Mathata a ho ruruha ha mali, mathata a thromboembolic ke maloetse a tebileng a hlokang kalafo e potlakileng.
Hangata maemong a joalo, lingaka li beha moriana o hlalosang Fraxiparin. Litlamorao le li-contraindication bakeng sa ts'ebeliso ea eona li fumanoa, 'me ho bohlokoa ho tseba ka tsona.
Litaba tsena, hammoho le tlhaiso-leseling mabapi le ts'ebeliso ea moriana, phello ea ona le litekolo li tla tšohloa hamorao.
Ketso ea pharmacological
Fraxiparin e na le heparin e tlase ea boima ba molek'hule, pōpo ea eona e entsoe ts'ebetsong ea depolymerization. Karolo e nang le tšobotsi ea lithethefatsi e bitsoa ketsahalo e mabapi le lintho tse matlafatsang, kapa ts'ebetso e fokolang ea factor Pa.
Ts'ebetso ea Anti-Xa e phatlalalitsoe haholo ho feta phello ea moemeli nakong ea ts'ebetso ea karolo ea thrombotic e sebetsang. Sena se bontša ts'ebetso ea antithrombotic.
Lithethefatsi Fraxiparin
Setlhare sena se na le litlamorao tse khahlanong le ho ruruha le ho hlohlona. Ho feta moo, ketso ea moemeli e ka lemohuoa kapele, 'me e nka nako e telele ho lekana. Kamora lihora tse 3-4, moriana o noelehile ka botlalo. E pepisoa hammoho le moroto ho ea liphatseng.
Matšoao a ho sebelisoa
Ts'ebeliso ea litaba tsa Fraxiparin maemong a latelang:
- kalafo ea infarction ea myocardial;
- thibelo ea mathata a thromboembolic, mohlala, ka mor'a ho buuoa kapa ntle le ho buuoa;
- coagulation prophylaxis nakong ea hemodialysis;
- kalafo ea mathata a thromboembolic;
- kalafo ea angina pectoris e sa tsitsang.
Fomu ea tokollo, sebopeho
Ho lokolloa ha Fraxiparin ho ka tsela ea tharollo ea ente, e behiloeng ka har'a sirapo. Serudu ka boeona se sebakeng sa blister, se tletse ka likotoana tse peli kapa tse 10 ka lebokoseng la karete.Moetso ona o kenyelletsa ntho e sebetsang e bitsoang calcium adroparin 5700-9500 IU. Lintho tse thusang mona ke: calcium hydroxide, metsi a hloekisitsoeng, le chloric acid.
Litlamorao
Joalo ka meriana e mengata, ka linako tse ling Fraxiparin e baka litlamorao:
- thrombocytopenia;
- litla-morao (hangata ho tsoa ka mpeng ea Fraxiparin itchy), ho kenyelletsa edema ea Quincke;
- ho tsoa mali libakeng tse fapaneng;
- necrosis ea letlalo;
- ntho ea sebele;
- eosinophilia ka mor'a ho tlohela lithethefatsi;
- hyperkalemia e fetolehang;
- ho thehoa ha hematoma e nyane sebakeng sa ente, ka linako tse ling ho ile ha hlaha le likhoele tse kholo tsa Fraxiparin (setšoantšo se ka tlase);
- keketseho ea litaba tsa enzymes tsa hepatic.
Litholoana tse tsoang Fraxiparin
Bakuli ba bang ba neng ba sebelisa Fraxiparin ba hlokometse maikutlo a matla a tukang ka mor'a ho entoa.
Contraindication
Contraindication Fraxiparin e na le tse latelang:
- thrombocytopenia;
- lilemo ho isa ho lilemo tse 18;
- liso tsa mmele tsa litho tse nang le tloaelo ea ho tsoa mali;
- intracranial hemorrhage;
- kutloelo-bohloko ea likarolo tse fetang se tloaelehileng;
- ho buuoa kapa ho lemala mahlo, bokong le lesapo la mokokotlo;
- ho tsoa mali kapa kotsi e kholo ea ho ba teng ha eona e khahlanong le hemostasis;
- ho hloleha ho matla ha renal ho bakoang ke myocardial infarction, angina e sa tsitsang, kalafo ea thromboembolism.
Ka kotsi e eketsehileng ea ho tsoa mali, Fraxiparin e lokela ho nkoa ka hloko. Maemo a tjena:
- ho hloleha ha sebete;
- maloetse a potoloha ka mokokotlong le mokokotlong;
- kalafo ea nako e telele ho feta e khothalelitsoeng;
- boima ba 'mele ho fihlela ho 40 kg;
- nako kamora ho ts'ebetso mahlong, mokokotlong, bokong;
- khatello e matla ea methapo ea kutlo;
- ho se latele maemo a kalafo;
- ulcers;
- ho nwa meriana ka nako e ts'oanang ho ka tlatsetsang ho tsoa mali.
Litaelo tsa ho sebelisoa
Fraxiparin e kenngoa ka mpeng ka har'a lisele tsa subcutaneous. Khoele ea letlalo e tlameha ho lula e le teng nako eohle ha tharollo e ntse e fanoa.
Mokuli o lokela ho bua leshano. Ho bohlokoa hore nale e lekantsoe, eseng ka sekhutlo.
Ka ts'ebetso e akaretsang ea thibelo ea mathata a thromboembolic, tharollo e fanoa ka bongata ba 0,3 ml hang ka letsatsi. Moriana o nooa bonyane beke ho fihlela nako ea kotsi e fetile.
