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Ingozi Yehlabathi Yokuxinzezeleka Kwemithambo Yemithambo (VTE)

I-Venous Thromboembolism (VTE), indibaniselwano ebulalayo ye-Deep Vein Thrombosis (DVT) kunye ne-Pulmonary Embolism (PE), ibulala abantu abangaphezu kwama-840,000 kwihlabathi liphela minyaka le—okufana nokufa komntu omnye rhoqo kwimizuzwana engama-37. Okubangela uloyiko kukuba, ama-60% eziganeko ze-VTE zenzeka ngexesha lokulaliswa esibhedlele, nto leyo eyenza ukuba ibe yeyona nto iphambili yokufa okungacwangciswanga esibhedlele. E-China, ukwanda kwe-VTE kuyaqhubeka nokunyuka, kufikelela kwi-14.2 kubantu abayi-100,000 ngo-2021, kunye namatyala angaphezu kwama-200,000 apheleleyo. Ukususela kwizigulana ezindala emva kotyando ukuya kubahambi beshishini kwiinqwelomoya ezinde, iingozi ze-thrombotic zinokucasha buthule—isikhumbuzo esicacileyo sendalo ye-VTE efihlakeleyo kunye nokuxhaphaka okubanzi.

I. Ngubani Osesichengeni? Ukuchonga Amaqela Asemngciphekweni Omkhulu

La maqela alandelayo afuna ukuqwalaselwa ngakumbi:

1. "Amaxhoba Angabonakaliyo" Ahleli Phantsi
   Ukuhlala ixesha elide (ngaphezulu kweeyure ezi-4) kucothisa kakhulu ukuhamba kwegazi. Umzekelo, umdwelisi weenkqubo ogama linguZhang wadumba ngequbuliso emva kokutshintshana kwexesha elaneleyo waza wafunyaniswa ene-DVT—umphumo oqhelekileyo wokungahlali kakuhle kwemithambo yegazi.

2. Amaqela Omngcipheko we-Iatrogenic

   • Izigulana ezityandwayo: Izigulana ezifakelwa utyando emva kokufakelwa amalungu omzimba zijongene nomngcipheko we-40% we-VTE ngaphandle kokuthintela ukujiya kwegazi.
   • Izigulane zomhlaza: Ukufa okunxulumene ne-VTE kubangela i-9% yabo bonke abantu ababulawa ngumhlaza. Isigulane somhlaza wemiphunga esibizwa ngokuba nguLi, esingazange sifumane unyango lokuthintela ukujiya kwegazi ngaxeshanye ngexesha le-chemotherapy, safa yi-PE—ibali elilumkisayo.
   • Abafazi Abakhulelweyo: Utshintsho lweehomoni kunye nokucinezelwa kwemithambo yegazi yesibeleko kukhokelele ekubeni umfazi okhulelweyo ogama linguLiu afumane ukuphelelwa ngamandla ngequbuliso kwi-trimester yakhe yesithathu, kamva kwaqinisekiswa ukuba yi-PE.

3. Izigulane zeZifo eziSisigxina ezineengozi ezingakumbi
   Ukwanda koburhabaxa egazini kubantu abatyebe kakhulu nabanesifo seswekile, kunye nokuncipha kokuphuma kwentliziyo kwizigulana ezinesifo sentliziyo, kudala indawo echumileyo ye-thrombosis.

Isilumkiso Esibalulekileyo: Funa uncedo lwezonyango ngokukhawuleza xa kukho ukudumba kwemilenze ngequbuliso ecaleni kwelinye icala, iintlungu zesifuba ezihambisana nokufunxwa, okanye i-hemoptysis—oku kugqatso oluchasene nexesha.

