Wessel Douai F injections: ntuziaka maka ojiji

Ndị ọrụ Antithrombotic. Sulodexide.

PBX koodu B01A B11.

• Ndị angiopathies nwere nnukwu nsogbu nke thrombosis, incl. thrombosis mgbe nnukwu ọrịa myocardial infarction
• ọrịa ụbụrụ: ọrịa strok (ọrịa strok (ọrịa ischemic na-arịa ọrịa na oge nhazigharị n'oge ọ bụla ọrịa strok))
• Ọrịa ensaphalopathy nke diski kpatara, atherosclerosis, ọrịa shuga, ọbara mgbali elu, na akwara vaskụla,
• ọrịa ndị na-enweghị ike ịpụta ọrịa akwara ndị na-arịa ọrịa atherosclerotic na ọrịa shuga
• phlebopathy na thrombosis miri emi
• microangiopathies (nephropathy, retinopathy, neuropathy) na macroangiopathies (ọrịa mamịrị n'ụkwụ, encephalopathy, cardiopathy) n'ihi ọrịa shuga,
• thrombophilia, ọrịa antiphospholipid
• heparin thrombocytopenia.

Usoro onunu ogwu na nhazi

ntụzịaka izugbe

Usoro ọgwụgwọ ndị a na-ejikarị gụnyere nchịkwa parenteral nke ọgwụ na-esochi capsules; n'ọnọdụ ụfọdụ, enwere ike ịmalite ọgwụgwọ na Sulodexide site na capsules ozugbo. Usoro ọgwụgwọ na usoro ọgwụgwọ a ga-agbatị nwere ike imeghari dịka mkpebi dọkịta si dabere na nyocha ụlọ ọgwụ na nsonaazụ nke ikpebi plọgum ụlọ nyocha.

Na mkpokọta, a na-atụ aro ka ewere ya n’etiti nri, ma ọ bụrụ na e kewara mkpụrụ ọgwụ kwa ụbọchị n’ọtụtụ ọgwụ, a na-atụ aro ka ịchekwa etiti oge awa iri n’etiti ọgwụ.

Na mkpokọta, a na-atụ aro ka ọgwụgwọ ahụ jupụta ugboro abụọ ugboro n’afọ.

Ndị angiopathies nwere nnukwu nsogbu nke thrombosis, incl. thrombosis mgbe nnukwu ọrịa myocardial infarction

N'ime ọnwa mbụ, a na-agbanye ọgwụ intramuscular nke 600 LO nke sulodexide (ọdịnaya nke 1 ampoule) kwa ụbọchị, mgbe nke ahụ gasịrị, ọ na-aga n'ihu na -eme ka a na-ahụ ọgwụ capsules 1-2 ugboro abụọ n'ụbọchị (500-1000 LO / ụbọchị). Enwere ike nweta nsonaazụ kacha mma ma ọ bụrụ na ịmalite ọgwụgwọ n'ime ụbọchị iri mbụ mgbe ihe gbasara nnukwu ọrịa myocardial infarction.

Ọrịa Cerebrovaskụla: ọrịa strok (ọrịa ischemic na-arịa ọrịa na ịmaliteghachi n'oge mmalite mgbe ọrịa strok)

Ọgwụgwọ na-amalite site na nchịkwa kwa ụbọchị nke 600 LO nke sulodexide ma ọ bụ bolus ma ọ bụ ntinye mmiri, nke a na-agbaze ọdịnaya nke 1 ampoule nke ọgwụ ahụ na 150-200 ml nke saline physiological. Ogologo oge nke infusion sitere na nkeji 60 (ọsọ 25-50 tụlee / min) ruo minit 120 (ọsọ 35-65 tụlee / min). Oge akwadoro ọgwụgwọ bụ ụbọchị 15-20. Mgbe ahụ, a ga-aga n'ihu ọgwụgwọ iji mkpụrụ ọgwụ capsules, nke a na-ewere ya site na okpu 1 na-ebu ọnụ ugboro abụọ n'ụbọchị (500 LO / ụbọchị) maka ụbọchị 30-40.

