"Heparin" (jakisoni): ntchito, wosuta, ndemanga, mlingo. Kugwiritsa ntchito jakisoni "Heparin" pa mimba

Mankhwala "Heparin" amatha m'mbuyo luso magazi kuti aumirira. Kutulutsa mankhwala wothandizila mu ampules galasi ndi mbale ya 5 ml. Iwo injectable njira, mmene mankhwala yogwira ndi 5,000 IU.

katundu pharmacological

Mankhwala "Heparin" (jakisoni) ndi anticoagulant. Iwo amatha msanga ndondomeko mapangidwe Ulimbo, kuchepetsa zinthu liwiro la coagulation magazi, ndi woipa lalikulu - kuchepetsa ntchito ya thrombin. Ngakhale Mlingo ka mankhwala yokwanira kuonjezera ntchito fibrinolytic magazi.

ntchito "Heparin" jakisoni kuchepetsa kukhuthala kwa thupi yaikulu ya madzimadzi kwachilengedwenso. Ntchito (mlingo jekeseni amasankha dokotala payekha) zochokera mfundo zimenezi zikutanthauza ndi anasonkhanitsa pa endothelium wa maselo a mwazi ndi kuonjezera akuwayang'anira negative. Chifukwa chuma ichi amachepetsa guluu wolimba ndi loitanirana ya maselo othandiza magazi kuundana, leukocytes ndi erythrocytes.

Komanso, "Heparin" kumathandiza chitukuko cha atherosclerosis, ali wotsutsa-matupi awo sagwirizana ndi wofatsa vasodilator kwenikweni. Ichi ndi chifukwa chakuti umagwirizanitsa pali zinthu za dongosolo womuyenerera ndipo kumachepetsa ntchito zake. Komanso, mankhwala kumathandiza mapangidwe immunoglobulins, lymphocyte Co chimamanga histamine ndi serotonin.

zikuonetsa

Tinganene, ngati muli mavuto ndi clotting magazi jakisoni "Heparin" mankhwala. Majekeseni kapena mtsempha kulowetsedwa bwino mu milandu:

1) kwambiri mtsempha thrombosis, inatsekeratu mtsempha wamagazi matenda, embolism m'mapapo mwanga;

2) m'mnyewa wamtima infarction;

3) angina wosakhazikika;

4) The gawo loyamba la DIC;

5) matenda fibrillation, amene anatsagana ndi thromboembolism.

Komanso mu zipatala chifukwa ntchito ndi njira extracorporeal makope akhoza perekani amatanthauza "Heparin". Majekeseni m'nsinga kapena subcutaneously, ngati n'koyenera wodzipangitsa magazi, hemodialysis kuteteza coagulation wa madzimadzi kwachilengedwenso.

Njira ntchito kwa mankhwala ndi kupewa matenda a microcirculation ndi microthrombogenesis Mwachitsanzo, thrombosis ya mitsempha aimpso, lupus nephritis, glomerulonephritis, endocarditis bakiteriya, matenda mitral mtima, gemolitikouremicheskom syndrome.

zotsatira za mankhwala

Ngati muli Kwalamulidwa jakisoni "heparin" mmimba, inu mukudziwa, iwo adzayenera kuchita zambiri. Mmene mankhwala kumachitika mofulumira, koma yochepa. Choncho, pamene kutumikiridwa m'nsinga zikutanthauza clotting kubweza pasanapite nthawi, mmene kumatenga za 4-5 maola. Pamene kutumikiridwa intramuscularly, zotsatira zake pambuyo Mphindi 15-30 ndi kumatenga maola 6, ndipo pamene jekeseni pansi pakhungu zimawonedwa pambuyo Mphindi 40-60 zimatha maola 8. kanthu achire umalimbana kuteteza mapangidwe magazi kuundana, limapitirira kwambiri.

