Anticoagulants isenzo ngqo nengxelo-ntetho. anticoagulants Ngokungangqalanga: uluhlu iziyobisi, indlela yokusebenza, yokuhlela. anticoagulants libanda ngqo

Kunye ukusebenza kakuhle kweenkqubo coagulation negazi antisvertyvayuschey kuqheleke eseleyo yangaphakathi emzimbeni. flow igazi ngokusebenzisa iimpahla akanayo imiqobo kunye nezithintelo, kunye thrombus uluhlu kwinqanaba elichanekileyo. Xa imali aphazanyiswa ukusebenza kweenkqubo wakhetha ukusebenza coagulation igazi, kukho iimeko ezinokukhokelela ekwakhiweni ngokugqithisileyo egazi. anticoagulants ngokungathanga - enye amaqela amachiza asetyenziselwa kwakhona ukuphazamiseka zangaphakathi.

Yintoni anticoagulants?

Anticoagulant wabiza imali, nto leyo kuba nesiphumo anticoagulant kwaye iyazingenela ukuxutywa igazi. Oku kukuvumela ukuba ukubuyisela iimpawu rheological nokunciphisa thrombosis.

Iindlela ziyafumaneka azipilisi, njengoko namafutha aqholiweyo, ijel kunye amalungiselelo inaliti. Bona abelwa hayi kuphela ekunyangeni izifo, kodwa ukunqanda ukwakheka nangakumbi egazi.

Uninzi amalungu eli qela amachiza ayakhekanga thrombus, kunye nomsebenzi ekunqandeni. Inkqubo sesichengeni imiba plasma, kunye nokuveliswa thrombin, nto leyo ithintela egazi.

Iziyobisi bohlulwa babe ngamaqela amabini ngokuvumelana nemisebenzi yabo;

• anticoagulants ngqo;
• anticoagulants ngqo.

isenzo ngqo zamachiza lweeHedfowuni-based

Eli qela kwemali kunempembelelo ngqo kwi cofactors plasma leyo zinqanda thrombin. Ummeli eyinhloko lweeHedfowuni. Ngenxa yesi sizathu kukho inani lamachiza zokubambela efana kunye ezingoonombini kunye negama:

• "Ardeparin".
• "Nadroparin."
• "Klivarin".
• "Longiparin".
• "Sandoparin".

LweeHedfowuni izithako ukubophelela antithrombin-III, nto leyo ekhokelela kutshintsho kwi indawo iimolekyuli yayo. Oku ikhawulezisa sokudityaniswa cofactor ngenxa thrombin, uze emva koko okunqanda inkqubo ekunqandeni.

Iimpawu ze isicelo "lweeHedfowuni"

izinto amanyathelo ezijolise ekuthinteleni ukukhula kunye nokwanda ihlwili legazi. LweeHedfowuni iimolekyuli ukwakha ezintsonkothileyo antithrombin, nto leyo inhibitor kwemiba coagulation. Le nto ke nomxokelelwane glycosaminoglycan. Ichiza lesitofu kwesikhumba kwaye iqala wesenzo emva kokuba isibini kweeyure.

Ukuba kuyimfuneko, inyathelo ngokukhawuleza "lweeHedfowuni" ukumnika ezilawulwa yegazi ekukhawuleziseni intsebenzo kunye nokwandisa bioavailability. Ukhetho iyeza idosi kuxhomekeke urhulumente ibekwe apho umguli. Ngaphezu koko, kuthathelwa ingqalelo ukubakhona kwezifo ezihamba, ulawulo engumzekelo namanye amaqela imithi, imfuno iinkqubo zotyando ezitsheni.

oligopeptides

Amayeza senze ngqo embindini thrombin kusebenze, zithathwa inhibitors ezithile kwinkqubo thrombosis olomeleleyo. Le esisebenza beziyobisi ngokwabo ukudibanisa izinto amahlwili, ukutshintsha Ukumila zabo.