Atherosclerosis na-akpata diski akpata ọrịa ụbụrụ, mellitus ọrịa shuga, ọbara mgbali elu, na akwara vaskụla.

A na-atụ aro ka ị were 1-2 ọgwụ ọgwụ ugboro abụọ n'ụbọchị (500-1000 LO / day) ọnụ maka ọnwa 3-6. Usoro ọgwụgwọ ahụ nwere ike ịmalite site na ntinye nke 600 LO sulodexide kwa ụbọchị maka ụbọchị 10-30.

Ọrịa ndị na - arịa ọrịa na - arịa ọnya na - arịa ọrịa na - arịa ọrịa na - arịa ọrịa na - efe efe

Ọgwụgwọ na-amalite site na nchịkwa intramuscular kwa ụbọchị nke 600 LO sulodexide ma na-aga n'ihu ruo ụbọchị 20-30. Mgbe ahụ ọzụzụ ahụ na-aga n'ihu, na-ewere 1-2 capsules ọnụ ugboro abụọ n'ụbọchị (500-1000 LO / ụbọchị) maka ọnwa 2-3.

Phlebopathy na thrombosis miri emi

Nchịkwa a na-ejikarị nchịkwa ọnụ nke sulodexide capsules na oge 500-1000 LO / ụbọchị (2 ma ọ bụ 4 capsules) maka ọnwa 2-6. Usoro ọgwụgwọ ahụ nwere ike ịmalite site na ntinye kwa ụbọchị nke 600 LO sulodexide kwa ụbọchị maka ụbọchị 10-30.

Microangiopathies (nephropathy, retinopathy, neuropathy) na macroangiopathies (ọrịa mamịrị n'ụkwụ, encephalopathy, cardiopathy) n'ihi ọrịa shuga.

A na-atụ aro ịgwọ ndị ọrịa na-arịa micro- na macroangiopathies na ọkwa abụọ. Nke mbu, a na-edozi 600 LOs nke sulodexide kwa ụbọchị maka ụbọchị 15, wee mesịa na-aga n'ihu, na-ewere capsule 1-2 ugboro abụọ n'ụbọchị (500-1000 LO / ụbọchị). Ebe ọ bụ na iji obere oge ọ ga - arụpụta ihe ya n’agha ruo n’ókè ụfọdụ, a na - atụ aro ka iwelie oge nke usoro ọgwụgwọ nke abụọ ọ dịkarịa ala ọnwa anọ.

Thrombophilia, ọrịa antiphospholipid

Usoro ọgwụgwọ a na-ejikarị bụ nchịkwa ọnụ nke 500-1000 LO sulodexide kwa ụbọchị (2 ma ọ bụ capsules abụọ) maka ọnwa 6-12. A na-enyekarị capsules Sulodexide mgbe agachara ya na heparin dị mkpụmkpụ mkpokọta yana Acetylsalicylic acid, ọ dịghịkwa mkpa ịgbanwe usoro onyunyo nke ikpeazụ.

heparin thrombocytopenia

N'ihe banyere heparin, thrombocytopenia, iwebata heparin ma ọ bụ heparin dị ala dị ala na-edochi infusion nke sulodexide. Iji mee nke a, etinyere ihe dị n’ime 1 ampoule nke ọgwụ (600 LO sulodexide) na 20 ml nke 0.9% sodium chloride solution ma rụọ ọrụ dịka infusion ngwa ngwa maka nkeji 5 (ọsọ 80 dara / min). Mgbe nke ahụ gasị, 600 LOs nke sulodexide na-dilisiri na 100 ml nke 0.9% sodium chloride solution ma na-ahụ maka ụdị infusions 60 nkeji (ọsọ 35 tụlee / min) kwa elekere 12:00 ruo mgbe ọ dị mkpa maka ọgwụgwọ anticoagulant.

Mmeghachi omume ọjọọ

Ihe a bu ihe omuma banyere mmeghachi omume ojoo a choputara na nnwale nke ulo ogwu nke metụtara ndi oria 3258 site na iji usoro onunu ogwu na usoro ọgwụgwọ.

