"LweeHedfowuni" (iinaliti): isicelo, umsebenzisi, ncomo, umthamo. Ukusetyenziswa lwezitofu "lweeHedfowuni" ngexesha lokukhulelwa

Drug "lweeHedfowuni" uyakwazi ukwehlisa ukukwazi igazi ukuba ihlwili. Ukukhupha arhente sonyango e ampules iglasi nengqayi ye ml-5. Ba isisombululo injectable, apho into esebenzayo ngu 5,000 IU.

iipropati kwemithi

Drug "lweeHedfowuni" (iinaliti) kuyinto anticoagulant. Oku uyakwazi ukwehlisa inkqubo ukubunjwa fibrin, ukwehlisa izinto isantya of coagulation igazi, yaye zoqhaphelo olukhulu - ukunciphisa umsebenzi thrombin. Nkqu iingedosi ezincinane beziyobisi kwanele ukwandisa umsebenzi fibrinolytic igazi.

ngokusebenzisa "lweeHedfowuni" iinaliti ukuze ukunciphisa viscosity na umzimba omkhulu kulwelo eziphilayo. Ukusetyenziswa (uwadle inaliti ukhetha ugqirha ngamnye) isekelwe kwinto yokuba oku kuthetha okongezeleke kwi endothelium iiseli zegazi kwandisa isigxina zabo ezimbi. Ngenxa kule propati liyancipha adhesion kunye udibaniso lwe zegazi, leukocytes kunye erythrocytes.

Ukongeza, i "lweeHedfowuni" ithintela uphuhliso yegazi, ngandlela vasodilator anti-komzimba kunye nowobulali. Oku kungenxa yokuba aba linani leziqalelo kwenkqubo ngumphelelisi kwaye kunciphise umsebenzi wayo. Kwakhona, ichiza luthintela ukuyilwa immunoglobulins, lymphocyte co ubophelela histamine kunye serotonin.

Ubungqina obubonakalayo buxela

Njengomthetho jikelele, ukuba uneengxaki igazi ekunqandeni isitofu "lweeHedfowuni" iziyobisi. Izitofu okanye ukumnika efakwa kucetyiswa kwezi meko:

1) umthambo nzulu thrombosis, isifo kwemithambo, Embolism pulmonary;

2) iposi engabalulekanga;

3) .â € Uxhaphazelayo;

4) Isigaba sokuqala DIC;

5) fibrillation atrial, nto leyo sikhatshwa thromboembolism.

Kwakhona kwizibhedlele ngenxa imisebenzi kunye ubuchule ejikeleza extracorporeal nga ukwabela lithetha "lweeHedfowuni". Izitofu yegazi okanye kwesikhumba, ukuba kuyimfuneko kukwenza ukutofelwa igazi, ihaemodialysis ukuthintela coagulation ye kulwelo eziphilayo.

Indlela ezisetyenziselwa unyango kunye nothintelo ukuphazamiseka of microcirculation kunye microthrombogenesis, umzekelo, thrombosis of imithambo kwezintso, lupus nephritis, glomerulonephritis, endocarditis ziibhakteriya, isifo sentliziyo mitral, gemolitikouremicheskom syndrome.

ukusebenza beziyobisi

Ukuba emiselweyo iinaliti "lweeHedfowuni" esiswini, uyazi, ukuba kuya kufuneka ukuba benze njalo. Isiphumo ichiza kwenzeka ngokukhawuleza, kodwa mfutshane. Ngoko, xa elawulwa yegazi kuthetha ekunqandeni imenza phantse nangoko, isiphumo ithatha malunga 4-5 iiyure. Xa ufakwe intramuscularly, isiphumo sayo emva kwemizuzu 15-30 kwaye ithatha iiyure ezi-6, yaye xa ngokuzitofela phantsi kwesikhumba emsebenzini emva kwemizuzu 40-60 kwaye sihlala iiyure ezisi-8. amanyathelo therapeutic ezijolise ekuthinteleni ukuyilwa amahlwili egazi, ithatha ixesha elide kakhulu.

