Heparin: nws yog dab tsi, nws yog dab tsi rau, yuav siv nws li cas thiab cov kev mob tshwm sim

Zoo Siab

• Dab tsi yog nws rau
• Dab tsi yog kev sib raug zoo ntawm kev siv heparin thiab COVID-19?
• Yuav siv li cas
• Muaj kev phiv ntau
• Leej twg yuav tsum tsis txhob siv

Heparin yog tshuaj anticoagulant rau kev siv tshuaj, qhia tau kom txo cov ntshav txhaws muaj peev xwm thiab kev pabcuam hauv kev kho thiab tiv thaiv kev tsim cov txhaws uas tuaj yeem cuam tshuam cov hlab ntsha thiab ua rau muaj kev cuam tshuam rau txoj hlab ntshav txhaws, mob ntshav hlab plawv lossis mob hlab ntsha tawg, piv txwv.

Muaj ob hom mob heparin, cuam tshuam tsis haum heparin tuaj yeem siv ncaj qha rau txoj leeg ntshav los yog txhaj tshuaj, lossis tswj los ntawm tus kws kho mob lossis kws kho mob, ua tshwj xeeb rau tsev kho mob, thiab tsis tshua muaj lub cev nyhav heparin, xws li enoxaparin lossis dalteparin, rau piv txwv li, nws muaj lub sijhawm ua haujlwm ntev dua thiab tsawg dua cov kev mob tshwm sim dua li cov heparin tsis sib xws thiab tuaj yeem siv hauv tsev.

Cov heparins no yuav tsum tau qhia los ntawm kws kho mob xws li kev kho plawv, hematologist lossis kws kho mob, piv txwv, thiab kev soj ntsuam tas li yuav tsum tau ua kom ntsuas qhov ua tau zoo ntawm kev kho lossis qhov tshwm sim ntawm kev mob tshwm sim.

Dab tsi yog nws rau

Heparin yog qhia rau kev tiv thaiv thiab kho mob txhaws uas ntsig txog qee yam mob, uas suav nrog:

• Kev mob ntsws txoj leeg ntshav khov;
• Tso tawm intravascular coagulation;
• Pulmonary embolism;
• Arterial embolism;
• Cawv Liab;
• Atrial fibrillation;
• Kev Ntshaw Mob Nruab Nrab;
• Hemodialysis;
• Kev phais mob rau pob txha lossis mob pob txha;
• Ntshav;
• Tshaj ntshav hauv kev los ntshav.

Ntxiv rau, heparin tuaj yeem siv los tiv thaiv kev tsim cov txhaws hauv cov neeg txaj, thaum lawv tsis txav, lawv muaj feem yuav ua mob ntshav txhaws thiab thrombosis.

Dab tsi yog kev sib raug zoo ntawm kev siv heparin thiab COVID-19?

Heparin, txawm hais tias nws tsis pab txhawb kom muaj tus kabmob coronavirus tshiab los ntawm lub cev, tau siv, hauv nruab nrab lossis mob hnyav, txhawm rau txhawm rau tiv thaiv kev mob thiav uas tuaj yeem tshwm sim nrog tus kabmob KEVID-19 xws li nthuav tawm kev mob hlab ntshav nrog, kev mob ntsws rau lub ntsws lossis mob ntshav txhaws. Cov.

Raws li kev tshawb fawb ua hauv Ltalis ^[1], tus mob coronavirus tuaj yeem ua kom mob ntshav khov ua rau muaj ntshav txhaws thiab, vim li no, prophylaxis nrog kev siv cov tshuaj anticoagulants xws li heparin tsis txaus lossis tsis tshua hnyav molecular hnyav heparin tuaj yeem txo coagulopathy, tsim microthrombi, thiab muaj kev pheej hmoo ntawm cov khoom hauv nruab nrog cev, cov koob tshuaj uas yuav tsum tau ua raws tus kheej qhov kev pheej hmoo ntawm coagulopathy thiab thrombosis.

Lwm qhov kev kawm hauv vitro pom tau hais tias cov phev nyhav nyhav heparin muaj qhov ua tshuaj tiv thaiv kabmob thiab tshuaj tiv thaiv kabmob tuaj yeem tiv thaiv tus kabmob coronavirus, tabsis tsis muaj pov thawj hauv vivo muaj thiab soj ntsuam sim hauv tib neeg uas xav tau los xyuas nws cov hauj lwm zoo hauv vivo, nrog rau kev kho mob kom zoo thiab kev nyab xeeb ntawm cov tshuaj ^[2].

