Waizviziva here kuti ropa rinoyerera nemutsinga dzako dzimwe nguva rinogona kugomara zvisina kufanira? Kana kugomara kweropa kwakadaro kukaenda kuuropi, kunogona kukonzera sitiroko, uye kana kukaenda kumoyo, kunogona kukonzera kurwara kwemoyo. Saka nhasi tichataura nezvemhando yemishonga inoshandiswa navanachiremba kudzivirira mamiriro aya ane njodzi. Aya anonzi Direct Thrombin Inhibitors.
Zvichitaurwa zviri nyore, chii chinonzi Direct Thrombin Inhibitors idzi?
Iyi imhando yemishonga inodzivirira kuumbwa kweropa. Ndiyo yatinowanzodaidza kuti "mishonga inoomesa ropa." Asi mashandiro ayo akasiyana zvishoma. Pfungwa yekugadzira mishonga iyi yakavakirwa papuroteni inowanikwa mumate ezvikwekwe. Ungave wakambonzwa kuti zvikwekwe zvaishandiswawo pakurapa kare.
Vanhu vazhinji pasi rose vanofa nechirwere chemwoyo. Chikonzero chikuru cheizvozvo kuumbwa kweropa. Saka vanachiremba vanopa mishonga yakaita seiyi kuponesa vanhu kubva panjodzi iyi.
Mushonga uyu unoshandiswa pamamiriro ezvinhu api?
Rudzi urwu rwemishonga, inonzi direct thrombin inhibitors, inowanzoshandiswa kudzivirira kana kurapa kuumbwa kweropa kunokonzerwa nezvirwere zvakasiyana-siyana. Ngationei kuti chii.
| Mamiriro echirwere | Tsananguro iri nyore |
|---|---|
| Chirwere chemwoyo chinokonzeresa chirwere chemwoyo (acute coronary syndrome) | Kuvharika kwetsinga dzinoendesa ropa kumoyo kana kunonoka kweropa. |
| Kuora kweropa kunokonzerwa neheparin (HIT) | Dambudziko rinokonzerwa nechimwe chinhu chinoderedza ropa chinonzi heparin. |
| Kubuda kweropa mutsinga (VTE) | Kugwamba kweropa mutsinga mumuviri. |
| Kupera kweAtrial (Afib) | Njodzi yekugwamba kweropa uye sitiroko nekuda kwekurova kwemoyo kusina kurongeka. |
| Mushure mekuvhiyiwa kwekutsiva hudyu | Deredza njodzi yekugwamba kweropa mushure mekuvhiyiwa. |
| Kugwamba kweropa mutsinga yakadzika mugumbo (Deep vein thrombosis - DVT) | Kugwamba kweropa, kunyanya mutsinga dzakadzika dzemakumbo. |
| Kugwamba kweropa mumapapu (Pulmonary embolism) | Ropa rinoumbwa kune imwe nzvimbo mumuviri rinoenda kumapapu robva ragara. |
Uyezve, unogona kupihwa mushonga uyu panguva yekurapwa kwakadai se angioplasty, iyo inovhura tsinga dzemwoyo wako.
Mishonga ipi iri muboka iri?
Kune mhando dzakasiyana dzemishonga inodzivirira thrombin inhibitor dziri kushandiswa zvakanyanya muSri Lanka nepasi rose.
- Argatroban (iyi inopihwa sejekiseni remutsinga)
- Bivalirudin (iyi inopihwawo sejekiseni remutsinga - jekiseni remutsinga)
- Dabigatran (iyi ndiyo yaunonwa sepiritsi)
Mushonga uyu unoshanda sei mumuviri?
Zviri nyore kwazvo. Sezvinoreva zita racho, mushonga uyu unoenda zvakananga kune imwe enzyme inonzi Thrombin uye unodzima mashandiro ayo.
Zvino ungangove uchibvunza kuti Thrombin iyi chii. Zvichitaurwa zviri nyore, Thrombin chinhu chakakosha mukugwamba kweropa mumuviri wedu. Zvakafanana nemubiki mukuru ari kugadzirira chikafu. Zvinoitwa nemushonga uyu ndekusiya mubiki iyeye parutivi. Ipapo kugwamba kweropa hakuitike nemazvo. Saka kuumbwa kweropa risingakoshi kunomira. Unonzwisisa here?
Asi dzimwe nguva mushonga uyu unogona kukonzera kubuda ropa kwakawanda. Kune jekiseni rakakosha rinogona kushandura mhedzisiro yepiritsi reDabigatran. Rinonzi `Idarucizumab`. Zvisinei, hapana mushonga wakakosha wemushonga wetsinga. Zvisinei, kana mushonga wacho wamiswa, mhedzisiro yawo inopera mushure mechinguva.
Ndinofanira kutora mushonga uyu kwenguva yakareba sei?
Zvinosiyana kubva pamunhu nemunhu. Vamwe vanhu vanongoda kuitora kwenguva pfupi chete, senge mwedzi mushure mekuvhiyiwa kwekutsiva chiuno. Asi munhu ari panjodzi huru yekugwamba kweropa angangoda kutora mushonga uyu kweupenyu hwake hwese . Chiremba wako ndiye achasarudza chaizvo zvekuita.
