mekanisme hemostasis

MEKANISME HEMOSTASIS

SUB BAG. HEMATO-ONKOLOGI

ANAK FK USU

ADA 5 KOMPONEN:

1. KOMP.JARINGAN:

- JAR.LONGGAR PERDARAHAN

BANYAK

2. KOMP.PEMBULUH DARAH:

- VASOKONSTRIKSI

- FAKTOR PENARIK TROMBOSIT

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3. KOMP.TROMBOSIT:

- MENJAGA INTEGRITAS PEMB.DARAH

- MEMBENTUK GUMPALAN

- CLUMPING

4. KOMP.PEMBEKUAN:

- MENGUBAH GUMPALAN TROMBOSITMASSA YG KOMPAK

- MENGHASILKAN BEKUAN DI DLM PEMB.DARAH BESAR

- REAKSI KASKADE

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5. KOMP.FIBRINOLISIS

- TERDAPAT FAKTOR-FAKTOR INAKTIF, AKTIF, AKTIFATOR & INHIBITOR

- DIAKTIFKAN OLEH LATIHAN BERAT, ANOKSIA, KETEGANGAN (STRESS) DAN SUNTIKAN ADRENALIN

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NORMAL HAEMOSTASIS

VESSEL INJURY

COLLAGEN EXPOSURE

PLATELET RELEASEREACTION

TROMBOXANE A2, ADP

PLATELET AGGREGATION

PRIMARY HAEMOSTATIC PLUG

PLATELET FUSION

STABLE HEMOSTATIC PLUG FIBRIN

REDUCED BLOOD FLOW THROMBIN

BLOOD COAGULATIONVACOKONSTRICTION

SEROTONIN PLATELET FACTORS

F. XII

TISSUE TROMBOPLASTIN

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TF • VIICONTACT

VESSEL INJURY

TF • VII a

TFPI

IX

VIIIa • IX a

XIa XI

V11

1 •

v W

F

Xa • Va THROMBIN

PROTHOMBRIN

XIII XIIIa

STABLE FIBRIN

FIBRIN POLYMER

FIBRINOPEPTIDESA+B

FIBRINOGEN FIBRIN MONOMER

PHOSPHOLIPID SURFACE

V

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COAGULATION FACTOR DEFICIENCIES

1. COMMON INHERITED DEFICIENCIES

- F. VIII ( CLASSICAL HEMOPHILIA; HEMOPHILIA A )

- vWF ( VON WILLEBRAND DISEASE )

- F.IX ( CHRISTMAS DISEASE; HEMOPHILIA B )

- F. XI

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2. UNCOMMON INHERITED DEFICIENCIES- FIBRINOGEN & DYSFIBRINOGEN- PROTHROMBRIN (F.II) & DYSPROTHOMBRIN- F. V ( PARAHEMOPHILIA )- F. VII- F. X- F.XII- F.XIII- COMBINED DEFICIENCIES- OTHER

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3. ACQUIRED DEFICIENCIES

- VIT. K

- CONSUMPTION COAGULOPATHY

- PARENCHYMAL LIVER DISEASE

- CONGENITAL HEART DISEASE

- CARDIOPULMONARY BYPASS

- RENAL DISEASE

- ACQUIRED INHIBITORS

( CIRCULATING ANTICOAGULANTS )

- OTHER

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4. NEONATAL DEFICIENCIES

- HEMORRHAGIC DISEASE OF THE NEWBORN

- INHERITED DEFICIENCIES

- ACQUIRED DEFICIENCIES

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PENILAIAN KLINIK: 10LARGE ECCHYMOSISHEMATOMAHEMARTHROSIS

PTT-PROLONGED PT-NORMAL

HEMOPHILIAS vWD CIRCULATING ANTICOAGULANT HEPARIN

PTT-NORMALPT- PROLONGED

PTT-PROLONGED PT-PROLONGED

PTT-NORMAL PT-NORMAL

F.VII DEF.

F.XII DEF. 2 NTIPLASMIN DEF.

TT-PROLONGED TT-NORMAL

AFIBRINOGENEMIA DYSFIBRINOGENEMIA DIC LIVER DISEASE HEPARIN

LIVER DIS. VIT.K DEF. WARFARIN F.II,V,X DEF. DIC (EARLY) CIRCULATING ANTICOAGULANT DYSPROTHOMBINEMIA