Mmeghachi omume ọjọọ na ojiji nke sulodexide, nkewa dị ka klas nke akụkụ ahụ sistemu na ugboro. A na-eji okwu ndị a na-esote iji chọpụta ugboro ole mmeghachi omume dị njọ: ọtụtụ mgbe (≥ 1/10), ọtụtụ mgbe (site na ≥ 1/100 ruo

Dodoụbiga ya ókè

Doụbiga ọgwụ ike ókè nwere ike iduga n'ọrịa ọgbụgba ọbara, dịka ọbara ọgbụgba ma ọ bụ ọbara ọgbụgba. N'ihe banyere ọbara ọgbụgba, a ga-enye 1% ọgwụ protamine sulfate. Na mkpokọta, na ị anụbiga mmanya ókè, a ga-akwụsị ị useụ ọgwụ ahụ ma nwee usoro ọgwụgwọ Symptomatic kwesịrị ịmalite.

Jiri n’oge ime ma ọ bụ n’ịra

Ebe ọ bụ na enweghị ahụmịhe iji ọgwụ ahụ eme ihe n'oge ọnwa atọ mbụ nke ịtụrụ ime, ekwesighi inye ụmụ nwanyị ọgwụ a oge a, belụsọ, dị ka dọkịta si kwuo, uru a na-atụ anya ọgwụgwọ nke nne ga-akarị ihe ọ bụla nwere ike ibute nwa ebu n’afọ.

Enweghi ahụmịhe eji ojiji nke sulodexide n'ime oge nke abụọ na nke atọ nke ịtụrụ ime maka ọgwụgwọ nke nsogbu vaskụla ụfụ nke ụdị I na ụdị ọrịa shuga II na ọdụ toxicosis na-akpata. N'ọnọdụ dị otu a, a na-achịkwa sulodexide kwa ụbọchị intramuscularly na dose nke 600 LOs kwa ụbọchị maka ụbọchị iri, mgbe nke a gasịrị, ebumnuche nchịkwa nke ọgwụ ahụ maka mkpụrụ ọgwụ kabrale ugboro abụọ n'ụbọchị (500 LOs / ụbọchị) maka ụbọchị 15-30. N'ihe banyere toxicosis, enwere ike ijikọ usoro ọgwụgwọ a na usoro ọgwụgwọ ọdịnala.

N'ime oge nke afọ II na nke III nke afọ ime, ekwesịrị iji ọgwụ ahụ mee ihe n'ilezi anya, n'okpuru nlekọta nke dọkịta.

Amabeghị ma sulodexide ma ọ bụ metabolites ya dị na mmiri ara. Ya mere, maka nchekwa, anaghị atụ aro ịhọpụta ụmụ nwanyị n'oge a na-enye nwa.

Enweghi ahụmịhe eji ojiji nke sulodexide na ọgwụgwọ nke ọrịa mamịrị nephropathy na glomerulonephritis na ndị nọ n'afọ iri na atọ ruo afọ iri na atọ. N'ụdị ndị ahụ, a na-elekọta 600 LO nke sulodexide kwa ụbọchị intramuscularly kwa ụbọchị ruo ụbọchị 15, mgbe ahụ, a na-eji ọgwụ 1-2 a na-eji ọgwụ ugboro abụọ n'ụbọchị (500-1000 LO / ụbọchị) maka izu 2.

Achọpụtaghị data banyere arụmọrụ yana nchekwa nke ọgwụ ụmụaka na-erubeghị afọ 12.

Njirimara ngwa

N'oge a na-eme ọgwụgwọ, a ga-enyocha usoro mgbochi hemocoagulation (mkpebi nke coagulogram) kwa oge. Na mbido na mgbe emechara ọgwụgwọ, ekwesịrị ịchebe usoro nyocha ụlọ nyocha ndị a: oge ​​ọrụ thromboplastin na-arụ ọrụ, oge ọbara ọgbụgba / oge coagulation, na ọkwa antithrombin III. Mgbe ị na-eji ọgwụ ahụ eme ihe, oge akụkụ thromboplastin na-arụ ọrụ na-abawanye site na 1.5 ugboro.

