Wakamboshandisa mushonga unonzi Heparin here? Pamwe mushure mekuvhiyiwa, kana kudzivirira kuumbwa kweropa, chiremba angangodaro akakupa mushonga uyu. Zvisinei, kunyange zvisingawanzoitiki, heparin iyi inogona kukonzera kuti miviri yedu iite macolting eropa akawanda uye kuderedza huwandu hwemaplatelet. Ndizvo zvatinodaidza kuti `Heparin-Induced Thrombocytopenia` kana `(HIT)`. Usazvidya moyo, izvi zvinganzwika zvakaoma, asi ngatitaure nezvazvo zviri nyore.
Chii chinonzi heparin? Sei HIT ichiitika?
Zvichitaurwa zviri nyore, heparin
mushonga unorwisa ropa kuti risaungane. Unoshandiswa kudzivirira kuumbwa kweropa mutsinga dzedu dzeropa. Vanachiremba vanoupa mushure mekuvhiyiwa kukuru, kana kunyungudutsa ropa rakaumbwa kare. Zvisinei, kashoma, kana heparin ikapihwa kune vamwe vanhu, inogona kukonzera kusawirirana. Apa ndipo apo
masoja edu emuviri anosangana neheparin zvisizvo uye otanga kushanda nemaplatelet edu. Maplatelet rudzi rwesero rinobatsira kumisa kubuda ropa kwedu. Saka, kana maplatelet akaitwa nenzira iyi, pachinzvimbo chekumisa kuumbwa kweropa,
anotanga kuumba kuumbwa kweropa zvisina kufanira (thrombosis). Panguva imwe chete, huwandu hwemaplatelet hunodererawo nekukurumidza (thrombocytopenia). Ndokusaka chirwere ichi dzimwe nguva chichinzi `Heparin-Induced Thrombocytopenia and Thrombosis (HITT)`.
Fungidzira, zvinoshamisa kuti mushonga unopiwa kudzivirira kuumbwa kweropa waizoita kuti ropa riwedzere kuumbwa uye kuderedza maplatelet, handiti? Asi zvinogona kuitika.
Kune mhando mbiri huru dzeHITs.
Vanachiremba vanopatsanura mamiriro aya e `(HIT)` kuita mhando mbiri huru: 1.
HIT I (Rudzi 1): Muchiitiko ichi, huwandu hwemaplatelet ako hunodzikira zvishoma mumazuva mashoma ekutanga mushure mekutanga heparin, asi hunodzokera kune zvakajairika mukati memazuva mashoma.
Iyi haisi mamiriro ane njodzi , uye hapana njodzi yekugwamba kweropa, saka hapana kurapwa kwakakosha kunodiwa. 2.
HIT II (Rudzi 2): Iyi ndiyo mhando yatinofanira kunetseka nayo. Muchiitiko ichi, masoja edu emuviri anomutsa maplatelet mukupindura heparin. Izvi zvinoita kuti huwandu hwemaplatelet huderere, uye pane
njodzi yekugwamba kweropa kwakanyanya . Kazhinji, patinotaura nezve `(HIT)`, tinowanzoreva rudzi urwu rune njodzi runonzi `(HIT II)`.
Ndiani ane mukana mukuru wekuwana HIT iyi?
Munhu wese anoshandisa heparin, zvisinei nedosi kana nguva yekushandiswa, anogona kuva nechirwere ichi. Zvisinei, zvakaonekwa kuti
vakadzi vane makore anopfuura makumi mana vane mukana wekuva nacho. Vanachiremba havazivi kuti nei vamwe vanhu vaine chirwere ichi kune heparin uye vamwe havazivi. Izvi
Haisi chirwere chinowanzoitika. Chirwere ichi chinonzi "(HIT)`` chinoitika muboka diki revanhu, vanenge 5%, vanotora heparin kwemazuva anopfuura mana. Ndezvipi zviratidzo zveHIV? Tinozviziva sei?
