Izindaba

Usongo Lomhlaba Wonke Lwe-Venous Thromboembolism (VTE)

I-Venous Thromboembolism (VTE), inhlanganisela ebulalayo ye-Deep Vein Thrombosis (DVT) kanye ne-Pulmonary Embolism (PE), ibulala abantu abangaphezu kuka-840,000 emhlabeni jikelele minyaka yonke—okulingana nokufa okukodwa njalo ngemizuzwana engama-37. Okushaqisayo nakakhulu ukuthi ama-60% ezehlakalo ze-VTE zenzeka ngesikhathi sokulaliswa esibhedlela, okwenza kube yimbangela ehamba phambili yokufa okungahleliwe esibhedlela. E-China, ukwanda kwe-VTE kuyaqhubeka nokukhula, kufinyelela ku-14.2 kubantu abayi-100,000 ngo-2021, kanye namacala angaphezu kuka-200,000 aphelele. Kusukela ezigulini ezindala ngemva kokuhlinzwa kuya kubahambi bebhizinisi ezindizeni ezinde, izingozi ze-thrombotic zingase zicashe buthule—isikhumbuzo esicacile semvelo ye-VTE engabonakali kanye nokusabalala okubanzi.

I. Obani Abasengozini? Ukubhala Iphrofayili Yamaqembu Asengozini Enkulu

Imiphakathi elandelayo idinga ukuqapha okukhulu:

1. "Izisulu Ezingabonakali" Ezihlala Phansi
   Ukuhlala isikhathi eside (ngaphezulu kwamahora ama-4) kunciphisa kakhulu ukugeleza kwegazi. Isibonelo, umhleli wezinhlelo ogama lakhe linguZhang waqala ukuvuvukala kwemilenze ngokuzumayo ngemva kokushintshana okulandelanayo kwesikhathi esengeziwe futhi kwatholakala ukuthi une-DVT—umphumela ojwayelekile wokungahlali kahle kwemithambo yegazi.

2. Amaqembu Engozi Ye-Iatrogenic

   • Iziguli Ezihlinzwayo: Iziguli ezifakelwa indawo ngemva kokufakelwa amalunga zibhekene nengozi ye-VTE engu-40% ngaphandle kokuvimbela ukwakheka kwegazi.
   • Iziguli Zomdlavuza: Ukufa okuhlobene ne-VTE kubanga u-9% wabo bonke abantu ababulawa umdlavuza. Isiguli somdlavuza wamaphaphu esibizwa ngokuthi uLi, esingazange sithole umuthi wokulwa nokuqina kwegazi ngesikhathi sokwelashwa ngamakhemikhali, sabulawa yi-PE—indaba eyisixwayiso.
   • Abesifazane Abakhulelwe: Izinguquko zama-hormone kanye nokucindezelwa kwemithambo yegazi esibelethweni kwaholela ekubeni owesifazane okhulelwe ogama lakhe linguLiu abhekane nokuphelelwa umoya ngokuzumayo ku-trimester yakhe yesithathu, kamuva kwaqinisekiswa ukuthi uyi-PE.

3. Iziguli Ezinezifo Ezingamahlalakhona Ezinezingozi Ezihlanganisiwe
   Ukwanda kwe-viscosity yegazi kubantu abakhuluphele nabanesifo sikashukela, kanye nokwehla kokukhishwa kwenhliziyo ezigulini ezinesifo senhliziyo, kudala indawo evundile ye-thrombosis.

Isexwayiso Esibalulekile: Funa usizo lwezokwelapha ngokushesha uma kwenzeka ukuvuvukala kwemilenze okungazelelwe ohlangothini olulodwa, ubuhlungu besifuba obuhambisana nokuminyana, noma i-hemoptysis—lokhu kuwumjaho ophikisana nesikhathi.

