Heparin: he aha ia, he aha ia no, pehea e hoʻohana ai a me nā hopena

Anter

• No ke aha ia
• He aha ka pilina ma waena o ka hoʻohana ʻana o heparin a me COVID-19?
• Pehea e ho ohana
• Nā hopena ʻē aʻe
• ʻO wai ka mea pono ʻole e hoʻohana

ʻO Heparin kahi anticoagulant no ka hoʻohana injectable, kuhikuhi ʻia e hōʻemi i ka hiki ʻana o ke kāpili ʻana o ke koko a kōkua i ka mālama ʻana a me ka pale ʻana i ka hoʻokumu ʻia ʻana o nā clots i hiki ke ālai i nā kīʻaha koko a hoʻoulu i ka coagulation intravastrence, trombosis aʻa hohonu a i ʻole hahau ʻia, no ka laʻana.

Aia he ʻelua mau ʻano heparin, heparin unfractionated i hiki ke hoʻohana pono ʻia i ka aa a i ʻole he inikua subcutaneite, a lawelawe ʻia e kahi kahu a kauka paha, no ka hana haukapila wale nō, a me ka heparin kaumaha molaki liʻiliʻi, e like me ka enoxaparin a i ʻole dalteparin, no ka ʻo kahi laʻana, ʻoi aku ka lōʻihi o ka hana a me nā hopena ʻē aʻe ma mua o ka heparin unfractionated a hiki ke hoʻohana ʻia ma ka home.

Hōʻike mau ʻia kēia mau heparins e ke kauka e like me ka cardiologist, hematologist a i ʻole ka mea hana maʻamau, e laʻa me ka nānā pinepine ʻana e loiloi i ka maikaʻi o ka mālama ʻana a i ʻole ke ʻano o nā hopena ʻaoʻao.

No ke aha ia

Hōʻike ʻia ʻo Heparin no ka pale a me ka mālama ʻana i nā clots e pili ana i kekahi mau ʻano, ʻo ia pū kekahi:

• Trombosis aa hohonu;
• Hoʻomaʻamaʻa intravascular coagulation;
• Embolism pulmonary;
• Embolism o ka Arterial;
• Infarction;
• Aibrial fibrillation;
• Kāleka Cardiac;
• Hemodialysis;
• ʻO nā kauka Cardiac a i ʻole orthopedic;
• Hoʻohuli koko;
• ʻO ke kahe o ke koko Extracorporeal.

Hoʻohui ʻia, hiki ke hoʻohana ʻia ka heparin e pale ai i ka hoʻokumu ʻia ʻana o nā clots i loko o ka poʻe moe, no ka mea ʻaʻole lākou e neʻe, aia lākou i ka nui o ka makaʻu o ka ulu ʻana o ke koko a me ka thrombosis.

He aha ka pilina ma waena o ka hoʻohana ʻana o heparin a me COVID-19?

ʻO Heparin, ʻoiai ʻaʻole ia e kōkua i ka hoʻopau ʻana i ka coronavirus hou mai ke kino, ua hoʻohana ʻia, i nā hihia kaulike a koʻikoʻi paha, e pale aku ai i nā pilikia thromboembolic e ala aʻe me ka maʻi COVID-19 e like me ka hoʻopili ʻana i ka intravascular coagulation, embolism pulmonary a i ʻole thrombosis venous hohonu .

Wahi a kahi noiʻi i hana ʻia ma Italia ^[1], hiki i ka coronavirus ke hoʻoulu i ke kāpili ʻana o ke koko e alakaʻi ai i ka hoʻonui nui ʻana o ke kahe ʻana o ke koko a, no laila, prophylaxis me ka hoʻohana ʻana i nā anticoagulants e like me heparin unfractionated a i ʻole heparin haʻahaʻa molaki haʻahaʻa hiki ke hōʻemi i ka coagulopathy, ke hoʻokumu ʻana o microthrombi, a me ka makaʻu o nā ʻino, ka mahele lāʻau e kau ai ma ka makaʻu o ka coagulopathy a me ka thrombosis.

ʻO kahi haʻawina ʻē aʻe i loko o vitro ua hōʻike ʻo ka heparin haʻahaʻa molaki haʻahaʻa i loaʻa antiviral a me nā pono hana pale i kū i ka coronavirus, akā ʻaʻohe hōʻike i loko o vivo loaʻa a pono nā hoʻokolohua hoʻokolohua i nā kānaka e hōʻoia i kona pono i loko o vivo, a me ka mahele lāʻau lapaʻau a me ka palekana o ka lāʻau ^[2].

