Kukhona inani labantu abasebenzisa igazi abasetshenziswa kakhulu, kuhlanganise ne-heparin.
I-Heparin imithi esetshenziselwa ukuvimbela ukwakheka kwegazi legazi. I-Heparin inganikezwa ngokuqondile emgodleni wegazi, noma njengomjovo ngaphansi kwesikhumba. Ayikho ifomu ye-heparin yomlomo (ngomlomo) etholakala, futhi yingakho ngokuvamile isetshenziswe esibhedlela.
UHeparin Usetshenziswe Nini Esibhedlela?
I-Heparin ivimbela ukwakheka kwezindwangu zegazi .
Ngezansi ezinye zezizathu ezivame kakhulu ze- heparin zisetshenziswa.
- Ukuvimbela ukwakheka kwezindwangu zegazi ezingase zibe yinkimbinkimbi yokulala embhedeni isikhathi eside . Umthamo we-heparin ophansi nsuku zonke uvame ukujova ngaphansi kwesikhumba kungasiza ekuvimbeleni ukwakheka kwe-thromboses ejulile (DVTs) emithanjeni ejulile yemilenze, amathanga, kanye ne-pelvis. Ama-DVTs angabangela nokushaywa kanye nezibilini zamapulmomu, (PE) ezingasongela ukuphila
- Ukwelapha izibilini zamapulmoni: Izibilini zamapululini ziyizindwangu zegazi ezifudukela emaphashini avela enhliziyweni, noma kusukela ohlelweni olujulile lomzimba. Ngesinye isikhathi emaphashini, izibilini zamapulmoni zingavimbela ukugeleza kwegazi kuya ezingxenyeni ezinkulu zamaphaphu futhi kuvimbele igazi elimpofu-elimpofu, igazi elingenayo i-oksijeni. Njengoba kushiwo ngaphambili, i-PE ingasongela ukuphila.
- Ukuvimbela ukukhuliswa kwezingcingo eziphezulu zegazi ezitholakala ngaphakathi kwenhliziyo, kanye nezinye izingxenye zomzimba, ngoba zingabangela izibopho zamapulmasi noma imivimbo.
- Ukuvimbela ukwakheka kwezindwangu zegazi ngesikhathi sokuhlinzwa kwenhliziyo, noma ngesikhathi sokuhlinzwa kwemithambo emikhulu.
U-Heparin Usebenzisa Nini Ukuphatha Isisu?
I-Heparin nayo isetshenziselwa ukuphatha imivimbo ebangelwa ama-blood clots ebonakalayo.
Ezinye zezimo eziphakamisa ngokuqinile ukuthi ukushaywa komzimba kuhlotshaniswa ne-clot yegazi kuhlanganisa:
- I-carotid noma i-dissection ye-vertebral
- I-dural sinus thrombosis
- Uma umuntu one-stroke ene-ultrasound ubonisa ukucindezeleka okujulile okubi kakhulu
- Uma umuntu oye waba nesifo sokushaya isifo sine -fibrillation ye-atrial
- Uma ukuhlolwa kwe-carotid doppler kusikisela ukuthi i-clot yegazi ikhona ngaphakathi kwe- artery carotid , noma i-echocardiogram ibonisa i-clot yegazi ngaphakathi kwenhliziyo.
Intravenous Heparin Isilinganiso
Ngokungafani nemithi eminingi, umthamo we-heparin kumele ukhethwe ngokusho kwemiphumela yokuhlolwa kwegazi okuthiwa i-thromboplastin isikhathi esithile noma i-PTT. Uma i-heparin iqalile ukukhipha okunamandla, umthamo wayo ulungiswa njalo amahora angu-4 kuya ku-6 ukuze kuqinisekiswe ukuthi igazi aligcini kakhulu kangangokuba umuntu ugibela ingozi yokuphuma ngegazi.
