Wake wezwa ngodokotela ekunika wena noma othile emndenini wakho umuthi 'wokunciphisa igazi' esibhedlela? Umuthi owunikezwayo ungase ube yi-heparin. Abantu abaningi bawubiza nangokuthi 'wokunciphisa igazi'. Kodwa leli gama lingadukisa kancane. Empeleni 'alinciphisi' igazi njengamanzi. Pho liyini? Livimba ukwakheka kwamahlule egazi ayingozi emizimbeni yethu, noma livimbele ihlule legazi elikhona ukuthi likhule. Ngakho-ke namuhla, ake sixoxe nge-heparin, ebalulekile kubantu abaningi, ngendlela elula neqondakalayo.
Iyini ngempela i-Heparin?
Kalula nje, i-heparin iyi -anticoagulant . Okusho ukuthi, umuthi ovimbela igazi ukuthi lingaqini. Ayiqhekeki futhi ayincibilikisi ihlule legazi eselivele lakhekile, kodwa ingasiza umzimba ukuthi ulincibilikise ngokuvimbela ukuthi lingakhuli.
Ungase uzibuze ukuthi kungani lokhu kunganikezwa njengephilisi. Isizathu ukuthi amathumbu ethu awakwazi ukumunca lo muthi obizwa ngokuthi i-heparin. Ngakho-ke, uma siwuthatha njengephilisi, ngeke ube usizo. Yingakho umuthi obizwa ngokuthi i-heparin uhlala unikezwa ngezindlela ezimbili:
1. Ngesisombululo sikasawoti esifakwa emthanjeni (IV Infusion): Lokhu kusebenza ngokushesha kakhulu ngoba umuthi ungena ngqo egazini.
2. Njengomjovo ngaphansi kwesikhumba (Umjovo Ongaphansi Kwesikhumba): Uma unikezwa ngale ndlela, kuthatha cishe ihora noma amabili ukuthi umuthi umunceke emzimbeni.
I-heparin isebenza kanjani emizimbeni yethu?
Ukuze siqonde lokhu, ake sithathe isibonelo esincane. Cabanga ukuthi ukwakheka kwehlule legazi emzimbeni wethu kuyinqubo eyinkimbinkimbi, njengokwenza umkhiqizo efektri. Lokhu kudinga izisebenzi eziningi ezahlukene (amakhemikhali namaprotheni ahlukene emzimbeni wethu) ukuthi zisebenzisane ndawonye.
Izisebenzi ezimbili eziyinhloko kule fektri yi -'Thrombin' kanye ne-'Factor Xa' . Laba ababili benza ezinye zezinyathelo zokugcina nezibaluleke kakhulu enqubweni yokwenza amahlule egazi.
I-Heparin isebenza njengomphathi ohlakaniphile ofika abeke eceleni izikhali zalaba basebenzi ababili ababalulekile. Okusho ukuthi, i-heparin iyangena futhi ivale kokubili i-'thrombin' kanye ne-'factor Xa'. Bese bengakwazi ukwenza umsebenzi wabo. Ekugcineni, yonke ifektri iyayeka ukusebenza, futhi amahlule egazi amasha ayayeka ukwakheka ngokuphelele. Uyaqonda? Kulula kakhulu, akunjalo?
Yiziphi izimo odokotela abasebenzisa i-heparin kuzo?
I-Heparin umuthi obaluleke kakhulu ongasindisa izimpilo. Ngakho-ke, isetshenziselwa ukwelapha nokuvimbela izimo zezokwelapha ezahlukahlukene. Ake sibheke izimo eziyinhloko.
