Hemostatic agents. Hemostatic cov neeg ua hauj nyob rau hauv Gynecology

Heev feem ntau nyob rau hauv peb xyaum kho mob cov neeg ua haujlwm nruab nrab managers muaj nrog hemorrhages ntawm txawv localization. Nyob rau hauv kev, nyob rau hauv cov me nyuam thiab cov laus - nrog ib tug nyo hau, tom qab qhov kev tshem tawm ntawm cov hniav - nrog gingival thiab lwm tus neeg. Niaj hnub no thov sib txawv hemostatics: uterine los ntshav, capillary txhab ntawm lub qhov ntswg thiab lwm qhov chaw. Tiv thaiv lub keeb kwm ntawm ib tug xov tooj ntawm pathologies tsim mob xws li generalized. Piv txwv li, thaum aplastic anemia, thrombocytopenic purpura kab mob, thiab lwm yam kapillyarotoksikoz. Tom ntej no, peb yuav tsum to taub, dab tsi yog qhov hemostatic yeeb tshuaj hnub no.

Txheej txheem cej luam

Dab tsi ua rau los ntshav? Qhov no mob yog tshwm sim ntawm ib tug ua txhaum cai ntawm kev ncaj ncees nyob rau hauv loj hlab ntsha los yog cov hlab ntsha. Puas tej zaum yuav tshwm sim los ntawm txoj kev loj hlob ntawm cov qog, kev poob plig, tsis muaj peev xwm ntawm cov ntshav txhaws. Feem ntau, thaum ib tug ntse nrog txaus hemostatic tshuaj muab ncaj qha rau ntawm qhov chaw los yog nyob rau hauv tus txheej txheem ntawm thauj tus neeg mus rau ib tug lub tsev kho mob.

coagulation yam

Tswvyim qhia tias nyob rau hauv lub internal pathologies tom qab los ntshav mob yog tshwm sim los tsuas yog nyob rau coagulation system. Cov dab ntawd yog heev cascade ntawm cov txheej xwm. Nws yuav siv sij hawm 13 yam tseem ceeb muab kev koom tes, tam sim no nyob rau hauv ntshav, thiab ntau tshaj ib tug teb - muaj nyob rau hauv lub qe ua ntshav khov. Qhov tseem ceeb tshaj ntawm lawv yog: fibrinogen, prothrombin, prothrombin hloov dua siab tshiab zoo tshaj, qhov zoo tshaj yuav ntawm kev sib cuag thiab antihemophilic globulin. Vim fibrinolytic (anticoagulant) cov ntshav system yog khaws cia nyob rau hauv kua hauv lub xeev.

Cov ua rau kev ua txhaum

Ntshav nyob rau hauv kev xyaum, feem ntau yog tshwm sim los ntawm tsis muaj peev xwm los yog tej coagulation tau, piv txwv li, nyob rau hauv kab kab mob siab, jaundice txhua yam hom, hemophilia los yog txo platelet suav (cov syndrome Verlgofa, tiv thaiv aplastic anemia thiab lwm yam pathologies). Feem ntau qhov tsawg tshaj plaws ntau yam thrombosis nyob rau hauv cov hlab ntsha ua raws li ib tug txhais. Lawv evolve nrog lub ntxiv overruns ntawm tej yam txhaws yam thiab platelets. Qhov no, nyob rau hauv lem, ua rau yus mus rau ib tug hemorrhagic syndrome. Zoo ib yam li yog pom nyob rau hauv lub keeb kwm yav dhau mob xwm ntawm cov poob siab (cardiogenic, puas), raug tshuaj lom, sepsis (tom qab criminal rho menyuam muaj), phais loj, tshwj xeeb tshaj yog thaum loj heev transfusion. Yav tas los, xws li ib tug pathological mob txhais tau hais tias "fibrinliticheskaya los ntshav." Tam sim no, nws yog hu ua tus syndrome ntawm intravascular ntau microcoagulation.

