Hemostatic wothandizira wammphuno, magazi a chiberekero, mabala ndi zotupa - mwachidule mankhwala

Mankhwala osokoneza bongo omwe amayenera kusiya magazi, hentatic mankhwala amagwiritsidwa ntchito - tranexam kapena dicinone pa nthawi yapakati.

Nthawi yapakati, azimayi amatha kukumana ndi vuto lalikulu monga kutulutsa magazi. Zimachitika pazifukwa zosiyanasiyana. M'miyezi itatu yoyambirira ya bere, ndikuwoneka kuti ndiwotulutsa magazi, mukukayikira kuti akuwopseza kutaya pathupi, ma ectopic ali ndi pakati komanso kubereka kwa mwana wosabadwayo. Ndipo kuyambika kwa magazi mu theka lachiwiri la kutenga pakati kumatha kukhala chizindikiritso cham'mimba (ndi kupangika kwa hematoma ya m'magazi), malo ochepa kapena preacacenta previa, komanso chizindikiro cha matenda ochulukirapo a khomo lachiberekero kapena la chiberekero.

Mulimonsemo, muyenera kulumikizana ndi dokotala wazachipatala yemwe angadziwe zomwe zimayambitsa matenda ndikupereka mankhwala.

Gwiritsani ntchito dicinone koyambirira kwa mimba, komanso koyambirira kwachiwiri ndi kwachitatu, ndizovomerezeka monga momwe dokotala wakupangirani.

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Malangizo a Dicinone pa mimba

Langizo la dicinone likuti "kugwiritsa ntchito panthawi yomwe mayi ali ndi pakati kumatheka pokhapokha ngati phindu la mankhwalawo kwa mayi limayeneranso kuwopsa kwa mwana wosabadwayo. Ngati ndi kotheka, kuikidwa kwa mankhwalawa panthawi yoyamwa, kuyamwitsa kuyenera kutha. " Kodi izi zikutanthauza chiyani? Mu pharmacology, kupangidwanso kofananako kumawonekera mu malangizo a mankhwalawo, pomwe sipanatenge maphunziro awo a embryotoxic ndi teratogenic. Ndiye kuti, chitetezo cha mankhwalawa ndikulowetsa chotchinga cha placental sichinakhazikitsidwe.

Malinga ndi malangizo, dicinone ya mankhwala (dzina lamalonda - etamzilate) amalimbikitsa kupanga mapulateleti ndi mafuta ofunda, komanso imathandizira kulowa kwa magazi a m'magazi. Kuphatikiza apo, mothandizidwa ndi wothandizila heentatic (he hetaticatic), mphamvu ya njira za mapangidwe a thromboplastin imachulukana, zomwe zimapangitsa kuti magazi azitha kulowa m'malo owonongeka a endothelium akalowa mkati mwa capillaries. Nthawi yomweyo, kuchuluka kwa zinthu zopezeka m'mwazi m'magazi kumakhalabe kosadabwitsa, chifukwa chake, okhala ndi mapuloteni ochepa, dicinone sizikumveka.

Dicinon pa nthawi yomwe ali ndi pakati, kapena,, pakukhetsa magazi komwe kumachitika panthawi yokhala ndi pakati, amakhala ngati othandizira pazomatira zophatikizira zamagulu ambiri (ndiko kuti "kumamatira" kumagawo owonongeka a khoma la mtsempha wamagazi ndi mapangidwe a mapulateleti. Ndi chifukwa cha izi (osati chifukwa cha kuchuluka kwa magazi) kuti magazi amasiya.

Zisonyezero zogwiritsira ntchito dicinone ndikutuluka kwa magazi kwa mkati kwam'magulu osiyanasiyana, kuphatikiza pa kuchitapo kanthu kwa opaleshoni, gynecology ndi obstetrics. Mwa zina mwadzidzidzi ntchito mankhwalawa ndi kuchuluka magazi (hemorrhagic diathesis), m'mapapo mwanga ndi magazi.

Ndipo pakati pa zotsutsana zake zidanenedwa: hypersensitivity to the zvinhu zomwe zimaphatikizidwa, kapangidwe kake ka matenda amtundu monga porphyria, magazi opatsika mwa mawonekedwe a mtsempha wamitsempha, komanso kufinya kwamtsempha wamagazi ndi thrombus (thromboembolism).

Tranexam kapena dicinone pa nthawi yapakati: ndibwino bwanji?

Monga dicinone, panthawi yoyembekezera, madokotala amatha kupereka mankhwala enanso a hepatatic - tranexam (ma syonyms - urugol, tranex). Mankhwalawa amawoloka chotchinga ndipo chifukwa chake amagwiritsidwa ntchito pokhapokha pokhapokha dokotala amafotokoza kuti maubwino omwe ali ndi pakati kwa mayi woyembekezera amaposa chiwopsezo cha mwana wosabadwayo.

Kuphatikiza apo, popereka tranescam, kuphwanya kwake kuyenera kuganiziridwanso: thrombosis kapena kuopseza kukula kwawo, mitsempha ya thrombophlebitis, thromboembolic syndrome, kuchepa kwa masanjidwe amtundu, kulephera kwa aimpso.

Tranexam pa nthawi ya pakati imagwiritsidwa ntchito pofanana ndi dicinone. Koma pharmacodynamics ake ndi osiyana. Tranexam imagwira ntchito ngati heentatic yokhala ndi chiwindi china chotchedwa fibrinolysin (plasmin), chomwe ndi gawo la magazi lomwe limalepheretsa kupindika kwake. Mankhwala amachepetsa kuyambitsa kwa proenzyme inayake ya plasminogen ndikusintha kwake kukhala fibrinolysin. Ndiye kuti, zimakhudza hemostasis, kukulira kwazinthu zamkati.

Mapiritsi a Tranexam (250 mg), madokotala amapereka piritsi limodzi katatu patsiku. Ndi magazi mu nthawi yoyambirira ya mimba - kusiya kuyamwa kwapadera - tsiku lililonse mankhwalawa si oposa 1000 mg (mapiritsi 4), mtsogolomo - 1000-2000 mg patsiku. Njira ya jakisoni imaphatikizira kulowetsedwa kwa transescam mu mawonekedwe a yankho (ma ampoules a 5 ml). Mlingo watsimikiza kutengera kuchuluka kwa kuchepa kwa magazi ndi thupi: 10 mg pa kilogalamu.

