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近年来由于止血和凝血机制的研究有了很大进展,对妊娠期凝血的生理变化也有深一步的认识,这将有助于产科医师对DIC 及血栓栓塞性疾病的预测和预防。一、正常止血生理:止血过程取决于三种相互关联的机制,即血管收缩、血小板和血液凝固;一般地说其主要程序为:①血小板聚集并粘附于伤口受损小血管的边缘形成临时性止血栓子;②聚集的血小板破裂,释放出血管收缩物质,使小血管收缩;③血浆凝血系统被激活,产生纤维蛋白网织结构形成血栓。因此血液凝固过程血小板及各种凝血因子都具有重要作用。凝血过程是一个连续的化学反应过程,包含着许多相互催化、相互制约的连续反应,目前仍以血液凝固的瀑布机制,最被大家所接受。
In recent years, great progress has been made in the research of hemostasis and coagulation mechanisms, and further understanding of the physiological changes of coagulation in pregnancy, which will help obstetricians predict and prevent DIC and thromboembolic diseases. First, the normal hemostasis physiology: The process of hemostasis depends on three interrelated mechanisms, namely, vasoconstriction, platelets and blood coagulation; generally speaking, the main procedures are: ① platelet aggregation and adhesion to the wound of small blood vessels to form a temporary edge Hemostatic emboli; â ’aggregation of platelet rupture, release of vasoconstriction substances, so that the contraction of small blood vessels; â’ ¡plasma coagulation system is activated, resulting in fibrin network structure to form thrombus. Therefore, blood coagulation process of platelets and various clotting factors have an important role. The coagulation process is a continuous process of chemical reaction, which involves many continuous reactions that are mutually catalytic and mutually restrictive. At present, the waterfall mechanism of blood coagulation is still the most accepted by all.