chen o ne a apara GCS ho tloha bekeng ea 20 ea bokhachane ho fihlela ka mor'a ho pepa, ho thibela ka katleho methapong ea varicose le DVT.
   • Intermittent Pneumatic Compression (IPC): Bakuli ba ka mor'a lefu la masapo ba sebelisang IPC ba bone ho fokotseha ha 40% kotsing ea DVT.
3. Thibelo ea Pharmacological: Stratified Anticoagulation Management
   E thehiloe ho Caprini Score:

   Boemo ba Kotsi	Baahi ba Tloaelehileng	Protocol ea Thibelo
   Tlase (0–2)	Bakuli ba banyane ba ho buuoa ka mokhoa o fokolang	Ho bokella pele + IPC
   E itekanetseng (3–4)	Bakuli ba karohano e kholo ea Laparoscopic	Enoxaparin 40 mg / letsatsi + IPC
   Holimo (≥5)	Bakuli ba mofetše / ba nang le mofetše o tsoetseng pele	Rivaroxaban 10 mg / letsatsi + IPC (katoloso ea libeke tse 4 bakeng sa bakuli ba mofets'e)

Tlhokomeliso ea Contraindication: Li-anticoagulants li thibetsoe ho tsoa mali a sebetsang kapa lipalo tsa platelet <50×10⁹/L. Thibelo ea mechine e bolokehile maemong a joalo.

III. Baahi ba Khethehileng: Maano a Thibelo a Tailored

1. Bakuli ba Kankere
   Lekola kotsi ka ho sebelisa mohlala oa Khomana: Mokuli oa mofetše oa matšoafo ea bitsoang Wang ea nang le lintlha ≥4 tse hlokahalang letsatsi le letsatsi tsa heparin ea boima bo tlase ba molek'hule. Novel PEVB barcode assay (96.8% sensitivity) e thusa ho tsebahatsa bakuli ba kotsing e kholo.

2. Basali ba Bakhachane
   Warfarin e hanyetsanoa (kotsi ea teratogenic)! Fetohela ho enoxaparin, joalo ka ha ho bontšitsoe ke moimana ea bitsoang Liu ea ileng a beleha a sireletsehile ka mor'a anticoagulation ho fihlela libeke tse 6 kamora ho pepa. Ho beleha ka kh'asarea kapa botenya bo feteletseng / lilemo tse tsoetseng pele tsa bakhachane li fana ka tumello ea ho thibela ho ruruha hang hang.

3. Bakuli ba Mathopo
   Anticoagulation e tlameha ho tsoela pele ≥14 matsatsi a post-hip replacement le matsatsi a 35 bakeng sa ho robeha ha letheka. Mokuli ea bitsoang Zhang o ile a hlahisa PE ka mor'a ho khaotsa pele ho nako - thuto ea ho khomarela.

IV. Lintlafatso tsa Tataiso tsa 2025 tsa China: Tsoelo-pele ea Phallo

1. Theknoloji ea ho Hlahloba ka Potlako
   Fast-DetectGPT ea Univesithi ea Westlake e fihlella ho nepahala ha 90% ho hloaeang mongolo o hlahisoang ke AI, e sebetsang ka makhetlo a 340 ka potlako-e thusa limakasine ho sefa litlhahiso tsa AI tsa boleng bo tlaase.

2. Mekhoa e Ntlafetseng ea Kalafo

   • Kenyelletso ea "catastrophic PTE" (systolic BP <90 mmHg + SpO₂ <90%), e bakang ho kenella ha lihlopha tse ngata tsa PERT.
   • Phokotso ea tekanyo ea apixaban e khothalletsoang ho senyeha ha renal (eGFR 15-29 mL / min).

V. Ketso e Kopanetsoeng: Ho Felisa Thrombosis Ka ho Kopanela Batho ka Bokahohle

1. Mekhatlo ea Bophelo bo Botle
   Tlatsa lintlha tsa Caprini nakong ea lihora tse 24 tsa ho amoheloa bakeng sa bakuli bohle ba robetseng. Sepetlele sa Peking Union Medical College se fokolitse liketsahalo tsa VTE ka 52% ka mor'a ho kenya ts'ebetsong protocol ena.

2. Boiketsi ba Sechaba
   Phokotso ea boima ba 5% ho batho ba nang le BMI> 30 e theola kotsi ea thrombosis ka 20%! Ho khaotsa ho tsuba le ho laola glycemic (HbA1c <7%) ke tsa bohlokoa.

3. Ho fihlella ho Thekenoloji
   Scan khoutu bakeng sa lithupelo tsa boikoetliso ba pompo ea maqaqailaneng. Litšebeletso tsa ho hira lisebelisoa tsa IPC joale li koahela litoropo tse 200.

Molaetsa oa mantlha: VTE ke "'molai ea khutsitseng" ea ka thibeloang, ea laolehang. Qala ka boikoetliso bo latelang ba pompo ea maqaqailana. Qala ka khalase ea hau e latelang ea metsi. Boloka mali a phalla ka bolokolohi

Litšupiso

1. Mmuso oa Masepala oa Yantai. (2024).Thuto ea Bophelo bo Botle ka Venous Thromboembolism.
2. Litaelo tsa Chaena bakeng sa Thibelo le Phekolo ea Maloetse a Thrombotic. (2025).
3. Setsi sa Setsi sa Mahlale sa Sechaena sa Fisiks le Khemistri. (2025).Tsoelo-pele e Ncha ho Boprofeta ba Kotsi ea VTE bakeng sa Bakuli ba Kankere.
4. Thuto ea Bophelo bo Botle ba Sechaba. (2024).Thibelo ea Motheo bakeng sa Baahi ba Kotsi e Phahameng ea VTE.
5. Univesithi ea Westlake. (2025).Phatlalatsa Tlaleho ea Botekgeniki ea GPT.