The blood clotting process automatically starts when you receive injuries, cuts, or burns. Due to diseases and characteristics of the body, blood stops clotting normally, which provokes bleeding and hemorrhage. Why does blood clot poorly? What influences this vital important process? You will find the answers in this article.

Blood does not clot due to lack of vitamin K in the body

Blood does not clot: causes of a dangerous condition

Immediately after a cut (burn, injury), platelets rush to the damaged area and create a clot that closes the wound. With normal coagulation, after damage to a blood vessel, the blood thickens within 4 minutes and becomes jelly-like. The blood clots completely after 7-8 minutes.

If blood clotting is low, even a minor cut will bleed. long time. Blood clots poorly when:

• Availability hereditary disease(hemophilia);
• decreased immunity;
• pregnancy;
• vitamin K deficiency;
• long-term and uncontrolled use painkillers;
• taking blood thinning medications;
• use large quantity liquids;
• presence of liver diseases.

Hemophilia is considered genetic disease, affecting males of all ages. Carriers are women; the disease rarely manifests itself in them. With minor cuts in people with hemophilia, there is profuse bleeding. Patients are also susceptible to unpredictable hemorrhages in the muscles, joints, and brain.

How long does it take for blood to clot in hemophilia? The process of blocking a damaged vessel lasts up to 2 days, because this condition requires immediate appeal see a doctor. The hemostasiologist prescribes a special replacement therapy and/or blood transfusion. Hemophilia cannot be cured, but with constant use special drugs the occurrence of abundant, fatal dangerous bleeding is reduced to a minimum.

During pregnancy and during various diseases Maybe sharp decline immunity. During this period, the rate of clotting decreases, but not as significantly as in hemophilia. As a maintenance therapy, the doctor prescribes iron supplements, but take them without consultation. medicines not recommended.

Blood does not clot if there is a lack of vitamin K. If the body becomes deficient in this substance, the risk of bleeding increases significantly. You can compensate for the lack of vitamin K by adding green tomatoes to your daily diet, cauliflower, rose hips, spinach, cereals.

Long-term use of painkillers (NSAIDs) and blood thinners helps reduce blood clotting. They should be used carefully and only as prescribed by the attending physician.

Liver diseases, as well as its damage by metastases from cancer of other organs, are considered one of the causes of poor blood clotting. Restore here normal condition Only doctors, a hepatologist and an oncologist will help the patient.

Remember, if the blood from small cuts does not clot within 5-8 minutes and you:

• often suffer from nosebleeds;
• are experiencing headache, weakness and joint pain:
• If you notice the appearance of bruises and abrasions from ordinary touch, you need to immediately seek help from a doctor.

The sooner the disease is detected, the greater the opportunity to prevent its further development. Do not neglect your own health, be vigilant.

Blood always remains in liquid form, which is ensured by a well-coordinated homeostasis system. When a blood vessel is damaged, a blood clot forms, which closes the damaged area. Insufficiently rapid formation leads to severe bleeding. To prevent serious complications, you need to know what it is poor clotting blood, its causes, treatment with folk remedies.

Causes of reduced clotting

There are common predisposing factors for bleeding disorders:

• liver pathologies;
• disturbances in the functioning of the immune system;
• anemia, leukemia;
• prolonged, uncontrolled use of non-steroidal anti-inflammatory drugs, which can cause disruption of the blood coagulation factors;
• lack of calcium;
• allergic reactions, accompanied by a significant increase in the production of histamine in the body and affecting the formation of fibrinogen;
• development of malignant pathology;
• von Willebrand disease;
• long-term use of antiplatelet agents;
• treatment of cardiac and vascular pathologies;
• vitamin K deficiency;
• use of certain strong antibiotics;
• unfavorable hereditary predisposition.

Other causes of poor clotting:

• use by women of drugs that can thin the blood (Warfarin, Troxevasin and others);
• harmful environmental conditions;
• consumption of certain foods.

If clotting is impaired, bleeding may not stop for a long time. To determine in detail the causes of the development of the disease in question, the doctor prescribes a platelet aggregation analysis to the patient.