Kev Kho Mob: Txheej txheem cej luam

Ib tug zoo-xaiv hemostatic neeg sawv cev nyob rau hauv uterine los ntshav, lub zos capillary kev puas tsuaj feem xyuam rau txoj disturbed thawj hemostasis. Nyob rau hauv kev, competent kho yuav siv ntawm ib tug, nyob rau hauv uas tsis tshua muaj mob, ob tshuaj nyob rau hauv qib siab noj tshuaj npaum cas. Piv txwv li, thaum hemophilic los ntshav siv yog tshiab ntshav Txoj kev lis ntshav neeg sawv cev "Kriopretsipiat". Thiab cov tshuaj xws li "Vikasol" los yog calcium chloride, nyob rau hauv xws li mob tsis thov. Cov caij nyob rau hauv lub hemostatic system yuav txiav txim nyob rau hauv raws li cov twb anamnestic cov ntaub ntawv thiab cov tsos mob kuaj thaum lub sij hawm kev soj ntsuam ntawm tus neeg mob. Nyob rau hauv no hais txog, ua ntej txoj kev kho, koj yuav tsum qhia hais tias tus genesis ntawm kev ua txhaum. Cuaj kaum hemostatic tshuaj pleev npaj muaj cai siv nyob rau hauv tej sab nraum zoov vascular txhab ntawm lub qog ua kua week. Medicaments tej zaum yuav kim heev, los yog ib tug kuj txwv ntau yam ntawm kev txiav txim. Muaj, rau Piv txwv li, hemostatic tshuaj rau cov hemorrhoids. Cov ntaub ntawv ntawm cov tshuaj no kuj sib txawv. Thaum lub localization ntawm kev puas tsuaj nyob rau hauv lub plab hnyuv cheeb tsam, e.g., tsim nyog siv hemostatic taws tswm ciab. Nyob rau hauv ib co lwm yam mob, zoo tshaj, kev daws teeb meem los yog ntsiav tshuaj. Piv txwv li, hemostatics poj niam nquag muaj nyob rau hauv cov ntsiav tshuaj daim ntawv los yog nyob rau hauv tsiav tshuaj.

Tshuaj "Vikasol"

Qhov no medicament yog ib tug dej soluble hluavtaws analog ntawm K-vitamin. Qhov no tshuaj yuav pab tau thiab txwv tsis pub los ntshav xwb, uas yog vim txo cov ntsiab lus ntawm prothrombin. Qhov no, nyob rau hauv lem, provoked los ntawm tsis muaj peev xwm ntawm K-vitamin. Medicament "Vikasol" nkoos synthesis ntawm prothrombin los ntawm lub siab lub hlwb. Los ntawm lub indications rau kev siv ntawm no lub cuab tam muaj xws li hemostatic mob nyob rau hauv mob npuas paug, kab mob siab, hepatic raum syndrome, obstructive daj ntseg. Cov tshuaj no yog pom zoo rau cov ntshav nyob rau tom qab ntawm ib tug overdose ntawm anticoagulants ntawm indirect kev txiav txim (cov tshuaj "pelentan", "neodikumarina" thiab lwm tus neeg). Tshuaj tsis qhia miv nyuas siv zug nyob rau hauv kab mob thrombocytopenic purpura thiab hemophilia. Cov tshuaj no muaj ib co hauv cov nyhuv hauv climacteric thiab hluas uterine, los ntshav rwj. Qhov kev txiav txim ntawm cov tshuaj yog cai tsis ntxov tshaj li 12-18 xuab moos tom qab thawj coj. Zoo li ntau hemostatic neeg sawv cev rau uterine los ntshav, medicament "Vikasol" yog muaj nyob rau hauv cov ntsiav tshuaj daim ntawv thiab raws li ib tug tshuaj. Ncauj tshuaj pom zoo los ntawm 0,015 g / 2-3 p / hnub. Hemostatic tshuaj "Vikasol" muab intramuscularly 1 ml ntawm ib feem pua daws yog 1-2 p / hnub, nyob rau hauv ib tug kab mus txog rau plaub hnub lawm (vim thrombosis yuav). Contraindications rau kev siv ntawm lub medicament xws li myocardial infarction (mob) thrombosis, nce coagulability.

