Digitalis intoxication yog lom nrog lub plawv glycosides. Nws yog ib qho tsim nyog hais tias qhov no yog qhov teeb meem loj heev hauv kev kho mob ntawm cov neeg mob uas raug kev txom nyem los ntawm cov kab mob plawv thiab noj tshuaj ntawm pawg digitalis (piv txwv li, Digoxin). Kev tuag ntau npaum li cas ntawm lub plawv glycosides, raws li txoj cai, tuaj yeem yog kaum npaug lossis ntau dua li kev kho mob. Tshwj xeeb yog rhiab heev rau lawv yog cov neeg laus thiab cov neeg mob uas muaj cov thyroid ua haujlwm tsis zoo, cov ntshav ncig thiab lub cev tso tawm. Cov tshuaj toxicity ntawm cov tshuaj hauv chav kawm digitalis nce ntxiv thaum muaj hypomagnesemia thiab hypokalemia. Cov menyuam yaus tiv taus lawv ntau dua.
Yog vim li cas
Digoxin, dav siv los ua cov tshuaj uas txo cov zaus ntawm ventricular contractions tiv thaiv keeb kwm ntawm atrial fibrillation, belongs rau cardiac glycosides. Kev siv cov tshuaj no rau cov hom phiaj no feem ntau tsis muaj txiaj ntsig yog tias tus neeg mob ua lub neej nquag. PlainQhov koob tshuaj yog 0.25 milligrams ib hnub. Ntau yam ua rau muaj qhov tshwm sim ntawm digitalis intoxication thiab yog lub hauv paus rau kev txo koob tshuaj. Ua rau muaj xws li: hypokalemia nrog rau lub raum tsis ua haujlwm, hnub nyoog, lub cev qhuav dej (feem ntau vim yog kev kho diuretic), tshuaj xws li Verapamil lossis Amiodarone.
Cov tsos mob
Daim duab kho mob ntawm kev qaug cawv digitalis muaj ntau yam ua cim, tshwj xeeb:
- GI cov tsos mob.
- Kev mob plawv thiab vascular manifestations.
- Psycho-neurological vision disorder.
Ua ntej ntawm tag nrho cov, cov neeg mob tau ntsib cov tsos mob dyspeptic nyob rau hauv daim ntawv ntawm xeev siab, ntuav ntuav nrog cov kua tsib nyob hauv cov zis tawm, qee zaum ntshav, mob plab thiab cov tsos mob ntawm lub cev qhuav dej. Qhov ua tau tshwm sim ntawm digitalis intoxication yuav tsum tsis txhob hnov qab. Tsis ntev, muaj mob taub hau nrog rau kiv taub hau thiab qhov muag tsis pom kev nyob rau hauv daim ntawv ntawm xanthopsia, annular nyuj, tsis pom kev acuity. Yog li ntawd, retrobulbar neuritis tshwm sim. Ataxia yog yam ntxwv, ntawm lwm yam, nrog rau insomnia, ntxhov siab, delirium, hallucinations, convulsions, ua tsis taus pa, cyanosis, hypoxia, thiab txo cov zis tso zis.
Digitalis cuam tshuam rau ECG - nws yog dab tsi?
Ntawm txoj kev tshawb fawb ECG, nrog rau kev txo qis hauv ST lub sijhawm thiab lub tiaj tus T nthwv dej, PQ qhov taw qhia tuaj yeem ua kom ntev, thiab lwm yam, atrial ib leeg P tsis tawm.tshwj xeeb tshaj yog thaum mob lom lom nrog glycosides ua ntej los ntawm kev ua txhaum ntawm lub plawv ua haujlwm hauv daim ntawv ntawm bradycardia, thaiv, thiab lwm yam. Kev txaus ntshai heev nrog digitalis intoxication ntawm ECG yog kev txhim kho ntawm ventricular extrasystole, paroxysmal hom tachycardia thiab atrial fibrillation. Nyob rau hauv tas li ntawd, kev tuag yuav tshwm sim vim asphyxia los yog mob plawv.
