"Heparin" (injections): noi, hoʻohana, nāʻana, mahele lāʻau. Ka hoʻohanaʻana i injections "Heparin" i hāpai keiki

Uluwehi O "Heparin" mea hiki ke 'ūlōlohi waiwai e clot i ke koko o ka. Ka hoʻokuʻu 'lapaʻau hope paha ma ka aniani ampules a me nā hue o 5 ml. Ka mea, e injectable pāʻoihana, ai kaʻeleu waiwai o 5,000 Iu.

pharmacological waiwai

Uluwehi O "Heparin" (injections) mea he anticoagulant. He hiki ke 'ūlōlohi i ke kaʻina hana o ka fibrin ho okumu, hōʻemi ai ka mämä holo kumumea o ke koko coagulation, a me ka nui nā hoʻohui like - e emi i ka ha awina o thrombin. O uuku nā māhele o ka lāʻau Ua lawa e hoomahuahua i fibrinolytic haʻawina o ke koko.

hoʻohana 'ana i "Heparin" injections e emi i ka (viscosity) o ka nui kino o ka liluwelo loli. Hoʻohana ana (he mahele lāʻau no ka pahu kui Nāna e koho i ke kauka pākahi) ma muli o ka mea i keia mea ua loaa ia ma ka endothelium o ke koko keena, a maoli he lākou io kauoha. Aie i keia waiwai emi mea pīlali a me aggregation o platelets, leukocytes a me erythrocytes.

Eia hou, i ka "Heparin" ua ālai 'ka hooulu ana o ka atherosclerosis, ua Anati-allergic a me ka mehana vasodilator kanawai. O ke kumu ho i ka mea ia ia e loulou iho ai i ka helu o ka oihana mua o ka hoʻokō'ōnaehana a me ka ho'ēmi i kā kona hope. Nō hoʻi, i ka lāʻau 'ano ua ālai' ke kahua o immunoglobulins, lymphocyte ke kākoʻo 'e hoopaa ana histamine a me ka serotonin.

nāʻikepili

E like me ka mau rula, ina oe i pilikia i ke koko clotting i hoakaka ia injections "Heparin" lāʻau. Injections a intravenous infusion ua paipaiʻia i loko o kēia mau hihia:

1) hohonu aa koko thrombosis, coronary artery maʻi, pulmonary embolism;

2) myocardial infarction;

3) He hu wale angina;

4) ka mua pae o DIC;

5) atrial fibrillation, i ua pu ma thromboembolism.

¶ A i loko o ka haukapilaʻo no ka hana me ka extracorporeal holo 'ana i kūpono e hāʻawi aku hoʻi "Heparin". Injections intravenously paha subcutaneously, ina e pono ai i ke koko transfusion, hemodialysis e pale aku coagulation o ka liluwelo loli.

Nā mea i hoʻohana ai no ka lapaau a me ka Kāohiʻana o kāna hana o ka microcirculation a me ka microthrombogenesis, no ka laʻana, thrombosis o kaʻaʻa puʻuwai aa koko, lupus nephritis, glomerulonephritis, mea koʻohune endocarditis, mitral naau maʻi, gemolitikouremicheskom maʻi pale.

kanawai o ka lāʻau

Inā 'oe i hoakaka ia injections "heparin" i loko o ka opu, e ike: ka mea, e loaʻa i ka hana loa pinepine. Kanawai o ka lāʻau ia lŘlŘ hoʻomaka koke, akā, ia mea pōkole. Penei, ka wā lawelawe intravenously o ia hoʻi, 'aʻole hoʻi clotting iho aneane koke, ke kanawai mau no 4-5 hola. I ka lawelawe intramuscularly, kona kanawai ma hope o 15-30 minuke, a mau no 6 hola, a me ka wā injected ma lalo o kaʻili ua malama ma hope o 40-60 minuke, a mau 8 hola. Pākōlea hana nona i pale i ke kahua o ke koko clots, mau mea hou.

