Pambuyo pakuchita opaleshoni ya kapamba, dokotala atha kukulemberani kugwiritsa ntchito Getasorb. Mankhwalawa ndi njira yosavuta kapena yachikasu yothetsera kulowetsedwa.
Chithandizo chogwira mankhwalawa ndi hydroxyethyl wowuma Na + ndi Cl-, sodium chloride ndi madzi ndizothandiza.
Mankhwalawa ali ndi kusintha kwa m'malo mwa plasma ngati wodwala ali ndi hypovolemia komanso kugwedezeka chifukwa cha opaleshoni, kuvulala, kuwotcha, kukula kwa matenda opatsirana, komanso kusokonezeka kwa kayendedwe ka magazi m'mitsempha.
Kodi mankhwalawa amagwira ntchito bwanji?
Mankhwala obweza plasma okhala ndi wowuma wa hydroxyethylated. Katunduyu ndi wolemera kwambiri wama cell omwe amakhala ndi zotsalira zama glucose. Zinthu izi zimapezeka kuchokera kuma polysaccharides achilengedwe; mbatata kucha ndi wowuma chimanga amagwiritsidwa ntchito ngati gwero.
Njira yothetsera vutolo italowa m'mitsempha, amylopectin imathiriridwa mofulumira, chinthu ichi chimakhala m'magazi kwa mphindi 20. Kuti muwonjezere kukhazikika ndikuwonjezera nthawi ya mankhwalawa, hydroxyethylation imagwiritsidwa ntchito.
Wowuma wa Pentac umathandizira kukonza magazi m'magazi chifukwa cha kuchepa kwa hematocrit, kuchepa kwa mamasukidwe a plasma, kuchepa kwa maselo ofiira am'magazi, komanso kubwezeretsanso kuchepa kwa magazi.
Ngati wowuma wa pentac amalumikizidwa kudzera m'mitsempha, chinthu chogwira chimaphulika mchikakamizo cha kagayidwe kakang'ono kuti apange zidutswa zochepa za kulemera kwa maselo. Pulogalamu ya metabolic imatulutsidwa mwachangu kudzera mu impso.
Ambiri mwa mankhwalawa amasiya thupi ndi mkodzo kudzera m'matumbo patsiku loyamba, komanso zinthu zotsalazo mkati mwa sabata.
Zizindikiro ndi contraindication
Ndi vuto la pancreatitis pachimake, malo kumbuyo kwa peritoneum amadzazidwa ndimadzi, omwe angayambitse hypovolemia. Mankhwalawa amagwiritsidwa ntchito ngati zotupa za hemorrhage zimawonedwa ndipo yankho la crystalloid silokwanira.
Mankhwala a GetaSorb a 10% ndi 6% amatsutsana pokhapokha ngati pali matenda am'mimba, matenda oopsa, magazi ochepa, magazi osokoneza bongo, kulephera kwamtima, kusokonezeka kwa impso, kuperewera kwa chiwindi, mtima.
Komanso, kugwiritsa ntchito mankhwalawa saloledwa kuchepa thupi, kuchepa thupi, kuchepa magazi, kusokonezeka kwa magazi kwambiri, hyperchloremia, hypernatremia, hypokalemia, hemodialysis, ana osaposa zaka 18.
- Mankhwala osokoneza bongo saloledwa ngati opaleshoni ya mtima yachita kale ndipo munthu ali m'mavuto.
- Chenjezo liyenera kuchitidwa pamaso pa kulipidwa osakwanira, matenda a chiwindi, von Willebrand matenda, hemorrhagic diathesis, hypofibrinogenemia.
- Panthawi yoyembekezera, mutha kugwiritsa ntchito mankhwalawa ngati njira yomaliza, ngati njira zina zochiritsira sizikuthandizira, pomwe maubwino omwe ali ndi amayi amakhala apamwamba kwambiri kuposa chiopsezo cha mwana wosabadwayo. Panthawi yoyamwa, yoyamwitsa iyenera kusiyidwa kuti isavulaze mwana.