vitamin P

Qhov cuab yeej no yog ib tug txheej ntawm cov tshuaj yej catechins. Vitamin P slows hyaluronidase kev ua si (nws yaj connective puag nyob rau hauv lub capillary phab ntsa), txo dog dig nkig thiab me me caliber vascular permeability. Ua ke nrog rau qhov no vitamin E tiv thaiv oxidation ntawm ascorbic acid. Nws kuj yog ib tug Firming ntxim rau cov capillary phab ntsa. Cov feem ntau hom tshuaj-tshuaj vitamin P yog xav tau "Rutin". Nws yog ib tug dej-insoluble hmoov greenish-daj xim. Tshuaj "Rutin" rau ib co raws li thiaj li muaj cov heev ntawm hemorrhagic tawm pob nyob rau tom qab ntawm tus kab mob thiab thrombocytopenic purpura kapillyarotoksikoz. Cov tshuaj no yog qhia rau retinal hemorrhage, qhua pias, kab mob endocarditis, kub taub hau. Nyob rau hauv daim ntawv thov ntawm vitamin P tsis yog tshwm sim thrombosis, tsis muaj contraindications. Ua medicament nyob rau hauv cov ntsiav tshuaj daim ntawv nyob hauv cov ntshiab daim ntawv los ntawm 0,02 g, thiab nyob rau hauv ua ke nrog nrog ascorbic acid (txhais tau tias "Ascorutin") (0.5 g ntawm txhua tivthaiv). Cov neeg laus medicament pom zoo ntau npaum ntawm 0.02-0.05 gr / 3 r / d.

Epsilon-aminocaproic acid

Qhov no neeg uas sawv cev nyob rau hauv daim ntawv ntawm ib tug dawb crystalline hmoov. Cov tshuaj yeeb dej caw yog cov mov thiab ntxhiab, heev soluble nyob rau hauv cov dej. Epsilon aminocaproic acid muaj hwj chim haemostatic nyhuv (lub zos thiab qhov tseem ceeb), fibrinolytic ua si slowing lug. Ua ke nrog rau qhov no medicament thiaj tryptic kev ua si uas muaj digestive juices. Epsilon aminocaproic acid yog qhia rau gingival, qhov ntswg, plab hnyuv, pais plab, ntawm winding, raum hemorrhage ntawm cov xwm sib txawv tshwm sim, thaum Verlgofa syndrome, hemophilia, anemia thiab aplastic tom qab uterine curettage xws li. Nyob rau hauv khov kho-lub xeev tej yam kev mob, cov tshuaj no yog siv tom qab phais nyob rau hauv lub cheeb tsam ntawm lub ntsws, prostate, nyob rau hauv ntxov ntxov detachment nquag situated tsev me nyuam. Tsa los ntawm txoj kev ntawm lub hauv 3-5 g / 3-4 p / hnub. Yuav kom ntxuav cia cov hmoov pom zoo qab zib dej. Tsis tas li ntawd, epsilon-aminocaproic acid yog tswvcuab thiab bolus thiab Txoj kev lis ntshav mus rau hauv lub cov hlab ntsha nrog rau 100 ml. Cov tshuaj ntse siv rau lub zos hemostasis ntawm los ntshav los ntawm lub qhov ntswg mucosa los yog lub qhov dej tom qab tshem tawm ntawm tus hniav. Nyob rau hauv rooj plaub no tus hmoov yog sprinkled nplua mias rau cov cov chaw. Tiv thaiv lub keeb kwm ntawm lub qhov ncauj medicament yog tsis khaus rau lub digestive ib ntsuj av. Nyob rau hauv tsis tshua muaj heev neeg mob, cov neeg mob tej zaum yuav tsis txaus siab ntawm xeev siab. Tom qab tso dej thawj coj, lub siab tshaj plaws cov nyhuv yog cai tom qab 1-4 teev. Epsilon aminocaproic acid muaj contraindications. Cov no muaj xws, nyob rau hauv particular, xws li lub raum tsis ua hauj lwm (mob kawg), thromboses.