II. Uhlelo Lokuvikela Olunezinga: Kusukela Ekuvinjweni Okuyisisekelo Kuya Ekuvimbeleni Okunembile

1. Ukuvimbela Okuyisisekelo: "I-Mantra Yamagama Amathathu" Yokuvimbela I-Thrombosis
   • Ukunyakaza: Zibandakanye emizuzwini engama-30 yokuhamba ngokushesha nsuku zonke noma ukubhukuda. Kwabasebenzi basehhovisi, yenza izivivinyo zokufutha iqakala (imizuzwana eyi-10 ye-dorsiflexion + imizuzwana eyi-10 ye-plantarflexion, ephindaphindwayo imizuzu emi-5) njalo emahoreni ama-2. Umnyango wabahlengikazi bePeking Union Medical College Hospital uthole ukuthi lokhu kwandisa ukugeleza kwegazi ezithweni ezingezansi ngo-37%.
   • Nikeza amanzi: Phuza inkomishi eyodwa yamanzi afudumele lapho uvuka, ngaphambi kokulala, kanye nalapho uvuka ebusuku (isamba esingu-1,500–2,500 mL/ngosuku). Udokotela wezifo zenhliziyo uDkt. Wang uvame ukweluleka iziguli: "Inkomishi eyodwa yamanzi inganciphisa ingxenye yeshumi yengozi yakho ye-thrombosis."
   • Yidla: Yidla i-salmon (ecebile nge-Ω-3 yokulwa nokuvuvukala), u-anyanisi (i-quercetin ivimbela ukuhlanganiswa kwama-platelet), kanye ne-fungus emnyama (ama-polysaccharides anciphisa ukujiya kwegazi).
2. Ukuvimbela Okwenziwa Ngemishini: Ukushayela Ukugeleza Kwegazi Ngamadivayisi Angaphandle
   • Amasokisi Okucindezela Aphothuliwe (GCS): Owesifazane okhulelwe ogama lakhe linguChen wayegqoka i-GCS kusukela ngesonto lama-20 lokukhulelwa kuze kube yilapho ekhulelwe, okuvimbela ngempumelelo imithambo yegazi evuvukalayo kanye ne-DVT.
   • Ukucindezeleka Kwamaphaphu Okungajwayelekile (IPC): Iziguli zamathambo ezisebenzisa i-IPC zithole ukwehla okungu-40% kwengozi ye-DVT.
3. Ukuvimbela Kwemithi: Ukuphathwa Kwe-Anticoagulation Ehlanganisiwe
   Kususelwa ku-Caprini Score:

   Izinga Lengozi	Inani labantu elijwayelekile	Iphrothokholi Yokuvimbela
   Okuphansi (0–2)	Iziguli ezisencane ezihlinzwa kancane kancane	Ukuthutha kusenesikhathi + IPC
   Okumaphakathi (3–4)	Iziguli ezihlinzwa kakhulu nge-laparoscopic	I-Enoxaparin 40 mg/ngosuku + IPC
   Okuphezulu (≥5)	Iziguli ezifakelwe izinqe/ezinomdlavuza othuthukile	I-Rivaroxaban 10 mg/ngosuku + IPC (ukwandiswa kwamasonto ama-4 kweziguli ezinomdlavuza)

Isexwayiso Sokungavinjelwa: Ama-anticoagulant awavinjelwanga ekopheni okusebenzayo noma ekubalweni kwama-platelet <50×10⁹/L. Ukuvimbela ngomshini kuphephile ezimweni ezinjalo.

III. Imiphakathi Ekhethekile: Amasu Okuvimbela Aklanyelwe

1. Iziguli Zomdlavuza
   Hlola ingozi usebenzisa imodeli kaKhomana: Isiguli somdlavuza wamaphaphu esibizwa ngokuthi uWang esinamaphuzu angu-≥4 adingekayo nsuku zonke e-heparin enesisindo esiphansi sama-molecule. Ukuhlolwa kwebhakhodi okusha kwe-PEVB (ukuzwela okungu-96.8%) kwenza kube lula ukuhlonza iziguli ezisengozini enkulu kusenesikhathi.