Ngati mutenga tranexam kapena dicinone pa nthawi yomwe muli ndi pakati, ndiye kuti mavuto ena osafunikira angawoneke. Chifukwa chake, kutenga dicinone kumatha kupweteka mutu, chizungulire, kufooka kwa nkhope, nseru, kutentha kwam'mimba, kupweteka m'mimba, kutsika magazi, dzanzi (paresthesia) m'miyendo.

Ndipo zotsatira zoyipa za tranexam zimawonekera mu mawonekedwe a chizungulire, kufooka, kugona, kuwotcha khungu, kuyabwa, kusanza, kutsegula m'mimba, kutentha kwa thupi, kusowa chilakolako, kuzindikira kwa khungu, komanso kupweteka pachifuwa.

Mlingo wa Dicinone pa nthawi yapakati

Mankhwalawa amapezeka mu mawonekedwe a mapiritsi (250 mg aliyense) ndi yankho la jakisoni (mu 2 ml / 250 mg ampoules).

Mankhwala othandizira tsiku ndi tsiku a dicinone pa nthawi ya pakati ndi 10-20 mg wa mankhwala pa kilogalamu yolemera. Monga lamulo, adotolo amafotokozera kuti atenge mapiritsi a dicinone pa nthawi yomwe ali ndi pakati, 250m kamodzi - katatu patsiku. Kuchuluka kwakukulu ndi kukonzekera kwa pakamwa kumatheka patatha maola atatu piritsi litalowa m'mimba ndipo limakhala kwa maola asanu. Kutalika kwa mapiritsi kumatsimikiziridwa ndi dokotala kutengera mphamvu yakuwona.

Kugwiritsa ntchito kwa dicinone - munjira ya jakisoni wamkati kapena wamkati - kumayambitsa kukhudzika kwakukulu: patatha kotala la ola, ndipo mphamvu yake imawonekera pafupifupi pakatha ola limodzi ndi theka (ndi makonzedwe a kutsekeka - kwakanthawi). Chifukwa chake, jakisoni wambiri wa dicinone pa nthawi yapakati ndi yoyenera kwambiri kuti mawanga awoneke bwino.

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Mtengo wa dicinone pa nthawi yapakati

Lero - kutengera wopanga komanso dera la Ukraine - mtengo wa dicinone pa nthawi yomwe ali ndi pakati umasiyanasiyana: dicinone pamapiritsi (250 mg, phukusi la zidutswa zana) - m'gulu la 95-135 UAH., Dicinone mwanjira yankho la jakisoni (250 mg, ma ampoules a 2 ml, kuyikika kwa 50 zidutswa) - kuchokera 90 mpaka 145 UAH. kunyamula. Mtengo wapakati wamagululi amodzi (ngati ku mankhwala ena ogulitsa omwe amagulitsa mankhwalawa payekhapayekha) ndi pafupifupi 2 UAH.

Mitengo ya tranex pamapiritsi (30 ma PC. Pack) yopangidwa ku Russian Federation - m'gulu la 178-225 UAH., Mtengo wanyamula tranex (30 makapisozi a 250 mg) wolemba Malesci - 132-168 UAH. Ugurol (tranexam) wa kampani ya Rottafarm mu ma ampoules a 5 ml (mu phukusi la ma ampoules 5) amatenga pafupifupi 220-240 UAH. Ndipo mtengo wa tranexam wogwiritsa ntchito makolo ndi 768-790 UAH. kwa ma 10 ampoules a 5 ml.

Ndemanga za dicinone pa nthawi yapakati

Mankhwala a hepatostatic, makamaka tranexam kapena dicinone pa nthawi yoyembekezera, pakafunika kusiya magazi, amagwiritsidwa ntchito ngakhale anali ndi mavuto. Kugwiritsa ntchito mankhwalawa, monga momwe zikuwonetsedwera ndi zitsanzo zamankhwala komanso kuwunika kwa dicinone pa nthawi yapakati, ndizoyenera, chifukwa zimathandizira kuyimitsa magazi komanso nthawi zambiri kupewa kutaya kolakwika pamigawo yoyamba ya kubereka. Nthawi yomweyo, magwiritsidwe a magawo a heestatic system, ndiko kuti, kachitidwe komwe kamatsimikizira kuchuluka kwa magazi ndi kuwundana ndikusungabe madzi ake, ndi kochepa.

Ndipo ndemanga za dicinone pa nthawi yomwe amayi omwe adamwa omwe adamwa mankhwalawa ndi osiyana. Adathandizira wina kukhalabe ndi pakati, koma wina, ngakhale akuyesetsa kwa madotolo, sanathe kuchita izi ...

Kumbukirani kuti dicinone pa nthawi yapakati - monga mankhwala ena aliwonse omwe ali pamavuto awa - ayenera kuuzidwa ndi dokotala! Ndipo adotolo ayenera kukhala otsimikizira kuti phindu lomwe lingakhalepo lamankhwala wolembedwa kwa mayi woyembekezera limakhala lalikulu kuposa chiopsezo ku moyo ndi thanzi la mwana wake wosabadwa.

Kodi mankhwala osokoneza bongo ndi otani

Mchitidwe wa kuphatikizika kwa magazi mthupi la munthu kumaimiridwa ndi dongosolo lovuta la zochita za gulu la zinthu (zophatikizika). Zambiri mwazinthu izi ndi mapuloteni. Mpaka pano, kukhalapo kwa zinthu 35 zosakanikirana kwakhazikitsidwa: ma plasma 13 ndi 22 mapulateleti. Kuperewera kwa chimodzi mwazinthuzi kumabweretsa kuwoneka kwa magazi amitundu mitundu.

Mankhwala a Hemostatic (kuchokera ku Greek. - kuyimitsa magazi) amapangidwa kuti athetse zomwe zimayambitsa kusokonezeka m'thupi ndikuletsa magazi. Mfundo yakuchitikira kwa ma he hetatic othandizira imakhazikika pakudzaza kuchepa kwa michere yawo, yolimbikitsa thrombosis pamitsempha yowonongeka ndikuwapanikiza ntchito ya fibrinolytic (Kutha kwa zigawo zamagazi).