Ukulungiselela "lweeHedfowuni" kwandisa kakuhle kwezintso flow igazi, kwandisa uxhathiso imithambo ebuchotsheni, ngandlela hypolipidemic. Ukudibanisa kuthetha kunciphisa umsebenzi lunezinto yemiphunga abangaphangeliyo kuyondelelaniswe ngokugqithisileyo aldosterone kwi neuron adrenal, inyusa esebenzayo impembelelo PTH lubopha adrenaline.

ukusebenzisa Iimpawu

Ngokuqhelekileyo abantu abaphethwe isifo sentliziyo, ukumisela "lweeHedfowuni" (kuqhume). Ixabiso eli chiza kubonakala phezulu abanye. Packaging of ampoules 5 ml 5 umsebenzi ka-5000 IU nganye-1 Ml malini 500-600 engange. Kodwa ukwala isicelo yayo akunakwenzeka. Ngapha koko, xa izigulane ischemia lithetha "lweeHedfowuni" lunciphisa ubungozi iposi engabalulekanga, Uqhaqho kwimithambo thrombosis nokufa ngesiquphe. Ngaphezu koko, ukusetyenziswa kweziyobisi kunciphisa amathuba isifo sentliziyo nezolo kwaye ziyakwehlisa ngokubonakalayo ipesenti yokufa kwezi izigulane.

Xa thrombosis lwemithambo kunye Embolism pulmonary ukumisela ukulungiselela idosi eliphezulu "lweeHedfowuni". Iinaliti (umyalelo ivumela ukujongana kunye nendlela ukubeka kakuhle kuzo) yenziwa ixesha elithile. Kodwa ke, ibe yinyaniso, kwezinye iimeko, ukuze ufumane isiphumo ngokukhawuleza ayinqwenelayo ukuba alawule iindlela efakwa.

Kwakhona ukumisela njengendlela "lweeHedfowuni" yokuthintela iziganeko thromboembolic, ezifana emva kotyando. Kulo mzekelo, oko kumiselwe ngeedosi ezincinane.

Indlela yokusebenzisa

Khetha umthamo efunekayo kunye nendlela ukusetyenziswa ichiza kufuneka ugqirha kuphela, ngokuxhomekeka imeko yomguli kunye nezizathu zokuba kufuneka eli chiza. Agent linokwenziwa yegazi ibe nokubandakanywa eqhubekayo okanye iinaliti rhoqo. Kwakhona, kwezinye iimeko, ongama, okanye banokuthi banyulwe ngenaliti intramuscular.

Ukuthintela thrombosis neziyobisi linokwenziwa kwesikhumba kunye ml 1 (5000 IU) kabini ngemini. Ngomhla imfuneko yale ngentetho iqhotyoshelwe ichiza "lweeHedfowuni" umyalelo manual. Iinaliti ngokuqhelekileyo yenziwa esiswini, eseludongeni yayo anterolateral. Ukuze wenze oku, thatha inaliti ocoliweyo, bafake kuyo nzulu esibayeni esikhumbeni. Oku kwenziwa xa licinezelwe phakathi lobhontsi Uvalo kwingingqi isisu kwindawo luwise inkaba. Le Inaliti kufuneka mzuzu. Kwiimeko ezizodwa kakhulu, izitofu kungenziwa kwinxalenye engentla ethangeni okanye ingalo eliphezulu.

Ukukhetha balawule

Ukulungiselela iinjongo zonyango ngokwemiqathango unyango izigulane ezibhedlele basoloko emiselweyo ukumnika efakwa. Izigulane abadala, esithathwa ka-1,000 IU / ngeyure. Kodwa ngaphambi kokuba kokufaka idriphu ye kangangoko ngayo ukungena bolus emthanjeni xa isixa-mali ka-5000 IU. Ukukhethwa ithamo ngqo ibhalwa ugqirha kuxhomekeka kwimeko kwaye ubunzima yesigulane.

Ukuba akunakwenzeka ukuba aqhube iimela efakwa, i-arhente linokwenziwa kwesikhumba: ml 2 ichiza (kufanekisela 10000 IU) amaxesha-4 ngosuku. Idosi iphezulu jikelele kusetyenziswa amalungiselelo iintsuku ezili-10.

Imali efunekayo ichiza ekhethiweyo emva kokuba iziphumo zovavanyo zovavanyo. ingqalelo ekhethekileyo ihlawulwe APTT (iyasebenza ixesha thromboplastin akakhethi).

