Kev txhaj tshuaj hauv plab nrog tus mob coronavirus thiab vim li cas lawv thiaj li tau sau tseg

2024 Tus sau: James Gerald | [email protected]. Kawg hloov kho: 2023-12-17 14:08

Qee tus neeg mob pw hauv tsev kho mob nrog kuaj mob tus mob coronavirus hais tias lawv tau txhaj tshuaj hauv plab. Cia peb kawm saib yog vim li cas cov txheej txheem tsim nyog thiab nws muab rau dab tsi.

Cov teeb meem ntshav khov hauv COVID-19

Cov kev tshawb fawb pom tias cov ntshav txhaws tsis zoo, tshwj xeeb hauv cov hlab ntsws, tuaj yeem nrog tus mob coronavirus thiab pab txhawb rau qhov mob hnyav ntawm COVID-19. Dab tsi ntxiv, nce ntshav D-dimer qib tau cuam tshuam nrog kev kwv yees tsis zoo hauv cov neeg mob coronavirus.

D-dimers yog cov khoom tawg ntawm cov ntshav txhaws, thiab lawv cov qib nce ntxiv qhia tias muaj cov hlab ntshav txhaws.

Kev kuaj lub cev los ntawm cov neeg mob uas tuag los ntawm COVID-19 qhia pom tias muaj cov chaw sib txuam hauv cov hlab ntshav hauv cov hlab ntsha me me ntawm lub ntsws thiab cov nqaij sib txuas ua ke necrosis. Cov ntaub ntawv ntau thiab ntau ntxiv kuj qhia tias hauv cov xwm txheej nyuaj, kev pheej hmoo ntawm cov hlab ntshav txhaws thiab cov hlab ntsha hauv lub ntsws nce ntxiv, uas ua rau muaj kev pheej hmoo tuag ntau dua.

Cov neeg mob nrog COVID-19 kuj tseem muaj plawv nres thiab mob hlab ntsha tawg txuam nrog ntshav txhaws. Yog li, anticoagulants yog qhov tsim nyog rau cov neeg mob coronavirus uas muaj kev pheej hmoo ntawm kev tsim cov thrombus. Cov tshuaj no muab kev tiv thaiv zoo ntawm cov teeb meem hauv cov hlab ntshav.

Anticoagulants yog dab tsi?

Ntau yam tseem ceeb yog lub luag haujlwm rau cov ntshav khov thiab ua rau cov ntshav khov. Ob qho txheej txheem tshwm sim ib txhij, tsim kom muaj qhov sib npaug uas ua kom cov ntshav ntws dawb thiab tib lub sijhawm nres ntshav thaum muaj kev puas tsuaj rau lub nkoj. Cov txheej txheem no hu ua hemostasis. Kuj tseem muaj ntau chav kawm ntawm anticoagulants uas sib txawv hauv lawv cov txheej txheem ntawm kev nqis tes ua.

Cov no suav nrog:

• Heparin yog cov tshuaj tiv thaiv kab mob ntuj tsim hauv lub siab, nws tau muab tshuaj subcutaneously lossis tso rau hauv cov hlab ntshav, txawm hais tias muaj cov gel rau thov rau ntawm daim tawv nqaij;
• factor Xa inhibitors - Rivaroxaban, Apixaban, Edoxaban (muag hauv qab lub npe Xarelto, Eliquis);
• vitamin K antagonists - Acenocoumarol thiab Warfarin, lawv thaiv kev tsim cov coagulation tseem ceeb hauv lub siab;
• direct thrombin inhibitors - Dabigatran (Pradaxa).

Nrog tus mob coronavirus, ntau yam tshuaj uas tau cais ua anticoagulants tuaj yeem sau tseg, raws li kev txiav txim siab ntawm tus kws tshaj lij.

Anticoagulant txhaj rau hauv plab

Los ntawm kev txo cov ntshav khov, tshuaj anticoagulant pab tiv thaiv cov hlab ntshav thromboembolism hauv tus kabmob coronavirus. Cov kab mob pathology tau tshwm sim los ntawm cov hlab ntshav sib sib zog nqus ntawm ob txhais ceg lossis caj npab lossis lub neej txoj kev pheej hmoo ua rau mob pulmonary embolism.

Cov tshuaj tau siv los ua kev txhaj tshuaj subcutaneous. Kev txhaj tshuaj ntshav ua kom ntshav suav nrog Heparin thiab cov txiaj ntsig. Tsawg molecular hnyav heparins kuj tseem tuaj yeem siv, piv txwv li, Lovenox, Fragmin, Fraxiparin, Neoparin. Cov no yog cov tshuaj.

Unfractionated heparins feem ntau yog siv los ntawm kev txhaj tshuaj txhaj tshuaj.

