Crystaloid kua muaj cov khoom tshwj xeeb. Nws yog nquag siv hauv kev phais thiab kho lub hom phiaj. Vim nws cov active muaj pes tsawg leeg, nws sai sai nkag mus rau hauv cov ntaub so ntswg, ntshav, regulating acid-base thiab dej-electrolyte metabolism.
Qhov no yog dab tsi?
Colloid thiab crystalloid cov kev daws teeb meem tseem hu ua cov ntshav hloov pauv, vim lawv hloov lossis ua kom cov ntshav ploj. Lawv yuav tsum ua kom tau raws li qhov yuav tsum tau ua:
- kev nyab xeeb (tsis muaj tshuaj lom);
- functionality (muaj cov khoom siv tshuaj);
- ruaj khov (yuav tsum tsis txhob nce ntxiv nrog kev tswj hwm rov qab).
Cov ntshav hloov pauv tau muab faib ua ob pawg: cov tshuaj colloidal thiab crystalloid. Thawj suav nrog "Laktosol", "Disol", "Atsesol", qhov thib ob - "Polyglukin", "Reogluman", "Volekam", "Infuzol" thiab lwm yam.
Kev qhia
Crystalloid tov yog siv los ntxiv cov ntim ntawm cov ntshav ncig yog tias qhov ceevlos ntshav me me, thiab ntshav poob qis dua kaum tsib feem pua. Hauv qhov no, Ringer's tov yog siv. Crystalloids yog siv los ua tshuaj hnyav. Feem ntau yog 5% qabzib, "Sterofundin", uas yog, me ntsis hypertonic thiab isotonic daws. Crystalloids yuav tsum tau them nyiaj rau qhov tsis muaj electrolytes thiab lub zog, ua tus neeg sawv cev hemostatic.
Colloids yog tsim los hloov osmotic siab hauv cov hlab ntsha. Qhov no stabilizes lub ntim ntawm cov ntshav ncig thiab hemodynamics. Lawv normalize ntshav siab thiab ua kom nws li qub. Colloids muaj xws li Venozol, Gelofuzin, Refortan, Stabizol, Voluven, Perftoran. Qee zaum, nyob rau hauv cov xwm txheej ntawm cov ntshav khiav qeeb, cov tshuaj crystalloid yog siv ua ke nrog cov tshuaj colloidal. Lawv txo cov ntshav viscosity, kho cov ntshav ncig, txhim kho hemodynamics, noj cov ntaub so ntswg thiab lub cev, kho hemoglobin thiab ua kom nws zoo li qub.
Kev faib tawm
Infusion tshuaj muaj kev faib ua haujlwm. Lawv muab faib ua cov khoom siv ntshav, cov tshuaj crystalloid thiab colloids. Kev faib tawm yog ua raws li cov khoom siv tsis muaj zog thiab cov organic thiab cov khoom. Tag nrho cov kev daws teeb meem yuav tsum yog cov kua dej, muaj kev nyab xeeb rau kev noj qab haus huv, tsis muaj tshuaj lom, yooj yim dosed, nruab nrab rau ntau yam tshuaj, thiab ruaj khov. Lawv ua raws li NaCl. Crystalloids suav nrog Ringer-Lock daws, electrolytes(hypertonic thiab hypotonic). Cov ntshav hloov pauv tau muab faib raws li cov txheej txheem ntawm kev kho mob:
- Hemodynamic.
- Detoxification.
- Parenteral.
- Regulators.
- ntshav hloov pauv uas nqa oxygen.
- Infusion antihypoxants.
- Cov ntshav hloov pauv.
- Colloids.
- YCrystaloids.
Colloids suav nrog cov tshuaj hloov pauv ntuj (plasma, albumin) thiab hluavtaws, crystalloid (ntsev) cov ntshav hloov pauv - hypotonic, hypertonic thiab isotonic daws. Colloids ntxiv ntim cov kua dej ntxiv, tswj nws thaum lub sijhawm phais, thiab kho mob me me hypovolemia.