Xa ukutofelwa igazi, zoshwankathelo zilawulwe ngokuqhelekileyo amawaka 7.5-10. IU lithetha "lweeHedfowuni".

Therapy kwiimeko ezizodwa

Xa iqhosha elibukhali engabalulekanga ezilawulwa nangoko 10-15 amawaka. IU butofelwe, ngoko ukusetyenziswa kwayo ngayo ubalo enjalo, isigulane wafumana 40 000 IU ngosuku lokuqala, kodwa idosi ngqo ikhethiwe kuxhomekeke ubunzima yesigulane. Oku kuyimfuneko ukuqinisekisa ukuba egazi igazi ngamaxesha 2.5-3 kancinci. Ukususela ngosuku lwesibini ithamo lifinyele. Kubalulekile ukuba ixesha ekunqandeni ngokuphindwe 1.5-2 ngaphezu eqhelekileyo. Unyango nalo eli chiza kuqhubeka iintsuku-8. Ukuphelisa idosi yemihla ngemihla kuncitshiswa yi 5-10 amawaka. IU, kodwa ekhefu phakathi izitofu musa ukwandisa. Emva ukupheliswa okuphumelela anticoagulants of ngqo amanyathelo. Kusenokuba iindlela ezifana "Fenilin", "neodikumarina" kunye nabanye.

emithanjeni Acute okanye isithintelo lwemithambo nazo zifuna indlela ethile ekhethekileyo. Kuba unyango emiselweyo lweeHedfowuni efakwa iintsuku 3-5 kwi ne nedosi ye-400-450 IU kg ubunzima isiguli ngasinye. Oko kukuthi, isigulane esiphakathi kunye ukuphakama kufuneka afumane usuku malunga 30-40 amawaka IU "lweeHedfowuni" iziyobisi.. Emva koko ugqithele iqhezu ingenisiwe, kodwa idosi inyuswe ukuya malunga 600 IU / kg, kunye inaliti ezingoononye ukuze umzimba kufuneka afumane 100 IU / kg. Unyango unokuthatha ukuya kwiintsuku ezili-16. Kwiintsuku nje ezimbalwa ngaphambi kokuba imali yakhe Nhoza ichiza kancane kancane. Unyango ke waqhubeka esebenzisa anticoagulants ngqo.

oyi

Nangona abanye bethetha ithuba isitofu intramuscular beziyobisi, oku ayikhuthazwa ngenxa yokuba xa hematoma inaliti rhoqo ukusekwa. Ukuze usebenzise dilutions ichiza 0,9% NaCl isisombululo.

Kwakhona kubalulekile ukwazi ukuba ngexesha unyango "lweeHedfowuni" kuthetha ukuba akukho mfuneko yokuba enze naluphi isitofu intramuscular kunye namaziko biopsy. Xa usebenzisa oko, kufuneka ibeke esweni imo coagulation. Kwiveki yokuqala unyango, igazi wahlola zonke iintsuku ezimbini, ukuqala kwiveki yesibini oko kwenziwe qho kwiintsuku ezi-3.

Nangona iindlela kwaye ugxile kwi ubisi lwebele, lokwaphusa ngexesha lonyango, kungakuhle lokuphelisa. Kuye kwafunyaniswa ukuba ichiza kukhokelela kwezinye iimeko ukuze ukonakalisa umnqonqo kwamathambo. Iingxaki ziqala emva kweeveki 2-4 zonyango.

Ngokwahlukeneyo, kubalulekile ukukhumbula ukuba isisombululo neziyobisi unakho tyheli, kodwa alunasiphumo kwi kwiipropati yayo amayeza okanye nonyamezelo lithetha "lweeHedfowuni". Lwezitofu, ixabiso esinokufumana kakhulu lwabiwo ekuqesheni kuye ngeedosi eziphezulu, kungenziwa nkqu bebodwa ekhaya.

Izimo

Njengazo naziphi na ezinye iindlela, awukwazi ukusebenzisa iziyobisi "lweeHedfowuni" Ukuba wena hypersensitive. It ungamiselwanga ukuba nokopha. Ngaphandle ke hemorrhages ukuba kwenzeka xa lung engabalulekanga (ichazwe ngohlobo hemoptysis) okanye kwizintso (hematuria bahamba).