Txhawm rau xaiv qhov tshuaj kom raug, ntsuas APTT (qhib lub sijhawm ua haujlwm ib nrab ntawm cov qib thromboplastin) hauv ntshav ntshav tom qab ntxiv kaolin-cephalin reagent thiab calcium chloride tov rau nws. Thaum kawg, nws lub hom phiaj kom ua tiav qhov ntsuas ntawm qib 1, 5-2, 5.

Qhov hnyav molecular hnyav heparins yog xaiv, ua rau lawv muaj kev nyab xeeb thiab tsim nyog rau kev tswj hwm tus kheej los ntawm cov neeg mob. Hauv qhov no, tsis tas yuav tshuaj xyuas qhov ntsuas APTT. Ib qho ntxiv, lawv nyob ntev dua, yog li nws txaus los txhaj lawv 1-2 zaug hauv ib hnub.

Nthuav! Kev txhaj tshuaj tiv thaiv tus kabmob coronavirus hauv ntshav qab zib mellitus

Anticoagulant txhaj tshuaj - taw qhia rau siv tus kabmob coronavirus

Heparins yog cov tshuaj xaiv thaum xav tau kev kho tshuaj anticoagulant tam sim. Lawv tau siv los tiv thaiv thiab kho cov hlab ntshav thromboembolism thiab kho venous thrombosis raws li qhov muaj peev xwm ua rau mob coronavirus. Ib qho ntxiv, cov tshuaj tsis siv tshuaj heparin kuj tseem siv rau kev kho thaum ntxov ntawm cov neeg uas muaj mob myocardial infarction lossis mob ntsws loj heev.

Cov neeg mob muaj ntau yam ua xyem xyav txog qhov xav tau txhaj tshuaj anticoagulants. Coob leej ntawm lawv tsis nkag siab tias vim li cas txhaj tshuaj tshwj xeeb hauv lub plab, thiab tsis yog hauv qee qhov.

Teeb meem ncig ncig tam sim no muaj ntau ntawm cov neeg uas nyob hauv tsev kho mob vim yog mob coronavirus lossis tom qab raug tso tawm ntawm pawg ntseeg. Hauv qee qhov xwm txheej, qhov kev pheej hmoo ntawm qhov teeb meem no tuaj yeem nce txog 80%. Qhov teeb meem yog nrog tus mob coronavirus, tus kab mob pib ploj mus yam tsis muaj tsos mob, thiab tam sim ntawd muaj kev phom sij rau lub neej txoj sia tuaj yeem tshwm sim.

Kev siv tshuaj tiv thaiv kab mob anticoagulant los ntawm kev txhaj tshuaj hauv plab nrog tus mob coronavirus txo qis kev pheej hmoo ntawm teeb meem hauv cov neeg mob. Ntxiv rau kev txhaj tshuaj, kev mob siab rau thaum ntxov ntawm cov neeg mob hauv txaj, kev kho lub cev thiab kev haus dej kom raug yog qhov tseem ceeb heev.

Qhov ncauj anticoagulants kuj tau siv, tab sis hauv lawv qhov xwm txheej nws siv sijhawm ntev dua los xaiv qhov koob tshuaj uas tsim nyog thiab tau txais kev kho mob. Kev siv Heparin rau kev tiv thaiv kab mob tau pom zoo thaum tsis muaj contraindications rau cov neeg uas muaj kev pheej hmoo:

• nrog rog hnyav;
• thaum laus;
• nyob rau hauv muaj cov ntshav thromboembolism yav dhau los;
• nrog rau kev ua kom tsis ruaj khov ntev, piv txwv li, tom qab tawg ntawm cov yas pov tseg lossis thaum mus ncig ntev hauv qhov chaw zaum;
• nrog mob stroke ua rau paresis;
• nrog mob ntsws;
• nyob rau hauv cov ntaub ntawv ntawm thrombophilia thiab antiphospholipid syndrome.

Kev txhaj tshuaj feem ntau nyob hauv plab, tab sis koj kuj tuaj yeem siv lawv hauv caj dab lossis xub pwg. Tus kws kho mob tuaj koom xaiv cov tshuaj twg yuav tsum tau muab rau tus neeg mob.

Cov txiaj ntsig

1. Kev txhaj tshuaj anticoagulants rau tus mob coronavirus rau hauv plab yog qhov tsim nyog los tiv thaiv teeb meem nrog ntshav khov.
2. Kev txiav txim siab ntawm kev teem sijhawm tseem nyob nrog cov neeg ua haujlwm kho mob, nrog rau kev xaiv cov tshuaj uas tsim nyog.
3. Yuav luag txhua zaus, cov txheej txheem no tau teev tseg rau cov neeg uas muaj kev pheej hmoo. Piv txwv li, cov no yog cov neeg uas muaj keeb kwm ntawm cov hlab ntshav thromboembolism thiab lwm yam teeb meem.