"Heparin" (werohanga): tono, kaiwhakamahi, arotake, horopeta. Ko te whakamahi o werohanga "Heparin" i roto i te hapū

taea ki te pōturi kaha o te toto ki te katinga Drug "Heparin" ko. Tuku kaihoko whāngai i roto i ampules karaihe me oko o 5 ml. Ko ratou otinga injectable, ai te taonga kaha ko 5,000 Iu.

āhuatanga pharmacological

Drug "Heparin" (werohanga) ko te anticoagulant. Ko te taea ki te pōturi te tukanga o te hanganga pūtōtepe, whakaiti i ngā āhuatanga tere te reira o coagulation toto, a i roto i nohanga nui - ki te whakaiti i te mahi o te thrombin. Ahakoa pota iti o te tarukino he nui ki te whakapiki ake i ngā mahi fibrinolytic o toto.

te whakamahi i "Heparin" werohanga ki te whakaiti i te pokey o te tinana matua o te inu koiora. Whakamahi o (te horopeta mo werohia kōwhiria e te rata takitahi) e hāngai ana i runga i te meka e te tikanga tenei kua putu i runga i te endothelium o ngā pūtau toto, me te faarahi to ratou tiaki tōraro. Nā ki tenei taonga heke adhesion me te whakawhāititanga o platelets, leukocytes me erythrocytes.

I tua atu, i te "Heparin" ārai te whanaketanga o te atherosclerosis, he pānga vasodilator anti-mate pāwera, me te ngawari. Ko e tika ana ki te meka e hono ana te reira i te maha o ngā āhuatanga o te pūnaha ngä me whakaiti tona mahi tenei. Ano, ārai te raau taero te hanganga o immunoglobulins, herea lymphocyte co histamine me serotonin.

Tuhinga

Ka rite ki te tikanga whānui, ki te whai koe i raruraru ki upoo- toto whakahau werohanga "Heparin" tarukino. Werohanga whaowhia rō-uaua ranei tūtohutia i roto i enei take:

1) rua hohonu Thrombosis, mate te AVC, Embolism pūkahukahu;

2) infarction myocardial;

3) angina pokarekare;

4) Ko te wāhanga tuatahi o hoki;

5) fibrillation Atrial, haere tahi nei i thromboembolism.

i roto i te hōhipera mō ngā ngā mahi ki te tikanga tohanga extracorporeal taea tautapa tikanga "Heparin" ano. Werohanga pâmuhia subcutaneously ranei, ki te hanga e tika ana toto huhu, tātari toto ki te ārai coagulation o te inu koiora.

Ko te tikanga e whakamahia ana mo te maimoatanga me te ārai o disorders o microcirculation me microthrombogenesis, mo te tauira, Thrombosis o uaua tākihi, lupus pauku, glomerulonephritis, endocarditis kitakita, mate ngakau mitral, syndrome gemolitikouremicheskom.

pānga o te tarukino

Ki te whakaritea koe werohanga "heparin" i roto i te kopu, e mohio ana koutou: ka whai ratou ki te mahi rawa maha. Pānga o te raau taero puta tere, engari ko reira poto. Ko te kupu, ka whakahaere pâmuhia tikanga pōturi upoo- raro tata tonu, te pānga pumau e pā ana ki 4-5 haora. A, no te whakahaere intramuscularly, tona pānga i muri i 15-30 meneti, me pumau mo 6 haora, a ka patia i raro i te kiri kitea te i muri i 40-60 meneti, me te pumau 8 haora. mahi haumanu e hāngai ana te ārai i te hanganga o clots toto, pumau nui roa.

Te faaineineraa "Heparin" faarahi rere toto tākihi, faarahi iaia ātete i roto i te roro, he pānga hypolipidemic. Addition tikanga whakaiti te mahi o te surfactant pūkahukahu inhibits kōtuitanga nui o aldosterone i roto i te uho adrenal, ee faarahi ho'ii kaha PTH mana herea Adrenaline.

whakamahi Āhuatanga

E mea pinepine te iwi e mate ana i te mate ngakau coronary, whakahau "Heparin" (matā). Ko te utu o tenei tarukino te mea tiketike ki etahi. Packaging o 5 ampoules o 5 ml ki te mahi o 5000 Iu ia 1 ml utu 500-600 moni. Ko ki te paopao ki tona tono e taea. I muri i te katoa, i roto i tūroro ki ischemia tikanga "Heparin" whakaiti i te mōrea o te infarction myocardial, Thrombosis te AVC me te mate ohorere. Ano, ko te whakamahi o te raau taero e taea te whakaiti i te tūponotanga o te whakaeke ngakau recurrent, me te tino whakaiti i te ōrau o mate i roto i enei tūroro.

A, no te whakahau Thrombosis venous me Embolism pūkahukahu horopeta teitei "Heparin" faaineineraa. E hanga werohanga (ako taea ki te mahi ki te pehea, ki te hoatu tika ratou) i roto i te tetahi wā o te wā. Ko, he pono reira, i roto i ētahi wā, ki te whiwhi hiahiatia pānga tonu te ki te whakahaere tikanga rō-uaua.

whakahau hoki te tikanga o "Heparin" mo te ārai o ngā thromboembolic, pērā i muri i te pokanga. I roto i tenei take, kua whakaritea te reira i roto i pota iti.

