Kukho inani labagcini begazi abasetyenziswa rhoqo, kuquka i-heparin.
I-Heparin yipilisi esetyenziselwa ukuthintela ukwakheka kwegazi. I-Heparin inokunikezwa ngqo ngqo kwigazi, okanye njengenjenge phantsi kwesikhumba. Akukho ndlela yomlomo (ngomlomo) ye-heparin ifumaneka, kwaye yesoko isetyenziselwa kwisilwanyana esibhedlele.
Uphi iHeparin esetyenziselwa esibhedlele?
I-Heparin ivimbela ukwakheka kwegazi .
Ngezantsi ezinye zezizathu eziqhelekileyo ze- heparin zisetyenzisiweyo.
- Ukuthintela ukwakheka kwamacandelo egazi angenza njengengxaki yokuhlala embhedeni ixesha elide . I-doparin ephantsi yemihla ngemihla ye-heparin ijojowe phantsi kwesikhumba inokusinceda ukubunjwa kweembandezelo ezinzulu (DVTs) kwiimvini ezinzulu zemilenze, iintamo kunye neentsimbi. I-DVTs inokubangela ukuba izibetho kunye ne- pulmary embolism (PE) ezinokuthi zisongele ubomi
- Ukuphatha izibilini zamapulmoni: Izibilini zepulmonary zi- clots zegazi ezifudukela emiphakeni evela entliziyweni, okanye kwi-system ye-venous deep body. Ngenye emaphapheni, izibilini zamapulmoni zingavimbela ukuhamba kwegazi ukuya kwiindawo ezinkulu zompompo kwaye zikhusele i-oksijeni-ihlwempuzekileyo, igazi elingenayo i-venous ukuba lizaliswe nge-oksijini. Njengoko kuchazwe ngaphambili, ii-PE zingabungozi bokuphila.
- Ukuthintela ukwandiswa kweengcambu zegazi eziphezulu ezifunyenwe ngaphakathi kwintliziyo, kunye nezinye iinxalenye zomzimba, njengoko zinokubangela ukugqithiswa kwempompo okanye imivimbo.
- Ukuthintela ukwakheka kwamacandelo egazi ngexesha lokuhlinzwa kwentliziyo, okanye ngexesha lotyando lweetriyeri ezinkulu.
I-Heparin iyasetyenziswa nini ukuphatha iSroroke?
I-Heparin nayo isetyenziselwa ukuphatha izibetho ezibangelwa ngamacwecwe egazi.
Ezinye zeemeko ezibonisa ngokucacileyo ukuba uhlangothi oluthatywayo ludibene ne-clot yegazi lubandakanya:
- I-carotid okanye i-versebral dissection
- I-sinural thrombosis
- Xa umntu onesifo esine-stroke ene-ultrasound ibonisa intsholongwane enzulu
- Xa umntu ophethe isigulane sogulane naye unesibindi sokuphefumula
- Xa uvavanyo lwe-carotid doppler lubonisa ukuba i-clot yegazi ifumaneka ngaphakathi kwe- artery carotid , okanye i-echocardiogram ibonisa i-clot igazi ngaphakathi entliziyweni.
Intravenous Heparin Dosage
Ngokungafani nemithi amaninzi, umthamo we-heparin kufuneka ukhethwe ngokwemiqathango yokuhlolwa kwegazi ebizwa ngokuba yi-thromboplastin ngexesha okanye iPTT. Emva kokuba kuqaliswe ukunyuka kwe-heparin enomngcipheko, i-doparin yayo ihlaziywa nganye iiyure ezine ukuya kweyesi-6 ukuze kuqinisekiswe ukuba igazi alibi kakhulu kangangokuba umntu uphatha umngcipheko wokuphuma ngegazi.
Ngokomyinge, iiproprotocol ezininzi zonyango ze-heparin zibiza ixesha elilodwa "i-bolus injection" ye-heparin elandelwa ukunyuka okuthe ngcipheko kwe dose ukuya kwi-PTT ephindwe kabini ixabiso eliqhelekileyo.