Momwe mungalere magazi kutaya msambo

Kuchepetsa magazi kwambiri kwa azimayi pa nthawi ya msambo (kuposa masiku 80 a 80) kumatha kuchitika pazifukwa zosiyanasiyana. Musanagule mankhwala a hepatatic mankhwala opangira mankhwala pa upangiri wa zamankhwala, muyenera kulumikizana ndi dokotala wazachipatala ndi vutoli. Ndi dokotala wokhazikika amene angadziwe chomwe chinayambitsa kupatuka, ndikuwalimbikitsa wothandizira.

Mankhwala ogwiritsira ntchito mankhwalawa. Amaletsa kwakanthawi kutuluka kwa magazi kuti thupi lithe kupanga kuchepa. Njira ya chithandizo imayikidwa ndi dokotala ndipo imaphatikizapo mankhwala omwe amakhudza mwachindunji zomwe zimayambitsa matenda.

Mapiritsi a Hemostatic ndi njira yothandiza yotaya magazi kwambiri msambo. Mankhwala osankhidwa molondola otengera kutuluka kwa magazi kutulutsa magazi kungabwezeretsenso kuchepa kwa zinthu zofunika kuzilala. Musanayambe kumwa mankhwala osokoneza bongo, muyenera kudziwa kuti zina mwazomwe zimayambitsa ndi zotsutsana. Mapiritsi ofala kwambiri olimbitsa thupi akufotokozedwa pagome apa:

Analogue yopanga ya vitamini K. Yopangidwira kuti ipangitse kaphatikizidwe ka prothrombin

Pathologically magazi kwambiri coagulability, kutupa thrombosis

Khungu limakhudza mawonekedwe a kuyabwa

Chithandizo cha mankhwala azitsamba vasoconstrictor

Kuthamanga kwa magazi, kutenga pakati, nthawi yotsitsa

Kuwonetsedwa kwa zizindikiro za mziwi

Vasoconstrictor kanthu limodzi ndi yafupika capillary kupezeka

Matenda a urological, thrombosis

Imathandizira kupanga thromboplastin, yomwe imathandizira pakupanga kwapamwamba kwa thrombus yoyamba

Kupweteka mutu, nseru, kupweteka kwa miyendo

Imaletsa mapangidwe a mapuloteni a plasmin, omwe amachititsa kuti magazi azisungidwa

Brain hemorrhage, myocardial infarction

Kusintha, mavuto amtundu wamtundu, chizungulire

Erythrostat msambo

Mankhwala a hemorrhage mothandizidwa ndi Erythrostat amapezeka mapiritsi awiri kapena atatu a heentatic maola 5 aliwonse asanadye. Maphunzirowa sayenera kupitilira masiku 10, pambuyo pake ndikofunikira kupuma pafupifupi miyezi itatu. Ngati mubwererenso nthawi imeneyi, muyenera kufunsa dokotala kuti akupatseni malangizo. Zikakhala choncho, chithandizo chamankhwala ena okhala ndi hepatatic ingafotokozeke.

Ascorutin ndi magazi a chiberekero

Ascorbic acid, yomwe ndi gawo la Ascorutin, imawerengedwa kuti ndi gawo lofunikira popanga mafupa a collagen. Chifukwa cha khalidweli, zotsatira zake zimatheka. Kukhazikika kwa mankhwala a Ascorutin popewa kumakuthandizani kuti mulimbikitse makoma amitsempha yamagazi ndikuchepetsa mphamvu yake. Imwani mapiritsi kanayi pa tsiku piritsi limodzi. Mphamvu ya mankhwalawa imachulukana, kotero, zotsatira zabwino za momwe tikugwiritsira ntchito zimawonekera kwambiri. Maphunzirowa adapangidwira masabata atatu.

Dicinon ndi Tranexam nthawi yomweyo

Mapiritsi ena okhetsa magazi amakhala othandiza kwambiri ngati amamwa pakamwa. Dicinon ndi Tranexam amasankhidwa ndi akatswiri pazochitika zofunikira zithandizo zadzidzidzi. Ntchito ya Tranexam ndikuchepetsa magazi, ndipo Dicinon amateteza thupi ku mwayi wokhala ndi thrombosis. Ma hepatatic othandizira amayenera kumwedwa malinga ndi chiwembu: mlingo woyamba ndi mapiritsi awiri aliyense, kenako piritsi lililonse maola 6.

Njira yodzidzimutsa yotaya magazi msanga ndi jakisoni wa hemostatic. Kutsekeka kwa mankhwalawa kumathandizira kupanga mapangidwe othamanga kwambiri a magazi omwe amawatchinga magazi. Mphamvu ya jekeseni wa mankhwalawa imatheka mu mphindi 10-15. pambuyo makonzedwe. Njira zabwino kwambiri zothetsera ma infusions poika chithandizo chamankhwala:

• Etamsylate
• Calcium calcium
• Aminocaproic acid
• Zopanda pake
• Oxetocin
• Methylergometrine
• Vikasol.

Oxetocin yotulutsa magazi muchiberekero

Kuchita kwa hexaticatic mankhwala Oxytocin ndikupititsa patsogolo ntchito za contractile minofu yosalala ya chiberekero. Zotsatira zake, izi, kuchuluka kwa calcium mkati mwa maselo kumawonjezeka, ndipo magazi amatuluka. Ndikulimbikitsidwa kupaka jekeseni ya mankhwala intramuscularly kuti mukwaniritse bwino. Mlingo amawerengedwa payekhapayekha kwa wodwala aliyense potengera zomwe zikupezeka pakumvetsetsa kwamankhwala. Dongosolo limodzi sangathe kupitilira 3 IU.

Aminocaproic acid wokhudza kusamba

Mphamvu yamphamvu ya hemostatic ya aminocaproic acid imakhazikitsidwa ndi chopinga cha kusintha kwa profibrinolysin (mawonekedwe osagwira a plasmin) kupita ku fibrinolysin (fomu yogwira). Kugwiritsa ntchito mankhwalawa kwa msambo wambiri kumakhudzana ndi kuyamwa kwamiyeso ya magawo asanu pa ola lililonse mpaka kuchuluka kwa mawonedwe kumachepetsedwa.

Hemostatic wothandizira kuti amete

Popewa kuchepa kwa magazi chifukwa cha kuwonongeka kwa ma minofu, minyewa ya mankhwala am'magazi imagwiritsidwa ntchito. Mabala ang'onoang'ono komanso mabala pakhungu limatha kuchiritsidwa ndi hydrogen peroxide chifukwa chakupha matenda. Mphamvu yopanga mphamvu ya peroxide imaletsa magazi kutuluka. Milandu yowopsa kwambiri imafuna kugwiritsa ntchito mankhwala osokoneza bongo omwe amatha kukhathamiritsa.