| Isimo/Isenzakalo | Incazelo elula |
|---|---|
| I-VTE (i-VTE) ye-Thromboembolism yemithambo yegazi | Ukwakheka kwehlule legazi emthanjeni emzimbeni. Kunezinhlobo ezimbili eziyinhloko zalokhu (i-DVT kanye ne-PE). |
| Ukuqhekeka kwegazi emthanjeni ojulile (i-Deep Vein Thrombosis - DVT) | Ihlule legazi, ngokuvamile emthanjeni ojulile emlenzeni noma engalweni. Le ngozi iphezulu ngemva kokuhlinzwa okukhulu noma uma kufanele uhlale endaweni eyodwa isikhathi eside. |
| I-Pulmonary Embolism (PE) | Ihlule legazi elakheka endaweni efana ne-DVT liyaqhekeka bese lihlala emthanjeni emaphashini. Lesi yisimo esiphuthumayo nesiyingozi. |
| Isifo senhliziyo | Ukuvimbela ukwakheka kwamahlule egazi engeziwe ekuhlaselweni yinhliziyo okubangelwa ukuqhekeka kwegazi emthanjeni ohlinzeka ngegazi enhliziyweni. |
| Isifo sohlangothi | Ezimweni zokuhlaselwa yisifo sohlangothi okubangelwa ukuqhekeka kwegazi emthanjeni wegazi ebuchosheni. |
| Ukuhlinzwa Okukhulu | Ikakhulukazi ngemva kokuhlinzwa okufana nokufakelwa i-hip noma idolo, isiguli sisengozini enkulu yokuba namahlule egazi ngoba awakwazi ukunyakaza. Ukuze sikuvimbele. |
| I-Atrial Fibrillation (Afib) | Ukunciphisa ingozi yokwakheka kwamahlule egazi enhliziyweni ngenxa yokushaya kwenhliziyo okungajwayelekile, okungaya ebuchosheni bese kubangela isifo sohlangothi. |
| Ukuhlanza izinso | Ukuvimbela ukuqhekeka kwegazi emshinini wokuhlanza igazi ohlanza igazi leziguli ezinenkinga yezinso. |
Ngaphezu kwalokho, kunezimo lapho kusetshenziswa khona i-heparin uma umama esengozini enkulu yokuqhekeka kwegazi ngesikhathi sokukhulelwa, njengoba ingalimazi ingane esanda kuzalwa.
Kwenzekani uma kunikezwa i-heparin? Iqashwa kanjani?
Odokotela abagcini nje ngokukunika i-heparin. Lona umuthi onikezwa ngokucophelela nangokuqashelwa njalo.
Ngaphambi kokuqala ukwelashwa nge-heparin, udokotela wakho uzothatha isampula yegazi lakho futhi enze ukuhlolwa.
Lokhu kuhlolwa kubizwa ngokuthi i-aPTT (isikhathi se-activated partial thromboplastin) . Kukala ukuthi kuvame ukuthatha isikhathi esingakanani ukuthi igazi lakho lijiye. Umphumela usetshenziselwa ukunquma umthamo we-heparin okudingeka uwunikezwe.
Ngisho nangemva kokuqala ukwelashwa nge-heparin, igazi lakho lizodonswa njalo ngezikhathi ezithile (isibonelo, njalo emahoreni ayi-6) futhi lokhu kuhlolwa kwe-aPTT kuzophindwa. Kuhlola ukuthi umthamo we-heparin owunikezwayo wanele yini, uphakeme kakhulu, noma awanele. Ngakho-ke, udokotela wakho uvame ukulungisa umthamo ukuze awugcine usezingeni elifanele kuwe. Kwezinye izimo eziphuthumayo, lapho kudingeka imiphumela esheshayo, kusetshenziswa olunye ukuhlolwa okubizwa ngokuthi i-ACT (isikhathi sokujiya esisebenzayo) .
Kufanele ngithathe i-heparin isikhathi esingakanani?
Lokhu kuncike ngokuphelele esizathwini onikwa ngaso i-heparin. Isibonelo, ngemva kokuhlinzwa okukhulu, inganikezwa cishe izinsuku eziyi-7 uze ukwazi ukuvuka uhambe. Esimweni esifana nokuhlaselwa yinhliziyo, inganikezwa izinsuku ezimbalwa kuze kube yilapho isimo sesilawulekile.
I-Heparin ivame ukuba umuthi onikezwa esibhedlela. Ngaphambi kokuba ubuyele ekhaya usuka esibhedlela, udokotela wakho uzokukhipha ku-heparin onikezwe nge-IV bese ekushintshela komunye umuthi onciphisa igazi ongawuthatha njengephilisi.
Izinzuzo, izingozi, kanye nemiphumela emibi ye-heparin
Njenganoma yimuphi umuthi, i-heparin inezinzuzo kanye nezingozi.
Izinzuzo eziyinhloko ze-heparin
- Ukusebenza okusheshayo: Kusebenza ngokushesha, ikakhulukazi uma kunikezwa ngemithambo yegazi.
- Ukususwa ngokushesha: Uma umuthi umiswa, imiphumela yawo iyanyamalala ngokushesha emzimbeni. Lokhu kubaluleke kakhulu ezimweni ezifana nangaphambi kokuhlinzwa.
- Ukuguqulwa komphumela: Uma umthamo we-heparin ukhushulwa ngandlela thile futhi ukuphuma kwegazi kwenzeka, kukhona ikhambi elibizwa ngokuthi i-protamine elingawuguqula ngokushesha umphumela wawo.
- Iminyaka yokwethembana:Kungumuthi ofundwe kahle osetshenziswe ngokuphephile odokotela emhlabeni wonke amashumi eminyaka.
