Lokacin da aka gano mutumin da ya kasance mai karfin motsa jiki, magani mai dacewa ya danganta ne akan ko halin da ke ciki na zuciya ne ko kuma maras kyau.
Ga masu alhakin Stable People
Yawancin mutanen da aka bincikar su tare da alamu na wucin gadi suna da kyau daga cikin yanayin kwakwalwar zuciya. Wato, suna da hankali da faɗakarwa, kuma karfin jini ba shi da ƙananan low.
Ga wadannan mutanen, magani tare da kwayoyi masu tayar da hankali (jini) sun fara farawa. Maganin farko ya rage haɗarin mutuwa daga wani abu mai tasowa mai tasowa.
Na farko 10 Kwana
A cikin kwanaki 10 na farko bayan an yi amfani da embolus na kwakwalwa, magani yana kunshe da daya daga cikin magungunan kwayoyin halitta masu zuwa:
- Nauyin ƙananan kwayoyin (LMW) heparin, irin su Lovenox ko Fragmin. Wadannan sunadaran tsarkakewar heparin wanda za'a iya ba ta ta allurar fata amma maimakon intravenously.
- Fondaparinux, wani ɓangaren da ake sarrafawa a cikin kwayar cutar heparin.
- Heparin da aka raguwa, "heparin" tsohuwar da aka ba da shi a cikin intravenously.
- Rivaroxiban (Xarelto) ko apixaban (Eliquis), biyu daga cikin "sababbin kwayoyi masu tsauraran magunguna" ( NOAC ) wadanda suke magana ne a madadin Coumadin . Wadannan magunguna guda biyu na NOAC sune kawai a halin yanzu an yarda da su don magance mummunar maganin tarin kayan huhu.
Duk waɗannan kwayoyi sunyi aiki ta hanyar hana jinsin halittar jini , sunadarai cikin jini wanda ke inganta thrombosis.
A yau, mafi yawan likitoci za su yi amfani da rivaroxiban ko apixaban a cikin kwanaki 10 na farfadowa a cikin mutanen da suka iya daukar magani na maganin. In ba haka ba, ana amfani da Heparin LMW mafi yawanci.
10 Days to 3 Months
Bayan kwana 10 na farfesa, an zaɓi magani don maganin lokaci mai tsawo. A mafi yawan lokuta, wannan ci gaba mai tsawo yana ci gaba da akalla watanni uku kuma a wasu lokuta har zuwa shekara guda.
Wannan magani kusan tsawon lokaci yana kunshe da ko dai daga cikin kwayoyi NOAC. A wannan lokaci na magani (wato, bayan kwanaki 10 na farko), ana amfani da dabi'un 'ya'yan kwayoyi NOAC (Pradaxa) da kuma watsar (Savaysa) don amfani, ban da rivaroxiban da apixaban. Bugu da ƙari, Coumadin ya kasance wani zaɓi don wannan magani na dogon lokaci.
Ƙarar iyaka
A wa] ansu mutane, dole ne a yi amfani da farfadowa na maganin maganin antiwagulation na dogon lokaci ba tare da wucin gadi ba bayan da aka yi amfani da shi a cikin mahaifa, watakila ga sauran rayuwarsu. Kullum, wadannan mutane sun fada cikin daya daga cikin biyun:
- Mutane da suka yi amfani da tarin hankalin magungunan jini ko wani ɓarna mai zurfi mai zurfi ba tare da wani abin da zai iya haifar dashi ba.
- Mutanen da suke da matsalar tashin hankali suna iya zama na yau da kullum, irin su ciwon daji, ko kuma jigilar kwayoyin jini ga jini maras kyau.
Idan An Yi amfani da Drugs Magunguna
A wa] ansu mutane, wa] annan magunguna ba su da wani zaɓi. Wannan yana iya zama saboda haɗarin wuce haddi na jini yana da yawa ko kuma sun kasance sun sake yin amfani da kayan ado na wucin gadi ba tare da farfadowa ba.
A cikin waɗannan mutane, dole ne a yi amfani da takaddama ta cava. Kuskuren cava ne na'urar da aka sanya shi a cikin ƙananan ƙananan ƙwayoyin cuta (babban kwayar da take tattara jini daga ƙananan ƙarancin kuma ya ba da shi a cikin zuciya) ta hanyar hanyar catheterization.
Wadannan samfurori na jini "tarkon" wanda ya rabu da su kuma ya hana su zuwa kai tsaye a wurare dabam-dabam.