Hemostatic ufa wokhala ndi ma anesthetics ndiwosavuta kugwiritsa ntchito. Chofunikira chachikulu ndi adrenaline, yomwe ili ndi mphamvu ya vasoconstrictor, potero ikukwaniritsa mphamvu yoletsa kutulutsa magazi pang'ono ndi zowonongeka zapamwamba.Kukonzekera kwa mankhwalawa kwakanthawi kwamabala kumapangidwa kuchokera ku magazi amunthu kapena a nyama.

Hemostatic mankhwala a nosebleeds

Kuti tisiye mphuno zamitundu yosiyanasiyana, plugging iyenera kuchitidwa. Pazifukwa izi, gauze, chithovu kapena chibayo cha pneumatic chitha kugwiritsidwa ntchito. Limbikitsani izi zingathandize he hentatic mankhwala omwe kale amagwiritsidwa ntchito pa swab. Mankhwalawa ndi:

• Etamsylate
• Dicinon
• Epsilon-aminocaproic acid,
• Calcium calcium
• Vikasol.

Chochititsa chachikulu kwambiri cha nosebleeds ndi ochepa matenda oopsa, chifukwa chake ndikofunikira kupereka mwachangu hypotensive zotsatira. Amakhala ndi kuchepetsa magazi munjira yamankhwala. Mankhwala omwe zochita zawo zimapangidwira kuti zizigwiritsidwa ntchito kwa nthawi yayitali, sizoyenera kuthandizidwa mwachangu chifukwa cha mphuno.

Ndi zotupa m'mimba

Kutulutsa kwadzidzidzi chifukwa cha kupindika kwa hemorrhoid kumatha kuimitsidwa mothandizidwa ndi ma heentatic othandizira omwe amagwiritsidwa ntchito mitundu ina ya kuchepa kwa magazi (Dicinon, Vikasol, Etamsylate, etc.). Kuphatikiza apo, Mpumulo ndi mankhwala othandiza, omwe amapezeka mu mawonekedwe a suppositories ndi mafuta. Mafuta, glycerin ndi mavitamini ovuta, omwe ali maziko a suppositories, adachiritsa mabala komanso katundu wa hemostatic. Kugwiritsa ntchito makandulo kutsekereza magazi nthawi zonse kumatsutsana.

Pochita opaleshoni yakumalo ndikuletsa magazi m'deralo kuchokera ku ming'alu ya anus, mutha kugwiritsa ntchito chinkhupule chodzikongoletsera chokha chokhazikika mu njira yothandizira mankhwalawa. Kukhazikitsidwa kwa suppositories ndi masiponji kumathandizira kuthetsa kutaya magazi, koma simuyenera kuwerengera phindu lokhalitsa.

Contraindication

The yogwira zinthu zomwe ndi gawo la he hentatic kukonzekera zimatha kuchititsa thupi lawo siligwirizana. Kuti mupewe mavuto, ndikofunikira kuchenjeza adotolo za kukhalapo kwa chizolowezi chomwe chilipo. Hypersensitivity imodzi mwazolemba za mankhwala ndikutsutsana mwachindunji ndikugwiritsa ntchito, kotero ndikofunikira kuphunzira mosamala malangizo ndi kapangidwe kake. Kunyalanyaza malangizo omwe ali mu malangizo a mankhwalawa, malinga ndi kuchuluka kwa kuphwanya kwapakati komanso pafupipafupi, zingayambitse kukula kwa thrombohemorrhagic syndrome.

Mukalandira malangizo a dokotala okhudzana ndi kugwiritsa ntchito mankhwala osokoneza bongo, mutha kuyang'ana pazomwe mungagwiritse ntchito pulogalamu yamagetsi yamagetsi kuti mudziwe momwe mungasankhire ndalama zomwe zingatheke. Pofuna kugula malo achidwi pamtengo wotsika mtengo wogulitsa pa intaneti, muyenera kudziwa bwino kuchuluka kwa mankhwalawa pogwiritsa ntchito dera lanu. Mutha kuyitanitsa chida chomwe mwasankha, mutayang'ana pafupifupi deta yomwe ili patebulopo:

Makhalidwe ambiri a Dicinon

Mankhwalawa amapangidwira kupewa komanso kuchiza magazi a capillary ochokera kumayendedwe osiyanasiyana. Amagwiritsidwa ntchito m'magawo ambiri azachipatala: otolaryngology, gynecology, immune obstetric, kuchiza matenda amaso, urology, etc.

Mankhwalawa amalembedwa kuti athetse magazi nthawi yayitali komanso atachitidwa opaleshoni, menorrhagia, yomwe imakhala ndi nthawi yayitali, magazi kuchokera pamphuno, m'kamwa, m'mimba. Kuphatikiza apo, Dicinon amagwiritsidwanso ntchito ngati ana: ndi chithandizo chake, zotupa za intracranial mwa ana zimachotsedwa atangobadwa.

Kufunikira kotere kwa mankhwalawa kumafotokozedwa ndi zomwe zimagwiritsidwa ntchito - ethamzilate, yomwe imayamba kuchita zinthu mwachangu: pambuyo pakubayidwa - pambuyo pa mphindi 5-15, mutatha kumwa mapiritsi, zotsatira zake zimawonekera patatha maola 1-2. Ethamsylate imayambitsa mapangidwe a mucopolysaccharides m'makoma a capillary, omwe chifukwa cha izi amawonjezera mphamvu zawo komanso kutsekeka, komanso amathandizira pakupanga kuchuluka kwakukulu kwa thromboplastin m'masamba a lesion. Nthawi yomweyo, kupanga zinthu zomwe zimapangitsa kuti magazi azithamanga, komanso nthawi yomweyo, Dicinon alibe gawo pakapangidwe kazinthu zamagazi.

Mankhwalawa amapezeka m'mapiritsi, omwe amagwiritsidwa ntchito maphunziro, ndi jakisoni wothandizira njira yolowerera ndi kutsekeka kwa makonzedwe. Nthawi zina, yankho la jakisoni limagwiritsidwanso ntchito kunja m'njira yovala kapena ma tampon: mavalidwe ake amakhala osungunuka pokonzekera ndikugwiritsa ntchito pamalo owonongeka.