Eia hou, ʻo ka World Health Organization, ma ke alakaʻi ʻo COVID-19 i ka hoʻokele hoʻokele ^[3], kuhikuhi i ka hoʻohana ʻana o ka heparin kaumaha molaki haʻahaʻa, e like me ka enoxaparin, no ka prophylaxis o ka veno thromboembolism i nā maʻi a me nā ʻōpio ʻōpio i hōʻola ʻia me COVID-19, e like me nā kūlana kūloko a kūwaho hoʻi, koe wale nō ka wā o ka mea maʻi i loaʻa i kekahi contra contications no kāu hoʻohana.

Pehea e ho ohana

Heparin pono e lawelawe ʻia e kahi ʻoihana mālama ola, ma lalo o ka ʻili (ma lalo o ka ʻili) a i ʻole intravenous (i loko o ka aa koko) a me nā mahele e hōʻike ʻia e ke kauka e noʻonoʻo nei i ka paona o kēlā kanaka a me ke koʻikoʻi o ka maʻi.

Ma ka laulaha, ʻo nā lāʻau i hoʻohana ʻia i nā haukapila:

• Hoʻomoʻi hoʻomau i ka aa: ka mahele lāʻau mua o nā hua 5000, hiki ke piʻi i 20 000 a i 40,000 wae i noi ʻia ma luna o 24 mau hola, e like me ka loiloi loiloi.
• Hoʻokomo i loko o ka aa i kēlā me kēia 4 a 6 mau hola. ʻo ka mahele hoʻomaka he 10,000 mau ʻāpana a laila hiki ke hoʻololi ʻia mai 5,000 a i 10,000 mau hua;
• Subcutaneous ka pahu kui: ʻo ka mahele lāʻau mua he 333 mau keneta i kēlā me kēia kg o ke kaumaha o ke kino, a ukali ʻia e nā 250 unit no kg i kēlā me kēia 12 hola.

I ka hoʻohana ʻana o ka heparin, pono ke kauka e nānā i ke kāpili ʻana o ke koko ma o nā hoʻokolohua koko a hoʻoponopono i ka mahele lāʻau o heparin e like me ka hopena a me ke ʻano o nā hopena ʻaoʻao.

Nā hopena ʻē aʻe

ʻO kekahi o nā hopena hopena maʻamau e hiki ke hana ʻia i ka wā o ka mālama ʻana me ka heparin ke kahe ʻana o ke kahe a me ke kahe ʻana o ke koko, me ke kū ʻana o ke koko i ka mimi, nā noho ʻeleʻele me nā papa kope, ka ʻeha ʻana, ka ʻeha o ka umauma, ke aʻa a me nā wāwae paha, keu hoʻi i ka bipi keiki, paʻakikī ka hanu ʻana a i ʻole nā ​​kepa koko.

E like me ka hoʻohana ʻana o ka heparin i loko o nā haukapila a nānā ke kauka i ka hoʻopili ʻia ʻana o ke koko a me ka maikaʻi o ka heparin, ke ʻike ʻia nā hopena ʻaoʻao, koke koke ka lāʻau.

ʻO wai ka mea pono ʻole e hoʻohana

Hoʻopili ʻia ʻo Heparin i ka poʻe hypersensitive i ka heparin a me nā ʻāpana formula a ʻaʻole pono e hoʻohana ʻia e ka poʻe me ka thrombositopenia koʻikoʻi, endocarditis koʻohune, ka hemorrhage lolo a i ʻole kekahi ʻano hemorrhage, haemophilia, retinopathy a i ʻole nā ​​hanana i loaʻa ʻole nā ​​kūlana no e lawe nei i nā hoʻokolohua coagulation kūpono.

Hoʻohui ʻia, ʻaʻole pono ia e hoʻohana ʻia i nā diastases hemorrhagic, ʻoki ʻōiwi, i nā hanana kahi e hiki koke mai ai ka ʻōpū, nā maʻi coagulation koʻikoʻi, i ke ake nui o ke akepaʻa a me nā puʻupaʻa, i ke alo o nā tumors malignant o ka ʻōnaehana digestive a me kekahi vura purpura. .

ʻAʻole pono e hoʻohana ʻia ʻo Heparin e nā wahine hāpai a hānai paha me ka ʻole o ka ʻōlelo aʻoaʻo kino.