Ngā Pūrongo

Te Riri o te Ao mō te Thromboembolism o ngā Uaua (VTE)

Ko te Vein Thromboembolism (VTE), he huinga whakamate o te Deep Vein Thrombosis (DVT) me te Pulmonary Embolism (PE), e mate ana i te neke atu i te 840,000 tāngata puta noa i te ao i ia tau—he rite ki te kotahi te mate i ia 37 hēkona. Ko te mea whakamataku ake, 60% o ngā mate VTE ka puta i te wā e noho ana i te hōhipera, ā, koinei te tino take o ngā mate ohorere i roto i te hōhipera. I Haina, kei te piki haere tonu te maha o ngā mate VTE, tae atu ki te 14.2 mō ia 100,000 taupori i te tau 2021, me te neke atu i te 200,000 ngā mate tino. Mai i ngā tūroro kaumātua i muri i te pokanga ki ngā kaihaerere pakihi i runga i ngā rerenga roa, tera pea ka noho puku ngā mōrearea thrombotic—he whakamahara nui ki te āhua kino o te VTE me te horapa whānui.

I. Ko wai kei te mōrearea? Te whakaahua i ngā rōpū mōrearea nui

Ko ngā rōpū e whai ake nei me tino mataara:

1. Ngā "Patunga Kāore e Kitea" e Noho Noho Ana
   Ka tino whakaroa te rere o te toto i te noho roa (>4 hāora). Hei tauira, i pupuhi ohorere te waewae o tētahi kaihōtaka ko Zhang tōna ingoa i muri i ngā mahi tāpiringa, ā, i kitea he DVT tōna—he hua noa iho o te korenga o te toto i roto i ngā uaua.

2. Ngā Rōpū Mōrearea Iatrogenic

   • Ngā Tūroro Pokanga: Ka pāngia ngā tūroro whai muri i te whakakapinga hononga e 40% te mōrearea VTE ki te kore he rongoā ārai mate toto.
   • Ngā Tūroro Matepukupuku: E 9% o ngā mate pukupuku katoa e pā ana ki te VTE. I mate tētahi tūroro matepukupuku pūkahukahu, ko Li tōna ingoa whānau, kāore i whiwhi i te rongoā ārai toto i te wā o te chemotherapy, i te PE—he kōrero whakatūpato.
   • Ngā Wahine Hapū: Nā ngā huringa homoni me te pēhanga o ngā uaua toto i roto i te kōpū, i pāngia ai tētahi wahine hapū ko Liu tōna ingoa e te mate pōrearea ohorere i tōna toru o ngā marama o te hapūtanga, ā, i muri mai ka whakaūtia ko ia he PE.

3. Ngā Tūroro Mate Pūmau me ngā Mōrearea Kua Whakanuia
   Ko te matotoru o te toto i roto i te hunga momona me te mate huka, me te heke o te putanga o te ngakau i roto i te hunga mate ngoikore o te ngakau, ka hanga he whenua momona mo te thrombosis.

Whakatūpato Tino Nui: Rapua tonutia te awhina hauora mō te pupuhi ohorere o te waewae i te taha kotahi, te mamae o te uma me te whakamomori, te hemoptysis rānei—he whakataetae tēnei ki te wā.

II. Pūnaha Parepare Taumata: Mai i te Tūāpapa ki te Ārai Tika

1. Te Āraitanga Tūāpapa: Te "Mantra Kupu-Toru" mō te Ārai i te Thrombosis
   • Nekeneke: 30 meneti te hikoi tere, te kaukau rānei i ia rā. Mō ngā kaimahi tari, me mahi ngā mahi whakakorikori pona waewae (10 hēkona o te piko o muri + 10 hēkona o te piko o te waewae, me te whakahoki anō mō ​​te 5 meneti) i ia 2 hāora. I kitea e te tari nēhi o te Hōhipera o te Kāreti Hauora o Peking Union ka piki ake te rere o te toto o raro o ngā peka mā te 37%.
   • Whakainu wai: Inuhia kia kotahi kapu wai mahana i te oho ake, i mua i te moe, me te oho ake i te pō (1,500–2,500 mL/rā te tapeke). He maha ngā tohutohu a te taote ngakau a Tākuta Wang ki ngā tūroro: "Ka taea e te kotahi kapu wai te whakaiti i te kotahi tekau o tō mōrearea toto toto."
   • Kai: Kainga te hāmana (he nui te Ω-3 hei ārai i te mumura), te riki (ka ārai te quercetin i te kohikohinga o ngā pereti toto), me te harore pango (ka whakaitihia e ngā polysaccharides te matotoru o te toto).
2. Te Ārai Ā-ringa: Te Whakahaere i te Rere o te Toto me ngā Pūrere o Waho
   • Tōkena Kōpeketanga Whakamātautau (GCS): I mau tētahi wahine hapu ko Chen tōna ingoa whānau i ngā Tōkena Kōpeketanga mai i te wiki 20 o te hapūtanga tae noa ki muri i te whānautanga, ā, i ārai pai tēnei i ngā uaua varicose me te DVT.
   • Te Pehitanga Hauātea Wā-poto (IPC): I kitea e ngā tūroro orthopedic i muri i te pokanga i whakamahi i te IPC te hekenga o te mōrearea DVT mā te 40%.
3. Te Ārai Rongoā: Te Whakahaere Ārai Toto Whakarōpū
   I runga i te Kaute Caprini:

   Taumata Mōrearea	Taupori Noa	Te Tikanga Ārai
   Iti (0–2)	Ngā tūroro taiohi e pokanga iti ana te whakaekenga	Te whakaohooho wawe + IPC
   Waenga (3–4)	Ngā tūroro pokanga nui Laparoscopic	Enoxaparin 40 mg/rā + IPC
   Teitei (≥5)	Ngā tūroro whakakapi hope/matepukupuku matatau	Rivaroxaban 10 mg/rā + IPC (whakaroa 4-wiki mō ngā tūroro matepukupuku)

Whakatūpato Ārai: Kāore e whakaaetia ngā rongoā ārai toto mō te toto e kaha ana te toto, te maha rānei o ngā pereti toto i raro i te 50×10⁹/L. He haumaru ake te ārai ā-ringa i roto i ēnei āhuatanga.

III. Ngā Taupori Motuhake: Ngā Rautaki Ārai i Whakaritea

1. Ngā Tūroro Matepukupuku
   Aromatawaihia te mōrearea mā te whakamahi i te tauira Khomana: I hiahiatia he heparin taumaha-iti-ngota-ia-rā e te tūroro mate pukupuku pūkahukahu, ko Wang tōna ingoa whānau, me te kaute ≥4. Mā te whakamātautau waehere pae PEVB hou (96.8% te aro) ka taea te tautuhi wawe i ngā tūroro mōrearea-nui.

2. Ngā Wahine Hapū
   Kāore e whakaaetia te warfarin (he mōrearea teratogenic)! Huri ki te enoxaparin, e ai ki te whakaaturanga a tētahi wahine hapu ko Liu tōna ingoa, i whānau haumaru i muri i te anticoagulation tae noa ki ngā wiki e 6 i muri i te whānautanga. Mēnā he whānautanga cesarean, he momona tāpiringa rānei/he pakeketanga o te whaea, me tere tonu te anticoagulation.

3. Ngā Tūroro Orthopedic
   Me haere tonu te rongoā ārai toto i ngā rā neke atu i te 14 i muri i te whakakapinga hope, ā, me haere tonu te rongoā ārai toto i ngā rā 35 mō ngā whati hope. I pāngia tētahi tūroro, ko Zhang tōna ingoa whānau, e te PE i muri i te whakamutu wawe i te rongoā—he akoranga tēnei mō te piripono ki te rongoā.

IV. Ngā Whakahōutanga Aratohu o Haina 2025: Ngā Whakatairanga Hou

1. Hangarau Tirotiro Tere
   E 90% te tika o te Fast-DetectGPT a Te Whare Wānanga o Westlake ki te tautuhi i ngā tuhinga i hangaia e te AI, ā, e 340 ngā wā tere ake te mahi—e āwhina ana i ngā hautaka ki te tātari i ngā tuku AI kounga iti.

2. Ngā Kawa Maimoatanga Whakarei Ake

   • Te whakaurunga mai o te "PTE kino rawa" (te toto toto iti iho i te 90 mmHg + SpO₂ <90%), ka tīmata te wawaotanga a te tīma PERT maha-mātauranga.
   • Kua whakaitihia te horopeta o te apixaban mō te ngoikore o te whatukuhu (eGFR 15–29 mL/min).

V. Mahi Ngātahi: Te Whakakore i te Thrombosis mā te Whai Wāhi Whānui

1. Ngā Whare Hauora
   Whakaotia te kaute Caprini i roto i ngā haora 24 o te whakaurunga mō ngā tūroro katoa. I whakaitihia e te Peking Union Medical College Hospital te maha o ngā VTE mā te 52% i muri i te whakatinanatanga o tēnei tikanga.

2. Te Whakahaere Whaiaro ā-Iwi
   Mā te whakaiti i te taumaha mā te 5% mō te hunga he BMI >30 te nui ka whakaiti i te mōrearea o te toto toto mā te 20%! He mea nui te whakamutu i te momi hikareti me te whakahaere i te huka toto (HbA1c <7%).

3. Te Wātea ki te Hangarau
   Matawaihia ngā waehere mō ngā akoranga whakakorikori pona waewae. E 200 ngā tāone e kapi ana i ngā ratonga reti taputapu IPC.

Karere Matua: He "kaikōhuru puku" ka taea te ārai, ka taea te whakahaere i te VTE. Tīmata ki tō mahi whakakorikori pona waewae e whai ake nei. Tīmata ki tō karāhe wai e whai ake nei. Kia rere noa te toto

Ngā Tohutoro

1. Te Kāwanatanga o Yantai. (2024).Mātauranga Hauora mō te Thromboembolism Vein.
2. Ngā Aratohu Hainamana mō te Ārai me te Maimoatanga i te Mate Thrombotic. (2025).
3. Te Whare Wānanga Pūtaiao Hainamana Te Whare Wānanga Ahupūngao me te Matū. (2025).Ngā Huarahi Hou ki te Matapae i te Mōrearea VTE mō ngā Tūroro Matepukupuku.
4. Mātauranga Hauora Tūmatanui. (2024).Te Ārai Taketake mō ngā Taupori Mōrearea-Tiketike VTE.
5. Te Whare Wānanga o Westlake. (2025).Pūrongo Hangarau GPT Kimi-Tere.