Izingozi nemiphumela emibi
Ingozi enkulu nenkulu kakhulu ukopha ngokweqile . Uma i-heparin isemzimbeni, ngisho nesilonda esincane singabangela ukopha ngokweqile.
Ngakho-ke, uma uzwa noma yikuphi ukuphuka okungajwayelekile ngenkathi uthola ukwelashwa kwe-heparin, ukuphuma kwegazi ezinsinini lapho uxubha amazinyo akho, noma okunye ukuphuma kwegazi okungajwayelekile , yazisa udokotela wakho noma umhlengikazi ngokushesha .
Uma uvuka embhedeni usesibhedlela, cela othile akusize ukunciphisa ingozi yokuwa. Uma uwa, usengozini enkulu yokopha.
Uma kutholwa umthamo omkhulu kakhulu, kunethuba elincane lokuthi izitho zangaphakathi ezifana nobuchopho, amaphaphu kanye nesisu zingase zophe ngokuzenzakalelayo. Kodwa-ke, le ngozi iphansi kakhulu ngoba umthamo ulawulwa ukuhlolwa kwegazi njalo esibhedlela.
Enye into ebalulekile! Eminye imithi oyithathayo ingase ihlangane ne-heparin. Ngakho-ke, kubalulekile ukutshela udokotela wakho nganoma yimiphi eminye imithi, amavithamini, noma imithi yamakhambi oyithathayo.
Eminye imiphumela emibi:
- Ubuhlungu noma ukudumba endaweni yokujova.
- Ukulahlekelwa izinwele (lokhu kungokwesikhashana).
- I-Thrombocytopenia (inani eliphansi lama-platelet). Lokhu futhi kuyinto odokotela abavame ukuyiqapha ngokuhlolwa kwegazi.
Izimpawu eziyisixwayiso ezidinga ukunakekelwa kwezokwelapha ngokushesha
Uma uhlangabezana nanoma yiziphi izimpawu ezilandelayo ngenkathi uthatha i-heparin, kungaba uphawu lokopha okukhulu. Ngakho-ke , ungalibali futhi ufune iseluleko sezokwelapha ngokushesha noma uye eMnyangweni Wezimo Eziphuthumayo (ETU) wesibhedlela esiseduze.
| Izimpawu eziyisixwayiso | |
|---|---|
| 🔴 Ubunzima bokuphefumula, ukuphefumula okusheshayo. | 🔴 Ukopha okungenakuvinjelwa (isb. kusuka ekhaleni). |
| 🔴 Imivimbo engavamile, amabala, noma ukuqubuka esikhumbeni. | 🔴 Ubuthakathaka obungazelelwe noma ukuba ndikindiki kolunye uhlangothi lomzimba. |
| 🔴 Ukudideka okungazelelwe, ubunzima bokuhamba. | 🔴 Ubunzima obungazelelwe bokubona noma bokuzwa. |
| 🔴 Ikhanda elibuhlungu kakhulu. | 🔴 Ubuhlungu besifuba noma ukushaya kwenhliziyo okusheshayo. |
| 🔴 Ukuhlanza njengekhofi. | 🔴 Indle emnyama, ephuzi, noma enamabala egazi. |
| 🔴 Umchamo uphenduka onsundu noma ube bomvu. | |
Uma udokotela esibhedlela enqume ukukunika i-heparin, ungesabi. Kusho ukuthi kubaluleke kakhulu ukuvimbela amahlule egazi kuye ngesimo sakho. Odokotela bazokuqapha njalo futhi bakunike umthamo odingekayo nophephile. Uma unemibuzo ngalokhu, ungesabi ukubuza udokotela wakho.
Umlayezo Wokuya Nawe Ekhaya
- I-Heparin akuyona into enciphisa igazi, kodwa iwumuthi ovimbela ukwakheka kwamahlule egazi ayingozi .
- Lokhu akukwazi ukuthathwa njengephilisi. Kunikezwa kuphela njengomjovo noma ngesisombululo se-saline esifakwa emthanjeni .
- Ingozi enkulu yalokhu kwelashwa ukopha kakhulu kunokujwayelekile , ngakho-ke qaphela izingozi ezifana nokuwa.
- Kubalulekile ukwazisa udokotela wakho ngayo yonke eminye imithi oyithathayo (kufaka phakathi amavithamini kanye nemithi ye-Ayurvedic).
- Uma ubona izimpawu eziyisixwayiso njengokuhlanza okufana nekhofi, indle emnyama, noma ukopha okungenakuvinjelwa, funa iseluleko sezokwelapha ngokushesha.
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