Ngokwesilinganiso, izinqubo eziningi zokwelapha ze-heparin zibiza isikhathi esisodwa "se-bolus injection" ye-heparin elandelwa ukwanda kancane komthamo ku-PTT okungenani kabili inani elivamile.
Ngenxa yokuthi ayikho ifomu yomlomo yale mithi, i-heparin kumele imiswe ngaphambi kokuba umuntu ashiye esibhedlela. Abantu abadinga ukwelashwa kwesikhashana eside ngegazi abaqhambela igazi bavame ukushiwo u- coumadin, elinye igazi elinamandla elinamandla elitholakala kwifomu lethebhulethi.
I-Coumadin iqalwa ngenkathi umuntu esaluthola i-heparin engaphakathi, kepha uma ukuhlolwa kwegazi kubonisa ukuthi umphumela wegazi we-coumadin uwanele, i-heparin ingamiswa.
Lokhu kwenziwa ngoba i-coumadin ingathatha amahora angama-72 ngaphambi kokuba kufinyelelwe umphumela wayo oyifunayo.
Imiphumela emibi ye-Heparin
I-side effect enkulu ye-heparin iphuma. Ngenxa yalesi sizathu, kubalulekile ukuthi odokotela balandele ukubala kwegazi uma abantu belashwa nge-heparin engenalutho ukuze kuqinisekiswe ukuthi ukubala kwegazi kuhlala kuzinzile ngesikhathi sokwelashwa. Ukusuka okungajwayelekile kungavela ezindaweni eziningana emzimbeni kufaka:
- Vula amanxeba noma amasayithi okuhlinzeka
- Isisu namathumbu
- Isibeletho nama-ovari
- Izinsini nomlomo
Ezimweni zokuphuma kwegazi ngenxa yokwelashwa kwe-heparin, imithi ebizwa ngokuthi i-protamine sulfate inganikezwa nge-intravenously ukunciphisa umphumela wegazi we-heparin.
Ezimweni zokumpontshelwa kwegazi okunzima kakhulu kuyadingeka ukufaka esikhundleni segazi elahlekile.
Omunye umphumela ohlangothini obalulekile we-heparin yisimo esaziwa ngokuthi i-thrombocytopenia (i-HIT) e-heparin. Kulesi simo i-heparin ikhuthaza isimiso somzimba sokuzivikela emzimbeni ukuba ithuthukise ama-antibodies ngama-platelet awo. Njengoba izinga elijwayelekile lamaplatelets lidingwa ngumzimba ukuvimbela ukuphuma, izinga eliphansi lamaplatele lisa abantu engozini yokuphuma okukhulu kwegazi. Ngokudabukisayo, lesi simo esifanayo singabangela nokubunjwa okungalungile nokuzenzekelayo kwegazi elikhulu, elingavimba ukugeleza kwegazi emithanjeni ebalulekile yegazi futhi lilimaze izinso, isikhumba, nobuchopho, phakathi kwezinye izitho.
Izwi elivela
I-Heparin imithi okufanele igcinwe ngomthamo esekelwe ekuphenduleni komzimba kwisenzo segazi esincane. Lokhu kudinga ukulandela okulandelayo ukuhlolwa kwegazi okungalinganisa umphumela we-heparin ukuqinisekisa ukuthi isenzo sigcinwa ngaphakathi kwewindi yokwelapha.
Uma kudingeke uthole ukwelashwa nge-heparin, kungenzeka ukuthi uzoshintshwa kwenye i-blood thinner ngokuhamba kwesikhathi.
Thola ngamanye ama- blood thinners nemiphumela yaso emibi .
> Imithombo
> Iziphazamiso eziphindaphindiwe eziphindaphindiwe zesiguli ngomdlavuza: ingabe kunendima ekuqalisweni kwe-anticoagulation therapy yokuvimbela ukushaywa yisifo sesibili? I-Suero-Abreu GA, i-Cheng JZ, I-RK, i-BMJ Case Rep. 2017 Juni 3; 2017. i-pii: bcr-2016-218105.