Olu nyango "inogatran", "Hirudin", "Efegatran", "Tromstop" kunye nabanye. Isetyenziswa ukuthintela uhlaselo intliziyo angina, isifo varicose, kuthintelo thromboembolism, reocclusion ngexesha angioplasty.

anticoagulants engathe ngqo (uluhlu)

I anticoagulant lokuqala sifunyenwe kwinkulungwane XX eUnited States, xa kwafunyaniswa sisifo entsha iimazi, ingqondo ukopha enzima. Xa unobangela iye cacisa imeko lwezidumbu, kwakungqina ukuba izilwanyana abanentsholongwane ngumngundo izenzo clover, ise-feed. Ukususela kule impahla eluhlaza ukuba kuhlelwe yi lokuqala antiplatelet ichiza isenzo ngqo - "Dicoumarol".

Ukuza kuthi ga ngoku, uluhlu lwe-asethi ukuba analogs izinto abangaphezu kwamakhulu omnye. Zonke ezi machiza - anticoagulants ngomlomo. Indlela yokusebenza yeqela iziyobisi ezisekelwe inhibition ye yesenzo vitamin K.

Kukho ekunqandeni zinto zixhomekeke kweli vitamin. anticoagulants ngokungathanga anqanda ukusebenza iiprothini coagulation kunye cofactors vitaminozavisimyh. Ukusetyenziswa kwamalweyile ngendlela kula machiza akuvumelekanga, njengoko ukwanda umngcipheko iingxaki ukopha.

Kukho amaqela amabini aphambili, leyo yahlulwe zonke anticoagulants ngqo na. Ucalulo kwemali isekelwe izinto esebenzayo zifakiwe kumalungiselelo. ahluke:

• yezabelo coumarin;
• ezisekelwe izixhobo indandiona.

amalungiselelo indandiona

Emva ukwenza inani elikhulu izifundo, oosonzululwazi bafumanisa ukuba iimveliso ezisekelwe le into esebenzayo kufuneka asetyenziswe kunyango. Le imixube waba inani elikhulu yeziphumo ebezingalindelekanga njengoko negazi lakho. Ukusebenza nefuthe kwindlela protivosvertyvaniya zange ukubonisa iziphumo engaguqukiyo.

Eli qela iziyobisi luquka amachiza, "phenindione", "Difenindion", "Anisindion". Kwagqitywa ukuba bayeke ukhetho olungundoqo iqela lesibini arhente antiplatelet kunye nezakhi indandiona njengangoku zisetyenziselwa kuphela "Fenilin".

Eli chiza ngendleko ephantsi, iyafumaneka azipilisi. Kusemthethweni iiyure ezili-10, kwaye oko kubaluleke kakhulu kukugcina ixesha olufunwayo unyango. Le nguqu yimpumelelo iiyure kuphela emva-24 ukususela kwixesha kwedosi yokuqala. Isicelo kwenzeka ngokusebenzisa esweni imeko yomguli nge igazi parameters yelebhu (coagulation, iimvavanyo jikelele, ngamachiza ezinto).

Icebo i 'fenilina ":

1. Ngosuku lokuqala - 1 tablet amaxesha 4.
2. Ngosuku lwesibini - 1 tablet amaxesha 3.
3. Ezinye unyango - 1 ipilisi nganye ngemini.

Imithi kufuneka zithathwe kunye amayeza zokunciphisa izinga glucose emzimbeni.

yezabelo coumarin

Coumarin - into leyo kwizityalo kwaye ofana elabhoratri. Okokuqala, emva kokuba ukususwa kwaso, isixhobo yayisetyenziswa njengendawo ityhefu ulawulo ibuzi. Kuphela kukuhamba kwexesha baqalisa ukusebenzisa ichiza lokujongana thrombosis ngokugqithiseleyo.

Anticoagulants amanyathelo ngqo - amalungiselelo ezisekelwe coumarin - zimelwe yi ndlela zilandelayo amayeza:

• "Warfarin" (analogue zayo - "Marevan" "Sodium Warfarin", "Varfareks").
• "Atsenokumarola" (analogu - "Sinkumar").
• "Neodikumarina" (analogu - "Etilbiskumatsetat").