Vena cava filters zai iya zama tasiri sosai, amma ba a fi son su da kwayoyi masu tayar da hankali ba saboda hadarin da suka shafi amfani da su. Wadannan sun hada da thrombosis a shafin yanar gizo na tace (wanda zai iya haifar da tayar da kwari), zub da jini, hijirar da tacewa zuwa zuciya, da yaduwar tace.
Za'a iya fitar da magunguna masu yawa na zamani a cikin jiki ta hanya ta biyu na catheterization idan ba'a bukatar su.
Ga mutanen da ba su da hankali
Ga wasu mutane, abin kunya na huhu shine cututtukan zuciya.
A cikin wadannan mutane, jigon yana da yawa don haifar da ƙananan hanzarin jini zuwa ga huhu, wanda zai haifar da ƙarewa na zuciya. Wadannan mutane suna nuna yawan tachycardia (m zuciya) da ƙananan jini, kodadden fata, da kuma canza sani.
A cikin waɗannan lokuta, farfadowa mai saurin maganin cutar-wanda ke da mahimmanci ta hanyar tabbatar da yaduwar jini da kuma hana karar jini-bai isa ba. Maimakon haka, dole ne a yi wani abu don warware abin kunya wanda ya riga ya faru, kuma mayar da kwakwalwa.
Maganin Thrombolytic ("Clot Busters")
Tare da maganin thrombolytic, ana amfani da kwayoyi masu magungunan ƙwayoyi wadanda suka riga sun kafa. Ta hanyar ƙetare jini (ko yatsun jini) a cikin rikici, za su iya mayar da kwarjin mutum.
Wadannan kwayoyi (wanda aka fi sani da maganin fibrinolytic saboda sunyi aiki ta hanyar tarwatsa fibrin a cikin kyakoki) suna ɗauke da hadarin jini na rikitarwa don haka ana amfani da su ne kawai lokacin da hoton mahaukaci ya zama barazanar rai. Magungunan thrombolytic da aka saba amfani dashi ga embolism mai tarin yawa shine alteplase, streptokinase, da urokinase.
Embolectomy
Idan ba za'a iya amfani da maganin thrombolytic ba saboda hadarin zubar da zubar da jini ya zama mai girma, ana iya yin ƙoƙari a embolectomy. Hanyar da aka yi amfani da shi a cikin ƙananan ƙoƙari yana ƙoƙari ta ƙetare babban jini a cikin rikici, ko ta hanyar tiyata ko kuma ta hanyar hanyar catheter.
Zaɓin da ke tsakanin magungunan ƙwayar cuta ko ƙananan kwalliya yakan dogara ne akan samun likitoci da suka kwarewa tare da waɗannan hanyoyi, amma a yawancin imbolectomy wanda aka fi sani da catheter ya fi dacewa saboda yawanci ana iya yin sauri.
Duk da haka, hanyar da ake amfani da shi na kwararru ta kowane hali ko da yaushe yana ɗauke da manyan haɗari - ciki har da rushewar ƙwaƙwalwar ƙwayar cuta, tare da bugun zuciya na zuciya da haɗari na jini (zub da jini a cikin hanyoyi). Don haka, embolectomy yawanci kawai ana yi ne a cikin mutane da aka yanke hukunci su zama marasa ƙarfi kuma suna da mummunar haɗarin mutuwa ba tare da magani ba.
> Sources:
> Aymard T, Kadner A, Wider A, et al. Babbar Gwajiyar Jiki: Tsarin Tsarin Tsakanin Tsarin Miki da Tsarin Tsarin Harshen Thrombolytic - Ya Kamata An Yi Saurin Bayanai? Eur J Cardiothorac Surg 2013; 43:90. DOI: 10.1093 / ejcts / ezs123
> Kearon C, Akl EA, Wajen AJ, et al. Antithrombotic far for VTE cutar: Antithrombotic Far da Rigakafin Thrombosis, 9th ed: Kwalejin Kwalejin Kwalejin Kwalejin Kwalejin Kwayoyi na Kwararrun likitocin Kwaskwarima. Chest 2012; 141: e419S. DOI: 10.1378 / chest.11-2301
> Kuo WT, van den Bosch MAAJ, Hofmann LV, et al. Magungunan Catheter-Edited Embolectomy, Fragmentation, da kuma Thrombolysis don maganin babban Pulmonary Embolism Bayan rashin cin nasara na Thrombolysis Systemic. Chest 2008; 134: 250. DOI: 10.1378 / chest.07-2846
> Tapson VF. Abolism mai yaduwa. N Engl J Med 2008; 358: 1037. DOI: 10.1056 / NEJMra072753