Koj puas paub tias cov ntshav uas ntws los ntawm koj cov leeg ntshav qee zaum tuaj yeem txhaws tsis tsim nyog? Yog tias cov ntshav txhaws ntawd mus rau lub hlwb, nws tuaj yeem ua rau mob stroke, thiab yog tias nws mus rau lub plawv, nws tuaj yeem ua rau mob plawv nres. Yog li hnub no peb yuav tham txog ib hom tshuaj tshwj xeeb uas cov kws kho mob siv los tiv thaiv cov mob txaus ntshai no. Cov no hu ua Direct Thrombin Inhibitors.
Hais yooj yim xwb, cov tshuaj Direct Thrombin Inhibitors no yog dab tsi?
Cov no yog ib pawg tshuaj uas tiv thaiv cov ntshav txhaws. Lawv yog yam uas peb feem ntau hu ua "cov tshuaj ua kom cov ntshav nyias." Tab sis txoj kev uas lawv ua haujlwm txawv me ntsis. Lub tswv yim rau kev ua cov tshuaj no yog raws li cov protein pom nyob rau hauv cov qaub ncaug ntawm cov kab laug sab. Tej zaum koj yuav tau hnov tias cov kab laug sab kuj tau siv rau kev kho mob yav dhau los.
Feem ntau cov neeg hauv ntiaj teb no tuag vim yog kab mob plawv. Qhov laj thawj tseem ceeb rau qhov ntawd yog cov ntshav txhaws. Yog li cov kws kho mob sau cov tshuaj zoo li no los cawm tib neeg ntawm qhov kev pheej hmoo no.
Cov tshuaj no siv rau cov mob twg?
Cov tshuaj no, hu ua cov tshuaj direct thrombin inhibitors, feem ntau yog siv los tiv thaiv lossis kho cov ntshav txhaws uas tshwm sim los ntawm ntau yam mob. Cia peb saib seb lawv yog dab tsi.
| Kab mob xwm txheej | Ib qho lus piav qhia yooj yim |
|---|---|
| Mob plawv dhia ceev ceev (mob plawv tsis txav mus rau lub plawv) | Kev thaiv cov leeg ntshav uas xa ntshav mus rau lub plawv lossis cov ntshav ntws qeeb. |
| Kev mob ntshav qis qis (HIT) uas ua rau muaj Heparin | Ib qho teeb meem uas tshwm sim los ntawm lwm yam tshuaj uas ua rau cov ntshav nyias hu ua heparin. |
| Kev mob ntshav txhaws hauv cov hlab ntsha (VTE) | Ib qho ntshav txhaws hauv cov hlab ntsha hauv lub cev. |
| Atrial Fibrillation (Afib) | Muaj feem yuav muaj ntshav txhaws thiab mob stroke vim yog lub plawv dhia tsis xwm yeem. |
| Tom qab phais hloov lub duav | Txo qhov kev pheej hmoo ntawm cov ntshav txhaws tom qab phais. |
| Cov ntshav txhaws hauv cov leeg ntshav tob hauv ceg (Deep vein thrombosis - DVT) | Cov ntshav txhaws, tshwj xeeb tshaj yog nyob rau hauv cov leeg ntshav tob ntawm ob txhais ceg. |
| Ib qho ntshav txhaws hauv lub ntsws (Pulmonary embolism) | Cov ntshav txhaws uas tsim nyob rau lwm qhov hauv lub cev mus rau hauv cov ntsws thiab nkag mus rau hauv. |
Tsis tas li ntawd xwb, koj yuav tau txais cov tshuaj no thaum lub sijhawm kho mob xws li angioplasty, uas qhib cov hlab ntsha hauv lub plawv.
Cov tshuaj twg koom nrog pawg no?
Muaj ntau hom tshuaj thrombin inhibitor uas tam sim no siv ntau hauv Sri Lanka thiab thoob ntiaj teb.
- Argatroban (qhov no yog muab ua kev txhaj tshuaj IV)
- Bivalirudin (qhov no kuj yog muab los ntawm kev txhaj tshuaj rau hauv cov hlab ntsha - IV txhaj tshuaj)
- Dabigatran (qhov no yog yam koj noj ua ib lub tshuaj)
Cov tshuaj no ua haujlwm li cas hauv lub cev?
