"Poliglyukin": cov lus qhia rau kev siv, contraindications, xyuas

"Poliglyukin" - antishock plazmozameshchath medicament tswj replenishing ntawm BCC. Raws li ib tug tshwm sim, siv cov tshuaj no yog tiv thaiv los ntawm adhesion ntawm platelets thiab cov ntshav liab.

Muaj pes tsawg leeg muaj "polyglukin"

Lub hauv paus ntawm cov tshuaj - dextran. Nyob rau hauv lub iav raj mis muaj 200 thiab 400 ml ntawm cov kev npaj nyob rau hauv daim ntawv ntawm ib tug aqueous tov. Cov tshuaj muaj pes tsawg leeg muaj sodium tshuaj dawb thiab dej rau txhaj tshuaj.

pharmacodynamics

"Poliglyukin" qhia rau cov lus raws li ib tug tshuaj muaj antiagregatnym thiab hemodynamic los. Cov tshuaj yog ib hydrophilic polysaccharide losis tswvyim dabtsi dej. Tom qab siv cov tshuaj BCC rov qab los nyob rau hauv ib tug luv luv lub sij hawm ntawm lub sij hawm vim lub fact tias nws absorbs dej txaus.

Lub active tivthaiv muaj ib tug siab kuj molecular luj, li ntawd nyob rau hauv cov hlab ntsha nws yog tam sim no rau ib ntev lub sij hawm, thiab nyob rau muab maj mam kis tau los ntawm cov hlab phab ntsa. Nta ntawm cov tshuaj kom sai nce thiab ntev mus kom ntshav siab li qub. "Poliglyukin" thiaj li cov ntaub so ntswg edema, restores BCC eliminates spasm, uas tshwm sim nyob rau hauv peripheral hlab ntsha.

Raug tshem tawm stability yog zoo tuaj ntshav tom qab kev kho mob "Poliglyukin" qhia hais tias cov tshuaj ua rau cov ntshav tsawg khov. Nyob rau hauv tib neeg, normalized nuj nqis, tawg vim txoj kev loj hlob ntawm kev poob siab: microcirculation, ntshav txaus rau cov ntaub so ntswg.

tshuaj

Feem ntawm medicament ua los ntawm lub cev tsuas yog los ntawm ob lub raum. Ib nrab tshem tawm yog nqa tawm thaum lub sij hawm ib hnub. "Poliglyukin" tshem tawm lawm, tsis tseem ceeb txaus feem ntawd nkag mus rau hauv lub hlwb ntawm lub reticuloendothelial system thiab yog tso muaj maj tshwm sim splitting medicament. Vim li no cov txheej txheem, qabzib yog ua, uas yog tsis suav tias yog raws li ib tug qhov chaw ntawm lub zog. Little "polyglukin" tau txais mus rau hauv lub digestive ib ntsuj av.

zaj lus tim khawv

"Poliglyukin" qhia ntawv nyob rau daim ntawv thov tso cai rau koj mus muab thaum tawg capillary ntshav txaus. Cov tshuaj haum rau cov kev kho mob ntawm lub xeev ntawm kev poob siab thiab tiv thaiv (lub taub dej khawb poob siab, lom, kub nyhiab, ua hauj lwm, kev puas). Ib tug yeeb tshuaj siv nyob rau hauv mob ntshav poob uas tshwm sim thaum lub sij hawm ib tug ectopic cev xeeb tub, yug menyuam los yog raws li ib tug tshwm sim ntawm kev poob plig rau sai sai rov qab kho cov BCC. Tshuaj yog hypovolemia, uas yog ib lub txim ntawm ntshav to (compartment syndrome, kub nyhiab). Cov hauj lwm zoo ntawm cov tshuaj yog cai nyob rau hauv qhov kev siv ntawm cov tshuaj tiv thaiv kev ntsuas tsom ntawm kev tiv thaiv embolism (preoperative, postoperative).