Izimo nazo zibandakanya:

- sophele diathesis kunye nezinye izifo apho kakuhle ekunqandeni igazi;

- anda permeability semithambo, ezifana nesifo Verlgofa;

- endocarditis bacteria ;

- ukopha kwimbali;

- hypoplastic ne-anaemia aplastic, leukemias ezingapheliyo kunye oyingozi;

- kakhulu wesibindi nezintso umsebenzi;

- nezilonda lwemithambo;

- uphuhliso ahlekise intliziyo kwemithambo.

amanyathelo okhuseleko

Ukongeza Izimo ngqo, kukho uluhlu iimeko apho kuyimfuneko ukuhlola zonke iingozi kunokwenzeka xa uthatha "lweeHedfowuni" iziyobisi. Iinaliti kunye efakwa kuphela kwiimeko ezizodwa kwaye phantsi kweliso abaziingcali yamathumba nangokujaduka sisilonda ye phecana zesisu, uxinzelelo oluphezulu lwegazi, Kukudandatheka kunye nexesha postoperative, ngaphandle angioplasty.

A amagama ambalwa malunga nonyango yoomama elizayo. Ngaphandle kwento yokuba unyango kwabafazi ngendlela usapho phambi kwethu kuthetha ezingathandekiyo (oku kukhokelela kuphuhliso iingxaki), iinaliti "lweeHedfowuni" esiswini kumiselwe kwezinye iimeko, ngexesha lokukhulelwa. Amathuba isenzeko iziphumo ezibi ukusuka-10 ukuya kwi-21%. Xa ukuba ukukhulelwa eqhelekileyo umngcipheko iingxaki ingaphantsi kwe-3.6%.

Kufuneka kuqatshelwe ukuba iziphumo thromboembolism kunokwenzeka oomama abakhulelweyo iyingozi kakhulu ebomini kunokuba ekufumaneni lithetha "lweeHedfowuni". Iinaliti ngexesha lokukhulelwa ukwenza kuphela phantsi kweliso zonyango kuphela xa kukho ubungqina ngokupheleleyo. Kodwa ichiza kungabangela ukopha, thrombocytopenia kwamathambo. Oku kuthetha ngumkhaya ntoni ukungena.

analogs kunokwenzeka yakhe namaxwebhu angqina ngaye nomonde

Amaxesha amaninzi abo baqeshwa neziyobisi "lweeHedfowuni" (iinaliti esiswini), ixabiso kubonakala phezulu kakhulu. Kodwa xa isetyenziswa njengenyathelo lokuthintela, 1 iphakheji zisenokwanela iintsuku ezimbalwa. Ngoko ke, nokupakishwa apho iintsuba 5, ibe yanele ukuba eziliqela iiveki. A ukulungiselela idosi ophezulu isetyenziswa ngokuqhelekileyo elingekho ngaphezulu kweentsuku ezingama 10-14.

Noko ke, abantu abaninzi bafuna ukuba bafunde kwabanye izigulane, kubalulekile ukuthenga iyeza, ukuba ukhangela "lweeHedfowuni" ukulungiselela ncomo. Analogue beziyobisi nabo banomdla nabo. Ngoko ke, ukuba kukho iingxaki igazi ekunqandeni, sisixhobo kakuhle kakhulu kwaye ikuvumela ukuba kufikelelwe isiphumo enyangayo ezinqwenelekayo ngokukhawuleza kakhulu. Oku kungqinwe zombini amagqirha nezigulane.

Kodwa kunokuba kusenokuba utyumbe anticoagulants "Troparin", "lweeHedfowuni Sandoz", "lweeHedfowuni Sodium Brown", "lweeHedfowuni-Verein" kunye nezinye analogs. Le umthamo la machiza kufuneka ukhethe kuphela ngugqirha esekelwe kwiziphumo analyses yomguli, imeko yempilo yakhe yaye sele kubonakala apho ichiza emiselweyo.

Kwezinye iimeko, oogqirha bacebisa ephantsi ezinto heparins ubunzima, ezifana "Fraksiparin", "Fragmin", "Tsibor", "Eniksum", "Fraksiparin Forte." ukusebenza lwabo, njengoko oko kungqinwa iimpendulo yezigulane, phantse iyafana naleyo ichiza phambi kwethu.