Medical gelatin

Collagen hydrolyzate yog ib tug tsis muaj kob, gelatinous loj los yog yellowish nplooj. Tiv thaiv lub keeb kwm ntawm tso dej tshuaj pab txoj kev ntshav viscosity, platelet stickiness. Qhov no saib kuas ib tug txaus ceev ceev thiab pronounced haemostatic nyhuv nyob rau hauv tus neeg mob ntawm sab hauv los ntshav. Cov no muaj xws, ntawm lwm tus neeg, xws li intrapleural, thiab hnyuv. Tus me nyhuv yog pom nyob rau hauv vasculature ntawm lub qog ua kua txhab. Raws li ib tug sab cov tshuaj tiv thaiv uas ua li ib koob tshuaj tiv thaiv. Cov tshuaj mas muab txia intravenously ntawm ib koob tshuaj 50-100 ml pre-sov rau 37 degrees tshuaj. Ua medicament nyob rau hauv ampoules ntawm 10 ml ntawm kaum feem pua gelatin nyob rau hauv tsib feem pua sodium tshuaj dawb.

Fibrinogen K3 los yog M2

Qhov no tshuaj yog tib neeg cov ntshav, kuv txhaws tau. Nws yog siv nyob rau hauv afibrinogemicheskih los ntshav. Txia muab intravenously (hnub rau 1.8-2 gr. Qhuav tshuaj). Tam sim ntawd ua ntej yuav siv rau cov hmoov yog yaj nyob rau hauv saline (muaj menyuam tsis taus) cov tshuaj, uas nws kub yog 25-30 degrees. Txoj kev lis ntshav yog tau nrog cov yuav tsum tau muaj ib tug lim system raws li nyob rau hauv tshuaj tej zaum yuav ntes tau los ntawm lub ntsiab ntawm cov insoluble protein. Tsis muab Txoj kev lis ntshav nyob rau hauv myocardial infarction (mob), thrombophlebitis.

Tshuaj "Trasylol"

Tej kev npaj no yog tau los ntawm nyuj parotid qog. Lub medicament muaj peev xwm sawv ntawm npleem qhov muaj mob ntawm intravascular microcoagulation thiab trypsin muab siab npuab. Yam uas luag muab rau los ntshav nrog nws kim heev cov ntaub so ntswg raug mob, post-lub taub dej khawb rho menyuam, tiv thaiv mob leukemia hom (promyelocytic, piv txwv li) thiab lwm lub xeev. Ntau npaum 10-20 txhiab. ED tso dej Txoj kev lis ntshav ib hnub twg rau 1-2 lub sij hawm nyob rau ntawm tsib feem pua zib kua (los yog saline). Feem ntau, thawj coj ntawm lub medicament yog nqa tawm nyob rau hauv ntawv tej yam kev mob. Tshuaj kuj yog siv rau mob thiab mob ntaub ntawv ntawm cov pancreatitis, mumps. Ntawm cov feem ntau phiv yog: kev tsis haum tshuaj mus anaphylactic poob siab, raws li tau zoo raws li phlebitis ntawm qhov chaw ntawv.

protamine sulfate

Qhov no protein derivative uas muaj peev xwm sawv ntawm txoj kev nrog heparin thiab thromboplastin insoluble ceg. Prescribers haemorrhage provoked hyperheparinemia. Nws, nyob rau hauv lem, yog lub txiaj ntsim ntawm ib tug overdose los yog muaj zog zus ntawm endogenous heparin. Tshuaj muab ib tug txaus ceev ceev (tsis pub dhau 1-2 xuab moos), tsis txhob rau cov ntshav khiav. Feem ntau, ib tug ib feem pua tshuaj txhaj nyob rau hauv ib tug ntim ntawm 5 ml intramuscularly los yog intravenously. Yog hais tias tsim nyog, txhaj tshuaj yog ua dua tom qab 15 feeb. Thaum lub sij hawm txoj kev kho siv cov protamine sulfate yuav tsum tau muab tswj txhaws lub sij hawm. Lub medicament manufactured nyob rau hauv ampoules tsib milliliters ntawm ib feem pua tshuaj.

Tshuaj "Gemofobin"

Qhov no yog ib tug kuj tsis muaj zog styptic rau hemorrhoids. Nws yog thov intramuscularly, lus los yog topically. Cov tshuaj thaum muab lus 1 lub rooj. diav 2-3 p / hnub. Intramuscularly muab rau 5 ml 1.5% tshuaj. Lub medicament "Gemofobin", zoo li ntau lwm yam hemostatic tshuaj, muaj nyob rau hauv 5 ml ampoules thiab vials ntawm 150 milliliters.

