"Poliglyukin": yokusetshenziswa, Izimo, ukubuyekezwa

"Poliglyukin" - antishock plazmozameshchath nomuthi kusiza libuyisele amanzi ka bcc. Ngenxa yalokho, ukusetshenziswa kwezidakamizwa is uvikelwe adhesion zegazi kanye amangqamuzana abomvu egazi.

Ukwakheka ehlanganisa "polyglukin"

Ngesisekelo izidakamizwa - dextran. Esikhathini ibhodlela equkethwe 200 no-400 ml ukulungiswa ngesimo i isixazululo aqueous. Ukwakheka izidakamizwa iqukethe sodium chloride namanzi umjovo.

pharmacodynamics

"Poliglyukin" afundiswe akubonisayo njengendlela umuthi kokuba antiagregatnym nemiphumela hemodynamic. Umuthi kuyinto polysaccharide hydrophilic nemkhawulo wemanti. Ngemuva kokusebenzisa imithi bcc abuyiselwe esikhathini esifushane ngenxa yokuthi ukuthi ubamba amanzi ngokwanele.

Uphiko asebenzayo has a isisindo yamangqamuzana kuqhathaniswa high, ngakho esegazini ke likhona isikhathi eside, futhi ngezinye ukukhishwa kancane sidlula izindonga isitsha. Izici zomuthi ukwandisa ngokushesha futhi isikhathi eside ukugcina umfutho wegazi evamile. "Poliglyukin" kunciphisa izicubu edema, sivuselela bcc aqede spasm, okuyinto eyenzeka ezitsheni neuropathy.

Ukumiswa ukuzinza is ngcono igazi emva kokwelashwa "Poliglyukin" imfundo ibonisa ukuthi izidakamizwa kwenza igazi ngaphansi viscous. Kubantu, izibalo kwesejwayelekile, abahlukaniswe ngenxa ukuthuthukiswa ukushaqeka: microcirculation, ukugeleza kwegazi ezicutshini.

Pharmacokinetics

Excretion of nomuthi ikhiqizwa umzimba ngokuyinhloko nezinso. ukususwa kwengxenye Kwenziwa emini. "Poliglyukin" isusiwe beqinile, ingxenye abangelutho yalo ingena amaseli kohlelo reticuloendothelial futhi ebekwe lapho kancane kancane kwenzeka eqhekeza nomuthi. Ngenxa yale nqubo, i-glucose ikhiqizwa, okuyinto njengenkulumo njengoba umthombo wamandla. Little "polyglukin" ingena ipheshana wokugaya ukudla.

ubufakazi

"Poliglyukin" imfundo on isicelo ikuvumela ukwabela lapho ngobugebengu capillary ukugeleza kwegazi. Umuthi ofanele ekwelapheni uthi ukushaqeka nezinto Prevention (ukushaqeka ukonakala, ezinobuthi, ukusha, imisebenzi, izinto ezihlasimulisa umzimba). Umuthi elisetshenziswa acute igazi ukulahlekelwa okuvele ngesikhathi ethunjini yokukhulelwa noma ngenxa ukuhlukumezeka ngokushesha ukubuyisela bcc. Isixazululo kukhona hypovolemia, okuyinto is phetho plasma ukuvuza (gumbi syndrome, ukusha). Ukuphumelela lomuthi siyenzeka ukuqaliswa izinyathelo zokuvimbela ukuze kuvinjelwe embolism (preoperative, nasezinkingeni ezilandela ngemva kokuhlinzwa).

Izimo

Ngaphambi ukwelashwa kubalulekile ukuba banake Izimo, equkethe esenezelwe kuya luhlobo "Poliglyukin" imfundo manual. Izimo for ukwelashwa kanye nokuvimbela lokhu ukulungiselela simiswe ngalendlela lelandzelako:

• unhlangothi-cerebral;
• ICP High;
• uthi lapho ukwethulwa uketshezi obuningi kakhulu engathandeki;
• isifo ephelezelwa isifo so-renal (anuria, oliguria);
• wegazi vele ophakeme kakhulu;
• ukuhluleka kwenhliziyo;
• iziyaluyalu homeostasis, coagulation;
• Ngokuqhubeka ukopha zangaphakathi (ngaphandle - blood pressure ngezansi 60 mm HG ..).

ukwelashwa Isikali

Isixazululo kwezokuphatha emthanjeni. Ezimweni lapho ukopha kubhekwa acute, ke kuvunyelwe ukusetshenziswa kwezidakamizwa naphakathi-ekhipha igazi enhliziyweni. Izinga izidakamizwa ekuphathweni kunqunywa ngamunye futhi kuncike isimo jikelele isiguli, inhliziyo yakhe rate, umfutho wegazi futhi hematocrit.

Ngu ukushaqeka uthi "Poliglyukin" imfundo manual incoma iqondiswa bolus umzila emthanjeni. Edingekayo umthamo owodwa we-ejenti ezimweni ezinjalo akuyona esingaphansi 400 kodvwa hhayi ngetulu 1200 ml. Kwezinye izimo kubalulekile ukwandisa umthamo imithi-2000 ml. Uma ukusebenza BP ngenxa yokuphathwa zomuthi ngakwazi ukuletha ezivamile, inguquko ukwethulwa amaconsi izidakamizwa.