"Warfarin": features isicelo

Anticoagulants of action ngqo (uluhlu iyafumaneka kweli nqaku) Amaxesha amaninzi limelwe yi "Warfarin". Oku kuthetha tableted, iveliswayo 2,5, 3 okanye 5 mg. Igalelo akhule okhula emva kweentsuku 1.5-3 emva kulawulo yokuqala tablet. kangangoko ekupheleni kweveki yokuqala.

Emva ezithatha ichiza i parameters rheological legazi babuyela yesiqhelo emva kweentsuku ezi-5 ukusuka kumhla wokucinywa "ye warfarin." Iindlela ukusebenziswa ngumsebenzisa kumaxesha 2 ngemini, kwelinye kunye nexesha elifanayo. Ngosuku 5 unyango ziya kutshekishwa parameters igazi ukuqinisekisa ukusebenza kunye nokusebenza.

Ikhosi ye unyango unyule yingcali kwimeko nganye nganye. Ezinye izifo States (umz, fibrillation atrial) ifuna isicelo oluqhubekayo. Ngophuhliso PE (pulmonary Embolism) arhente antiplatelet akukho esiwabelwe elingaphantsi kweenyanga ezintandathu okanye ubomi.

Xa kwimfuneko yokungenelela ngoncedo ngotyando "Warfarin" ukurhoxisa iintsuku ezi-5 phambi uqhaqho. Oku kuya kuvumela indices igazi ubuyele esiqhelweni. Kunye nemfuno ephezulu ukusetyenziswa okuqhubekayo unyango anticoagulant, esi sixhobo indawo lweeHedfowuni unfractionated. Ithamo lokugqibela nolwathi iiyure ezi-4 phambi kokuba ungenelelo ngoncedo.

Emva ukusebenza nge-4 chasa kule ndawo lweeHedfowuni unfractionated. Ukwamkela agents ngqo antiplatelet zingabuyiswa ngeentsuku ezimbini, emva esweni imeko igazi ngoncedo iimvavanyo elebhu.

Apho iimeko isetyenziswa anticoagulants?

anticoagulant ngqo nengxelo- esetyenziselwa nokuthintela thromboembolism, thrombosis zale nkqubo lwemithambo xa kuthe kwavela mechanical kwemithambo yenhliziyo Prosthetic and fibrillation atrial.

Izifo eziphambili kuphuhliso leyo anticoagulants abelwe ngqo kunye namanyathelo ngqo, babe ukwahlulwa kulandelayo kumaqela:

1. Thrombosis yenkqubo umfutho:
   • iposi engabalulekanga;
   • Embolism pulmonary;
   • stroke zikhala ischemia;
   • ukulimala ezibuhlungu ukuba imithambo nxamnye yegazi.
2. Esasaziweyo coagulation intravascular :
   • yabanjwa ithi;
   • ukulimala ebuhlungu;
   • kuphuhliso nokudumba.
3. thrombosis nokoyika yegazi ngokuthi:
   • igazi egazi kwi imvelaphi imithambo varicose;
   • thrombosing plexus hemorrhoidal lwemithambo;
   • ihlwili kwi Vena cava ophantsi.

main Izimo

anticoagulants ngokungathanga - iziyobisi zithintelwe ngokungqongqo xa kukho intswelo lactose, malabsorption glucose kunye galactose. Kukho inani iziyobisi ngelo xesha ukuba awukwazi ukusebenzisa anticoagulants ngomlomo. Uluhlu iziyobisi equka iziyobisi nonsteroidal anti-ukudumba, "aspirin", "Dipyridamole", "clopidogrel", "penicillin", "Chloramphenicol", "Cimetidine".

Izimo asinakusetyenziswa anticoagulants ngqo kunye nesenzo ngqo:

• izifo wenze le iphecana zesisu;
• kwemithambo yegazi;
• isifo sesibindi;
• ukopha;
• thrombocytopenia;
• ukusilela kwezintso;
• I senyanga nenyanga zokugqibela zokumitha;
• Amanqanaba aphezulu creatinine.

engemihle arhente antiplatelet

Ngalinye amachiza kweli qela arhente lineziphumo ebezingalindelekanga efanayo. Abazibonakalisayo ngokwabo ngokusebenzisa self okanye ithamo engafanelekanga okanye ukuhlukunyezwa ngokusetyenziswa iingcebiso.