Kev kub ntxhov
Qhov kev pab cuam ntawm kev pab cuam nrog kev loj hlob ntawm kev mob hnyav nrog glycosides muab rau kev tshem tawm thaum ntxov los ntawm kev ntsuas resuscitation thiab tshuaj tua kab mob, ntxiv rau cuam tshuam cov kab mob enterohepatic (tshwj xeeb tshaj yog tias muaj kev lom nrog "Digitoxin" lossis "Isolanide"). Nws yog ib qho tseem ceeb heev kom tshem tawm qhov tshwm sim ntawm PSCE, arrhythmia, ntuav, agitation thiab hypoxia. Kev txhim kho ntawm kev ua haujlwm contractile ntawm myocardium yog xav tau. Txhawm rau ua qhov no, ua cov hauv qab no:
- Cessation of cardiac glycoside treatment.
- Kev qhia txog "Unithiol", vitamin "E" thiab glycocorticoids kom txo tau qhov tshwm sim ntawm PSCE thawj hnub peb zaug, thiab hnub tom qab ob zaug.
- Rov ua kom plab zom mov, qhia txog cov kua qaub qaub thiab ua kom muaj hluav taws xob los ntawm lub raj kom tiv thaiv kev nqus cov tshuaj lom hauv lub plab zom mov. Nws tseem yuav tsum tau noj 200 milliliters ntawm vaseline roj los yog 8 grams ntawm cholestyramine, uas ua kom lub cessation ntawm ncig nyob rau hauv cov xwm txheej uas intoxication tshwm sim los ntawm Isolanid los yog Digitoxin.
- Muab cov pa nqus pa nrog cov nyhuv digitalis, ua haujlwm10% qabzib infusion nrog insulin, vitamin B6.
- Kev ua haujlwm ntawm lub plawv thiab kev ua haujlwm ntawm lub plawv nrog cov tshuaj tiv thaiv arrhythmic, tshwj tsis yog Quinidine thiab Novocainamide, uas yog contraindicated. Yog tias tsis muaj kev cuam tshuam, defibrillation lossis mob plawv tau ua tiav.
- Tawm tsam keeb kwm yav dhau los ntawm hypokalemia, kev npaj cov tshuaj potassium yog siv rau hauv daim ntawv ntawm "Panangin" lossis sodium aspartate.
tshuaj tiv thaiv kab mob plawv glycoside lom
Cov tshuaj tiv thaiv tshwj xeeb nyob rau hauv muaj cov digitalis intoxication nrog glycosides, tshwj xeeb tshaj yog cov tshuaj digoxin, yog cov khoom tawg ntawm cov tshuaj tiv thaiv tshwj xeeb. Lub ntsiab lus ntawm lawv cov tshuaj tua kab mob yog nyob rau hauv cov txheej txheem ntawm kev khi dawb digoxin muaj nyob rau hauv cov ntshav plasma tom qab ib tug txheeb ze los yog kiag li overdose, thiab yog li tiv thaiv nws kev koom tes nrog myocardial hlwb. Cov tshuaj yog siv nyob rau hauv ib koob ntawm 800 milligrams, uas yog, nees nkaum ampoules ntawm 40 milligrams.
Digoxin cov tshuaj tiv thaiv kab mob yog muab los ntawm cov khoom tshwj xeeb uas tsim tawm hauv lub cev yaj. Lawv txoj kev sib raug zoo nrog lantoside thiab digitoxin ntau dua li kev sib raug zoo ntawm cov glycosides nrog receptors hauv myocardium. Yog li, cov tshuaj no nyiam khi rau cov khoom ntawm cov tshuaj tiv thaiv tshwj xeeb, thiab tsis yog rau cov receptors hauv myocardium thiab lwm cov ntaub so ntswg.
Ib nrab teev tom qab kev qhia txog cov tshuaj tua kab mob hauv cov ntshav, cov ntsiab lus ntawm digoxin lossis lwm yam glycoside uas ua rau qaug cawv pib loj tuaj. Glycosides ua ke nrog cov protein poob pharmacologicalkev ua si, thiab lawv thiaj li tawm ntawm lub cev. Qhov ntau npaum ntawm cov tshuaj yog teem rau tus kheej, thiab nws ncaj qha nyob ntawm tus nqi ntawm cov tshuaj lom uas tau absorbed. Kev suav cov koob tshuaj yog ua raws li cov lus qhia uas txuas nrog rau cov khoom siv tshuaj.