Zomwe zimagwiritsidwa ntchito pamafomu amodzi kapena mitundu ina ya mankhwalawa zimatengera mtundu wa kutulutsa magazi ndi cholinga chamankhwala. Ngati mukufuna kuthandiza mwachangu, ndiye kuti wodwalayo amapatsidwa jakisoni, chifukwa makonzedwe a prophylactic, mapiritsi nthawi zambiri amawayikira, koma mapangidwe a jekeseni ndizothekanso.

• Mapiritsi: Mlingo wa tsiku ndi tsiku wa akulu - 10-20 mg / kg pamagulu angapo, ngati kuli kotheka, gawo limodzi limatha kufika 750 mg. Mu nthawi ya postoperative, mapiritsi amamwa ndi kupumula kwa maola 6 a 250-500 mg. Kwa ana, muyezo umatsimikizika kuchokera pazowerengeka za 10-15 mg pa 1 makilogalamu, zomwe zimagawidwa m'magawo angapo.
• Zingwe zimaperekedwa mkati / m kapena / in. Mlingo wa tsiku ndi tsiku wa akulu ndi 10 mpaka 20 mg / kg. M'magulu olinganizidwa, mankhwalawa amaphatikizidwa ola limodzi isanachitike komanso atamaliza - maola 6 aliwonse, 250-500 mg, mpaka magazi atasiya. Ngati ndi kotheka, mankhwalawa amaperekedwa pa opareshoni. Jekeseni wa ana amapatsidwa mankhwala, omwe amawerengera kutengera chiŵerengero cha 10-15 mg pa 1 kg, yogawidwa majekeseni angapo.

Dicinone nthawi zambiri imalekerera, koma imatha kupweteketsa mutu, kuzizira kwamiyendo, chizungulire, kupsinjika, kutupa, nkhope ndi mayankho amisala.

Mankhwala sayenera kugwiritsidwa ntchito kwa odwala omwe ali ndi thrombosis, coagulability yayikulu, hemoblastosis mwa ana, chidwi chachikulu ndi zigawo zikuluzikulu.

Ntchito gynecology

Monga mankhwala aliwonse, Dicinon ayenera kugwiritsidwa ntchito ndi lingaliro la dokotala. Ngati mankhwalawa adafotokozedwa ngati azimayi amayamba msambo, ndiye kuti ndi bwino kuyamba kumwa mankhwalawa kwa masiku atatu musanachitike tsiku lomwe mukuyembekeza ndipo mkati mwa masiku 5 a MC, kumwa mapiritsi awiri katatu patsiku. Maphunzirowa ali masiku 10. Mwezi wotsatira, ndibwino kubwereza phwandolo kuti muphatikize zomwe mwapeza.

Sitikulimbikitsidwa kumwa mapiritsi oti muchepetse nthawi ya msambo, chifukwa izi zimakhudza kwambiri msambo.

Zolemba za Tranexam

Mankhwala okhala ndi he hetatic kwenikweni, koma kugwira ntchito mosiyana ndi Dicinon. Hemostatic zotsatira zimatheka chifukwa cha zimatha tranexamic acid. Zotsatira zake zimawonetsedwa ngati magazi atayambitsa kuchuluka kwa fibrinolysis m'magazi - imodzi mwazinthu zamagazi zomwe zimalepheretsa kupangika kwake. Acid imalepheretsa kutsegula kwa plasminogen, yomwe imafunika kuti khungu lipangidwe ndipo limakhudza kayendedwe ka magazi, limathandizira kusintha kwake mkati mwa ziwiya.

Mankhwalawa, monga Dicinon, amapezeka m'mitundu ingapo (mapiritsi ndi ma jakisoni), omwe amalola kuti azigwiritsidwa ntchito popanga magazi amtundu uliwonse oyambitsidwa ndi anticoagulant chigawo: mphuno, gingival, uterine, m'mimba, atachitidwa maopareshoni zosiyanasiyana. urological). Mankhwalawa amamuthandizira kuti apange cholowa m'magazi, matupi awo sagwirizana ndi kutupa.

Ndizotheka kugwiritsa ntchito panthawi yomwe muli ndi pakati, koma pokhapokha ngati kugwiritsidwa ntchito kwake kuli ndi zifukwa zabwino zofunikira kwa mayi. Kuchepetsa kumeneku kumachitika chifukwa chakuti tranexamic acid imawoloka placenta ndipo imatha kusokoneza kukula kwa mluza / fetus.

Chifukwa chake, zikafika pakukhazikitsidwa kwa imodzi mwazamankhwala awiri: Dicinon kapena Tranexam, ndipo ndizabwino kwambiri, muyenera kutuluka pazinthu zambiri: kuzindikira koyenera, momwe wodwalayo alili, zifukwa zomwe zimadzetsa matenda, contraindication, etc.

Vikasol ndi chiyani?

Mankhwala ochepetsa mphamvu ya antihemorrhagic yozikidwa pa menadione - chinthu chopangidwa, cholowa m'malo mwa vitamini K. Amatha kukhudza kaphatikizidwe ka prothrombin ndi zinthu zina zomwe zimatsimikizira kuwumba kwa magazi ndi kusintha kwa matenda ake.

Amagwiritsidwa ntchito ngati magazi amatuluka chifukwa cha kuperewera ndi hypovitaminosis K: ndi matenda am'mimba, matenda a hemorrhagic mwa akhanda, ovulala ndi magazi akulu, atachitidwa opaleshoni. Amagwiritsidwa ntchito mosamala mu matenda akhunyu kuti athetse magazi osafunikira m'chiberekero, kusamba kwa msambo, komanso amatchulidwa kukhetsa magazi chifukwa cha mankhwala ena. Amawerengera amayi apakati omwe ali m'magawo omaliza kuti ateteze magazi kuchokera kwa ana akangobadwa.

Mankhwalawa amapangidwa m'mapiritsi ndi yankho la jakisoni wamkati ndi wamkati.

Mankhwala a hepatostatic amadziwikiratu anthu omwe amakhala ndi magazi ochulukirapo, ma thrombosis, thromboembolism, komanso amatsutsana pazinthu zomwe zili. Nthawi zambiri amaloledwa nthawi zonse, koma mwa ena mawonedwe olakwika kuchokera pakhungu amatha (kuyabwa, zotupa, urticaria), makamaka kwa odwala omwe ali ndi vuto la bronchospasm. Mwa makanda, zimatha kudwala matenda a hemolytic.