Contraindications

Ua ntej kev kho mob yog tsim nyog them sai sai mus contraindications, uas muaj ib tug qhua rau lub chaw "Poliglyukin" phau ntawv qhia. Contraindications rau kev kho mob thiab kev tiv thaiv ntawm kev npaj no yog raws li nram no:

• cerebral stroke;
• High ICP;
• lub xeev nyob rau hauv uas cov kev taw qhia ntawm cov dej nyob rau hauv loj qhov ntau yog undesirable;
• kab mob nrog raum kab mob (anuria, oliguria);
• mob loj heev tawg;
• lub plawv tsis ua hauj lwm;
• mob ntawm homeostasis, coagulation;
• ntxiv nrog los ntshav (tsuas yog - ntshav siab hauv qab no 60 mm Hg ..).

ntau npaum kev kho mob

Ib tug tov tso dej raws leeg thawj coj. Nyob rau hauv tus neeg mob qhov twg cov ntshav tsis yog xam tau tias yog mob, nws tso cai rau kev siv ntawm intra-arterial tshuaj. Tus nqi ntawm cov tshuaj thawj coj los yog txiav txim ib lub zuj zus thiab nyob rau hauv lub dav mob ntawm tus neeg mob, nws lub plawv dhia, cov ntshav siab thiab hematocrit.

Los ntawm kev poob siab lub xeev "Poliglyukin" phau ntawv qhia xav muab bolus tso dej lawv. Cov yuav tsum tau ib koob tshuaj ntawm cov kab mob nyob rau hauv xws li mob yog tsis tsawg tshaj li 400 tiam sis tsis ntau tshaj li 1200 ml. Nyob rau hauv tej zaum nws yog tsim nyog los ua rau kom cov tshuaj ntawm tshuaj mus rau 2000 ml. Yog hais tias qhov kev kawm ntawm BP raws li ib tug tshwm sim ntawm thawj coj ntawm cov tshuaj yog tau coj mus rau li qub, ib tug kev hloov mus rau cov kev taw qhia ntawm cov tshuaj mob.

Nrog tseem ceeb ntshav poob, sib nug xov mus rau 500 ml thiab ntau yam ntxiv, zoo li hauv lub xub ntiag mob anemizatsii tsuas yog siv "polyglukin" tshuaj yog ua ntshav. Raws li ib tug tiv thaiv kev ntsuas kom tiv thaiv kom txhob poob siab thaum lub sij hawm kev phais tshuaj los siv rau cov nrog kua thaum lub siab tau poob - dav hlau. Tus ntse poob nyob rau hauv cov ntshav siab mus rau 60 mm hg. Art. thiab hauv qab no yuav tsum tau cov kev taw qhia ntawm "polyglukin" nyob rau hauv ib tug ntim tsis ntau tshaj 400 mL intraarterially. Tom qab ua hauj lwm uas siv cov tshuaj tiv thaiv khoom, uas tiv thaiv cov kev loj hlob ntawm kev poob siab.

tov yog feem ntau siv rau ib tug concentration ntawm 6% active tshuaj, tab sis siv "Poliglyukin 33" nyob rau hauv tej rooj plaub. Cov lus qhia rau kev siv qhia tau hais tias lub formulation nrog ib tug concentration ntawm dextran yog ib tug pab reagent thaum khij lub compatibility ntawm tus neeg thiab pub.

Thaum nws yog tsim nyog los tshem tawm hlawv poob siab, cov thawj hnub ib tug neeg laus yog xeem los ntawm 2 txhiab. Txhiab mus rau 3. ML tov, yog thov rau lub thib ob hnub tsis ntau tshaj li 1.5 txhiab. Ml npaj. Nyob rau hauv cov zaus thaum lub poob siab yog tsim nyog los tshem tawm cov me nyuam, nws yog thawj muab 40-50 ml / kg txhais tau tias, nyob rau lub thib ob hnub cov tshuaj ib kilogram lub cev hnyav yog txo mus rau 30 ml. Raws li ib tug tiv thaiv kev ntsuas, mus tshem tawm cov tseem ceeb, cov me nyuam kom paub nrog tso dej lawv. Cov kev kawm tshuaj rau ib tug me nyuam yog hom twg los ntawm 10 mus rau 15 ml / kg "Poliglyukin" kev npaj. Cov lus qhia rau kev siv rau cov tsiaj txhu, dhau lawm, ua rau nws tau mus thov cov kev kho mob, raws li nyob rau hauv cov kev taw qhia "polyglukin". Rau cov hom phiaj cov tshuaj txhaj koob tshuaj ntawm 15 mus rau 20 ml / kg. Cov feem ntau tsim nyog koob tshuaj ntawm cov tshuaj no yog txiav txim los ntawm tus kws kho mob.