Ib qho ntxiv rau, Lub Txheej Txheem Thoob Ntiaj Teb Kev Noj Qab Haus Huv, hauv COVID-19 Phau Ntawv Qhia Txog Kev Tswj Xyuas Cov Haujlwm ^[3], qhia txog kev siv cov tshuaj loog tsawg hauv cov cev nyhav heparin, xws li enoxaparin, rau prophylaxis ntawm cov mob txha mos hauv cov neeg laus thiab cov neeg mob hauv tsev kho mob nrog COVID-19, raws li cov qauv hauv zos thiab thoob ntiaj teb, tshwj tsis yog thaum tus neeg mob tau muaj kev sib kis rau koj siv.

Yuav siv li cas

Heparin yuav tsum yog cov kws kho mob ua tus saib xyuas, txawm tias subcutaneously (hauv qab tawv nqaij) lossis mob ntshav (rau hauv cov leeg ntshav) thiab cov koob tshuaj yuav tsum tau qhia los ntawm tus kws kho mob xav txog tus neeg qhov hnyav thiab qhov mob hnyav.

Feem ntau, cov koob tshuaj siv hauv tsev kho mob yog:

• Kev txhaj tshuaj tas mus li rau txoj leeg ntshav: thawj koob tshuaj 5000 units, uas tuaj yeem ncav 20,000 txog 40,000 units tau thov hauv 24 teev, raws li kev ntsuas tshuaj;
• Kev txhaj tshuaj rau hauv txoj leeg txhua 4 mus rau 6 teev: qhov pib siv yog 10,000 units thiab tom qab ntawd tuaj yeem hloov los ntawm 5,000 txog 10,000 units;
• Kev txhaj tshuaj subcutaneous: koob tshuaj thawj yog 333 units toj ib kg ntawm lub cev hnyav, tom qab ntawd 250 ntu ib kg txhua 12 teev.

Thaum siv cov tshuaj heparin, tus kws kho mob yuav tsum kuaj xyuas cov ntshav txhaws los ntawm kev kuaj ntshav thiab kho qhov tshuaj ntawm heparin raws li nws qhov ua tau zoo lossis qhov tshwm sim ntawm kev mob tshwm sim.

Muaj kev phiv ntau

Qee qhov kev mob tshwm sim feem ntau uas yuav tshwm sim thaum kho nrog heparin yog los ntshav lossis los ntshav, nrog rau cov ntshav hauv cov zis, cov quav dub nrog kas fes thaj tsam tsos, doog ntshav, mob hauv siab, puab tais lossis ceg, tshwj xeeb yog cov plab hlaub, nyuaj ua tsis taus pa los yog pos hniav los ntshav.

Raws li kev siv tshuaj heparin tau tsim nyob rau hauv tsev kho mob thiab kws kho mob soj ntsuam ntshav txhaws thiab qhov ua haujlwm ntawm heparin, thaum muaj kev phiv tshuaj zoo li cas, kev kho mob yog tam sim ntawd.

Leej twg yuav tsum tsis txhob siv

Heparin yog cov tsis pom tseeb hauv cov neeg uas muaj lub siab mob siab rau heparin thiab cov qauv mis thiab yuav tsum tsis txhob siv los ntawm cov neeg muaj mob loj thrombocytopenia, kab mob endocarditis, xav tias mob hlwb los sis qee yam mob hemorrhage, haemophilia, retinopathy lossis hauv cov xwm txheej uas tsis muaj mob rau nqa tawm kev ntsuas tsim nyog kev coagulation.

Ib qho ntxiv, nws kuj yuav tsum tsis txhob siv cov hemorrhagic diastases, phais pob txha nraub qaum, nyob rau hauv cov xwm txheej uas rho menyuam tawm, muaj mob hnyav coagulation, nyob rau hauv daim siab hnyav thiab lub raum tsis ua haujlwm, nyob rau hauv muaj malignant qog ntawm lub plab zom mov thiab qee qhov vascular purpura. Cov.

Heparin yuav tsum tsis txhob siv los ntawm cov poj niam cev xeeb tub lossis pub niam mis yog tias tsis muaj lus qhia kho mob.