Kutulutsa magazi mu ziwalo ndi minyewa kumachitika pazifukwa zosiyanasiyana, chifukwa chake, posankha mankhwala kuti muthane nawo, wina ayenera kuchoka pazomwe zimayambitsa matenda. Chifukwa chake, zomwe zingakhale bwino - Dicinon, Vikasol kapena Tranexam - zimatengera kupezeka kwake komanso mawonekedwe a mkhalidwe wa wodwalayo.

Kodi pali kusiyana kotani pakati pa Tranexam ndi Dicinon?

Choyamba, zinthu zosiyanasiyana zogwira ntchito. Mu Chislovenia Dicinon ndi etamzilatezolimbikitsa kupanga mapulateleti m'thupi ndi zinthu zophatikizika m'malo owonongeka khoma lamitsempha. Ndi mankhwala opangira ma hemostatic omwe ndi othandiza kwambiri pakukha magazi kwa capillary.

Kuyesedwa kwamankhwala koyesedwa ndi placebo kumawonetsa bwino othandizira a etamsylate osagwira ntchito ya uterine yotulutsa magazi mosiyanasiyana. Imagwira pang'onopang'ono ndipo nthawi zambiri imalekeredwa bwino, makamaka ndi DMK - magazi osokonekera a chiberekero (chifukwa cha kusokonekera kwa mahomoni kapena kuwonongeka kwa ntchito yamchiberekero) ngati kulera sikufunika.

Dicinon amapezeka mu mawonekedwe a mapiritsi kapena jakisoni, pafupipafupi komanso nthawi yogwiritsira ntchito zomwe zimatengera kuuma kwa magazi ndi mphamvu zakusintha. Nthawi zambiri izi ndi 250-500 mg (ofanana ndi mapiritsi 1-2) katatu patsiku, koma chizindikirochi chimasankhidwa nthawi zambiri ndi dokotala malinga ndi kulemera kwa wodwalayo ndipo amatha kuwonjezeka kwambiri malinga ndi kuopsa kwa vutolo.

Domane Tranexam ndi mankhwala atsopano a heentatic okhala ndi chinthu chogwira ntchito tranexamic acid. Monga Dicinon, Tranexam amagwiritsidwa ntchito pochita opareshoni, koma ndiwothandiza kwambiri pakukha magazi kwa matenda a m'mimba (kusanthula kwa meta ka 2018). Mwachitsanzo, ndi msambo wolemera, umatsimikiziridwa kuti umachepetsa magazi ndi 34-58%. Amapereka zotsatira zabwino pakatupa am'mimba komanso pambuyo pake.

Imapezekanso m'mapiritsi kapena ma ampoules, koma mankhwalawa ndi apamwamba kwambiri (kupatula pakati pathupi) ndipo amakhazikitsidwa kutengera matenda kapena matenda ena ake. Mwachitsanzo, mwa akazi, 1 g ya tranexamic acid maola 6 aliwonse amachepetsa kuchepa kwa magazi kwa msambo ndi theka. Chifukwa chake, avareji ya pafupifupi 3000-5000 mg patsiku, yogawidwa mu 3-4 Mlingo, womwe umapatsa kuchuluka kwakukulu malinga ndi mapiritsi. Chifukwa chake, nthawi zambiri amalembera mtundu wa majekeseni ndikusintha kwa mawonekedwe a piritsi mutatha kukonza. Kutalika kwa maphunzirowa kumasiyana kuyambira masiku 3 mpaka 10.

Khalidwe la Tranexam

Ichi ndi mankhwala osokoneza bongo, omwe kumasulidwa kwake ndi mapiritsi ndi yankho mu ma ampoules othandizira. Izi zimapangitsa kuti pakhale anti-yotupa m'deralo, imitsani magazi ndikuchepetsa chiopsezo cha chifuwa. Mankhwala omwe amagwira ntchito ndi tranexamic acid, omwe amachotsa bwino edema ndikuchepetsa kutuluka kwa magazi.

Kupanga kwa kanthu kwa mankhwalawa ndikuti chigawo chogwira ntchito chimakhudza kutseguka kwa plasminogen ndikuwongoletsa, ndikuletsa kutembenuka kwake kukhala plasmin. Imasiya magazi oyambitsidwa ndi kuchuluka kwa fibrinolysis. Chifukwa cha kuponderezedwa kwa mapuloteni othandizira ndi ziwalo zomwe zimayambitsa zochitika zosiyanasiyana, zimakhala ndi zotsutsa komanso zosagwirizana ndi zotsatira zake.

Kuphatikiza kwakukulu kwa mankhwalawa kumachitika patatha maola atatu pambuyo pake. Zigawo za mankhwala zimatha kumangiriza mapuloteni a plasma, kulowa mkati mwa placenta ndikuchotseredwa mkaka wa m'mawere. The achire zotsatira kumatenga mpaka 17 maola. Ngati munthu wasokoneza ntchito ya impso, ndiye kuti pali mwayi wambiri wothandizira. Chifukwa cha kukonzekera kwamitsempha, mankhwalawa amakhala ndi mphamvu ya analgesic.

Zisonyezero zogwiritsira ntchito mapiritsi ndi hentatic mapiritsi:

• chapamimba, m'mphuno, pambuyo pake, kutulutsa magazi mu chiberekero, kuphatikizira kumbuyo kwa matenda a von Willebrand,
• hematuria, magazi pambuyo kupaka dzino kwa odwala hemorrhagic diathesis, khomo lachiberekero kwa carcinoma, prostatectomy,
• magazi pa maziko a zilonda zam'mimba za chikhodzodzo, khansa ya m'magazi, matenda a chiwindi, atachitidwa opaleshoni pachifuwa komanso kulekanitsidwa kwa chindapusa.
• magazi munthawi ya pakati
• Matenda oopsa - mankhwala osokoneza bongo ndi poizoni, uritisaria, khungu
• matenda ashuga retinopathy,
• cholowa chamakolo,
• matenda otupa - stomatitis, laryngitis, pharyngitis, tonsillitis, aphthae wa mucosa pamlomo.