Tshuaj "Adrokson"

Qhov no medicament yog ib tug txiv kab ntxwv hmoov muaj tsis muaj saj thiab tsis hnov tsw. Cov tshuaj teev miv nyuas siv zug nyob rau hauv capillary los ntshav vim me me kev raug mob tom qab hniav extraction, tonsillectomy. Siv 0,025% tshuaj ntawm ntxoov tampons thiab intramuscular tshuaj pheej ua ntej, thaum lub sij hawm thiab tom qab cov kev pab. Cov tshuaj no yuav siv tau thiab LCD los ntshav. Ua medicament nyob rau hauv ampoules ntawm 1 ml ntawm 0,025%.

Tshuaj "Etamsylate"

Qhov no tshuaj yuav pab los txhim kho platelet muaj nuj nqi, kom txhob muaj capillary permeability. Pom zoo medicament rau cov kev kho mob thiab kev tiv thaiv ntawm vascular mob tom qab hniav extraction, tonsillectomy. Yuav kom muaj xws li kev nyeem ntawv thiab plab hnyuv thiab pulmonary hemorrhage. Qhov siab tshaj plaws ntev ntawm cov nyhuv ntawm 1-2 teev thaum txhaj mus rau hauv cov hlab ntsha, thiab 3 teev - haus. Nyob rau hauv prophylactic tshuaj muab intramuscularly los yog hais lus. Yuav kom tshem tawm los ntshav mus rau hauv lub cov hlab ntsha los yog nqaij muab 2-4 ml, ces txhua txhua 4-6 teev nyob rau hauv 2 ml. Qhov tshuaj nyob rau hauv cov ntsiav tshuaj daim ntawv los ntawm 0.25 grams. nyob rau hauv 2 ml ampoules nyob rau hauv ib tug 12.5% tshuaj.

tshuaj ntsuab

Lub kho thaj chaw ntawm cov nroj tsuag tau tau paub txij ancient sij hawm. Lam tshuaj ntsuab nyob rau hauv daim ntawv ntawm cov extracts tuaj nyob rau hauv ntau hemostatic tshuaj. Thov xws hemostatic agents thaum lub sij hawm hnyav ua poj niam mob, laus nyob rau hauv lwm qhov chaw. Muaj nyob rau hauv ib tug ntau yam ntawm tinctures, dej thiab dej cawv, tshuaj, dauv. Kws txawj feem ntau siv hemostatic cov neeg ua hauj nyob rau hauv Gynecology. Tshwj xeeb tshaj yog thaum lub sij hawm cev xeeb tub thiab thaum lub sij hawm lactation. Txawm li cas los, mus thov lub hemostatic thaum lub sij hawm cev xeeb tub thiab thaum lub sij hawm pub yuav tsum tau ceev faj heev tsis txhob ua mob rau hauv lub me nyuam hauv plab.

tincture lagohilusa

Qhov cuab yeej no muaj tannins thiab latohilin. Tincture muaj ib tug stimulating (ntsis) ntxim rau cov coagulation system thiab lub teeb ua kom loog. Nws siv nws li ib tug hemostatic thaum lub sij hawm ua poj niam, nosebleeds. Nws yog pom zoo kom me nyuam haus tau ib me nyuam diav ntawm ib tug kaum feem pua cov kua dej (0.25 khob) ib hnub twg 3-4 lub sij hawm. Raws li ib sab nyhuv yog manifested laxative mob pesnrab. Lub ntub tshuaj tampons tej zaum yuav siv nyob rau hauv ob lub hemorrhoidal epistaxis.

Extract ntawm nettle nplooj

Qhov no txhais tau tias muaj ib tug vitamin K, ascorbic acid, tannins. Pom zoo extract plab hnyuv, lub raum ntxhee nyob rau hauv lub syndrome ntawm thrombocytopenic purpura. Nettles muaj ntau hemostatic agents, nrog hnyav menses thiab lwm yam vascular txhab siv.