Kana uri kutora heparin, chiremba wako anowanzo tarisa huwandu hwemasero muropa rako, kunyanya huwandu hwemaplatelet. Kuwanda kwemaplatelet kushoma kunogona kuva chiratidzo chekutanga cheHIT. Vanhu vanenge hafu vane HIT vanotanga kuumbwa kweropa idzva. Izvi zvinogona kuva deep vein thrombosis (DVT) mugumbo kana pulmonary embolism (PE). Chenjerera zviratidzo izvi: Pamusoro pezvo, unogona kuona kurwadziwa, chironda, kana mapundu paganda panzvimbo yekubaiwa jekiseni reheparin. Chinonyanya kukosha: Kana uri kutora heparin uye ukaona chimwe chezviratidzo izvi, tsvaga rubatsiro rwechiremba nekukurumidza . Izvi hazvisi zvekunonoka.
HIT inoitika rini?
Kazhinji, zviratidzo zvinotanga mukati memazuva mashanu kusvika kumavhiki maviri mushure mekutanga heparin. Zvisinei, zvinogonawo kuitika pane dzimwe nguva:- KUBVA KUKUTANGA KWEMUSHONGA: Izvi zvinogona kuitika mukati mezuva rimwe kusvika matatu kubva pakatanga heparin. Izvi zvinowanzoitika kana wakamboshandisa heparin kare (kazhinji mukati memwedzi mitatu). Zvadaro, muviri wako "unoyeuka" heparin, uchigadzira masoja ekudzivirira chirwere anoirwisa, uye unenge wagadzirira kuita chimwe chinhu nekukurumidza.
- Kurapwa Kusingadzoreki: Dambudziko iri rinogona kuramba riripo kwemavhiki mushure mekunge heparin yamiswa.
- Kunonoka kutanga kubatwa: Izvi zvinoitika mushure mekunge mushonga we heparin wamiswa. Zvinowanzoitika mazuva mashanu kana kupfuura mushure mekumira mushonga.
Chii chaizvo chinokonzera kukuvadzwa uku?
`HIT` inoitika kana mushonga weheparin wakabatana nepuroteni inonzi `PF4` (Platelet Factor 4) mumaplatelet edu. Heparin iyi ne`PF4` zvakabatana kugadzira `Heparin-PF4 complex`. Patinoona kuti `Heparin-PF4 complex` mumuviri wedu, masoja edu emuviri anonetseka uye anotanga kugadzira maantibodies anorwisa. Maantibodies aya anoenda obatana ne`Heparin-PF4 complex` iyoyo. Ndipo panotanga zvese. Maantibodies aya paanongobatana, maplatelet anobva angotanga kushanda uye anotanga kugadzira maclots eropa. Nenzira iyi, `PF4` yakawanda inoburitswa kubva mumaplatelet anoita maclots eropa. Ipapo `PF4` ichangosvika inobatanawo neheparin, ichigadzira `Heparin-PF4 complex` yakawanda. Maantibodies anodzoka obatanazve nayo, maclots eropa akawanda anoumbwa... Izvi zvinoramba zvichienderera mberi sechain reaction. Nekuda kweizvi zvese zvinogadzira maclots eropa, maplatelet mumuviri anoshandiswa nekukurumidza. Nekuda kweizvozvo, huwandu hweplatelet hunoderera. Nekuda kwekuwanda kweropa iri, magwamba eropa makuru, anotyisidzira hupenyu anogona kuumbwa, achivhara mitsipa yedu netsinga dzeropa. Ndezvipi zvinhu zvinokonzera njodzi yeHIT?
Kune zvinhu zvakawanda zvinowedzera njodzi yekubatwa neHIT:- Murume kana mukadzi: Vakadzi vane mukana mukuru wekubatwa nechirwere chepabonde.
- Rudzi rweheparin rwunoshandiswa: Dzimwe ongororo dzinoratidza kuti njodzi yeHIT inogona kusiyana zvichienderana nerudzi rweheparin yaunotora. Semuenzaniso, pane humbowo hwekuti kushandisa heparin isina kupatsanurwa panzvimbo peheparin ine huremu hushoma kunogona kuderedza njodzi. Zvisinei, kutsvagurudza kwakawanda kunodiwa pane izvi.