YContraindications
Txawm hais tias qhov ua siab ntev ntawm crystalloids los ntawm tib neeg lub cev, lawv muaj contraindications nyob ntawm seb muaj pes tsawg leeg. Isotonic sodium chloride saline kua, nws muaj cuaj grams ntawm cov khoom tseem ceeb. Nyob rau hauv kev sib raug rau cov ntshav plasma, nws yog hypertonic, cov tshuaj tiv thaiv yog me ntsis acidic. Yog tias koj nkag mus rau ntau cov tshuaj sodium chloride, koj tuaj yeem ua rau metabolic acidosis. Ringer's tov nrog lactate muaj ib tug physiological muaj pes tsawg leeg. Cov tshuaj yog ua ke, muaj ib tug dav, tshwj xeeb tshaj yog nyob rau hauv cov ntaub ntawv ntawm raug mob ntawm tsis paub etiology. K + ions hauv cov tshuaj tuaj yeem cuam tshuam tsis zoo rau cov qog adrenal thiab ob lub raum yog tias tus neeg mob muaj kev ua haujlwm tsis zoo ntawm cov kabmob no.
Cov tshuaj "Normasol", piv nrog rau yav dhau los, muaj cov txiaj ntsig kho tau zoo dua. Cov tshuaj no paub txog nws cov nyhuv vasodilatory, tab sis tuaj yeem tiv thaiv qhov tshwm sim ntawm vasoconstriction, uas tswj cov ntshav siab nyob rau hauv ib txwm muaj kev tiv thaiv keeb kwm ntawm hypovolemia. Tsis tas li ntawd, Ringer cov tshuaj yog ib nrab thiab kuj tsis sib haum nrog cov tshuaj xws li Ampicillin, Vibramycin, Minocycline, Amikacin, Ornid, Anaprilin, Urokinase, thiab lwm yam. Rau kev tswj hwm hauv cov hlab ntsha, siv cov kua qab zib. Nws tswj cov qib ntawm carbohydrates, ua kom lub cev ua haujlwm ntawm lub hauv paus paj hlwb hauv cov neeg mob uas muaj teeb meem ntawm lub paj hlwb. Txawm li cas los xij, cov piam thaj infusions tuaj yeem ua rau cov tsos mob ntawm lactic acid hauv lub cev cuam tshuam los ntawm kab mob coronary. Ua ntej tshaj plaws, qhov no cuam tshuam rau lub hauv nruab nrab lub paj hlwb.
Yuav siv li cas
Tsim nyog cov kev daws teeb meem crystalloid rau kev kho infusion thiab hloov cov kua dej tawm sab nraud. Feem ntau lawv yog siv rau kev poob ntshav loj. Piv txwv li, nyob rau hauv hemorrhagic shock, cov tshuaj yog muab nyob rau hauv ib tug ntim ntawm 3 ml ib milliliter ntawm cov ntshav poob nyob rau hauv ib tug ratio ntawm 3: 1. Rau cov neeg laus, cov tshuaj yog txhaj rau hauv ib kwj ntawm ib liter. Tus nqi ntawm cov tshuaj yog hloov mus rau hauv tus account lub hnub nyoog, nrog rau muaj cov kab mob plawv. Invasive soj ntsuam yog yuav tsum tau kom tsis txhob overdose.
Rau cov menyuam yaus, cov tshuaj yog muab los ntawm dav hlau ntawm ib koob ntawm 20 ml / kg. Tom qab kev qhia ntawm txhua koob tshuaj, qhov xwm txheej ntawm tus menyuam raug ntsuas. Yog tias tom qab peb koob tshuaj cov tshuaj hemodynamic tsis ruaj khov, tus kws kho mob maj mam pib hloov ntshav. Yog xav tias los ntshav sab hauv, tus neeg mob raug xa mus rau chav ua haujlwm.