II. Inkqubo yoKhuselo oluneZinga: Ukusuka kwiSiseko ukuya kwiNqanaba lokuThintela ngokuNgqinisisa

1. Uthintelo oluSisiseko: "I-Mantra yamagama amathathu" yoThintelo lweThrombosis
   • Ukushukuma: Zibandakanye kwimizuzu engama-30 yokuhamba ngokukhawuleza imihla ngemihla okanye ukudada. Kwabasebenzi baseofisini, yenza umthambo wokumpompa iqatha (imizuzwana eli-10 yokujika i-dorsiflexion + imizuzwana eli-10 yokujika i-plantarflexion, ephindaphindwayo imizuzu emi-5) rhoqo emva kweeyure ezi-2. Isebe labongikazi lePeking Union Medical College Hospital lifumanise ukuba oku kunyusa ukuhamba kwegazi kwimilenze esezantsi ngama-37%.
   • Hydrate: Sela ikomityi enye yamanzi afudumeleyo xa uvuka, ngaphambi kokuba ulale, naxa uvuka ebusuku (iyonke yi-1,500–2,500 mL/ngosuku). Ingcali yentliziyo uGqr. Wang uhlala ecebisa izigulane: "Ikomityi enye yamanzi inokunciphisa isinye kwishumi sengozi yakho ye-thrombosis."
   • Yitya: Yitya isalmon (etyebileyo kwi-Ω-3 yokulwa nokuvuvukala), itswele (i-quercetin ithintela ukuhlanganiswa kweeplatelet), kunye nefungus emnyama (ii-polysaccharides zinciphisa i-viscosity yegazi).
2. Ukuthintela Oomatshini: Ukuqhuba Ukuhamba Kwegazi Ngezixhobo Zangaphandle
   • Iisokisi zoxinzelelo eziphumeleleyo (GCS): Umfazi okhulelweyo ogama linguChen wayenxiba i-GCS ukususela kwiveki yama-20 yokukhulelwa ukuya kuthi ga emva kokubeleka, nto leyo eyayithintela imithambo yegazi eyomileyo kunye ne-DVT ngempumelelo.
   • Uxinzelelo lwe-Pneumatic oluqhubekayo (IPC): Izigulane ezisebenzisa i-IPC emva kotyando lwamathambo zithole ukwehla kwe-40% kumngcipheko we-DVT.
3. Uthintelo lweMithi: Ulawulo lwe-Stratified Anticoagulation
   Ngokusekelwe kwiCaprini Score:

   Umgangatho woMngcipheko	Abemi abaqhelekileyo	Imigaqo yoThintelo
   Ephantsi (0–2)	Izigulane ezincinci ezityandwayo ezingafunekiyo kakhulu	Ukuhanjiswa kwangethuba + IPC
   Eliphakathi (3–4)	Izigulana ezinkulu zotyando lweLaparoscopic	I-Enoxaparin 40 mg/ngosuku + IPC
   Phezulu (≥5)	Izigulane ezifakelwe isinqe/ezinomhlaza ophucukileyo	I-Rivaroxaban 10 mg/ngosuku + IPC (ulwandiso lweeveki ezi-4 kwizigulane ezinomhlaza)

Isilumkiso Sokungaqini Kwegazi: Ii-anticoagulants azivumelekanga xa kuphuma igazi okanye kubalwa iiplatelet <50×10⁹/L. Ukuthintela ngoomatshini kukhuselekile kwiimeko ezinjalo.

III. Amaqela aKhethekileyo: Amaqhinga oThintelo oluHleliweyo

1. Izigulane zomhlaza
   Vavanya umngcipheko usebenzisa imodeli kaKhomana: Isigulana somhlaza wemiphunga esibizwa ngokuba nguWang esinamanqaku angama-≥4 afunekayo imihla ngemihla kwi-heparin enobunzima obuphantsi beemolekyuli. Uvavanyo olutsha lwe-PEVB barcode (96.8% sensitivity) lwenza ukuba kuchongwe kwangethuba izigulana ezisengozini enkulu.