Cov tshuaj ntsuab milfoil (kua extract)

Cov tshuaj no muaj resins thiab tannins, ascorbic acid, alkaloids. Lug txhim khu cov nyhuv, nyob rau hauv tej rooj plaub ua ke hemostatic tshuaj. Thaum hnyav coj khaub ncaws yog tshwj xeeb yog ib qho tseem ceeb. Nyob rau hauv tej lub sijhawm, ib tug heev zoo tshuaj ntsuab yarrow thiab nettle extract.

Cov kua Extract ntawm kua txob

Nws muaj rutin, quercetin. Zoo li ib co lwm yam hemostatic agents thaum lub sij hawm hnyav ua poj niam, kua txob extract muaj tannins. Nws yog pom zoo kom 30-40 dauv peb lub sij hawm ib hnub twg. Kua txob extract yog muaj nyob rau hauv lub medicament "Anestezol" (taws tswm ciab).

hauv zos tshuaj

Feem ntau, siv xws hemostatic agents rau tej qhov nqaij ntuag. Lawv cia koj mus sai heev thiab zoo tshem tawm cov kev ua txhaum. Lawv yuav siv tau nyob rau hauv ib qho xwm ceev. Muaj hospitality hemostatic agents rau kev raug mob. Tom ntej no, xav txog ib co ntawm lub zos lub tshuaj.

hemostatic li ntaub nqus dej

Qhov no kev npaj ntawm tib neeg ntshav. Lub hemostatic li ntaub nqus dej yog tam sim no thromboplastin thiab calcium chloride. Xeem muaj ib tug zoo zoo nyob rau hauv lub zos gingival, qhov ntswg, hemorrhoidal los ntshav. Los ntawm muaj menyuam tsis taus li ntaub nqus dej daim yog sib cais thiab thov rau cov pre-qhuav feem. Cov tshuaj yog nruj nreem nias ib tug gauze ncoo. Ib hnub tom qab lub remnants tsim fibrin zaj duab xis nrog sawv ua tib zoo muab tshem tawm. Seem li ntaub nqus dej daws nws tus kheej rau 20-30 hnub. Tsis Siv residues los ntawm cov qhib lub thawv nrog daim ntaub yuav siv tau tsuas yog tom qab resterilization. Contraindications ntawm cov tshuaj muaj.

thrombin

Qhov no kev npaj ntawm tib neeg ntshav yog ib tug xoob dawb-liab loj. Plaug ib tug transformation catalyst cov tshuaj tiv thaiv ntawm fibrinogen rau fibrin, lub medicament niamntiav ib tug ncaj qha hemostatic nyhuv. Thrombin yog siv tsuas yog rau cov hauv zos capillary kev puas tsuaj ntawm cov xwm sib txawv tshwm sim, tom qab qhov kev tshem tawm ntawm ib tug hniav li. Muaj menyuam tsis taus vial yog qhib ua ntej yuav siv, nws yog tso rau hauv saline (10-15 ml) ntawm chav tsev kub. Thaum cov thrombin tshuaj, ib tug tampon impregnated nrog no sib tov thiab nruj nreem rau lub puas cheeb tsam. Tom qab siv ceev xwmphem qhov los ntshav ntawm nws ua tib zoo muab tshem tawm los ntawm soaking nrog saline kom tsis txhob re-raug mob.

Fibrin zaj duab xis

Qhov npaj ntawm tib neeg los yog tsiaj (nyuj) ntshav. Nws muaj thromboplastin. Cov tshuaj muaj ib tug mob loj tsawv hemostatic nyhuv. Fibrin zaj duab xis yog siv nyob rau hauv lub zos txhab nyob rau hauv lub qog ua kua membrane. Ua ntej yuav siv muaj menyuam tsis taus xeem raj yog qhib, cov zaj duab xis yog muab tshem tawm. Tom ntej no, nws yog ntxuav nrog saline los yog lub tsheb "penicillin" los yog "rivanol". Tom qab ntawd, lub medicament yog thov mus rau lub puas nto. Thaum uas siv cov fibrin zaj duab xis yuav tsim ib qho kev tsis haum tshuaj.