Kukonzekera "Heparin" kumawonjezera aimpso magazi, kumaonjezera mtima kukana mu ubongo, lili ndi zotsatira hypolipidemic. Kuwonjezera zikutanthauza amachepetsa ntchito surfactant m'mapapo mwanga kumabwezera mmbuyo kaphatikizidwe kwambiri a aldosterone mu kotekisi adrenal, amakulitsa yogwira chikoka PTH chimamanga zikuwonjezereka masiku ano.

ntchito Features

Nthawi zambiri anthu odwala matenda a mitima, mankhwala "Heparin" (akatemera). Mtengo wa mankhwala zikuwoneka mkulu ena. Kenaka 5 ampoules a 5 ml ndi ntchito za 5000 IU pa 1 ml ndalama 500-600 rubles. Koma kukana tanthauzo lake ndi zosatheka. Ndipotu, odwala ndi ischemia amatanthauza "Heparin" amachepetsa chiopsezo infarction m'mnyewa wamtima, thrombosis inatsekeratu mtsempha wamagazi ndi imfa yadzidzidzi. Komanso, kugwiritsa ntchito mankhwala akhoza kuchepetsa Mwina kuukira kobwereza mtima ndi kuchepetsa kuchuluka kwa imfa odwala awa.

Pamene venous thrombosis ndi embolism m'mapapo mwanga mankhwala mkulu mlingo "Heparin" kukonzekera. Majekeseni (malangizo zimathandiza kuthana ndi momwe bwino kuziika) anapangidwa nthawi zina za nthawi. Koma, izo nzoona, zina, kupeza zotsatira msanga adafuna kupereka njira mtsempha.

Komanso mankhwala njira "Heparin" chifukwa kupewa zochitika thromboembolic, monga pambuyo opaleshoni. Mu nkhani iyi, Kwalamulidwa pa mlingo yaing'ono.

Njira ntchito

Sankhani mlingo chofunika ndi njira ntchito mankhwala ayenera dokotala yekha, malingana ndi mmene alili ndi zifukwa amafunika mankhwala. Mtumiki akhoza kutumikiridwa m'nsinga monga kulowetsedwa mosalekeza kapena jakisoni zonse. Komanso, nthawi zina, subcutaneous, kapena kuikidwa jekeseni mu mnofu.

Pofuna kupewa thrombosis mankhwala akhoza kutumikiridwa subcutaneously ndi 1 ml (5000 IU) kawiri pa tsiku. Pa kufunika kutanthauzira izi Ufumuyo mankhwala "Heparin" malangizo Buku. Majekeseni amakhalabe m'mimba mwa mpanda wake anterolateral. Kuti tichite zimenezi, kutenga singano chabwino ndi andibaye mwakuya mu khola khungu. Iwo aumbike pamene mbamuikha pakati chala ndi mkombaphala m'dera m'mimba m'dera m'michombo. Jekeseni ayenera alternated. Nthawi yapadera, jakisoni wa zikhoza kuchitika mu kumtunda kwa ntchafu kapena mkono chapamwamba.

mlingo kusankha

Zolinga achire mawu a chithandizo inpatient mu zipatala nthawi zambiri zotchulidwa mu mtsempha kulowetsedwa. Kwa odwala wamkulu, mlingo wa 1,000 IU / ola. Koma pamaso khazikitsa kukapanda kuleka kwa zotsatira pazipita akhoza kulowa bolus mu mtsempha kuchuluka kwa 5,000 IU. Kusankha mlingo enieni ndi kutumikiridwa mu dokotala malinga ndi vuto ndi kulemera kwa wodwalayo.

Ngati ndi kosatheka kuti kuchititsa kulowetsedwa mtsempha, wothandizila mwina kutumikiridwa subcutaneously: 2 ml ya mankhwala (Chofanana 10000 IU) Nthawi 4 pa tsiku. Mlingo pazipita amagwiritsidwa ntchito yokonza masiku 10.