2. Abafazi abakhulelweyo
   I-Warfarin ayivumelekanga (umngcipheko we-teratogenic)! Tshintshela kwi-enoxaparin, njengoko kubonisiwe ngumfazi okhulelweyo ogama linguLiu owabeleka ngokukhuselekileyo emva kokuthintela ukujiya kwegazi de kwadlula iiveki ezi-6 emva kokuzalwa. Ukubeletha ngotyando okanye ukutyeba okuhambisana noko/ubudala obuphezulu bomama bufuna ukuba kuthintelwe ukujiya kwegazi ngoko nangoko.

3. Izigulana ze-Orthopedic
   Unyango lokuthintela ukujiya kwegazi kufuneka luqhubeke emva kweentsuku ezili-14 emva kokutshintshwa kwesinqe kunye neentsuku ezingama-35 zokuqhekeka kwesinqe. Isigulana esibizwa ngokuba nguZhang safumana i-PE emva kokuyeka kwangethuba—isifundo sokunamathela.

IV. Uhlaziyo lweSikhokelo saseTshayina sika-2025: Ukuqhubela phambili kwempumelelo

1. Itekhnoloji yoHlolo oluKhawulezayo
   I-Fast-DetectGPT yeYunivesithi yaseWestlake ifikelela kwi-90% yokuchaneka ekuchongeni umbhalo owenziwe yi-AI, isebenza ngokukhawuleza ngokuphindwe ka-340—inceda iijenali ekuhluzeni ukuhanjiswa kwe-AI okusemgangathweni ophantsi.

2. IiProtocols zoNyango oluPhuculweyo

   • Ukwaziswa kwe-"catastrophic PTE" (i-systolic BP <90 mmHg + SpO₂ <90%), okubangela ukungenelela kweqela le-PERT elinamacandelo amaninzi.
   • Idosi ye-apixaban encitshisiweyo icetyiswayo xa kukho ukungasebenzi kakuhle kwezintso (eGFR 15–29 mL/min).

V. Isenzo Esihlangeneyo: Ukuphelisa iThrombosis Ngokusebenzisana neHlabathi

1. Amaziko ezeMpilo
   Gqibezela amanqaku eCaprini kwiiyure ezingama-24 emva kokungeniswa kwabo bonke abaguli abangenisiweyo. Isibhedlele sasePeking Union Medical College sinciphise ukwenzeka kwe-VTE ngama-52% emva kokusebenzisa le nkqubo.

2. Ulawulo Loluntu
   Ukwehla kobunzima nge-5% kubantu abane-BMI engaphezulu kwama-30 kunciphisa umngcipheko we-thrombosis ngama-20%! Ukuyeka ukutshaya kunye nokulawula i-glycemic (HbA1c <7%) kubalulekile.

3. Ukufikeleleka kweTekhnoloji
   Skena iikhowudi ukuze ufumane izifundo zokuzilolonga ngepompo yeqakala. Iinkonzo zokuqesha izixhobo ze-IPC ngoku zigubungela izixeko ezingama-200.

Umyalezo Oyintloko: I-VTE "ngumbulali othuleyo" onokuthintelwa, onokulawuleka. Qala ngokuzilolonga kwakho okulandelayo kokumpompa iqatha. Qala ngeglasi yakho elandelayo yamanzi. Gcina igazi lihamba ngokukhululekileyo

Iireferensi

1. Urhulumente kaMasipala waseYantai. (2024).Imfundo yezeMpilo kwi-Venous Thromboembolism.
2. Izikhokelo zaseTshayina zoThintelo kunye noNyango lweSifo seThrombotic. (2025).
3. I-Chinese Academy of Sciences Institute of Physics and Chemistry. (2025).Inkqubela phambili entsha kwi-VTE Risk Prediction for Cancer Guides.
4. Imfundo yezeMpilo kaRhulumente. (2024).Uthintelo oluSisiseko lwaBantu abakwiMngcipheko ephezulu ye-VTE.
5. IYunivesithi yaseWestlake. (2025).Ingxelo yoBugcisa yeGPT eKhawulezayo.