Тромбоз. Геморрагии презентация

NMO

unasue++8x upo- m a+wm›oaryne+w+8x Øa›wopoæ m wpou6oymwoæ
a›wmæayme Øm6pm+onmsa
›poæowoumæocwa (æo II – III Øasax)

m1aneu (uonmwpaæu8, wpaæuawmu+8e xmpyprmuec›me æuemawenacwæa, ›pam- cm+gpou, ocwp8u æ+ywpmcocygmcw8u reuonms, wpa+cØysmm
+ecoæuecwmuou m "cwapou" ›poæm),
wewen8e unØe1yuonno-cenmu¬ec1ue ta6oneøanue,
a1yuepc1ae namonosue (su6onme o›onounog+8um æogaum, ceucmc, pa++ee owcnou›a unaye+w8, rmuowo+muec›me ›poæo- weue+me m gp.),
ocmp;e ompaønenue (›mcnow8, yenoum, suem+8e eg8 m gp.),
uo1 m mepuunanan;e cocmoenue.
6/cwpoe patæuwue, ocwpae uonuopra++ae +egocwawou+ocwa, wewen/e remopparuu.

namonosue ne¬enu (yuppot m gp. )
me+ee æ/pawe++/e ınu+uuecıue u na6opawop+/e upoeæne+ue uo cpaæ+e+uD c ocwp/m ¶BC.

upo- cwaw8, ueue+m) m xponu¬ec1ue neu1ot;,
xponu¬ec1ae cep6e¬nae m nerou+o-cepgeu+ae ne6ocmamo¬- nocma,
caxapn;u 6ua6em, amepoc1nepot, sunepmonu¬ec1ae 6onetna,
uaccmæ+8u 1onma1m 1poøu c ¬ymepo6n;uu noøepxnocmeuu upm s›cwpa›opuopana+8x upoyegypax (reuogmanms, reuocop6- yme, mc›yccwæe++oe ›poæoo6paye+me m gp.).
gnuwena+/u uepuog ruuepıoaryneyuu u ruueparperayuu wpom6oyuwoæ, 6eccumuwom+oe weue+ue, uacwo o6+apywuæaew- ce nu+a na6opawop+/mu wecwamu.

wpou6oymwouawmeu uowpe6ne+me

FEMOKOAFVflª]EOHHAª c uawonormuec›ou a›wm- æaymeu Øm6pm+onmsa mnm 6es +ee

ECXO¶ (æoccwa+oæne+me mnm cuepwa)

MOBPEK¶EHEª 5H¶OTEflEª
upeumyyecwæe++ae aıwuæayue æ+e++ero uywu cæepw/æa+ue, uaye ocwp/u unu uogocwp/u xapaıwep ¶BC.

MOªBflEHEE "KOHTAKTHOM MOBEPXHOCTE" bOfl@HOM MflO]A¶E
upeumyyecwæe++ae aıwuæayue æ+ywpe++ero uywu cæepw/æa+ue, uaye uogocwpoe unu xpo+uuecıoe weue+ue ¶BC.

F. FEMEPAKTEBA]Eª TPOMbO]ETOB – æo æcex cnyuaex.

cæepw9æa+ue, wpou6oyuwoæ

Auwuæayue $u6pu+onusa,

gerpagayue $u6pu+a,
$u6pu+ore+a, unasue++9x 6enuoæ

Hauoune+ue M¶0 u M¶$,
+apyue+ue uonuuepusayuu $u6pu+a

TEMOPPATN1ECKNN CNH¶POM

uacwoe +esØØe›wmæ+oe g8xa-
+me, yma+os, xpmu8, m+Øap›w8 m awene›was8, owe› ner›mx),
no¬e1 (c+mwe+me gmypesa æunowa go a+ypmm, 6eno› m spmwpoym- w8 æ uoue, upm xpo+muec›ou weue+mm - ›peawm+m+eume),
na6no¬e¬nu1oø (ocwpae +egocwawou+ocwa c uoæwop+8um uage+meum A¶ m rmuornm›eumeu),
sonoønoso motsa (sawopuowe++ocwa, sarpywe++ocwa uayme+woæ, mmeumuec›me m+cynaw8),
ne¬enu (6onm æ upaæou upegpe6epae, cmuuwou8 ymwonmsa, rmuep6mnmpy6m+eume),
meny6o¬no-1uue¬noso mpa1ma (uapes, pasæmwme ocwp8x esæ),
1omu (upauop+ocwa, cmuuewpmu+8e uepmØepmuec›me
+e›pos8).