Kuchuluka chofunika mankhwala amusankha pambuyo zotsatira kuwunika mayeso. chidwi linaperekedwa kwa APTT (adamulowetsa tsankho thromboplastin nthawi).

Pamene magazi mwiniwake, zambiri kutumikiridwa 7.5-10 zikwi. IU amatanthauza "Heparin".

Therapy milandu wapadera

Mu pachimake m'mnyewa wamtima infarction yomweyo kutumikiridwa 10-15 zikwi. IU m'nsinga, ndiye ntchito anapitirizabe aziwerenga zimenezi, mtima analandira 40 000 IU pa tsiku loyamba, koma mlingo enieni amusankha malinga ndi kulemera kwa wodwalayo. Izi ndi zofunika kuonetsetsa kuti magazi kuundana mu nthawi 2.5-3 pang'onopang'ono. Kuchokera tsiku lachiwiri mlingo yafupika. Nkofunika kuti nthawi clotting nthawi 1.5-2 kuposa mwakale. Chithandizo ndi mankhwala akupitiriza masiku 8. Kuletsa mlingo tsiku yafupika ndi 5-10 zikwi. IU, koma intervals pakati jekeseni musati kuwonjezera. Pambuyo chiyembekezo chakuti ya chiphaso kwa anticoagulants wa mozungulira kanthu. Zimakhala njira monga "Fenilin", "neodikumarina" ndi ena.

Pachimake wolumikizira kapena kutsekeka venous imafunanso njira yapadera. Zochizira zotchulidwa mu mtsempha heparin kwa masiku 3-5 pa mlingo wa 400-450 IU pa makilogalamu kulemera mtima. Ndiye kuti, ndi mtima wa kumanga sing'anga ndi kutalika ayenera kupeza tsiku za 30-40 zikwi. IU "Heparin" mankhwala. Pite ku fractional oyamba ake, koma mlingo wake ndi kuchuluka kwa pafupifupi 600 IU / kg, ndi jekeseni limodzi mu thupi ayenera 100 IU / kg. Chithandizo ukhoza kwa masiku 16. Mu masiku ochepa kale kuchuluka achire mankhwala pang'ono ndi pang'ono yafupika. Chithandizo ikupitirira ntchito anticoagulants zina.

Kusamala

Ngakhale kuti ena kulankhula zokhuza kuthekera mu mnofu jekeseni wa mankhwala, izi osavomerezeka chifukwa chakuti pa jekeseni malo hematoma zambiri anapanga. Ntchito dilutions mankhwala 0,9% NaCl njira.

Ndi kofunika kudziwa kuti pamene mankhwalawa "Heparin" amatanthauza si koyenera kuti jekeseni aliyense mu mnofu ndi ziwalo biopsy. Pamene ntchito, muyenera kuwayang'anira boma la coagulation. Mlungu woyamba wa mankhwala magazi kufufuzidwa aliyense masiku awiri, kuyambira sabata chachiwiri n'zotheka masiku 3.

Ngakhale njira ndi chiyani mkatikati mu mkaka wa m'mawere, mkaka wa m'mawere nthawi ya chithandizo, ndi zofunika kutsirizitsa. Anapeza kuti mankhwala kumabweretsa zina kuwononga msana ndi kufooka kwa mafupa. mavuto anayamba pambuyo masabata 2-4 mankhwala.

Payokha, ndi Dziwani kuti njira mankhwala usiye chikasu, koma alibe mphamvu pa katundu pharmacological kapena kulolera kumatanthauza "Heparin". Majekeseni, mtengo umene akhoza kwambiri bwanji bajeti mu anamuika mu mlingo waukulu, zikhoza kuchitika ngakhale pa awo kunyumba.

contraindications

Ngati njira ina iliyonse, simungathe ntchito mankhwala "Heparin" ngati ndinu hypersensitive. Si analamula kuti magazi alionse. Kuchotserapo ndi kukha magazi zimene zimachitika pamene m'mnyewa wamtima m'mapapo (anafotokoza mu mawonekedwe hemoptysis) kapena impso (limodzi hematuria).