Ikike ime ka ọnụego mmeghachi omume dị mgbe ị na-anya ụgbọala ma ọ bụ na-arụ ọrụ na usoro ndị ọzọ.

Ọ bụrụ n ’ọnya a hụrụ n’oge ọgwụgwọ, mmadụ kwesịrị ịhapụ ịkwọ ụgbọala yana iji ya arụ ọrụ.

Ngwongwo ogwu

Ọgwụ ọgwụ. Wessel Douai F bụ nkwadebe nke sulodexide, ngwakọta sitere n'okike nke glycosaminoglycans dịpụrụ adịpụ na mucosa eriri afọ nke ezì, mejupụtara mkpụrụ ego heparin dị ka nnukwu mkpụrụ ndụ ihe dịka 8000 Da (80%) na dermatan sulfate (20%).

Sulodexide bụ ọgwụ antithrombotic, anticoagulants, profibrinolytic na mmetụta angioprotective.

Mmetụta anticoagulants nke sulodexide bụ n'ihi mmekọrịta ya na hefarin II cofactor, na-egbochi thrombin.

Mmetụta antithrombotic nke sulodexide bụ onye ogbugbo site na mgbochi nke ọrụ Xa, na-akwalite njikọta na nzuzo nke prostacyclin (PGI2) yana mbelata ọkwa plasma fibrinogen.

Mmetụta profibrinolytic bụ n'ihi mmụba nke ọrụ onye na - eme ihe na - arụ ọrụ plasminogen anụ ahụ yana mbelata nke ọrụ onye na - egbochi ya.

Mmetụta angioprotective nwere njikọ na mweghachi nke nhazi na iguzosi ike n'ihe nke mkpụrụ ndụ endothelial yana nha nke njupụta nke ebubo na-adịghị mma nke akpụkpọ ahụ okpuru ulo.

Na mgbakwunye, sulodexide na-ahụ maka ihe ndị metụtara ọbara nke ọbara site na ibelata ọkwa triglycerides (nke metụtara njikọ nke lipoprotein lipase, enzyme nke na-akpata hydrolysis nke triglycerides).

A na-ekpebi ịdị irè nke ọgwụ ahụ na nephropathy ọrịa mamịrị site na ike nke sulodexides iji belata ọkpụrụkpụ nke mejupụtara okpuru ulo na imepụta matrix intercellular site na ibelata mmụba nke mkpụrụ ndụ mesangium.

Mlọ ọgwụ Sulodexide na-abanye n'ime obere eriri afọ. 90% nke nchịkwa nke sulodexide na-agbakọta na endothelium vaskụla, ebe mgbanye ya bụ ugboro 20-30 karịa nke ịta ụbara n’akwara anụ ahụ ndị ọzọ. Sulodexide bụ imeju mejupụtara ya, akụrụ na-ahụkarị ya. N'adịghị ka heparin dị mkpụmkpụ na obere ihe dị ala, ịsa ahụ na-eme ka ihe belata, nke ga-eduga na mbelata ihe antithrombotic na nnukwu osooso nke mmepụta sulodexide, anaghị eme. Na nyocha nke nkesa sulodexide, egosiri na ọ bụ ya na-amịpụta akụrụ ya na ọkara ndụ nke ruru 4:00.

Ndakọrịta

Ebe ọ bụ na sulodexide bụ polysaccharide nwere ngwongwo acidic dị ntakịrị, mgbe ewepụtara ya dịka ngwakọta nke ederede, ọ nwere ike etolite ogige na ihe ndị ọzọ nwere njiri mara. Ihe ndị a na-ejikarị eme ihe maka ọgwụ injections ejikọtara ọnụ na-ekwekọ na sulodexide: vitamin K, ihe mgbagwoju nke vitamin B, hyaluronidase, hydrocortisone, glucose glucose, quaternary salmonate, chloramphenicol, tetracycline na streptomycin.