A¶, æ owno- rmx uacwex wena;
6numenanoe unu noømopnoe 1poøome¬enue ms uecw upo›ona ›owm (uanay8, no›weæou crm6), ›poæowoumæocwa ouepaymo++8x pa+ m cepos+8x o6onoue›;
mamo¬n9e 1poøome¬enue (æo æpeue pogoæ, uocne
a6opwa), +ecæepw8æaeuocwa mnm unoxae cæepw8æaeuocwa æ8we›aDyeu ›poæm.
nocoø9e u meny6o¬no-1uue¬n9e 1poøome¬enue,
nputna1u opsannou ne6ocmamo¬nocmu (c+mwe+me gmypesa m gp.).

m+ae›ymu
+ napyuenue mu1poçup1yneçuu æ opra+ax (sarpywe++ocwa, 6ecuo›oucwæo, cwpax, c+mwe+me gmypesa, owe›m, 6eno› m ymnm+gp8 æ uoue).

Xponu¬ec1oe ¶BC
Cmuuwou8 oc+oæ+oro sa6oneæa+me + ø9pamennae sunep- 1oasyneçue 1poøu. Heuowmæmpoæa++8e u+owecwæe++8e wpou6os8 æe+, æosuow+8 uewexmm, cm+e›m, ›poæoweue+me ms +oca m gece+ æ couewa+mm c wpou6osaum.

›apwm+8!

Peaıyuu, yıat/æaDyue +a aıwuæayuD cæep- w/æa+ue (P8MK, 8uA).
Peaıyuu, yıat/æaDyue +a uowpe6ne+ue øaı- wopoæ cæepw/æa+ue (Øm6pm+ore+, AT III,
AfTB, MTB, TB - wona›o æ gm+aum›e !).
Peaıyuu, yıat/æaDyue +a aıwuæayuD øu6- pu+onuta (D-gmuep8, M¶8 + M¶Ø, 8uA).
Knewou+/e mapıep/ ¶BC (›onmuecwæo wpou-
6oymwoæ m mx cuo+wa++ae arperayme, mmsoymwos m Øparue+wayme spmwpoymwoæ).

oue+a 68cwpoe cæepw8æa+me, II-III Øas8 - crycwo› p8xn8u, o6pasyewce uegne++o mnm +e o6pasy- ewce coæceu).
Konuuecwæo wpom6oyuwoæ, ıo+ye+wpayue øu6pu+o- re+a æ gu+amuıe – æ I Øase +opuana+8e mnm yæenmue-
+8, æo II-III Øasax yue+amaDwce (<1,5 r/n - rmuoØm6-
pm+ore+eume, <0,5 r/n – aØm6pm+ore+eume). Oupege- ne+me uowew 68wa sawpyg+e+o.
A1TB, MTB (MO) æ I Øase ¶BC y›opaumæaDwce, æo II- III Øasax - ygnm+eDwce (rmuepuowpe6ne+me).
P8MK – yæenmumæaDwce.

wou umcne ›ouue+cmpoæa++ou.
Kouune›c unatmu+-a+wuunatmu+ (P-AP)

- uo›asawena

a›wmæaymm Øm6pm+onmsa, æ wou umcne ›ouue+cmpoæa++ou.
Tpom6oyuwap+/u øaıwop 4 (PF4), ⎭-wpom6orno6ynu+ - uo›asawenm a›wmæaymm wpou6oymwoæ.
Pewpaıyue crycwıa – uo›asawena Øy+›ymm wpou6oymwoæ.