Thrombocytopenia

This is a condition caused by a decrease in the number of platelets in the blood. It is caused by autoimmune pathologies (thrombocytopenic purpura, rheumatoid arthritis, lupus). This pathology may be a complication viral infections, alcohol abuse, chemotherapy or radiation.

Thrombocytopenia manifests itself frequent bleeding from the nose and gums, an increased tendency to bruise, and the presence of blood in feces and urine. Often patients have small rash over the body. Women experience prolonged menstruation. Treatment of the problem depends on its severity.

Hemophilia

This is a hereditary pathology associated with a violation of blood clotting processes. It is inherited by female line, and men get sick.

Its main symptoms are hemorrhages in the joints, heavy bleeding that occur after even the smallest injuries. Recurrent hemarthrosis leads to damage and immobilization of the joints, which is why disability develops by the age of 20. Large retroperitoneal or muscle hematomas may appear. Due to their compression of the nerves, severe pain, paresis and paralysis occur.

Severe forms of hemophilia lead to severe abdominal bleeding. These conditions are life-threatening.

Patients should always strictly follow all doctor's recommendations. When contacting specialists, you need to inform about hemophilia. Treatment of the disease is carried out by introducing clotting factors into the body.

Symptoms of poor clotting

Bleeding disorders are associated with characteristic symptoms:

• prolonged and severe bleeding with minor vascular lesions;
• the appearance of bruises on the body, and for no apparent reason;
• prolonged and frequent nasal hemorrhages;
• heavy periods in women;
• bleeding gums when brushing teeth and eating;
• hemorrhages in the intestines. They can be detected by color changes feces: They become dark, almost black.

The symptoms and treatment of bleeding disorders are closely related. If even minor signs of blood pathology appear, you should immediately contact a specialist.

Danger during pregnancy

During pregnancy, a woman's body undergoes enormous changes. Because of them, hemostasis primarily suffers. Poor coagulation is caused by amniotic fluid embolism and premature placental abruption.

Impaired blood clotting during pregnancy has a negative impact on a woman’s health. Arises high risk postpartum hemorrhages, especially resistant to treatment. Therefore, gynecologists prescribe a series of examinations necessary to determine the causes of impaired coagulation and prescribe effective therapy.

A pregnant woman should completely stop smoking and drinking even the smallest quantities alcoholic drinks. The menu should contain a sufficient amount of vitamin B 12. If you are prone to poor clotting, you should limit your fluid intake.

Treatment

Therapy for impaired blood clotting requires patience, as it can be quite lengthy. Medicines are prescribed only on the recommendation of a doctor. Their independent use may cause severe complications. Great value has proper nutrition, the use of some effective folk remedies.

Nutrition for decreased blood clotting

The diet should include foods that have a positive effect on blood composition and increase blood clotting. The menu should be enriched with the following dishes and products:

• greens;
• fatty fish (salmon or trout);
• cod liver;
• vegetables;
• fruits (especially bananas, apples, pomegranates);
• red berries;
• nuts;
• legumes;
• buckwheat;
• wheat bread;
• cream, natural butter;
• fatty meats.

Alcohol, mayonnaise, sweets, sausage, processed foods, and coffee should be excluded from the menu.

Folk remedies

1. Shell decoction pine nuts. To obtain it, you need to pour 500 ml of boiling water into a glass of raw material and cook over low heat for a quarter of an hour. You need to drink 2 tbsp of the decoction. 3 times a day for 3 weeks.
2. To prepare an infusion of yarrow, you need to take about 15 g of dry and crushed raw materials, pour a glass of boiling water over it, and leave for about 15 minutes. Take a tablespoon 3 times a day before meals.
3. An infusion of nettle leaves improves blood clotting properties well due to the presence of vitamins K and C in them. To prepare the medicine, you need to pour 1 tablespoon of boiling water into a glass. dry grass (or 5 young leaves). Leave for 30 minutes. It is recommended to drink ¼ cup of this infusion before eating.

These simple homemade recipes will help normalize blood clotting.

Malfunctions the most important system of the body - the hemostatic system designed to protect a person from blood loss - manifest themselves as a blood clotting disorder, that is, pathology of coagulation of protein components of the blood in the event of bleeding.