Contraindications mulinso:

- hemorrhagic diathesis ndi matenda ena omwe mkhutu magazi clotting;

- kuchuluka mtima permeability, monga matenda Verlgofa;

- endocarditis bakiteriya ;

- magazi m'mbiri;

- hypoplastic ndi aplastic magazi, aakulu ndi pachimake leukemias;

- aakulu chiwindi ndi impso ntchito;

- venous chilonda;

- chitukuko cha mtima aneurysm pachimake.

kusamala

Kuwonjezera contraindications mwachindunji, pali mndandanda wa zinthu zimene m'pofunika kupenda mavuto n'kotheka pamene mukumwa "Heparin" mankhwala. Majekeseni ndi mtsempha kuchita pokha pokha wosiyana ndi kuyang'aniridwa ndi akatswiri mu zotupa ndi zotupa anam'peza wa kapepalako m'mimba, kuthamanga kwa magazi, postpartum ndi postoperative nthawi, kupatula angioplasty.

mawu ochepa za mankhwala a amayi m'tsogolo. Ngakhale kuti mankhwala a akazi m'njira banja patsogolo pathu zikutanthauza oipa (kuti akhoza kuchita chitukuko cha mavuto), jakisoni "heparin" mmimba Kwalamulidwa zina, pa mimba. Mwina wa zosayembekezereka ya mavuto kuyambira 10 mpaka 21%. Ngakhale kuti mimba yachibadwa chiopsezo cha matenda oyamba ndi zosakwana 3.6%.

Tikumbukenso kuti mavuto a thromboembolism n'zotheka amayi oyembekezera ndi owopsa kwambiri kwa moyo kuposa kulandira amatanthauza "Heparin". Majekeseni pa mimba kuchita kokha moyang'aniridwa ndi achipatala ndi pokhapokha ngati pali umboni mtheradi. Koma mankhwala zingachititse magazi, thrombocytopenia ndi kufooka kwa mafupa. Zikutanthauza latuluka Kodi mkatikati.

analogs zotheka ndi umboni mtima

Nthawi zambiri anthu amene amaikidwa mankhwala "Heparin" (jakisoni m'mimba), mtengo zikuwoneka kwambiri. Koma pamene ntchito ngati muyeso njira, 1 phukusi kungakhale kokwanira kwa masiku angapo. Choncho, ma CD imene mabotolo 5, wokwanira kwa masabata. A kukonzekera apamwamba mlingo ntchito zambiri palibe masiku kuposa 10-14.

Komabe, anthu ambiri amafuna kuphunzira kwa anthu odwala, ndi bwino kugula mankhwala, akufunafuna "Heparin" yokonza ndemanga. Analogues wa mankhwala iwonso ali ndi chidwi. Choncho, ngati pali mavuto ndi clotting magazi, chida othandiza kwambiri ndipo amalola kuti tikwaniritse kufunika kwenikweni achire mwamsanga. Izi zikutsimikiziridwa ndi madokotala ndi odwala awo.

Koma m'malo mwina akulu anticoagulants "Troparin", "Heparin Sandoz", "Heparin Sodium Brown", "Heparin-Verein" ndi analogs ena. Mlingo wa mankhwala ayenera kusankha dokotala potengera zotsatira za kufufuza wodwalayo, ukupeza wake ndi zizindikiro zimene mankhwala Kwalamulidwa.

Nthawi zina, madokotala amalangiza otsika maselo kulemera heparins, monga "Fraksiparin", "Fragmin", "Tsibor", "Eniksum", "Fraksiparin forte." mmene, monga zatsimikiziridwa mwa mayankho odwala, pafupifupi zofanana ndi za mankhwala pamaso pathu.