wecw M¶8+M¶Ø, swa+onoæ8u, ⎭-+aØwonoæ8u, upowaum+- cynaØaw+8u wecw8, wecw c›nemæa+me cwaØmno›o››oæ.
D-gumep Τow +auana ¶BC. Ogm+ ms +am6onee +agew+8x uo-
›asaweneu a›wmæaymm Øm6pm+onmsa.
Tpom6u+oæoe æpeme Τ. 3aæmcmw ow ypoæ+e Øm6pm+ore+a, M¶8, reuapm+a. Bapma+w - peuwmnas+oe æpeue.
A+wuwpom6u+ III – † ypoæe+a m a›wmæ+ocwa. Baw+8u uo›a- sawena pesepæoæ a+wm›oaryne+w+ou cmcweu8 m æosuow+ocwm reuapm+owepaumm. + Mpoweu+/ C u S †.
8u6pu+onuwuuecıae aıwuæ+ocwa ıpoæu Τ (nmsmc syrno6y- nm+oæ mnm crycw›a yena+ou ›poæm, XIIa-saæmcmu8u Øm6pm-
+onms, cwpeuwo›m+as+8u wecw); +o ıo+ye+wpayue unatmu-
+ore+a † (rmuepuowpe6ne+me).
8parme+wayue spuwpoyuwoæ, +utoyuwot.

0

AT III

N

†

†† - †††

P8MK + M¶8

±

+

+++

D-guuep

NΤ

ΤΤ

ΤΤΤ

owgene+me, upmæneue+me wpa+cØysmonoroæ m cue- ymanmcwoæ uo uawonormm reuocwasa.
b8cwpeumee ycwpa+e+me upmum+ ¶BC (neue+me oc-
+oæ+oro sa6oneæa+me).
Pea+muaymo++8e uepoupmewme: 6opa6a c mo›ou m
+apyme+meum Øy+›ymu wms+e++o æaw+8x opra+oæ, uoggepwa+me æog+o-sne›wponmw+oro, ›mcnow+o- yenou+oro 6ana+ca m w.g.
Koppe›yme +apyme++oro reuocwasa.

wpou6oymwoæ, æoccwa+oæne+me a›wmæ+o- cwm AT III, ynyume+me peonormuec›mx cæoucwæ ›poæm.
Henapun (mnm HMF) go 50.000 ME æ cyw›m. Ecnm ›poæa "cæepw8æaewce æ mrne" - +euegne++oe ææege+me reuapm+a.
Cøemetauopomennae nnatua go 600-800 un/cyw.
¶etaspesanm;: acumpm+ 0,5 r, unaæm›c 75 ur/cyw.
Mpenapam;, yny¬uaαyue peonosu¬ec1ue cøoucmøa 1poøu: wpe+wan 100 ur æ/æ; ›ypa+wmn uo 100-300 ur 3 p/cyw, seuo6unαyue (peouonmrnD›m+, 5% rnD›osa, Ømspacwæop).
51cmpa1opnopanan;e uemo6; (unasuaØepes).
Monumopuns ne¬enue: † rmueparperaymm wpou6oymwoæ, cgæmr uapauewpoæ ›oarynorpauu8 go +opu8 / yuepe++ou rmuo›oa- ryneymm, Τa›wmæ+ocwm AT III, † cweue+m wpou6m+eumm, ›yum- poæa+me cnagw-Øe+oue+a.

gepwa+me wms+e++8x Øy+›ymu opra+msua.
Cøemetauopomennae nnatua go 2000 un/cyw m 6onee.
Henapun æo Øna›o+ c unasuou mnm æ +auane ›awgou wpa+c- Øysmm æ uan8x gosax – 2500-5000 ME. HMH.
"Peonosu¬ec1ue" npenapam;, seuo6unαyue: wpe+wan, ›y-
pa+wmn, peouonmrnD›m+, 5% rnD›osa, Ømspacwæop m w.g.
Ansuonpome1mop;: gmym+o+ 2-4 un 2 p/cyw æ/æ.
Mpeuapaw8 c anmuo1cu6anmn;u 6eucmøueu: a›woæerm+ 10 un æ/æ, æmwaum+ C m w.g.
Mnatuotauena (unasuaØepes + 600-1000 un C3M).
Monumopuns ne¬enue: upm6nmwe+me › +opue uapauewpoæ
›oarynorpauu8, æ wou umcne AT III m Øm6pm+ore+a, c+mwe+me ypoæ+e D-gmuepoæ, P8MK m M¶8.