The ability of blood to clot various reasons may decrease, leading to severe and fatal coagulopathies.

ICD-10 code

D65-D69 Bleeding disorders, purpura and other hemorrhagic conditions

Causes of bleeding disorders

Before highlighting the key causes of blood clotting disorders, it should be recalled that coagulation in the process of stopping bleeding is a complex of complex biochemical processes caused by the influence (and interaction) of almost four dozen physiologically active substances, which are called plasma and platelet blood clotting factors.

In a simplified form, the process of blood clotting upon injury blood vessels can be described as the conversion of the blood protein prothrombin (plasma coagulation factor II) into the enzyme thrombin, under the action of which plasma fibrinogen (a protein produced by the liver, coagulation factor I) is converted into the polymerized fibrous (insoluble) protein fibrin. The action of the enzyme transglutaminase (coagulation factor XIII) stabilizes fibrin, and special (non-nucleated) blood elements - platelets - adhere to its fragments. As a result of platelet aggregation and their adhesion to the vessel wall, a blood clot is formed. It is he who closes the “hole” in the event of a violation of the integrity of the blood vessel.

Pathogenesis

The pathogenesis of deviations in the process of hemocoagulation is directly related to the imbalance of blood clotting factors, since only when they are activated the natural mechanism of formation blood clot and stopping bleeding. No less important factor– the number of platelets in the blood synthesized by bone marrow cells.

The existing classification of bleeding disorders divides them - depending on the etiology - into acquired, genetically determined and congenital, as well as autoimmune.

Causes of bleeding disorders include the following genetic and congenital pathologies:

• hemophilia A (deficiency of antihemophilic globulin - coagulation factor VIII), hemophilia B (deficiency of clotting factor IX) and hemophilia C (deficiency of thromboplastin - factor XI);
• von Willebrand disease (constitutional thrombopathy or von Willebrand-Jurgens syndrome, when there is not enough antihemophilic globulin in the blood);
• thrombocytopenic purpura (Werlhof's disease);
• Glanzmann's hereditary thrombasthenia;
• congenital afibrinogenemia (lack of fibrinogen in the blood) and dysfibrinogenemia (structural defects in fibrinogen molecules).

Symptoms of a bleeding disorder

Typical symptoms Blood clotting disorders in almost all of the pathologies listed above manifest themselves in various combinations and with different intensities.

The first signs are hemorrhagic syndrome - a tendency to bleeding into the skin and subcutaneous tissue, as well as increased bleeding of mucous membranes.

Bleeding can be capillary, hematoma or mixed. Thus, in the case of a deficiency of such blood coagulation factors as prothrombin, proaccelerin, proconvertin, Stewart-Prower factor (with von Willebrand disease, thrombocytopenia or dysfibrinogenemia), small red-violet spots appear on the skin of the legs in the ankle area and on the feet - petechiae (capillary hemorrhages).

If there is a deficiency of antihemophilic globulin, bruises (ecchymoses) constantly appear. Subcutaneous hematomas characteristic of hemophilia, as well as most acquired bleeding disorders, including after long-term use anticoagulant drugs.

In addition, symptoms of bleeding disorders include frequent spontaneous bleeding from the nose, bleeding gums, significant loss of blood during menstruation (menorrhagia), prolonged bleeding even with minor damage to the most small vessels. Frequent redness of the whites of the eyes is possible, and melena (black stool) may also be observed, which indicates bleeding localized in the gastrointestinal tract. In hemophilia, blood flows not only into organ tissues abdominal cavity and muscles, but also into joints (hemarthrosis). This causes necrosis bone tissue a decrease in calcium content and subsequent functional complications of the musculoskeletal system.

Symptoms of thrombosis hemorrhagic syndrome, as well as his possible consequences(which can be fatal) - see Disseminated intravascular coagulation (DIC) syndrome.

Serious complications most coagulation disorders - anemia, which leads to hypoxia of all body tissues, causing general weakness and decline vitality with frequent dizziness and tachycardia.

Diagnosis of bleeding disorders

Clinical diagnosis bleeding disorders begins with a history taking and necessarily includes laboratory tests patients' blood.