phiv

Ua ntej siv cov khoom "Poliglyukin cov lus qhia rau kev siv, cov lus teb yog xav kom los saib xyuas cov tau tshwm sim. Feem ntau teeb meem tsis tshwm sim, thiab lub cev ntawm cov neeg mob teb zoo mus rau yeeb tshuaj. Tej zaum nws yuav tsum muaj cai nyob rau hauv daim ntawv ntawm cov kev tsis haum tshuaj ntawm anaphylactic poob siab, o, khaus thiab ua pob liab vog. Nyob rau hauv ib co neeg mob, cov kaus siab muaj yog ib tug zoo nkaus li compression, muaj mob. Tej zaum yuav tam sim no kub taub hau, txo cov ntshav siab, acceleration ntawm lub plawv dhia. Tej zaum koj yuav muaj teeb meem nrog ua pa, kiv taub hau thiab muaj acrocyanosis txoj kev loj hlob. Raws li ib tug tshwm sim overdose nqa ntxiv load rau hauv lub plawv, txwv tsis pub muaj ntau tshaj cov pom zoo koob tshuaj txhais tau tias "Poliglyukin" phau ntawv qhia. Ntsiav tshuaj thiab lwm yam tshuaj uas tus neeg mob noj, muaj peev xwm cuam tshuam rau kev txiav txim ntawm cov tshuaj.

analogs xyuas

Hloov medicament tau "HyperHAES", "Reoglyumanom" los yog "Hai-muaj menyuam tsis taus". Ntsiab uas yog siv rau tib lub hom phiaj raws li lub "Poliglyukin" xws li "Sterofundin", "Reopoligljukin", "Stabizol".

Hloov "Poliglyukin" cov lus qhia rau kev siv uas nyob rau hauv tus neeg mob qhov twg tus neeg mob tsis haum lub tsev no. Rau hloov yuav tsum tau siv "gelofusin", "Refortan N», «Sorbilakt". Ib tug zoo xws li cov nyhuv yuav muaj cob "Albunormom" thiab "Neorondeksom".

Xyuas qhia tias feem ntau cov tshuaj yuav pab nyob rau hauv xa qhov teeb meem. Tab sis txij thaum txhua rooj plaub yog sib txawv, cov kev tshwm sim ntawm nws cov thawj coj tej zaum yuav txawv. Ntau nyob ntawm tus neeg mob tus mob. Cov neeg uas muaj feem yuav tsis siv "Poliglyukin" rau lawv tus kheej, vim txoj kev pheej hmoo ntawm kev saib xyuas ntawm cov nyiaj thiab cov kev loj hlob ntawm sab los.

Nws muaj nuj nqi tshuaj "Poliglyukin" ua, tab sis rau kev kho mob, raws li tau zoo raws li qhov kev siv ntawm kev tiv thaiv, nws tsis yog zoo thiab tau coj mus rau lwm yam teeb meem, lub koob tshuaj ntawm cov tshuaj yuav tsum tau xaiv los ntawm tus kws kho mob ib lub zuj zus. Tsuas yog ib tug kws muaj peev xwm muab cov tshuaj raws li ib tug qub neeg yuav tsis tau los yog txiav txim qhov yuav tsum tau txhaj koob tshuaj thiab tsim nyog txoj kev ntawm cov thawj coj ntawm cov tshuaj. Ntev koob tshuaj ntawm cov tshuaj yog txaus ntshai rau lub plawv, yog li tsis txhob muab kev txaus ntshai, thiab rau nws tus kheej-medicate.