Nge abalulekile ukopha, elihambisana 500 ml nokuningi, kanye khona anemizatsii ezinzima ngaphandle usebenzisa "polyglukin" isixazululo wenziwa igazi. Njengoba isilinganiso izifo ukuvimbela ukushaqeka ngesikhathi ukuhlinzwa izidakamizwa iqondiswa iconsa esinjengalesi lapho ingcindezi uwile - jet. Ukuncipha abukhali wegazi kuya ku-60 mm HG. Art. futhi ngezansi kudinga ukwethulwa "polyglukin" emqulwini asisikhulu kunenkosi 400 ml intraarterially. Ngemva kokwenza imisebenzi usebenzisa le imithi umkhiqizo zokuvimbela, ukuvumela ukuvimbela ukuthuthukiswa ukushaqeka.

Isixazululo ngokuvamile isetshenziswa ngesikhathi lokuhlushwa 6% izidakamizwa esebenzayo, kodwa osebenza "Poliglyukin 33" kwezinye izimo. Yokusetshenziswa ebonisa ukuthi ekwakhiweni nge lokuhlushwa dextran kuyinto reagent asizayo uma uhlola ukuhambisana umamukeli bese abanikelayo.

Lapho kubalulekile ukuqeda ezishile ukushaqeka, ngosuku lokuqala omdala iqondiswa kusukela ayizinkulungwane 2. Eyinkulungwane ukuze 3. ML isixazululo, sisetshenziswa ngosuku ezingekho ngaphezu 1.5 ayizinkulungwane. Ml ukulungiselela yesibili. Kulezo zimo lapho ukushaqeka kuyadingeka ukususa ingane, it is okokuqala iqondiswa 40-50 izindlela ml / kg, ngosuku lwesibili umthamo ngamunye esisindo amakhilogramu kuyehla kube 30 ml. Njengoba isilinganiso izifo, ukuqeda kungenzeka ukushaqeka, izingane ukwethula ukuvuza umzila emthanjeni. Umthamo wazifunela ingane zokhahlamba kusuka 10 kuya 15 ml / kg "Poliglyukin" ukulungiselela. Yokusetshenziswa izilwane, futhi, kwenza kube nokwenzeka ukusebenzisa ukwelashwa, esekelwe isingeniso "polyglukin". Ngenxa yalezi zinjongo umthamo isixazululo 15 kuya ku-20 ml / kg. I isilinganiso ezifanele iningi izidakamizwa kunqunywa udokotela.

side effects

Ngaphambi kokusebenzisa umkhiqizo "imiyalelo Poliglyukin 'ukusetshenziswa, izimpendulo bayakhuthazwa ubuyekeze imiphumela engemihle. Ngokuvamile yezinkinga musa kuphakama, futhi umzimba iziguli isamukele lesi sidakamizwa. Ngezinye izikhathi kungabonakala nasemkhakheni ifomu komzimba nezinto ka anaphylactic ukushaqeka, ukuvuvukala, ukulunywa futhi ukuqubuka. Kwezinye iziguli, le sternum kukhona umuzwa kokucindezelwa, kukhona ubuhlungu. Kungase kube imfiva samanje, enciphile blood pressure, ukusheshisa kwenhliziyo. Ungase unezinkinga ukuphefumula, isiyezi kanye nokuthuthukiswa khona acrocyanosis. Ngenxa yalokho ukweqisa izidakamizwa awuthwala umthwalo owengeziwe inhliziyo, uvimbela idlule umthamo Kunconywa kusho "Poliglyukin" imfundo manual. Amaphilisi kanye neminye imithi lapho isiguli kuthatha uma ungalawulwa, uphazamise isinyathelo yesixazululo.

Izibuyekezo Analogs

Ukushintshwa nomuthi can "HyperHAES", "Reoglyumanom" noma "Hai-oyinyumba". Ukuze izixazululo ezisetshenziswa ngenjongo efanayo ngokuthi "Poliglyukin" zihlanganisa "Sterofundin", "Reopoligljukin", "Stabizol".

Miselela "Poliglyukin" yokusetshenziswa ngokuvumela ezimweni lapho isiguli kungahlali kule ndawo. Ukuze izisusi ingasetshenziswa "gelofusin", "Refortan N», «Sorbilakt". A nomphumela ofanayo lingasetjenziswa ngokuthi "ukunqophisa Albunormom" futhi "Neorondeksom".

Izibuyekezo abonisa ukuthi izidakamizwa kakhulu kusiza ekuqedeni inkinga. Kodwa kusukela esimweni ngasinye sihlukile, imiphumela nohulumeni wakhe ingase ibe khona ehlukile. Okuningi kuxhomeke ekutheni ukufunde isimo lesiguli. Abantu abaku ingozi hhayi ukusebenzisa "Poliglyukin" bebodwa, ngenxa ingozi yokuphathwa engafanele kwezimali kanye nokuthuthukiswa engemihle.

isixazululo yayo umsebenzi "Poliglyukin" wenza, kodwa ekwelashweni, kanye nokuqalisa uhlelo lokulwisana, kwakungekhona ngempumelelo futhi kuye kwaholela nezinye izinkinga, umthamo we izidakamizwa kufanele akhethwe udokotela ngamunye. Kuphela onguchwepheshe angakwazi ukuphatha izidakamizwa njengomuntu ovamile ngeke akwazi ukunquma ngokunembile umthamo edingekayo futhi umzila ezifanele of nokuphathwa imithi. Ukweqiwa ngokweqile kwezidakamizwa kuyingozi ngoba inhliziyo, ngakho musa ukuthatha izingozi, futhi ukuzithiba medicate.