- Kutora heparin mushure mekuvhiyiwa: Vanhu vanotora heparin kudzivirira kuumbwa kweropa mushure mekuvhiyiwa vane mukana wekuwana HIT kupfuura avo vanotora iyo kurapa kuumbwa kweropa kuripo. Njodzi iyi yakanyanya kukwira mushure mekuvhiyiwa kwemapfupa, kuvhiyiwa kwemoyo, uye cardiopulmonary bypass .
HIT inoonekwa sei? (Kuongororwa)
Kuongororwa ropa kwakawanda kunogona kubatsira kuona kana uine HIT:- Maplatelet levels: Izvi zvinogona kuona kana platelet count yako yakaderera (thrombocytopenia).
- Kuumbwa kweropa: Kuongororwa kweropa kunoratidza kana ropa rako richigwamba.
- Mazinga ePF4 antibody: Huwandu hwePF4 antibodies muropa rako hunogona kuona kana immune system yako iri kushanda nemaplatelet. Iyi bvunzo yeantibody ndiyo inosimbisa kuongororwa kweHIT.
Chiremba wako anogonawo kuraira kuti apinzwe ultrasound kuti aone kana ropa rakagwamba mumakumbo ako (DVT). Zvichienderana nemamiriro ako ezvinhu, vanogonawo kuraira kuti aongorore kana ropa rakagwamba mune dzimwe nzvimbo, dzakadai semaoko ako. Zvisinei, nekuda kwekuti mhedzisiro yekuyedzwa kweantibody iyi inotora nguva kuti idzoke, vanachiremba havamiriri kuti idzoke vasati vatanga kurapwa. Nekuti HIT chirwere chinogona kuuraya kana chikasarapwa, kurapwa kunobva pakuti ungangove neHIV sei. Chii chinonzi "bvunzo ye4Ts" iyi?
Bvunzo ye `4Ts` inzira yekuongorora zviratidzo inofungidzira kuti ungangove ne `HIT` zvakadii. Inopa ruzivo rwaunoda kuti utange kurapwa usingamiriri mhedzisiro yebvunzo ye antibody. Chiremba anopa mamakisi (kubva pa 0 kusvika pa 2) ezvinhu izvi zvina:- Thrombocytopenia (nhamba shoma yemaplatelet): Nhamba yako yemaplatelet yakaderera zvakadii?
- Nguva (nguva yekuita heparin): Maplatelet ako akadzikira rini?
- Thrombosis (kugwamba kweropa): Pane zviratidzo zvekugwamba kweropa here?
- Zvimwe Zvikonzero: Pangave nechimwe chikonzero kunze kweheparin here chinoita kuti uve ne platelet shoma?
Kana zvibodzwa zvakwira, mukana wekuti `HIT` unowedzera. Ndeipi mishonga yeHIT?
Danho rekutanga rekurapwa nderekurega kutora heparin nekukasika. Zvadaro, uchachinjwa kuenda kune imwe mushonga unodzikisa ropa. Kuwanda kwemaplatelet ako kunofanira kutanga kuwedzera zvakare mukati memazuva mashoma mushure mekumira kweheparin. Kusvika panguva iyoyo, chiremba wako angangokupa mumwe mushonga wekubatsira kudzivirira kuumbwa kweropa. Kune mishonga yakati wandei inogona kushandiswa panzvimbo peheparin:- "Mishonga inodzivirira thrombin zvakananga" (semuenzaniso `argatroban', `bivalirudin')
- `Fondaparinux`
- `Mishonga inorwisa ropa kuungana zvakananga` (mishonga inodzivirira kuumbwa kweropa inogona kutorwa zvakananga nemuromo)
Kana huwandu hwemaplatelet ako hwadzokera pahunhu hwakanaka uye njodzi yekugwamba kweropa nekuda kweHIT yapera, chiremba wako anogona kukuchinjira kune mumwe mushonga unodzikisa ropa, wakaita sewarfarin. Tinogona kudzivirira HIT here?
Hapana chaunogona kuita kudzivirira HIT. Zvisinei, kuva nachiremba wako nguva dzose achitarisa huwandu hwemaplatelet ako kunogona kubatsira kuderedza njodzi yezvinetso zvinokonzerwa neheparin. Chii chaunotarisira kana uine HIT?