The following blood tests are needed:

• general clinical;
• coagulogram (blood clotting time is determined);
• PTT and PTI (prothrombin time and prothrombin index give an idea of ​​the speed of the coagulation process);
• TV (determines thrombin time, that is, the rate of conversion of fibrinogen to fibrin);
• ABC test (determines activated blood clotting time);
• on platelet aggregation with stimulation by adenosine diphosphate (ADP);
• APTT (determines the presence of a deficiency of several plasma coagulation factors);
• for antithrombin III (a blood anticoagulant glycoprotein that inhibits the process of blood clotting).

Can be used instrumental diagnostics(fluoroscopy, ultrasound, MRI) - to determine the condition of the liver, spleen, intestines or brain.

Differential diagnosis

Considering the polyetiology of blood clotting disorders, real opportunity define specific reason coagulopathy and prescribing the correct therapy can only be achieved by differential diagnosis.

Treatment of bleeding disorders

If there is bleeding, treatment of the bleeding disorder requires urgent measures - see Bleeding. Medicines that promote the formation of a blood clot (Fibrinogen, Thrombin) are also used in a hospital setting to stop bleeding.

And therapy for acquired coagulation disorders involves etiological treatment of the diseases that caused them and neutralization of provoking factors.

In many cases, the use of antihemorrhagic and hemostatic drugs is recommended: those that activate the formation of thromboplastin, heparin antagonists, fibrinolysis inhibitors, as well as agents that promote thrombus formation.

Medicines prescribed to stimulate the production of tissue thromboplastin (blood clotting factor III) - Dicynon (other. trade name Etamsylate). This drug used to stop capillary and internal bleeding Available in the form of a solution for injection, and in tablets of 0.5 g for the treatment of blood clotting disorders. The dose is determined by the doctor in accordance with blood counts (usually 0.25-0.5 g two to three times a day), the duration of administration also depends on the diagnosis. Dition gives side effects in the form of headache, nausea, decreased blood pressure, skin hyperemia and impaired sensitivity of the skin on the legs. The drug is contraindicated if increased bleeding and hematomas are the result of taking anticoagulants.

Medicines such as Aminocaproic acid, Tranexam, Ambien, etc., inhibit the dissolution of a blood clot (fibrinolysis). Aminocaproic acid (Epsilon-aminocaproic acid, Acicapron, Afibrin, Karpacid, Carpamol, Epsamon) in tablets of 0.5 g is prescribed orally based on weight, the maximum daily dose should not exceed 15 g. Side effects include dizziness catarrhal symptoms, nausea, diarrhea. At bad work kidneys Aminocaproic acid is contraindicated.

The hemostatic agent Tranescam (tranexamic acid) in tablets of 0.25 g is recommended to be taken for frequent nosebleeds and menorrhagia, two tablets three times a day, but not longer than a week. Side effects and contraindications are similar to the previous drug.

When prescribing treatment for bleeding disorders, a drug containing a vitamin K analogue, Vikasol (Menadione sodium bisulfite, Menadione), is often recommended. Vikasol (15 mg tablets) increases the ability of blood to clot, acting on the production of vitamin K-dependent prothrombin and proconvertin (clotting factors). Dosage of this drug: for adults - 15-30 mg per day (in courses of 3 days with breaks), for children under one year old - 2-5 mg, 1-3 years old - 6 mg, 4-5 years old - 8 mg, 6-10 years - 10 mg.

Vitamins also recommended by hematologists include B9 and B12. Pills folic acid(vitamin B9) should be taken orally after meals - 1-2 mg up to two times a day. Daily dose should not exceed 5 mg, duration of continuous use - no more than a month.

Alternative treatment for bleeding disorders

With this pathology, traditional treatment cannot in any way affect the causes of its occurrence or make “corrections” to the synthesis of plasma and platelet coagulation factors.

Therefore, you can use treatment with herbs that are known for their hemostatic properties: yarrow, shepherd's purse, stinging nettle (leaves), water pepper (pepper knotweed), cuckoo adonis. Water pepper and shepherd's purse contain vitamin K. For the decoction, take a tablespoon of dry herb in a glass of boiling water and cook for 8-10 minutes, infuse and take: water pepper - a tablespoon 3-4 times a day; decoction shepherd's bag- a third of a glass three times a day.