Methods o te whakamahi

Tīpakohia te inenga e hiahiatia ana, me te tikanga o te whakamahi o te raau taero kia tākuta anake, i runga i te huru o te manawanui, me te take he aha me ia tenei tarukino rānei. kia whakahaerea e pâmuhia ai Agent rite te whaowhia tonu ranei werohanga auau. Hoki, i roto i ētahi wā, subcutaneous, kia whakaritea ranei e werohia intramuscular.

Kia kore ai Thrombosis tarukino kia whakahaerea ai subcutaneously ki 1 ml (5000 Iu) rua te ra. I runga i te akiaki o tenei tikanga e piri ki te tarukino "Heparin" ā-ako. Werohanga e te tikanga hanga i roto i te puku, i roto i tona taiepa anterolateral. Ki te mahi i tenei, tangohia te ngira pai, me te wero i te reira hohonu ki te taiepa kiri. Kei te hanga e te reira, no te aki i waenganui i koromatua, me te maihao o te rohe puku i roto i te rohe pito. Me kīnakinaki te werohanga. I roto i te take rawa, ka taea te mahi i te werohanga i roto i te wahi o runga o te huha ringa o runga ranei.

kōwhiringa inenga

Kei te maha hoki ngā take whakaora i roto i ngā o te maimoatanga tūroro noho i roto i te hōhipera i whakaritea e whaowhia rō-uaua. No te tūroro pakeke, te inenga o 1,000 Iu / haora. Otiia i mua i te tāuta maturuturu mō te pānga mōrahi e taea e te reira te tomo i te bolus ki te rua i roto i te nui o 5,000 Iu. whakahaere Tīpakonga o te horopeta tangohia te i roto i te tākuta i runga i te āhuatanga me te taimaha o te manawanui rānei.

Ki te he e kore e taea ki te whakahaere i te whaowhia rō-uaua, kia whakahaerea subcutaneously ai te āpiha: 2 ml o te tarukino (e hāngai ana ki 10000 Iu) 4 wa ia ra. Kei te te tikanga e whakamahia ana te inenga mōrahi faaineineraa ki te 10 nga ra.

tīpakohia te nui e hiahiatia ana o te raau taero e i muri i te hua whakamātautau aro mātai. utua ngā aro te ki te APTT (whakahohe wā thromboplastin wāhanga).

A, no te nga huhu toto kaituku, e te tikanga whakahaere 7.5-10 mano. Iu te tikanga "Heparin".

Therapy i roto i ngā take motuhake

I roto i te infarction myocardial whakapeka whakahaerea tonu 10-15 mano. Iu pâmuhia, ka tona whakamahi tonu o te tātai taua, riro te manawanui e pā ana ki 40 000 Iu i te ra tuatahi, engari kei te tīpako i te inenga tangohia i runga i te taimaha o te manawanui. Ko te tika tenei ki te whakarite i clots toto i roto i te 2.5-3 wa pōturi. Mai i te rua o nga ra heke te horopeta te. He mea nui e ko 1.5-2 wa ki runga ake i te täkupu te wa upoo-. Maimoatanga ki tenei tarukino tonu ki 8 ra. Hei whakakore i te horopeta rā iti e 5-10 mano. Iu, engari te wā i waenganui i werohanga kore e ake i. I muri i te whakakāhoretanga o haere ki nga anticoagulants o autaki mahi. E nehenehe te reira i taua tikanga rite "Fenilin", "neodikumarina" me etahi atu.

titau hoki matua whakapeka tukuna ai venous ranei te huarahi motuhake. Hoki te maimoatanga i whakaritea heparin rō-uaua mō te 3-5 ra i te horopeta o 400-450 Iu ia kg o taimaha manawanui. Ko, he manawanui o te hanga reo me te teitei kia whiwhi i te ra e pā ana ki 30-40 mano. Iu "Heparin" tarukino. Na ka neke i runga i ki te hautanga tona whakataki, engari kua nui haere te inenga ki pā ana ki 600 Iu / kg, ki te werohanga kotahi ki te tinana kia whiwhi 100 Iu / kg. Treatment taea muri ake ki te 16 nga ra. I roto i te torutoru noa ra i mua i te tona nui tarukino withdrawal āta iti. tonu maimoatanga te whakamahi i anticoagulants autaki.

Ara

Ahakoa te meka e kōrero etahi e pā ana ki te taea o te werohia intramuscular o te tarukino, e kore e tūtohu tenei e tika ana ki te meka e i te kanokanototo pae i werohia maha i hanga. Hei whakamahi i te dilutions tarukino 0,9% otinga NaCl.

He mea nui hoki ki te mohio e i roto i te maimoatanga o "Heparin" tikanga e kore te mea e tika ana ki te hanga i tetahi i werohia intramuscular me whekau unuhanga. A, no te whakamahi i te reira, e hiahia ana koe ki te aroturuki i te āhua o te coagulation. I roto i te wiki tuatahi o te therapy, takina toto katoa e rua nga ra, timata mai i te rua i te wiki e taea te mahi i tenei 3 ra.