Heparin-Induced Thrombocytopenia (HIT) chirwere chakakomba chinogona kuuraya kana chikasarapwa nekukurumidza. Kugwamba kweropa kukuru mumaoko nemakumbo kunogona kukonzera kukuvara kwenguva refu kunhengo idzodzo. Kugwamba kweropa kunokanganisa nhengo huru kunogona kuuraya. Nerombo rakanaka, neruzivo rwakawedzerwa rweHIT uye nzira dziri nani dzekurapa, mwero wekurarama wavandudzika zvakanyanya. Kuonekwa nekukurumidza, ropa risati ragwamba zvakanyanya, ndicho chinhu chikuru chinoita kuti pave nemhedzisiro yakanaka.Kana chiremba wako angoona zviratidzo zveHIT, zvakaita sehuwandu hwemaplatelet akaderera, anogona kukupa mushonga wekuderedza njodzi yekugwamba kweropa. Ndinozvitarisira sei?
Uchafanira kuona chiremba wako nguva nenguva kuti utarise huwandu hwemaplatelet ako uye uve nechokwadi chekuti hausi kuita macoagulant eropa. Pamusoro pezvo, chiremba wako achaziva nezvemigumisiro inogona kuitika (yakadai sekubuda ropa mune vamwe vanhu) paunenge uchichinja kubva kuheparin kuenda kuanticoagulant itsva. Panguva ino, zvakakosha kuti utore mushonga wako sezvawakarairwa. Kunyangwe usati waita macoagulant eropa, uchafanira kutora anticoagulant isiri heparin kwemwedzi unopfuura. Kana wakambova necoagulant yeropa, ungangoda kuitora kwenguva yakareba. Nzira yakanakisisa yekuzvitarisira ndeyekuudza chero chiremba anokurapa mune ramangwana kuti wakambosangana nedambudziko iri. Kana wakambobatwa ne "HIT", haufanirwe kutora heparin zvakare.
Kana ukaona chero shanduko mumuviri wako paunenge uchitora heparin, tsvaga rubatsiro rwekukurumidzira nekukurumidza. Heparin-Induced Thrombocytopenia (HIT) chirwere chisingawanzoitiki, asi chero chiratidzo chekugwamba kweropa chakakomba zvekuti hachifaniri kuregeredzwa. Kana usina kurapwa, HIT inogona kuuraya. Nekurapwa, huwandu hweplatelet yako hunofanira kudzokera pahwakajairika uye njodzi yako yekugwamba kweropa inofanira kudzikira. Taura nachiremba wako nezvemushonga wakanakisa wekushandisa pane heparin mune ramangwana. Mharidzo Yekupedzisira Yekuenda Kumba
- Kunyangwe heparin iri mushonga unokosha unodzivirira kuumbwa kweropa, haigone kukonzera chirwere chakakomba chinonzi `Heparin-Induced Thrombocytopenia (HIT).`
- Chinoitika munyaya iyi ndechekuti pachinzvimbo chekudzivirira kuumbwa kweropa, kuumbwa kweropa kunowedzera uye huwandu hwemaplatelet hunoderera.
- Tarisa zviratidzo zvakaita sekuzvimba mumakumbo/maoko ako, kurwadziwa, kurwadziwa muchipfuva, uye kuoma kufema. Kana ukaona izvi, enda kuna chiremba nekukasika.
- Kana `HIT` yaonekwa, chinhu chekutanga chekuita kumisa heparin. Zvadaro uchafanira kushandisa mimwe mishonga inoderedza ropa.
- Kana wakambobatwa ne "HIT", nyora pasi zvese zviri muzvinyorwa zvako zvekurapa uye udza chero chiremba wauchaona mune ramangwana. Haufanire kuzopihwa heparin zvakare.
Ndinovimba ruzivo urwu ruchakubatsira. Ramba uine hutano! Heparin, Thrombocytopenia, Kuvhara ropa, Maplatelet, Anticoagulant, HIT, Mhedzisiro yechipfuva, Kuvhara ropa, Maplatelet, Heparin, Mhedzisiro yechipfuva
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