Ngenxa yokuba ayikho ifomu yomlomo yalo myeza, i-heparin kufuneka imiswe ngaphambi kokuba umntu ashiye esibhedlele. Abantu abadinga unyango lwexesha elide kunye nabagcini begazi abaqhelekileyo baqeshwe i- coumadin, elinye igazi elinamandla elincinci elitholakala kwifom yephepha.
I-Coumadin iqaliswa ngelixa umntu esasifumana i-heparin engena-intravenous, kodwa emva kokuba iimvavanyo zegazi zibonisa ukuba igazi le-coumadin luchukumisa umbane lanele, i-heparin inokumiswa.
Oku kwenziwa ngenxa yokuba i-coumadin ingathatha iiyure ezingama-72 ngaphambi kokuba ifumaneke.
Iimpembelelo ze-Heparin
Igalelo eliphambili le-heparin liphuma. Ngenxa yoko, kubalulekile ukuba oogqirha balandele ukubala kwegazi xa abantu bephathwa nge-heparin engenangqungquthela ukuze kuqinisekiswe ukuba ukubala kwegazi kuhlala kuzinzile ngexesha lotyando. Ukuphuma ngegazi ngokukhawuleza kunokuvela kwiindawo eziliqela emzimbeni kuquka:
- Amanxeba avulekileyo okanye ii-sites eziqeshwe
- Isisu kunye namathumbu
- Isibeleko kunye namaqanda
- Iintlobo kunye nomlomo
Kwiimeko zokuphuma kwegazi ngenxa yonyango lwe-heparin, unyango olubizwa ngokuba yi-protamine sulphate lunokunikezwa kwangaphakathi ukuze luthintele umonakalo wegazi we-heparin.
Kwiimeko zokupheliswa kwegazi olukhuselekileyo kufuneka ukuba kufakwe igazi.
Omnye umphumo osisigxina we-heparin yimeko eyaziwayo njenge-heparin-induced thrombocytopenia (i-HIT). Kule meko i-heparin inokunyusa umzimba womzimba ukuphuhlisa izixhobo zokulwa neeplatelet zayo. Ukususela kwinqanaba eliqhelekileyo leeplatelets lifunwa ngumzimba ukukhusela ukuphuma kwamanzi, iqondo eliphantsi leeplatelet libeka abantu engozini yokuphuma kwamanzi. Ngokuxhomekeka, le meko efanayo ingakhokelela ekuveleni okungafanelekanga nokuzenzekelayo kwamanzi amaninzi, anokuthintela ukuhamba kwegazi kwiimitha zegazi ezibalulekileyo kunye nokulimaza iintso, ulusu, kunye nengqondo, phakathi kwezinye izitho.
ILizwi
I-Heparin yinyango emele igcinwe kwisantya esekelwe kwimpendulo yomzimba kwisenzo esincinci segazi. Oku kudinga ukulandelelana okufutshane kunye neemvavanyo zegazi ezingakwazi ukulinganisa umphumo we-heparin ukuqinisekisa ukuba isenzo sigcinwe ngaphakathi kwefestile yokwelapha.
Ukuba ufanele ufumane unyango nge-heparin, mhlawumbi uya kutshintshela kwelinye igazi elincinci ixesha elide.
Fumana malunga nabanye abacebisi begazi kunye neempembelelo zabo .
> Imithombo
> Iziphazamiso eziphindaphindiweyo ze-ischemic kwisigulane esinomdlavuza: ngaba kukho inxaxheba ekuqalisweni kwonyango lwe-antiticoagulation kwisithintelo sokukhuselwa kwesibini? I-Suero-Abreu GA, i-Cheng JZ, i-RK, i-BMJ I-Rep Rep. 2017 Juni 3; 2017. i-pii: bcr-2016-218105.