Mu gynecology, Tranexam amagwiritsidwa ntchito kuletsa kutulutsa magazi muchiberekero. Fotokozerani mankhwalawa ndikuwopseza kuti muchotse mimbayo, mikwingwirima yayikulu m'mayambiriro oyamba, ndikukhala kukhetsa magazi kwa nthawi yayitali (sabata 1). Mankhwala amagwiritsidwa ntchito pakuwonongeka kwambiri kwa magazi nthawi ya msambo.

• Hypersensitivity pamagawo a mankhwala,
• akuwuka patokha.

Moyang'aniridwa ndi dokotala, Tranexam amatengedwa pazinthu zotsatirazi:

• myocardial infaration
• thromboembolic syndrome
• vein thrombophlebitis,
• matenda am'mimba,
• kulephera kwa aimpso
• kwamikodzo thirakiti hematuria,
• kuwonongeka kwa mawonekedwe
• thrombohemorrhagic zovuta,
• kuopseza thrombosis.

Nthawi zina kumwa mankhwalawa kumayambitsa mavuto:

• kusanza, kusanza, kuchepa kwa chakudya, kutsegula m'mimba, kutentha kwa mtima,
• kuphwanya mtundu wamtundu, kugona, chizungulire,
• thromboembolism, thrombosis,

• Hypersensitivity pamagawo a mankhwala,
• akuwuka patokha.

Moyang'aniridwa ndi dokotala, Tranexam amatengedwa pazinthu zotsatirazi:

• myocardial infaration
• thromboembolic syndrome
• vein thrombophlebitis,
• matenda am'mimba,
• kulephera kwa aimpso
• kwamikodzo thirakiti hematuria,
• kuwonongeka kwa mawonekedwe
• thrombohemorrhagic zovuta,
• kuopseza thrombosis.

Nthawi zina kumwa mankhwalawa kumayambitsa mavuto:

• kusanza, kusanza, kuchepa kwa chakudya, kutsegula m'mimba, kutentha kwa mtima,
• kuphwanya mtundu wamtundu, kugona, chizungulire,
• thromboembolism, thrombosis,
• urticaria, kuyabwa, zotupa pakhungu.

Tranexam adalembedwa kuti aziwopseza kutha kwa bere, kutulutsa kumayambiriro kwa magawo oyamba, ndikutuluka kwa magazi kwa nthawi yayitali.

Opanga mankhwalawa: Moscow Endocrine Chomera (Moscow), Nizhpharm OJSC (Nizhny Novgorod), Obninsk Chemical and Pharmaceutical Company CJSC (Obninsk).

Chikhalidwe cha Dicinon

Ndi mankhwala osokoneza bongo omwe amathandiza kupewetsa magazi. Zomwe zimagwiritsidwa ntchito ndi mankhwala ndi ethamylate. Mlingo wa mitundu - mapiritsi ndi yankho la jakisoni. Dicinon amadziwika osati ndi heestatic katundu. Mankhwalawa amathandizira kulimbitsa makoma amitsempha yamagazi, kuchepetsa kutsika kwawo, komanso kumalimbikitsa kugundika kwa magazi.

Dicinon ali ndi machitidwe a vasoconstrictive, chifukwa amathandizira kutulutsidwa kwa prostacyclin Pgl2.

Zimathandizanso kuti magazi asiye kutuluka. Ngakhale atakhala othekera kwambiri, mankhwalawa samatsogolera pakupanga magazi ndikuwonjezera magazi.

Pambuyo makonzedwe, achire zotsatira zimawonedwa pambuyo 2,5 maola atatu, pambuyo mtsempha wamagazi - pambuyo mphindi 20, pambuyo mu mnofu jekeseni - pambuyo 1-1.5 maola. Mankhwalawa amatha kwa maola 4-6. Imatha kulowa mu placenta.

Zisonyezero zogwiritsidwa ntchito:

• kuyimitsa ndi kupewa magazi akutuluka ndi mafunde a m'magazi mu otolaryngology,
• m'mano opaleshoni
• matenda oopsa chifukwa cha mphuno
• mu ntchito ophthalmology mankhwalawa glaucoma, matenda a mtima ndi keratoplasty,
• matenda a shuga a shuga
• hemorrhagic diathesis (kuphatikizapo matenda a Werlhof),
• mu neurology - ndi ischemic stroke, mu opaleshoni yodzidzimutsa - kuyimitsa magazi m'mapapo ndi m'matumbo,
• intracranial hemorrhage musanabadwe komanso makanda obadwa kumene.

Dicinon amagwiritsidwa ntchito kuletsa kusamba, chifukwa ndi chida champhamvu. Koma tikulimbikitsidwa kuti muzigwiritsa ntchito ngati njira yomaliza, ngati pali zisonyezo zachindunji za izi.

• pachimake porphyria
• thromboembolism
• thrombosis
• hemoblastosis ana,
• Hypersensitivity pazigawo za mankhwala.

Mosamala, tikulimbikitsidwa kumwa mankhwalawa kuti muthe magazi chifukwa cha mankhwala osokoneza bongo. Pa nthawi yoyembekezera, mankhwala amadziwika kwambiri.

Dicinon amathandizira kulimbitsa makoma amitsempha yamagazi, kuchepetsa kutsika kwawo, komanso amalimbikitsa kugundana kwa magazi.

Nthawi zina, pogwiritsa ntchito Dicinon, zotsatirazi zimabweretsa:

• chizungulire, kupweteka mutu, kuchuluka kwa malekezero otsika,
• nseru, kulemera kwam'mimba, kutentha pa chifuwa,
• kuchepa kwa kuthamanga kwa magazi, kuchepa kwa khungu la nkhope, matupi awo sagwirizana.

Wopanga mankhwalawa ndi Lek D.D., Slovenia.

Kuyerekeza kwa Tranexam ndi Dicinon

Kuti mudziwe mankhwala omwe ndi othandiza kwambiri, ndikofunikira kudziwa kufanana kwawo komanso kusiyana kwake.

Mankhwala onsewa ndi ofanana:

• mitundu yomweyo
• ankakonda kusiya magazi,
• contraindication womwewo
• kumabweretsa chitukuko cha mavuto.

