"Poliglyukin": imiyalelo ukusetyenziswa, Izimo, ncomo

"Poliglyukin" - antishock plazmozameshchath medicament lula libuyisele ze BCC. Ngenxa yoko, ukusetyenziswa kweziyobisi uthintelwe adhesion of zegazi kunye neeseli ezibomvu zegazi.

Ukwakhiwa eliquka "polyglukin"

Isiseko beziyobisi - dextran. Entsubeni njengokwasesipilini eziqulathwe 200 no 400 ml yokulungiselela ngohlobo isisombululo zolwelo. Ukwakheka chiza iqulethe sodium chloride namanzi ngenaliti.

pharmacodynamics

"Poliglyukin" umyalelo phezu iziboniso nje amayeza kokuba antiagregatnym kunye neziphumo hemodynamic. Ichiza eli polysaccharide esibamba nomphetho amanzi. Emva kokusebenzisa amayeza bcc ubuyiselwa ngexeshana elifutshane ngexesha ngenxa yokuba oko afunxa amanzi ngokwaneleyo.

Icandelo esebenzayo enobunzima eliphezulu eziphilayo, njalo egazini ngayo ekhoyo ixesha elide, kwaye nolawulo kancinane udlula iindonga isitya. Iimpawu ze ichiza ukunyusa ngokukhawuleza elide ukuze ugcine uxinzelelo lwegazi eqhelekileyo. "Poliglyukin" unciphisa izihlunu nokudumba, kubuyisela kwakhona BCC ephelisa spasm, olwenzeka kwiinqanawa peripheral.

uzinzo Ukurhoxiswa uyaphuculwa igazi emva unyango "Poliglyukin" umyalelo ibonisa ukuba ichiza yenza igazi viscous kangako. Xa abantu, amanani nganye ezinga malungu abantu, kwaphulwa ngenxa kuphuhliso bothukile: microcirculation, ukuhamba kwegazi emzimbeni.

Pharmacokinetics

Kukhuthaza medicament eveliswe ivela emzimbeni kakhulu nezintso. ukususwa Partial lwenziwa ngexesha lasemini. "Poliglyukin" isusiwe uphelele, inxenye engabalulekanga yayo engena iiseli kwenkqubo reticuloendothelial kwaye ezazibekwe ngcembe kwenzeka wokuqhekeka medicament. Ngenxa kule nkqubo, iswekile iveliswa, nto leyo kuthathwa njengomthombo wamandla. Little "polyglukin" ungena lokugaya.

ubungqina

"Poliglyukin" umyalelo kwi isicelo ikuvumela ukuba abele xa kwaphulwa ukuhamba kwegazi capillary. Ichiza ofanelekileyo kunyango kwiimo ukothuka kunye noThintelo (umothuko yokubolisa, ityhefu, ukutsha, imisebenzi, izinto ezibuhlungu). A chiza esetyenziswa ekulahlekeni igazi etsolo ukuba yenzekile ngexesha lokukhulelwa ethunjini, ngexesha lokubeleka okanye ngenxa trauma ukubuyisela ngokukhawuleza BCC. Solution hypovolemia, nto leyo ngenxa plasma ukuvuza (gumbi syndrome, ukutsha). Ukusebenza ichiza iqatshelwe ngokuphumeza amanyathelo othintelo ezijolise ekuthinteleni Embolism (ipreoperative, postoperative).

Izimo

Phambi unyango kuyimfuneko ukunikela ingqalelo Izimo, equlethe i ungasinika kwiziko "Poliglyukin" umyalelo manual. Izimo ukuba unyango kunye nokuthintela le yokulungiselela imi ngolu hlobo lulandelayo:

• stroke yobuchopho;
• ICP High;
• States apho ukuqaliswa ulwelo kukuninzi ayinqweneleki;
• isifo kunye isifo sezintso (anuria, oliguria);
• BP kakhulu;
• Ukungaphumeleli intliziyo;
• ukuphazamiseka of homeostasis, coagulation;
• Ukuqhubeka yophela yangaphakathi (ngaphandle - uxinzelelo lwegazi ngaphantsi kwe-60 mm HG ..).

unyango Izikali

A Isisombululo lolawulo efakwa. Kwiimeko apho ilahleko igazi lijongwa etsolo, oko ukuba ukusetyenziswa kweziyobisi intra-umfutho. Izinga lolawulo ichiza uzimisele ngamnye kwaye kuxhomekeke kwimeko yomguli, izinga intliziyo yakhe, uxinzelelo lwegazi kunye hematocrit.

Xa Ndothuka ithi "Poliglyukin" umyalelo ncwadi ikhuthaza ilawulwa indlela efakwa bolus. Ithamo kufuneka single-arhente kwiimeko ezinjalo ayikho ngaphantsi kwe-400, kodwa hayi ngaphezulu kwe 1200 ml. Kwezinye iimeko kuyimfuneko kukwandisa ithamo amayeza ukuya ku-2000 ml. Ukuba nokwenziwa BP ngenxa zolawulo ichiza yakwazi ukuba kuziswe eqhelekileyo, inguqulelo ekuqalisweni amathontsi iziyobisi.