Ntse
Crystalloid tov belongs rau pab pawg ntawm cov ntshav hloov. Qhov no suav nrog cov tshuaj infusions ntawm cov suab thaj thiab electrolytes. Ua tsaug rau lawv, dej, electrolyte thiab acid tshuav nyiaj li cas rov qab los hauv lub cev. Kev daws teeb meem los ntawm pab pawg no sai dhau los ntawm cov hlab ntsha mus rau hauv lub hlwb, nyob ntawm seb muaj pes tsawg leeg. Lawv tau muab faib ua ob peb pawg ntxiv:
- hloov pauv (yog tias ib tus neeg poob ntshav ntau thiab xav tau hloov cov electrolytes thiab dej);
- basic (muab tshuav);
- kho (rov kho qhov tsis sib xws ntawm ions thiab dej).
Crystalloids xyuas kom cov kua dej nkag mus rau hauv qhov chaw ntxiv, tawm sai sai los ntawm lub raum, muaj qhov txwv tsis pub siv thiab nws lub sijhawm, tuaj yeem ua rau hypoxia, edema ntawm lub ntsws thiab cov kab mob hauv nruab nrog cev. Lawv yuav tsum tau siv ceev faj rau cov neeg mob plawv thiab raum.
Side effects
Crystalloid cov kev daws teeb meem ua ntej txhaj tshuaj yuav tsum tau kuaj xyuas kom ua raws. Feem ntau lawv tau yooj yim zam los ntawm cov neeg mob, tsis cuam tshuam rau lub cev tiv thaiv kab mob, cov kab mob hauv nruab nrog cev (yog tias tsis muaj cov kab mob sib txuas), tswj cov electrolyte tshuav, tab sis tuaj yeem ua rau hypertonic edema vim kev xa rov qab sai.cov hlab ntsha mus rau hauv cov hlwb thiab yuav tsum tau txhaj tshuaj loj. Colloids feem ntau siv hauv kev kho mob.
Feem ntau suav nrog cov tshuaj albumin 25% thiab 5%, hetastarch 6% thiab dextran-40. Yog tias qhov ntim loj ntawm colloids raug txhaj rau hauv cov hlab ntsha, dilutional coagulopathy thiab kis tus kab mob siab rau tus kab mob siab (tej zaum tsis tshua muaj) tuaj yeem tshwm sim. Kev mob tshwm sim yog qee zaum ua xua. Hetastarch daws tuaj yeem nce qib ntawm amylase hauv cov ntshav ntau zaus. Cov xwm txheej no tshwm sim rau tsib hnub, tab sis tsis ua rau mob pancreatitis. Nws yog ib qho tseem ceeb los saib xyuas tus neeg mob lub sijhawm kho.
Lub ntim loj ntawm cov tshuaj tsis ua rau muaj teeb meem ntshav txhaws. Kev daws ntawm dextrans ua rau los ntshav, txo cov platelet aggregation, thiab txhawb kev fibrinolysis. Qee lub sij hawm cov neeg mob tau ntsib cov tshuaj tiv thaiv anaphylactic. Cov tshuaj rau lub sijhawm siv tuaj yeem ua rau nws tsis tuaj yeem txiav txim siab txog pawg ntshav, ua rau lub raum tsis ua haujlwm. Crystalloid cov kev daws teeb meem tau muab npe tom qab lawv cov khoom thiab muaj pes tsawg leeg, uas suav nrog cov tshuaj nquag.
Price
Colloid thiab crystalloid daws feem ntau yog siv hauv tshuaj. Lawv cov nqi yog nyob ntawm lub npe ntawm cov khoom, chaw tsim tshuaj paus, ntim. Piv txwv li, ib lub raj mis ntawm Reopoliglyukin 10% tov, 400 ml nqi 119 rubles. Cov kev daws teeb meem colloidal rau tus neeg mob yog kim, thiab cov txiaj ntsig zoo tsis yog ib txwm tsim nyog.