Ahakoa e kore e nga tikanga, me te tomo ki roto ki te waiu, uma, hohipera i te wa o te maimoatanga, he reira e minaminatia ki te whakamutu. I kitea te reira e arata'i te tarukino i roto i ētahi wā ki te tūkino i te tuaiwi me osteoporosis. timata nga raruraru i muri i 2-4 wiki o te maimoatanga.

Wehe, Ko ia tapao e kia tahuri te otinga tarukino kōwhai reira, engari te mea kahore pānga i runga i ona āhuatanga pharmacological kātakí ranei te tikanga "Heparin". Werohanga, te utu o e taea tino pā te pūtea i roto i meinga ia i roto i pota tiketike, e taea te mahi noa i runga i to ratou ake i te kāinga.

contraindications

Ka rite ki tetahi atu tikanga, e kore koutou e taea e te whakamahi i te tarukino "Heparin" ki te he hypersensitive koe. E kore te whakaritea te reira mo tetahi toto. Okotahi he pakaruhanga toto e puta ka pūkahukahu myocardial (whakahuatia i roto i te puka hemoptysis) tākihi (hematuria tahi) ranei.

ngā ano Contraindications:

- hemorrhagic diathesis me ētahi atu mate i roto i nei upoo- toto waimaero;

- nui haere uruhanga iaia, pērā i te mate Verlgofa;

- endocarditis kitakita ;

- toto i roto i te hītori;

- hypoplastic me anemia aplastic, leukemias ma'i, me te whakapeka;

- nui ate me te tākihi mahi;

- kikohangatia venous;

- te whanaketanga o te aneurysm ngakau whakapeka.

mehua whakatūpato

I tua atu ki contraindications tika, i reira te mea he rārangi o ngā āhuatanga i roto i te mea e tika ana ki te arotake i ngā tūponotanga taea katoa ka tango "Heparin" tarukino. Werohanga me rō-uaua mahi anake i roto i ngā take rawa me te i raro i te mātakitaki o ngā tohunga i roto i te pukupuku, me pāpaka ulcerative o te wahi gastrointestinal, pēhanga toto tiketike, e kulukia me te wā postoperative, ki te kahore hoki angioplasty.

He kupu ruarua e pā ana ki te maimoatanga o te mau metua vahine i mua nei. Ahakoa te meka e te maimoatanga o te wahine i roto i te ara whānau i mua i te tikanga o ia tatou houhou (taea arahi reira ki te whanaketanga o pōauautanga), werohanga "heparin" i roto i te kopu i whakaritea i roto i ētahi wā, i roto i te hapūtanga. Ko te tūponotanga o te takanga o ngā pānga kōaro mai i te 10 ki te 21%. I hoki te hapūtanga tonu te mōrea o pōauautanga he iti iho i te 3.6%.

Me kï reira e he atu mōrearea ki te ora i te fariiraa i te tikanga "Heparin" te mau hopearaa o te thromboembolism taea i roto i te mau metua vahine expectant. Werohanga i roto i te hapū mahi i raro i te tirotiro hauora anake me anake, ki te reira he taunakitanga tino. Ko te raau e taea meinga toto, thrombocytopenia me te osteoporosis. Te auraa ra, e kore e te ewe tomo.

analogs taea me mua manawanui

E mea pinepine te hunga e whakaritea tarukino "Heparin" (werohanga i roto i te kopu), te mea tiketike rawa te utu. Otira, ka oti te whakamahia te reira rite te mehua ārai, kia rato 1 mōkihi mo te torutoru nga ra. Na, ko te tākai i ai nga ipu 5, kia nui hoki o wiki i te tokorua. whakamahia te faaineineraa nui-horopeta te nuinga o te wā e kore ake atu i te 10-14 ra.

Otiia, e hiahia ana nga iwi maha ki te ako i ētahi atu tūroro, he mea utu hoko i te rongoā, e rapu ratou mo "Heparin" faaineineraa o arotake. Analogues o te tarukino hoki e hiahia ratou. Na, ki te mea i reira e raruraru ki te upoo- toto, ko te tino whai hua te taputapu, me te taea ki a koe te whakatutuki i te pānga haumanu hiahiatia rawa hohoro. whakapumautia tenei e rua rata me ratou tūroro.

Otiia hei utu kia hoki whakarite reira anticoagulants "Troparin", "Heparin Sandoz", "Heparin Sodium Brown", "Heparin-Verein" me ētahi atu analogs. kia whiriwhiri anake te inenga o enei taero he tākuta e hāngai ana i runga i nga hua o tätari o te manawanui, te āhua o tona hauora me te tohu mo i whakaritea te tarukino te.

I roto i ētahi wā, tūtohu tākuta iti heparins taimaha rāpoi, pērā i "Fraksiparin", "Fragmin", "Tsibor", "Eniksum", "Fraksiparin nōna." Ratou pānga, rite kitea e nga whakautu o tūroro, tata te taua rite e o te tarukino i mua ia tatou.