Malangizo ogwiritsira ntchito mankhwalawa
Musanayambe chithandizo, muyenera kuzolowera zolemba zowerengera. Mankhwalawa amagwira ntchito pokhapokha gawo loyamba la kuchuluka kwa magazi, chifukwa chake limaperekedwa kudzera m'mitsempha yokhayo pakangodutsa tsiku loyamba magazi.
Mankhwalawa amachitika moyang'aniridwa ndi achipatala mosamala. Atangolandira zizindikiro zabwino, kulowetsaku kumayima.
Mlingo wokhazikika wa tsiku ndi tsiku komanso kuchuluka kwa njira yothetsera mavutowo akuyenera kuonedwa bwino. Choyamba, Geta-Sorb imayendetsedwa pang'onopang'ono kuti kusintha ndikusintha kwa wodwalayo kuwunikidwe. Ngati n`kotheka anaphylactoid zimachitika, chithandizo yomweyo kusiya.
Dokotalayo amamulembera aliyense payekha, akungotengera momwe wodwalayo alili, kuchuluka kwa magazi omwe atayika, mulingo wa hematocrit ndi hemoglobin.
- Mukamagwiritsa ntchito yankho la 6%, kulowetsedwa kwa mankhwalawa sikuyenera kupitirira 20 ml pa ola limodzi kutengera kilogalamu ya kulemera kwa odwala.
- Ngati mankhwala 10% agwiritsidwa ntchito, kuchuluka kwa kulowetsedwa kungakhale 20 ml pa ola limodzi.
- Kwa okalamba, mlingo uyenera kusankhidwa mosamala, apo ayi wodwalayo angayambe kulephera kwa mtima.
Zotsatira zoyipa
Zotsatira zoyipa zitha kuchitika ngati zigawo zowonjezera zamagazi sizinawonjezedwe. Kusakaniza kolakwika kungasokoneze magazi kuundana.
Nthawi zina, kuwonetseredwa kwa hypersensitivity ndikotheka, komwe sikudalira mlingo womwe umayendetsedwa. Hematocrit nthawi zambiri imachepetsedwa ndipo dilution hypoproteinemia imayamba.
Kupitilira muyeso womwe waperekedwa kumayambitsa kuphwanya magazi, kuchuluka kwa magazi nthawi. Mafinya samawonekera pakhungu, pomwe nkhope ndi khosi zimayamba kufinya, kugwedezeka, mtima komanso kupuma.
- Ntchito yamagazi ya plasma cy-amylase nthawi zina imachulukanso, koma ichi sichizindikiro cha kupunduka kwa kapamba. Nthawi zambiri, pakubwereza njira yothetsera vutoli tsiku lonse, khungu loyenda limayamba.
- Ngati mankhwalawa amaperekedwa kwakukulu komanso mofulumira kwambiri, kulephera kwamitsempha yamagazi kwam'mimba ndi mapangidwe am'mitsempha, ndipo magazi amawundana.
- Zikakhala zovuta kuti wodwalayo apume, amamva kuwawa m'dera lumbar, kuzizira, cyanosis, pomwe magazi ndi njira yopuma zimasokonekera, chithandizo chake chimasiya.
Yogwira pophika mankhwala kumawonjezera nephrotoxicity wa aminoglycoside mankhwala. Ndi munthawi yomweyo makonzedwe anticoagulants, nthawi ya magazi ukuwonjezeka. Kuphatikiza mankhwalawa ndi mankhwala ena saloledwa.
Gwiritsani ntchito yankho pokhapokha ngati dokotala wakupatsani. Alumali moyo wa 6% yankho ndi zaka 4, 10% - 5 zaka. Vial yosatsegulidwa imasungidwa kutentha mpaka madigiri 25 kutali ndi ana. Kuzizira kwam'madzi sikuyenera kuloledwa.
Mtengo wa mankhwalawa ndi wotsika ndipo ndi ma ruble 130 okha pa botolo la 500 ml. Mutha kugula njira yothetsera kulowetsedwa ndi mankhwala. Ma analogu okwera mtengo kwambiri akuphatikizapo Voluven, Refortan, HyperKHPP, Infuzol HES, Stabizol, Gemokhes, ndi Volekam.
Zambiri pazamankhwala a kapamba zimaperekedwa mu kanema munkhaniyi.