E hoomakaukau ai "Heparin" maoli heʻaʻa puʻuwai koko, maoli he vascular ia'ku i loko o ka lolo, he hypolipidemic hopena. Eia hou, 'o ia hoʻi ho'ēmi i kā ka ha awina o pulmonary surfactant inhibits excessive hoʻololi kemikala o aldosterone i loko o ka adrenal cortex, amplifiesʻeleu keiki PTH e hoopaa ana adrenaline.

hoʻohana Hiʻona

Pinepine kanaka e loaa ana mai ka coronary naau maʻi, i hoakaka ia "Heparin" (pana pua aku makou). Ke kumukuai o keia k mea kiʻekiʻe i kekahi. 'ōpala o 5 ampoules o 5 ml me ka ha awina o 5000 Iu no 1 ML loaʻa 500-600 rubles. Akā, e hōʻole kona palapala noi mea ole. Ma hope o nā mea a pau, ma nā mea maʻi me ka ischemia o ia hoʻi, "Heparin" ho'ēmi i kā ka pilikia o myocardial infarction, coronary artery thrombosis a me ka manawa e make. A, i ka hoʻohana 'ana i ka lāʻau' ke emi i ka pahiki o recurrent naau ino, a me ka nui loa emi i ka pakeneka o ka make i loko o kēia mau hoʻomanawanui iki mai.

I ka venous thrombosis a pulmonary embolism i hoakaka ia kiʻekiʻe mahele lāʻau "Heparin" hoʻomākaukau. Injections (aʻo e leie aku e hana me pehea e pono waiho ia) i i loko o ka kekahi wā o ka manawa. Akā, ka mea, he oiaio, ma kekahi manawa, e loaa koke ia ua makemake e lawelawe intravenous mea.

No hoi i hoakaka ia i kekahi mea o ka "Heparin" no ka Kāohiʻana o thromboembolic hanana, e like me ma hope oʻoki kino. Ma keia hihia, ka mea, ua koi 'ia ma nā māhele liʻiliʻi.

Nā Papahana O Ka hoʻohana

E koho i ka mea koi laʻau heluna a me ka ano o ka hoʻohana 'ana i ka lāʻau e wale Kauka, ke kaumaha ma muli o ka hoʻomanawanui ka ana, a me nā kumu i makemake ai i kēia k. Hope paha i ke lawelawe intravenously me ke ana infusion a mau injections. Nō hoʻi, ma kekahi hihia, subcutaneous, a hiki e kohoia e intramuscular ka pahu kui.

E pale ai thrombosis lāʻau i ke lawelawe subcutaneously me 1 ml (5000 Iu) palua i ka lā. Ma ka nele o keia hoohalike ana hoi, ua pili ia i ka lāʻau "Heparin" manual. Injections e ana i loko o ka abdomen, i loko o kona anterolateral paia. E hana i kēia, lawe i ka uku kui kele, a inject mea hohonu i loko o ka ili pa. Ua Ua hanaʻia ka wā i hopu ai ma waena o manamana nui a me ka forefinger o ka'ōpū wahi i loko o ka piko wahi. Ke ka pahu kui pono e koho 'ē aʻe. I ka loaʻa kekahi hihia, na injections hiki ke hana i loko o ka luna o ka uha a mauka lima.

laʻau heluna koho

No ka pākōlea manao ma ka hua'ōlelo o inpatient lapaʻau i loko o ka haukapilaʻo e pinepine hoakaka intravenous infusion. No ka kanaka makua nā mea maʻi, i ka laʻau heluna o 1,000 Iu / hora. Akā, ma mua a hāpai drip no i kā mākou ia mea, hiki ke komo i ka bolus i loko o ka aa koko i loko o ka nui o ka 5,000 Iu. Koho ana o ka mea kiko'ī mahele lāʻau ua lawelawe i loko o ke kauka ke kaumaha ma muli o ka pilikia, a me ka hoʻomanawanui ka hoʻokauʻana.

Inā he mea hiki ole i ka hoʻomaka i ka intravenous infusion, na konohiki i e lawelawe subcutaneously: 2 ml o ka lāʻau (i hoʻopili like i 10000 Iu) 4 manawa no ka lā. ʻO kā mākou laʻau heluna Ua nui hoʻohana makaukau no 10 lā.

Na koi nui o ka lāʻau ua koho ma hope o ka loiloi 'hoao ana i nā hualoaʻa. Mau noonoo ana ua uku i ka APTT (ho'ā 'hapa thromboplastin manawa).

I ka wā o ka pou koko transfusions, ku una lawelawe 7.5-10 tausani. Iu o ia hoʻi, "Heparin".