Yooj yim heev. Raws li lub npe qhia, cov tshuaj no mus ncaj qha rau thiab ua kom tsis txhob muaj ib qho enzyme hu ua Thrombin.
Tam sim no tej zaum koj yuav nug tias Thrombin no yog dab tsi. Hais yooj yim xwb, Thrombin yog ib qho tseem ceeb hauv cov txheej txheem ntshav txhaws hauv peb lub cev. Nws zoo li tus kws ua zaub mov tseem ceeb npaj pluas mov. Cov tshuaj no ua yog kom tus kws ua zaub mov ntawd tso tseg. Ces cov txheej txheem ntshav txhaws tsis tshwm sim kom raug. Yog li ntawd, cov ntshav txhaws tsis tsim nyog yuav tsum nres. Koj puas nkag siab?
Tiamsis qee zaum cov tshuaj no tuaj yeem ua rau los ntshav ntau ntxiv. Muaj ib qho kev txhaj tshuaj tshwj xeeb uas tuaj yeem thim rov qab cov teebmeem ntawm cov tshuaj Dabigatran. Nws hu ua 'Idarucizumab'. Txawm li cas los xij, tsis muaj tshuaj tshwj xeeb rau cov tshuaj txhaj rau hauv cov hlab ntsha. Txawm li cas los xij, thaum cov tshuaj raug tso tseg, nws cov teebmeem yuav ploj mus tom qab ib pliag.
Kuv yuav tsum noj cov tshuaj no ntev npaum li cas?
Nws txawv ntawm ib tus neeg mus rau ib tus neeg. Ib txhia neeg tsuas yog yuav tsum tau noj nws rau lub sijhawm luv luv xwb, xws li ib hlis tom qab phais hloov lub duav. Tab sis ib tus neeg uas muaj feem yuav ntshav txhaws ntau dua yuav tsum tau noj cov tshuaj no rau tas lawv lub neej . Koj tus kws kho mob yuav txiav txim siab seb yuav ua li cas.
Cov txiaj ntsig ntawm hom tshuaj no yog dab tsi?
Cov tshuaj tshiab no muaj ntau yam zoo dua li cov tshuaj qub.
- Cov txiaj ntsig zoo ib yam: Vim tias cov no tsuas yog cuam tshuam ncaj qha rau Thrombin, koj tuaj yeem cia siab tias yuav tau txais cov txiaj ntsig zoo ib yam los ntawm tib koob tshuaj txhua zaus.
- Tsis txo cov platelets: Tsis zoo li qee cov tshuaj qub, cov no tsis txo cov platelets, uas pab cov ntshav txhaws.
- Koj tsis tas yuav kuaj koj cov ntshav ntau zaus: Qee cov tshuaj, xws li Warfarin, yuav tsum tau kuaj ntshav tas li kom paub tseeb tias koj cov ntshav khov sai npaum li cas. Tab sis cov tshuaj no tsis tas yuav tsum tau ua li ntawd.
- Cov kev mob tshwm sim tsawg dua: Dabigatran, uas noj ua tshuaj ntsiav, muaj kev pheej hmoo tsawg dua ntawm kev los ntshav thiab kev cuam tshuam nrog lwm yam tshuaj thaum piv rau Warfarin.
- Siv tau yooj yim: Nws yooj yim heev rau siv vim koj tsuas yog yuav tsum noj ib lub tshuaj ib lossis ob zaug ib hnub.
- Lwm txoj kev xaiv: Cov no yog ib txoj kev xaiv zoo rau cov neeg uas siv tsis tau cov tshuaj xws li Heparin.
Cov tshuaj no zoo npaum li cas? Thiab muaj kev pheej hmoo dab tsi?
Kev tshawb fawb pom tias cov tshuaj no muaj kev nyab xeeb thiab zoo ib yam li Warfarin lossis Heparin. Txawm li cas los xij, lawv tsis haum rau cov neeg uas muaj qee yam kab mob plawv.