Eziphawulekayo ukopha, ulungelelene ml 500 nangaphezulu, kwakunye ubukho anemizatsii ezinzima ngaphandle usebenzisa 'polyglukin "isisombululo lwenziwa igazi. Njengenyathelo lokuthintela ukukhusela ukothuka ngexesha ichiza utyando elawulwa athontsize xa Uxinzelelo iwile - jet. Ukucutheka elibukhali uxinzelelo lwegazi ku-60 mm HG. Art. nangaphantsi ifuna ukuqaliswa "polyglukin" zibe ngumqulu umkhulu 400 ml intraarterially. Emva kokwenza imisebenzi usebenzisa le kuthintelo imveliso amayeza, uvumela ukuba iyaluthintela uphuhliso yokothuka.

isisombululo ezisetyenziswa xa iqela into esebenzayo-6%, kodwa usebenza "Poliglyukin 33" kwezinye iimeko. Imiyalelo yokusebenzisa ibonisa ukuba kuqulunqo nge xi dextran i reagent encedisayo xa ekuhloleni zokungahambisani umamkeli kunye nalowo.

Xa kuyimfuneko ukuphelisa zokutsha shoka, ngosuku lokuqala umntu omdala ilawulwa ukusuka amawaka-2. Eliwaka ukuya 3. isisombululo ML, lusetyenziswa ngosuku lwesibini elingekho ngaphezulu kwe-1.5 amawaka. Ukulungiselela Ml. Ngaloo iimeko xa ukothuka kuyimfuneko ukususa umntwana, oko kuqala ilawulwa 40-50 ml / kg kuthetha, ngosuku lwesibini pamo kilogram ubunzima bomzimba ngalinye liye lancitshiswa ml-30. Njengenyathelo lokuthintela, ukuze kupheliswe ukufunyanwa bothukile, abantwana kusungulwe indlela efakwa idriphu. Ithamo wazifunela umntwana isusela ukusuka ml-10 ukuya kwi-15 / kg "Poliglyukin" ukulungiselela. Imiyalelo zokusetyenziswa izilwanyana, kakhulu, kwenza kube lula ukusebenzisa unyango, ngokusekelwe intshayelelo "polyglukin". Ukuze ezi njongo isicombululo ithamo-15 ukuya ku-20 ml / kg. Ithamo kakhulu ifanelekileyo ichiza emiselwe ngugqirha.

imiphumela emibi

Ngaphambi usebenzisa imveliso "imiyalelo Poliglyukin 'ukusetyenziswa, iimpendulo bayakhuthazwa ukuba ukuphonononga iziphumo ebezingalindelekanga kunokwenzeka. Ngokuqhelekileyo musa kuvela iingxaki, kunye umzimba izigulane basabela kakuhle ichiza. Ngamanye amaxesha ibonakala ngokohlobo kukwalisa bothukile anaphylactic, ukudumba, ukurhawuzelela krwada. Kwezinye izigulane, kwentamo kukho yimvakalelo ucinezelo, kukho intlungu. Ngamana kuba fever langoku, nokuphungulwa uxinzelelo lwegazi, ukukhawulezisa ireyithi kwentliziyo. Usenokuba uneengxaki ukuphefumla, isiyezi kunye nophuhliso phambi acrocyanosis. Ngenxa libanda yoko olwenziwe umthwalo ongaphaya entliziyweni, uthintela ngaphezu ithamo ekucetyiswa lithetha "Poliglyukin" umyalelo manual. Iipilisi kunye namanye amayeza apho isigulane uthatha, uphazamise yesenzo sisombululo.

ukubuyekeza Analogs

Ukwenziwa kwezilungiso medicament angakwazi "HyperHAES", "Reoglyumanom" okanye "Hai-wawuqalekisa". Kuba ngezisombululo zisetyenziselwa injongo efanayo njenge "Poliglyukin" ziquka "Sterofundin", "Reopoligljukin", "Stabizol".

Buyisela "Poliglyukin" imiyalelo zokusetyenziswa ngokuvumela kwiimeko apho isigulane okungalungelaniyo eli ziko. Kuba esikhundleni zingasetyenziswa "gelofusin", "Refortan N», «Sorbilakt". A nomphumela ofanayo kunokuthiwa ngalo, "Albunormom" yaye "Neorondeksom".

Ukuphonononga zibonisa ukuba uninzi chiza kunceda ukuphelisa le ngxaki. Kodwa ukusukela kwimeko nganye yahlukile, iziphumo ulawulo lwakhe inokuba nomahluko. Kuxhomekeka imeko yesigulane. Abantu abasengozini yokuba ukuba usebenzise "Poliglyukin" ngokwabo, ngenxa umngcipheko kulawulo ngokungafanelekanga-mali kunye nophuhliso yeziphumo ebezingalindelekanga.

isisombululo sayo umsebenzi "Poliglyukin" lenza, kodwa kunyango, kwakunye nokusetyenziswa yothintelo, akuzange kube kakuhle kukhokelele ezinye iingxaki, ukuba ithamo ichiza kufuneka zikhethwe ngugqirha ngabanye. oyingcaphephe kuphela alawule eli chiza njengomntu eqhelekileyo kuba nako ukufumanisa ngokuchanekileyo pamo ezifunekayo kunye nendlela ezifanelekileyo zolawulo iyeza babeza. ngeedosi kakhulu amachiza kuyingozi intliziyo, ngoko musa ukuthatha imingcipheko, kunye nokuzeyisa medicate.