Inc ma kūikawā hihia

I ka huʻi myocardial infarction koke lawelawe 10-15 tausani. Iu intravenously, laila kona hoomau hoʻohana o ia ka i ka ho omaulia, i ka hoʻomanawanui i loaa ma kahi o 40 000 Iu i ka lā mua, akā, i ka kiko'ī laʻau heluna ua wae ke kaumaha ma muli o ka hoʻomanawanui ka hoʻokauʻana. He mea pono i ka hōʻoia i ke koko clots ma 2.5-3 manawa ke kua'āina. Mai ka lua o ka lā o ka mahele lāʻau ua hoemiia. He mea nui i ka clotting manawa mea 1.5-2 manawa ma luna ma mua o ke kūmau. Iapaau ana me keia k mau i 8 lā. E ana i kela la i keia mahele lāʻau hoemi ma 5-10 tausani. Iu, akā, i nāʻanuʻu ma waena o injections mai i hoʻonui. Ma hope iho o ka abolition o ka hele ana i na anticoagulants oʻauhau'ēʻaʻe hana. Ua hiki e na kumu e like "Fenilin", "neodikumarina" a me na mea e ae.

Huʻi arterial a venous iaʻi kekahi pono he kupaianaha kokoke loa i kahi. No ka iapaau ana i hoakaka ia intravenous heparin no 3-5 lā ma ka mahele lāʻau o 400-450 Iu no kg o ka hoʻomanawanui kaumaha. Ia mea, he ahonui o ka meakino hana, a kiekie e kiʻi i ka lā ma kahi o 30-40 tausani. Iu "Heparin" lāʻau. A laila, neʻe ma i ka fractional kona hoike, akā, ua mahuahua no ma kahi o 600 Iu / kg i ka laʻau heluna, a me ka hookahi ka pahu kui i loko o ke kino e loaa 100 Iu / kg. Lapaʻau hiki mau mai i 16 mau lā. Ma wale i kekahi mau lā ma mua o kona lāʻau withdrawal dala ua i nā hoemiia. Lapaʻau ua hoomau ka hoʻohana 'anaʻauhau'ēʻaʻe anticoagulants.

Cautions

I loko nō o ka mea i kekahi olelo e pili ana i ka manawa kūpono o ka intramuscular ka pahu kui o ka lāʻau, keia ua i waiho no i ka mea e ma ka ka pahu kui paena hematoma pinepine hana. E hoʻohana i ka lāʻau dilutions 0,9% NaCl pāʻoihana.

Ua mea e ike ia i ka iapaau ana o "Heparin" 'o ia hoʻi ia mea,ʻaʻole e pono ke hana i kekahi intramuscular ka pahu kui a me ka biopsy nā loko i nui. I ka hoʻohana 'ana i ia, e pono e kanaka hoʻoponopono i ka moku'āina o coagulation. Ma ka hebedoma mua o ka Inc, koko kulana kupono kēlā mau lā, e hoʻomaka ana, mai ka lua o ka pule, ka mea hiki ke hanaia kela 3 lā.

ʻOiai ka mea, a aole i komo iloko i loko o ka umauma o ka waiu, lactation i ka manawa o ka lapaʻau, ka mea mea kupono i ka 'ōlelo. Ua Ua loaʻa i ka lāʻau hiki aku ai i loko o kekahi manawa, e hanaʻino i ka spine a me ka osteoporosis. Nā pilikia hoʻomaka hope 2-4 pule o ka nohoʻana.

Kaawale, e pono ke kūʻai 'ana i kumumanaʻo i i huli yellow ka lāʻau pāʻoihana, akā, ka mea,ʻaʻohe kanawai ma kona pharmacological waiwai a me ke ahonui,' o ia hoʻi "Heparin". Injections, ke kumukuai o ka i hiki me ka nui loa pili i ka Bedroom i kauoha mai ai iā ia i loko o nā māhele kiʻekiʻe, hiki ke hana e like ma luna o lākou iho ma ka home.

Contraindications

Like kekahi 'ē aʻe paha, e hiki ole hoʻohana i ka lāʻau "Heparin" ina oe e hypersensitive. Ua 'aʻole i koi' ia no kekahi kahe ana ke koko. 'Ia nā hemorrhages i hana ia myocardial akemāmā (hoikeia ma ka palapala hemoptysis) ole hakuʻala (pu hematuria).