Ndemanga za madotolo za Tranexam ndi Dicinon

Oksana, wazaka 51, wazachipatala, Vladivostok: "Mzochita zanga, nthawi zambiri ndimapereka mankhwala a Tranexam. Awa ndi mankhwala amphamvu omwe amaletsa magazi kutuluka kwa uterine mwachangu. Zotsatira zoyipa sizingachitike ndi mtundu wabwino wa mankhwala. Ndizothandiza pa nthawi ya pakati ngati pali vuto lakusokonekera koyambirira. ”

Vladimir, wazaka 53, wazamakhwala, a Nizhny Novgorod: "Nthawi zambiri ndimapereka Dicinon kwa odwala anga. Imagwira ndipo imatchinjiriza magazi kuchokera pamphuno. Mtengo wake ndi wotsika kuposa ma analogu ena. Mosiyana ndi Tranexam, sizikhudza kayendedwe ka mtima ndipo limalekerera bwino. ”

Ndemanga za Odwala

Svetlana, wazaka 29, Barnaul: “Ndinali ndi chotupa pa muzu wa dzino. Pambuyo pochotsa, magazi owopsa adachitika. Adotolo adasungunula timatumba tating'onoting'ono ta Tranexamine ndikuyikamo. Magazi anayima mwachangu, pakatha mphindi 2-3. "

Victoria, wazaka 31, ku Moscow: “Nthawi zonse ndimadwala matenda otaya magazi nthawi yayitali. Komabe, pachaka chapitachi ndataya magazi ambiri kotero kuti magazi m'thupi adayamba. Dokotala adalamula chithandizo cha Dicinon. Mankhwalawa adandipulumutsa, chifukwa vuto lidatha. "

Kodi pali kusiyana kotani?

Tranexam ndi Dicinon ali ndi zida zosiyanasiyana zogwira ntchito. Ndalama zomaliza monga njira yothetsera vutoli zitha kugwiritsidwa ntchito kudzera m'mitsempha. Tranexam mu mawonekedwe amadzimadzi amathandizira kokha. Kuphatikiza apo, mankhwalawa atha kugulidwa m'mapiritsi okhala ndi filimu, omwe amachepetsa kwambiri kusokonezeka kwa dongosolo logaya chakudya. Mankhwalawa amathandizira pazinthu zosiyanasiyana, koma amapereka zomwezo.

Tranexam ikhoza kugulidwa pamapiritsi, omwe amachepetsa kwambiri kusokonezeka kwa dongosolo logaya chakudya.

Chotsika mtengo ndi chiyani?

Mtengo wa Tranexam umasiyanasiyana: 385-1550 rubles. Mapiritsi (500 mg, ma PC 10. Paketi iliyonse) itha kugulidwa kwa ma ruble 385. Njira yothetsera vutoli imawonongera kangapo. Mtengo wa Dicinon: 415-650 rub. Chida ichi ndi zotsika mtengo kwambiri pamtundu uliwonse wamasulidwe. Poyerekeza, ma ruble 415. Mutha kugula phukusi lomwe lili ndi miyala 100 ya Dicinon.

Ndi magazi

Kusankhidwa kwa mankhwala othandiza kwambiri kumapangidwira poyang'ana chidziwitso choyambirira: kupezeka kwa ma pathologies omwe amaphatikizidwa ndi kuchuluka kwa magazi, mawonekedwe ndi mawonekedwe a magazi panthawi yamankhwala (mwachitsanzo, kuchuluka kapena kuchepa kwa mawonekedwe), etc. Pachifukwa ichi, ndizovuta kupereka yankho losatsutsika lomwe mankhwalawa amapezeka. izikhala yothandiza kwambiri pakukhetsa magazi. Kuthamanga kwa kuchitapo kanthu kuyenera kuganiziridwanso. Mwachitsanzo, ndikutuluka kwa chiberekero, Tranexam amathandiza msanga, chifukwa imayendetsa mwachindunji plasminogen yomwe imakhudzidwa ndi njira ya magazi.

Pa nthawi yoyembekezera

Ngati m'mimba mwatangoyamba kumene pali zizindikiro zokuwopsezeni kusokonezeka (m'mimba mwayamba kulimba, mawanga ang'onoang'ono awoneka), zonse ziwiri zingagwiritsidwe ntchito. Onse a Dicinon ndi a Tranexam amalowa m'magawo ochepa kudzera mwa placenta. Dokotala wazachipatala ayenera kusankha mankhwala ndi kupereka mtundu wa mankhwala.

Ndemanga za Dokotala pa mankhwala a Dicinon: zikuonetsa, kugwiritsa ntchito, mavuto, analoguesTranexam malangizoDicinon

Chothandiza kwambiri ndi chiyani?

Mpaka pano, kafukufuku m'modzi yekha wodalirika kuchokera ku 2012 amadziwika. Amapezeka ndi azimayi 50 omwe ali ndi menorrhagia (kusamba kwakulemera), amagawika m'magulu awiri, omwe amayerekezera mphamvu ya etamsylate (Dicinone) ndi tranexamic acid. Imawunikidwa osati yamphamvu kokha, komanso mtundu wa moyo womwe umagwirizanitsidwa ndi thanzi la azimayi asanafike komanso atalandira chithandizo (zolimbitsa thupi ndi zochitika, zochitika zamagulu onse). Zotsatira zake zinawonetsa kuti kuchepa kwapakati pakukhetsa magazi kunali pafupifupi ofanana m'magulu onse awiriwa, ndikungokhala ndi mwayi pang'ono ku Tranexam potengera kusintha kwa moyo.

Kodi ndingagwiritse ntchito Dicinon ndi Tranexam pamodzi?

Njira ina yochitira zinthu imapangitsa kuphatikiza mankhwala onse awiri kuchipatala chovuta kwambiri. Kuphatikiza mankhwala kumapereka njira ziwiri zothetsera magazi:

• antifibrinolytic zochita za tranexamic acid,
• kukwaniritsa kwa hemostasis (kuphwanya) pakukonza zomata (zomata) za masipulatifomu komanso kubwezeretsa khoma la capillary mothandizidwa ndi etamzilate.

Dokotala wokhayo amene angapereke mankhwala Tranexam ndi Dicinon nthawi imodzi, chifukwa izi sizimangowonjezera chiwopsezo cha mavuto obwera chifukwa cha ziwalo zopanga magazi, komanso zimafunikira kuwunikira nthawi zonse. Izi zimachitika kawirikawiri kuchipatala. Ndikofunika kukumbukira kuti mphamvu zosintha zimakhudzidwa osati ndi mahomoni kapena zinthu zina, komanso mkhalidwe wamalingaliro, kupsinjika, kutsatira mokwanira malangizo a dokotala panthawi yamankhwala.