Yuav ua li cas kho rau digitalis lom?
Kev kho mob nrog kev txhim kho ntawm cov kab mob xws li
Ib qho teeb meem tsis txaus ntseeg nrog kev siv cov tshuaj digitalis yog qhov ua xua ntawm cov neeg mob sensitized uas tau raug tswj hwm yav dhau los npaj muaj cov yaj protein.
Cov nyhuv vagomimetic ntawm glycosides (uas yog, bradycardia thiab ntuav) yuav tsum raug tshem tawm nrog atropine sulfate (1 milliliter ntawm kev daws). Nyob rau hauv cov ntaub ntawv ntawm arrhythmias uas tau tshwm sim los ntawm digitalis intoxication, Difenin los yog polarizing sib tov yog siv (100 milliliters ntawm kaum feem pua qabzib ntxiv rau 0.5 grams ntawm poov tshuaj chloride thiab 2 units ntawm insulin, thiab 100 milligrams ntawm cocarboxylase ntxiv). Txhawm rau txhim kho kev ua haujlwm ntawm lub plawv, "Riboxin" yog siv.
Lub cev qhuav dej yog tshem tawm los ntawm kev qhia txog cov tshuaj infusion ntawm tsib feem pua qabzib nrog insulin. Raws li kev qaug dab peg, lawv raug tshem tawm nrog cov tshuaj hauv daim ntawv ntawm sodium oxybutyrate, Sibazon thiab Aminazin. Qhia txog kev kho cov pa oxygen thiab kev kho cov vitamin. Thaum tsis muaj cov txiaj ntsig zoo, nws raug nquahu kom ua cov hemosorption, thiab yog tias muaj kev lom hnyav nrog "Digoxin" lossis "Strophanthin", yuav tsum tau ua kom hemodialysis nrog rau cov lus qhia.cov tshuaj tiv thaiv tshwj xeeb.
Digitalis npaj yog dab tsi?
Cov kab mob plawv glycosides uas ua rau muaj kev qaug cawv zoo li no suav nrog cov tshuaj uas tau txais los ntawm ntshav foxglove. Cov no yog Digitoxin, Cordigite, Digoxin, Acetyldigitoxin, Acetyldigoxin, Gytoxin, Celanide thiab Lantoside.
Yuav ua li cas thiaj ua rau muaj kev ntxhov siab zoo li no?
Ntau yam cuam tshuam rau kev ceev ntawm cov txheej txheem lom:
- Lub hnub nyoog siab ntawm tus neeg mob, uas ua rau qeeb tus nqi ntawm kev tshem tawm cov tshuaj lom hauv lub cev thiab pab txhawb rau lawv cov tsub zuj zuj hauv cov ntshav.
- Muaj kab mob raum, cov tshuaj tau tawm hauv cov zis, thiab kev ua haujlwm tsis zoo ntawm lub cev ua rau muaj kev nce qib ntawm cov khoom xyaw digitalis hauv cov ntshav.
- Tsis ua haujlwm hauv lub siab, uas khi cov khoom ntawm digitalis nrog lwm cov khoom.
- Ib yam mob hormonal uas cuam tshuam rau kev ceev ntawm cov txheej txheem metabolic.
- mob plawv hnyav, mob ua ntej infarction.
- Qee cov kab mob ntsws ua rau ua pa nyuaj.
- Nyob rau hauv cov tshuaj diuretics.
Zoo thiab cov ntsiab lus xaus ntawm kab lus
Yog li, kev teem sijhawm ntawm lub plawv glycosides nkaus xwb yog qhov muaj cai ntawm tus kws kho mob. Kev kho tus kheej hauv qhov no tuaj yeem ua rau muaj kev phom sij heev rau kev noj qab haus huv thiab lub neej. Nrog rau cov kev kawm ntev ntawm kev kho mob lossis muaj qhov ua rau hnyav dua, kev tswj ntshav tau pom zoo txhua rau 6 teev tom qab siv tshuaj, tag nrho. Cov cim qhia ntawm kev lom tau pom zoo ntawm ECG.