Nettle is also known for its vitamin K content; aqueous infusion of its leaves medicinal plant prepared by pouring a tablespoon of dry raw material into 200 ml of boiling water and leaving for 1-1.5 hours (in a closed container). Take the infusion for bleeding gums, heavy periods, nosebleeds - before meals, one tablespoon 3-4 times a day.

Of all the measures that are usually proposed to prevent the development of certain diseases, almost none can have a positive effect in the case of bleeding disorders. An exception is the prevention of vitamin K deficiency in the body, as well as refusal long-term use medications (anticoagulants, aspirin, NSAIDs) that can reduce blood clotting. And for people with poor clotting ability, it is important to avoid situations that could cause injury and cause bleeding.

The considered bleeding disorders are classified as blood diseases. In domestic medicine there is a concept “ hemorrhagic diseases", as well as "hemorrhagic syndrome", that is, a set of symptoms characterizing conditions in which hemorrhages occur. And specialists from the American Society of Hematology (ASH) identify only hemorrhagic syndrome of newborns associated with a lack of vitamin K (ICD-10 code P53). Obviously, the presence of terminological discrepancies is also typical for this area. clinical medicine, like hematology.

Low clotting blood is observed (decrease in platelet count), acquired thrombocytopathies, deficiency of certain coagulation factors, hypofibrinogenemia. They cause a capillary type of bleeding, which is characterized by hematomas on the skin and mucous membranes, small rashes, nosebleeds, possible cerebral hemorrhages. With an overdose of anticoagulants, a hematoma type of bleeding appears: hemorrhages in the muscles, joints, under the skin, stomach, kidneys, intestinal bleeding, prolonged bleeding due to mechanical damage.

Immune and infectious vasculitis (inflammation of the walls of blood vessels) cause vasculitic purpuric type of bleeding: nephritis, skin rashes, intestinal bleeding. Poor blood clotting occurs with angiomas (tumor), installation of arteriovenous shunts, it manifests itself as an angiomatous type of bleeding: copious, repeated bleeding that does not change location. Deterioration of coagulation is observed in late DIC (impaired coagulation due to massive release of thromboplastic substances from tissues), this condition is a consequence of sepsis, shock, amniotic fluid embolism, premature detachment placenta. Poor blood clotting develops with liver diseases (mainly due to hepatitis), due to acute blood loss.

Today, scientists still argue about what blood is. Some believe that it is an organ, others claim that it is tissue. Despite this controversy, we know that this fluid performs many functions in our body. Like other parts of the body, it can be susceptible to disease. One of serious illnesses is poor blood clotting. What kind of disease is this and what can it develop from? What danger does this disease pose, and are there any measures to prevent this disease?

The danger of the disease and its manifestations

Many people have probably heard about such a disease as hemophilia. This is also a form of poor coagulation ability, however, it is only one of several types of this disease. Low blood clotting carries with it real danger for human life. In fact, no specific blood clot forms with any injury. This can lead to severe blood loss and even death.

Arises this pathology when there is a malfunction in the mechanism of blood clot formation, which causes these red drops to clot healthy people. The blood clotting process consists of several stages and is triggered by the reaction of blood cells with oxygen. More than ten different proteins, cells and microelements are involved in this process.

Each of them performs its own function.

If there is a deficiency of one of the components involved in stopping bleeding, a malfunction occurs and it simply does not stop. People with reduced blood clotting should be careful when carrying out any surgical treatment, and even tooth extraction must take place under special supervision.

Causes of the disease

The causes of poor blood clotting are varied. Today, doctors are inclined to believe that blood coagulation is most often disrupted due to a defect in one of the substances that take part in coagulation. It happens that protein compounds are completely absent from the patient’s analysis or their content is extremely low. This pathology is most often inherited, mainly to boys.