Contraindications i nā:

- hemorrhagic diathesis a me nā maʻi i loko o i hoʻopōʻino koko clotting;

-, a mahuahua nui vascular permeability, e like me Verlgofa maʻi;

- mea koʻohune endocarditis ;

- kahe ana ke koko ma ka mōʻaukala;

- hypoplastic a me ka anaemia aplastic, maʻi a me ka huʻi leukemias;

- loa ake a me ka hakuʻala ho'āʻo;

- venous gangrene;

- i ka hooulu ana o ka huʻi naʻau aneurysm.

precautionary ana

Ma waho aʻeo ia ala contraindications, aia no he papa inoa o ka wahi, i hiki ai i ka mea e pono ke loiloi i hiki a pau ka pilikia, i ka wa e lawe "Heparin" lāʻau. Injections a intravenous hana wale i loaʻa kekahi hihia, a ma lalo o ka hooponopono ana o hoʻomalu ma ka hikoko, a ulcerative lesions o ka gastrointestinal'āpana, kiʻekiʻe ke koko, a me ka postpartum postoperative manawa, koe wale no ka angioplasty.

A mau olelo e pili ana i ka iapaau ana o ka wā e hiki mai makuwahine. I loko nō o ka mea i ka iapaau ana o nā wāhine i loko o ka ohana ala mua mai 'o ia hoʻi undesirable (ka mea, ke alakaʻi aku i ka ulu ana o complications), injections "heparin" i loko o ka'ōpū ua koi' ia ma kekahi mau hihia, i hāpai keiki. Ka pahiki o ka hanana o adverse loa HEN, mai 10 a hiki i 21%. Oiai no ka maʻamau hāpai keiki i ka pilikia o ka complications Ua emi o 3,6%.

It E e hoʻomaopopo i ka hopena o ka hiki thromboembolism ma expectant makuwahine i oi pilikia i ke ola ma mua o ka loaa ana i na mea "Heparin". Injections i hāpai keiki hana ma lalo o wale 'inikua hooponopono a wale nō inā he mea loa hoike. Akā, i ka lāʻau hiki i kahe ana ke koko, a me ka thrombocytopenia osteoporosis. Ka mea, 'o ia hoʻi ke keiki, aole ia i komo iloko.

Hiki analogs a me ka hoʻomanawanui, e hoike

Pinepine ka poe i waeia lāʻau "Heparin" (injections i loko o ka opu), ke kumukuai manao oi kiʻekiʻe. Akā, i ka wa a ka mea, ua hoʻohana 'ia me ke kāohi ana, 1 AEeAaOA e lawa no i kekahi mau lā. No laila, i ka'ōpala ma i na hue 5, e e lawa no ka mau o ka pule. A kiʻekiʻe-mahele lāʻau makaukau ua hoʻohana 'ana i oi aku 10-14 lā.

Aka hoi, makemake nui kanaka e aʻo mai nā nā mea maʻi, ia mea kumukuai kūʻai i ka lapaau, mea, e huli no ka "Heparin" hoʻomākaukau o ka nāʻana. Analogues o ka lāʻau 'ka mea hoi e pili. No laila, ina e haule ana na pilikia a me ke koko clotting, i ke koʻi lipi ma ka loa a me ka pono e leie aku oe, e kū ai i ka makemake pākōlea hopena loa koke. Keia ua hookupaa iho la ia e na kahuna lapaau a me kā lākou nā mea maʻi.

Akā, kahi mea i kekahi koho anticoagulants "Troparin", "Heparin Sandoz", "Heparin paʻakai Brown", "Heparin-Verein" a me nā analogs. Ka laʻau heluna o kēia mau ai 'e koho wale i kekahi kauka ma muli o ka hopena o kālailai o ka hoomanawanui, me ka moku'āina o kona ola kino, a me nā nāʻikepili no i ka lāʻau' ua kuhikuhi.

Ma kekahi mau hihia, kauka waiho haʻahaʻa hakakino kaumaha heparins, e like me "Fraksiparin", "Fragmin", "Tsibor", "Eniksum", "Fraksiparin forte." Ko lakou manao, e like me ka mea e hoikeike ma na pane o nā mea maʻi,ʻaneʻane ka like me ia o ka lāʻau i mua o mākou.