wpou6oym- woæ, +euwpanmsayme "upoweas+oro æsp8æa" m uawonormuec›oro Øm6pm+onmsa, pea+muaymo++8e uep8.
Cøemetauopomennae nnatua – cwpyu+8e wpa+cØysmm go 2-3 n/cyw. Mpm ›poæoweue+mex reuapm+ +e upmue+eewce.
Tpou6o1onyenmpam – upm ›onmuecwæe wpou6oymwoæ ue+ee (20-25)·109/n m yæenmue+mm gnmwena+ocwm ›poæoweue+me 6o- nee ueu æ 2-3 pasa uo cpaæ+e+mD c +opuou.
Mpm rmuepØm6pm+onmse - 6onauue 6ot; anmunpomeat (wpa- cmnon, ›o+wpm›an æ/æ go 300.000-500.000 E¶/cyw).
Mnatuotauena (unasuaØepes + C3M), +ms›ouone›ynep+8e ge›cwpa+8 (peouonmrnD›m+), ansuonpome1mop;, anmuo1- cu6anmn;e npenapam;.
Mecmnae ocmanoø1a 1poøome¬enue ›oaryneymeu m uepe- æes›ou cocygoæ, wauuo+mpoæa+meu pa+, upmue+e+meu uecw-
+8x reuocwawmuec›mx cpegcwæ.

rpauu8 go yuepe++ou rmuo›oaryneymm mnm +opu8, æos- pacwa+me ›onmuecwæa m a›wmæ+ocwm wpou6oymwoæ, yæenm- ue+me ›o+ye+wpaymm Øm6pm+ore+a, Øa›wopoæ cæepw8æa-
+me m a+wm›oaryne+woæ, +opuanmsayme uo›asaweneu Øm6- pm+onmsa, c+mwe+me ypoæ+e D-gmuepoæ, P8MK m M¶8.

cycwaæax), gnmwena+8e ouepa- ymm +a ›mmeu+m›e, ueue+m m w.g. (uaccmæ+oe uocwyune+me Ø.III æ ›poæowo›). Xmpyprmuec›me æuemawenacwæa +a opra+ax, 6oraw8x a›wmæawopaum unasum+a (uaw›a, ner›me, upocwawa, pancreas) => rmuepØm6pm+onms.
Mpoeæne+ue ¶BC: nocneonepaçuonnae mpom6oØunue.
H+Øap›w umo›apga, mmeumuec›me m+cynaw8, uonmopra++ae
+egocwawou+ocwa (uopawe+me ner›mx, uoue›, ronoæ+oro uosra, cepgeu+o-cocygmcwou cmcweu8, ›mmeu+m›a, ›owm m gp. Kpo- æoweue+me ms ouepaymo++8x pa+, reuawou8.
Mpoøunaıwuıa uocneouepayuo++/x wpom6otoæ: Øpa›cm- uapm+ (ogm+ mupmy) sa 2-3 uaca go ouepaymm m uepes 12 uac uocne ouepaymm. HeØpa›ymo+mpoæa++8u reuapm+ - 5000 eg 2-4 pasa æ ge+a.

o›onounog+8um æogaum; awo+muec›me uawou+8e
›poæoweue+me; a+we+awana+ae rm6ena unoga; cwmuyneyme po-
goæou geewena+ocwm m unogopaspymaDyme ouepaymm; uocne- pogoæ8u ceucmc; uys8p+8u sa+oc; ›pmum+ana+8u a6opw; we- wen8u uosg+mu recwos; s›nauucme. bonamme gos8 a+wm6mowm-
›oæ, ›opwm›ocwepomgoæ, ymwocwawm›oæ, agpe+ocwmuynewopoæ,
s-AKK, +eupaæmna+oe upmue+e+me a+wm›oaryne+woæ m Øm6pm-
+onmwm›oæ, opana+8x ›o+wpayeuwmæoæ m w.g. Maccmæ+8e re- uowpa+cØysmm m pem+Øysmm ›poæm.
Mpoeæne+ue ¶BC: mamo¬n9e 1poøome¬enue, uonmopra++ae
+egocwawou+ocwa (uopawe+me ner›mx, uoue›, ronoæ+oro uosra, cepgeu+o-cocygmcwou cmcweu8, ›mmeu+m›a, ›owm m gp.) Kpo- æoweue+me ms ouepaymo++8x pa+.
Mpoøunaıwuıa patæuwue ¶BC: cæoeæpeue++ae gmar+ocwm›a m upoØmna›wm›a a›ymepc›mx ocnow+e+mu. Heo6xogmu sauac cæewesauopowe++ou unasu8.