Iziphumo ebezingalindelekanga ziquka uphuhliso ukopha, iimpawu dyspeptic njengoko ukugabha, isicaphucaphu kunye norhudo. Kukho iintlungu eyomeleleyo esiswini, umzimba irhashalala kuhlobo ezindlwini okanye onokhwekhwe. Inokuphuhlisa necrosis, ilahleko iinwele, isikhumba ukurhawuzelela.

Phambi kokuqala unyango, isigulane kufuneka kudlule uthotho lweemvavanyo ukufumanisa ukuba usebenzisa la machiza. Isigulane linikezela epheleleyo segazi, ezinto urinalysis, umchamo kwi Nechiporenko, coagulation. Kukwacetyiswa kwakhona ukuba enze uviwo ultrasound izintso idlule njengesitulo igazi nemimoya.

anticoagulants libanda ngqo

Ngaphezulu eli qela neziyobisi kakhulu inqabile. Oku kwenzeka xa umntwana omncinci ndlu ichiza uzame yona kukhetho. Ngokuqhelekileyo, uyazikhomba iziyobisi iphantsi, ngoko amacwecwe idosi enye ayizange babesoyika. Kwimeko yokuba ukusetyenziswa ezizodwa okanye ngempazamo of amathamo ezinkulu iziyobisi ngokugqithisileyo ukuphuhlisa coagulopathy kwegazi.

iklinikhi libanda, akanayo iimpawu ezithile, ngoko ndiyaqikelela ukuba kwenzeka ukusela izixa ezikhulu ichiza, kunzima. Symptomatology obubonakala efanayo zizifo ezahlukahlukeneyo ithi zophendlo lwezifo ze eziphilayo. Ogulayo:

• amanxeba ukukhanya esikhumbeni;
• igazi umchamo okanye ngendle;
• wesizalo ukopha;
• hematoma entanyeni;
• yokopha intracranial.

Eku sunguleni, stroke elidlulileyo, izigulane abadala, ukopha zesisu kunye nembali eliphantsi hematocrit - izinto ezinxulumene ezinokuthi ukunciphisa susceptibility umbundu uyondelelwano lwee- iziyobisi.

Antiplatelet therapy libanda

1. Ukucocwa okanye ezibomvana nge esiswini iiyure eziliqela emva ulawulo iziyobisi akukho ntsingiselo.
2. Isigulane unikwa amalahle access ukufunxeka emathunjini.
3. "Cholestyramine 'ngaphakathi elawulwa kwimeko" warfarin "libanda, okanye analogue yayo.
4. Isigulane ibekwa kwiimeko antitravmaticheskie, ukunqanda ukuvela hematomas amatsha kunye hemorrhages.
5. Kunye nokopha kakhulu okanye plasma olwenziwe kwasekwa elements, maxa wambi igazi lonke. Olunobuchule kokusetyenziswa iiseli ezibomvu ngeembambo, cryoprecipitate, prothrombin complex.
6. Iimveliso abamiselweyo "Phytomenadione" isekelwe vitamin K.
7. Ukuba kuyimfuneko, ukwabela akukho unyango antiplatelet, ichiza "Phytomenadione" ikhondo unyango elimisiweyo, kunokuba nje zoncedo lokuqala.

Ukuba imeko yomguli babuyela esiqhelweni, kodwa kuyimfuneko ukuba uqhubeke ukusebenzisa anticoagulants ngomlomo, kuyimfuneko ukuba "Warfarin" indawo okwexeshana iziyobisi lweeHedfowuni series.

isiphelo

Ukusetyenziswa kweziyobisi antiplatelet nga bunjani kuphela igazi imigangatho rheological, kodwa ukuphucula imeko jikelele kumguli ukuthintela ukunwenwa kwezifo.

ingqalelo ukusetyenziswa anticoagulants, ukhetho idosi esweni imeko yomguli nga kunceda ekunciphiseni ubungozi iingxaki kunye nempumelelo. Iingcali abasebenzisa eli qela iziyobisi emsebenzini wakhe, kuyimfuneko ukuphucula ulwazi ukuba zilandele ngqo iingcebiso zempilo ngamazwe.