Ndezvipi zvakanakira mushonga uyu?
Rudzi urwu rutsva rwemishonga rune zvakanakira zvakawanda pane mishonga yekare.
- Mhedzisiro yacho yakafanana: Sezvo izvi zvichingokanganisa Thrombin zvakananga, unogona kutarisira mhedzisiro yakafanana kubva pamushonga mumwe chete nguva dzese.
- Hapana kudzikira kwemaplatelet: Kusiyana nemimwe mishonga yekare, iyi haideredzi huwandu hwemaplatelet, izvo zvinobatsira kuti ropa rigwambe.
- Hamufanirwe kuongororwa ropa renyu nguva nenguva: Mimwe mishonga, yakaita seWarfarin, inoda kuongororwa ropa nguva nenguva kuti ione kuti ropa renyu riri kugwinya nekukurumidza zvakadii. Asi mushonga uyu haudi izvozvo.
- Migumisiro mishoma: Dabigatran, iyo inotorwa sepiritsi, ine njodzi shoma yekubuda ropa uye kusangana nemimwe mishonga kana ichienzaniswa neWarfarin.
- Zviri nyore kushandisa: Zviri nyore kushandisa sezvo uchingofanira kunwa piritsi kamwe chete kana kaviri pazuva.
- Imwe sarudzo: Iyi sarudzo yakanaka kune avo vasingakwanise kushandisa mishonga yakaita seHeparin.
Mushonga uyu unoshanda zvakadini? Uye njodzi dzawo ndedzipi?
Ongororo yakawana kuti mushonga uyu wakachengeteka uye unoshanda seWarfarin kana Heparin. Zvisinei, hauna kukodzera vanhu vane zvimwe zvirwere zvevharuvhu yemwoyo.
Asi chinonyanya kukosha pano ndechekuti nguva inosara mumuviri inoderedzwa. Semuenzaniso, kana ukatora mushonga weWarfarin, inenge 50% yawo inogona kuva mumuviri kwemaawa 20-60. Asi kana ukatora Dabigatran, 50% yawo inobviswa mumuviri mukati memaawa 12-14.
Izvi zvinorevei? Haufanire kupotsa zuva rimwe chete rekutora mushonga uyu. Kana ukapotsa zuva rimwe chete rekutora mushonga uyu, njodzi yako yekuva neropa rakagwamba inowedzera zvakanyanya.
Migumisiro inogona kuitika
Kufanana nemishonga chero ipi zvayo, iyi inogona kuva nemigumisiro yakaipa, mimwe yacho inogona kunge yakakomba.
| Mhedzisiro yedivi | Tsananguro |
|---|---|
| Kubuda ropa zvakanyanya | Kubuda ropa kubva mumazino, kubuda ropa mumhino, kana ronda risingamisi kubuda ropa. |
| Kusagadzikana kwekugaya chikafu (Dyspepsia) | Kurwadziwa kwemudumbu, kusagadzikana. |
| Kuchinja kweruvara rweweti | Weti inoshanduka kuita brown kana pink. |
| Musoro, dzungu | Musoro wemusoro kana dzungu. |
| Kurwadziwa pachipfuva, kuoma kufema | Izvi zvinogona kuva zviratidzo zvakakomba. |
| Fivha, hutachiona (Sepsis) | Matambudziko akakomba anokonzerwa nehutachiona. |
Ndinofanira kuona chiremba rini?
Kana ukasangana nemigumisiro yakaipa paunenge uchishandisa mushonga uyu, zivisa chiremba wako nekukasika.
Zvikuru sei, kana uchibuda ropa rakawanda (semuenzaniso, kana usingakwanise kumisa kubuda ropa kubva paronda, kana uine ropa mutsvina yako, kana uine kubuda ropa mumhino kuri kukonzera kuti uve nemusoro) kana kana uine zvimwe zviratidzo zvakakomba (kurwadziwa kwechipfuva kwakanyanya, kunetseka kufema), enda kuchipatara chiri pedyo neEmergency Department (ETU) nekukurumidza.
Chekupedzisira, hapana chikonzero chekutya kuti ropa ringagwamba. Mishonga yemazuva ano yakaita se direct thrombin inhibitors inogona kudzora njodzi iyoyo zvakanyanya. Asi chiremba wako ndiye achasarudza kuti ndeipi mishonga yakakunakira uye kuti unofanira kuitora kwenguva yakareba sei. Saka gara uchitevera zano rachiremba wako.
Mharidzo Yekuenda Nayo Kumba
- Mishonga inodzivirira ropa kubva muropa (Direct Thrombin Inhibitors) imhando itsva yemishonga inodzivirira kuumbwa kweropa.
- Izvi zvinoshanda nekumisa zvakananga thrombin, iyo enzyme inokosha mukuita kwekugwamba kweropa.
- Kana ukashandisa mushonga uyuUsambofa wakasiya mushonga wawatora. Kuita izvi nekukurumidza kunowedzera njodzi yekugwamba kweropa.
- Kana ukaona kubuda ropa rakawanda kana zvimwe zviratidzo zvisingawanzoitiki, taura nachiremba wako nekukasika.
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