Pilisi ea pele e fanoa pele ho buuoa ka lihora tse 2 ho ea ho tse ling. Tabeng ea ts'ebetso ea methapo, ngaka e fuoa lihora tse 12 pele ho ts'ebetso le lihora tse 12 kamora hore e phethoe. Ho feta moo, moriana o nooa bonyane matsatsi a 10 ho fihlela qetellong ea nako ea kotsi.
Tekanyetso ea thibelo e fanoa ho latela boima ba 'mele ba mokuli:
- 40-55 kg - hang ka letsatsi bakeng sa 0.5 ml;
- 60-70 kg - hang ka letsatsi bakeng sa 0,6 ml;
- 70-80 kg - habeli ka letsatsi, 0,7 di ml ka ngoe;
- 85-100 kg - habeli ka letsatsi bakeng sa 0,8 ml.
Bakeng sa kalafo ea mathata a thromboembolic, moriana o fanoa ka linako tse ling tsa lihora tse 12 habeli ka letsatsi matsatsi a 10.
Molemong oa phekolo ea mathata a "thromboembolic", boima ba motho bo nka karolo ho bona hore na lethal dose ke lefe:
- ho fihlela ho 50 kg - 0,4 mg;
- 50-59 kg - 0.5 mg;
- 60-69 kg - 0,6 mg;
- 70-79 kg - 0,7 mg;
- 80-89 kg - 0,8 mg;
- 90-99 kg - 0,9 mg.
Thibelo ea ho fetoha ha mali, lethal dose le lokela ho laeloa ka bonngoe ho latela maemo a botekgeniki a dialysis. Ka tloaelo, ha coagulation e thijoa, tšireletso ke lethalamo la pele la 0,3 mg bakeng sa batho ho fihlela ho 50 kg, 0,4 mg ho 60 kg, 0,6 mg ka 70 kg.
Ho khothalletsoa kalafo ea myocardial infarction le angina e sa tsitsang hammoho le Aspirin ka matsatsi a 6. Pele, moriana o kenngoa ka har'a catheter ea venous. Motsoako o sebelisitsoeng ke 86 ME anti-Xa / kg. Ka mor'a moo, tharollo e sebelisoa habeli ka letsatsi ka tekanyetso e le 'ngoe.
Bongata
Haeba ho na le lithethefatsi tse ngata tse ngata, ho tsoa madi ho sa tsitsinyeheng ho hongata ho hlaha. Haeba li sa bohlokoa, joale se ke oa tšoenyeha. Maemong ana, o hloka ho fokotsa tekanyetso, kapa ho eketsa sekhahla pakeng tsa ente. Haeba ho tsoa mali ho bohlokoa, joale o hloka ho nka protamine sulfate, e leng 0,6 mg ea eona e khonang ho khelosa 0.1 mg ea Fraxiparin.
Ho sebelisana le lithethefatsi
Ho nka franksiparin ka nako e le ngoe le meriana e itseng ho ka lebisa ho hyperkalemia.
Tsena li kenyelletsa: letsoai la potasiamo, li-inhibitors tsa ACE, heparins, li-NSAID, li-diuretics tsa potasiamo, Trimethoprim, angiotensin II receptor blockers, Tacrolimus, Cyclosporin.
Lithethefatsi tse amang hemostasis (li-anticoagulants tse sa tobang, acetylsalicylic acid, NSAIDs, fibrinolytics, dextran) hammoho le ts'ebeliso ea moemeli enoa li matlafatsa phello ea e mong.
Kotsi ea ho tsoa mali e eketseha haeba Abciximab, Beraprost, Iloprost, Eptifibatide, Tirofiban, Ticlopedin le tsona li nkuoa. Acetylsalicylic acid le eona e ka kenya letsoho ho sena, empa ho litekanyetso tsa antiplatelet feela, e leng 50-300 mg.
Fraxiparin e lokela ho laeloa ka hloko haholo ha bakuli ba fumana li-dextrans, anticoagulants, le systemic corticosteroids. Tabeng ea ho nka li-anticoagulants tse sa tsamaeang hammoho le sethethefatsi sena, tšebeliso ea sona e ntse e tsoela pele ho fihlela letšoao la INR le thatafala.
Litlhahlobo
Joalo ka lithethefatsi tse ling tse ngata, ho na le litlhahlobo tse hanyetsanang ka Fraxiparin. Ho na le bao a ba thusitseng, mme o nkuoa a sebetsa, empa bakuli ba nkang hore moriana o hloka thuso ka ho phethahala ha ba qheleloe ka thoko.Litlhahlobo tse mpe li tla ho latela boteng ba bongata ba litla-morao, li-contraindication. Ka nako e ts'oanang, ho sa tsotelloe litemoso tsa ho isa moriana ho basali ba baimana, ha ho na phello ho bophelo bo botle le kholo ea ngoana e fumanoeng.
Livideo tse amanang
Mokhoa oa ho kenya Fraxiparin:
Ka hona, Fraxiparin hangata e laeloa bakeng sa mathata a ho fetoha ha mali, tlhoko ea kalafo kapa thibelo ea mathata a bophelo. Ntho ea bohlokoa ke ho latela litlhahiso tsa setsebi se ka khethollang ho nepahala ha tšebeliso ea eona le litekanyetso tse hlokahalang. Ntle le moo, ntle le ho se sebetse hantle, ho fapana le hoo, ho ka ba le tšusumetso e mpe e amanang le ts'ebeliso e feteletseng, nts'etsopele ea ho tsoa mali, le hyperkalemia.