Tiam sis qhov tseem ceeb tshaj plaws ntawm no yog lub sijhawm uas cov tshuaj no nyob hauv lub cev raug txo qis. Piv txwv li, thaum koj noj ib koob tshuaj Warfarin, kwv yees li 50% ntawm nws tuaj yeem nyob hauv lub cev rau 20-60 teev. Tab sis yog tias koj noj Dabigatran, 50% ntawm nws raug tshem tawm ntawm lub cev hauv 12-14 teev.
Qhov no txhais li cas? Koj yuav tsum tsis txhob ncua ib hnub ntawm kev noj cov tshuaj no. Yog tias koj ncua ib hnub ntawm kev noj nws, koj qhov kev pheej hmoo ntawm kev mob ntshav txhaws yuav nce ntxiv ntau heev.
Tej zaum yuav muaj tej yam tshwm sim tsis zoo
Ib yam li lwm yam tshuaj, cov tshuaj no tuaj yeem muaj cov kev mob tshwm sim, qee qhov tuaj yeem ua rau mob hnyav.
| Cov teebmeem sab nraud | Kev piav qhia |
|---|---|
| Los ntshav ntau dhau | Los ntshav ntawm cov pos hniav, los ntshav ntswg, lossis qhov txhab uas los ntshav tsis tu ncua. |
| Kev zom zaub mov tsis zoo (Dyspepsia) | Mob plab, tsis xis nyob. |
| Kev hloov xim ntawm cov zis | Cov zis hloov xim av los yog liab dawb. |
| Mob taub hau, kiv taub hau | Mob taub hau dav dav lossis kiv taub hau. |
| Mob hauv siab, ua pa nyuaj | Cov no tuaj yeem yog cov tsos mob hnyav. |
| Kub taub hau, kis kab mob (Sepsis) | Cov mob hnyav uas tshwm sim los ntawm kev kis kab mob. |
Kuv yuav tsum mus ntsib kws kho mob thaum twg?
Yog tias koj muaj tej yam kev mob tshwm sim thaum siv cov tshuaj no, qhia rau koj tus kws kho mob tam sim ntawd.
Tshwj xeeb, yog tias koj los ntshav ntau dhau (piv txwv li, yog tias koj tsis tuaj yeem tso tseg los ntshav ntawm qhov txhab, yog tias koj muaj ntshav hauv koj cov quav, yog tias koj muaj qhov ntswg uas ua rau koj muaj kev cuam tshuam) lossis yog tias koj muaj lwm yam tsos mob loj (mob hauv siab hnyav, ua pa nyuaj), mus rau lub tsev kho mob ze tshaj plaws Chav Kho Mob Thaum Muaj Xwm Ceev (ETU) yam tsis muaj kev ncua.
Thaum kawg, tsis tas yuav ntshai tsam ntshav txhaws. Cov tshuaj niaj hnub xws li cov tshuaj tiv thaiv thrombin ncaj qha tuaj yeem tswj tau qhov kev pheej hmoo ntawd mus rau qib zoo. Tab sis koj tus kws kho mob yuav txiav txim siab seb cov tshuaj twg zoo tshaj plaws rau koj thiab koj yuav tsum noj nws ntev npaum li cas. Yog li ntawd, ib txwm ua raws li koj tus kws kho mob cov lus qhia.
Cov Lus Qhia Txog Kev Coj Mus Tsev
- Cov tshuaj Direct Thrombin Inhibitors yog ib hom tshuaj tshiab uas tiv thaiv cov ntshav txhaws.
- Cov no ua haujlwm los ntawm kev ncaj qha inactivate thrombin, ib qho enzyme tseem ceeb hauv cov txheej txheem ntshav txhaws.
- Yog koj siv cov tshuaj noTsis txhob hla ib koob tshuaj. Ua li ntawd tam sim ntawd yuav ua rau muaj kev pheej hmoo ntawm cov ntshav txhaws.
- Yog koj pom ntshav ntau dhau los yog lwm yam tsos mob txawv txawv, hu rau koj tus kws kho mob tam sim ntawd.
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Tsis muaj lus teb tau muab tso tawm. Ntxiv koj cov lus tawm ntawm no thawj zaug.
Ntxiv koj cov lus