Exactly like this hereditary form poor blood clotting is called hemophilia. You can also highlight following reasons bleeding disorders:

• Reduced blood clotting occurs from a lack of vitamin K.
• Coagulation may be impaired in cancer.
• Any liver pathology prevents normal coagulation.
• Long-term treatment with drugs that reduce clotting.
• A decrease in coagulation is observed with antibiotic therapy.
• Taking substances that prevent blood clotting.
• Chronic anemia.
• Thrombocytopenia.

Symptoms of the disease

Blood clotting disorders usually manifest themselves:

• Subcutaneous hemorrhages. This symptom can be expressed in both pinpoint and extensive subcutaneous effusions.
• Bruises and hematomas. Usually, bruises due to poor coagulation occur with the slightest blow. The patient most often does not notice these impacts, they are so insignificant.
• Bleeding gums and any scratches.
• Frequent nosebleeds that are difficult to stop.

These signs indicate a decrease in the body’s ability to stop bleeding. Children are most susceptible to this pathology. Poor blood coagulation in a child often occurs due to a lack of vitamins, particularly calcium, vitamin K, which has a clotting effect, and iron. At the first symptoms of weakened coagulation, you should consult a doctor. It is necessary that after the examination he prescribes medications to the child that will increase coagulation. However, it must be remembered that in a newborn, coagulation indicators differ significantly from those of adults.

Disease detection

The first step to diagnosis is a doctor interviewing the patient. This stage is necessary to determine the causes of the disease as accurately as possible. The patient must accurately describe his symptoms, when they first appeared and how they progressed.

Using these data, the doctor will determine why the coagulation pathology appeared and prescribe the necessary examinations.

What to do if you have poor blood clotting? Coagulation disorders are diagnosed using biochemical analysis and other studies. Without this research it is simply impossible to identify real reasons incoagulability and prescribe adequate treatment. The test will reveal a deficiency of a vitamin or protein compound that interferes with the normal coagulation process. What is the clotting test called? This study is called a coagulogram. The material for the study is taken from a vein or finger of the patient. Only after this analysis can you begin to treat problems with blood clotting.

As treatment, you may be prescribed vitamin or drug therapy. Treatment medications should only be prescribed by the attending physician. You may also be offered plasma transfusions and other methods in combination with nutritional correction. The treatment schedule should only be drawn up by an experienced specialist who can take into account all the features of your disease.

High coagulation

Along with insufficient coagulation, the opposite disease often occurs - increased coagulability blood. The causes of increased blood clotting are also varied. Increased coagulation is dangerous due to the formation of blood clots, which occur if the plasma suddenly and without reason coagulates inside the vessels, which can lead to blockage of the arteries and fatal outcome. The treatment of this disease is that it is necessary to reduce blood clotting, for this purpose anti-clotting drugs are used.

These drugs are called anticoagulants; these drugs should only be used under the supervision of the attending physician, otherwise the level can be reduced to dangerous condition. Any bleeding disorder should be corrected by a doctor. Active substance Heparin prevents blood clotting.

Increased coagulability in atherosclerosis, arterial hypertension, diabetes mellitus and thrombophilia. This pathology can also develop in women during pregnancy. A rapid clinical effect can be achieved by taking heparin and aspirin. Special cardiac medications also have a clotting-lowering effect. The drugs and their dosage should be determined by the doctor based on the results of the examination.

Prevention of deviations

The main measure to prevent acquired abnormalities in coagulation is the management healthy image life. This concerns primarily the refusal bad habits and balanced nutrition.

Alcohol and nicotine have such a detrimental effect on the composition of plasma that when they are used, in 98 cases out of 100, problems with coagulation arise after just a few years of abuse.

It is also important to eat properly to ensure that the plasma composition remains optimal. Food should contain everything essential vitamins and microelements. Your diet should include as many greens, vegetables, fruits, meat and dairy products as possible. If deviations have already arisen, you can refer to recipes traditional medicine, among which there are both increasing and decreasing plasma viscosity. Apply any recipes traditional treatment only after consultation with a doctor.

Remember that decreased or increased blood clotting can be caused by a variety of causes, and must be treated by a specialist. You should not take medications on your own without a doctor’s prescription, including aspirin. Otherwise, you can quickly move from one state to the opposite, which will cause additional complications. Self-medication can lead to hemorrhages, blood clots and death.