mekanisme hemostasis
TRANSCRIPT
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