2. Abesifazane Abakhulelwe
   I-Warfarin ayivunyelwe (ingozi ye-teratogenic)! Shintshela ku-enoxaparin, njengoba kuboniswe ngowesifazane okhulelwe ogama lakhe linguLiu owabeletha ngokuphepha ngemva kokuvimbela ukujiya kwegazi kwaze kwaba amasonto ayi-6 ngemuva kokubeletha. Ukubeletha ngokuhlinzwa noma ukukhuluphala ngokweqile/ubudala obuphezulu bomama budinga ukuvimbela ukujiya kwegazi ngokushesha.

3. Iziguli Zamathambo
   Ukwelashwa kokuvimbela ukujiya kwegazi kumele kuqhubeke izinsuku ezingu-≥14 ngemva kokufakwa esikhundleni kwe-hip kanye nezinsuku ezingu-35 zokuphuka kwe-hip. Isiguli esibizwa ngokuthi uZhang saba ne-PE ngemva kokuyeka ngaphambi kwesikhathi—isifundo sokunamathela.

IV. Izibuyekezo Zeziqondiso ZaseShayina Zango-2025: Intuthuko Ethuthukisiwe

1. Ubuchwepheshe Bokuhlola Okusheshayo
   I-Fast-DetectGPT yaseWestlake University ifinyelela ukunemba okungu-90% ekuboneni umbhalo owenziwe yi-AI, isebenza ngokushesha okuphindwe izikhathi ezingu-340—kusiza omagazini ekuhlungeni okuthunyelwe kwe-AI okuseqophelweni eliphansi.

2. Izinqubo Zokwelapha Ezithuthukisiwe

   • Ukwethulwa kwe-"catastrophic PTE" (i-systolic BP <90 mmHg + SpO₂ <90%), okubangela ukungenelela kweqembu le-PERT elihlukahlukene.
   • Kunconywa ukunciphisa umthamo we-apixaban ngenxa yokukhubazeka kwezinso (eGFR 15-29 mL/min).

V. Isenzo Esihlangene: Ukuqeda I-Thrombosis Ngokuzibandakanya Komhlaba Wonke

1. Izikhungo Zokunakekelwa Kwezempilo
   Ukuthola amaphuzu aphelele eCaprini zingakapheli amahora angama-24 kusukela ekwamukelweni kwabo bonke abaguli abangenisiwe. Isibhedlela iPeking Union Medical College sinciphise ukwanda kwe-VTE ngo-52% ngemuva kokusebenzisa le nqubo.

2. Ukuzilawula Komphakathi
   Ukwehla kwesisindo ngo-5% kubantu abane-BMI >30 kunciphisa ingozi ye-thrombosis ngo-20%! Ukuyeka ukubhema nokulawula i-glycemic (HbA1c <7%) kubalulekile.

3. Ukufinyeleleka kobuchwepheshe
   Skena amakhodi ukuze uthole izifundo zokuzivocavoca ngephampu yeqakala. Izinsizakalo zokuqasha amadivayisi e-IPC manje sezihlanganisa amadolobha angu-200.

Umyalezo Oyinhloko: I-VTE "ingumbulali othule" ongavinjelwa, ongalawuleka. Qala ngokuzivocavoca kwakho okulandelayo kokupompa iqakala. Qala ngengilazi yakho elandelayo yamanzi. Gcina igazi ligeleza ngokukhululeka

Izinkomba

1. Uhulumeni Kamasipala waseYantai. (2024).Imfundo Yezempilo Nge-Vous Thromboembolism.
2. Iziqondiso zaseShayina Zokuvimbela Nokwelapha Izifo Ezibangelwa Yi-Thrombotic. (2025).
3. Isikhungo Sesayensi Nekhemistri Se-Chinese Academy of Sciences. (2025).Intuthuko Entsha Ekubikezelweni Kwengozi Ye-VTE Yeziguli Zomdlavuza.
4. Imfundo Yezempilo Yomphakathi. (2024).Ukuvimbela Okuyisisekelo Kwabantu Abasengozini Ephakeme Ye-VTE.
5. IYunivesithi yaseWestlake. (2025).Umbiko Wezobuchwepheshe we-GPT Othola Ngokushesha.