Nyob hauv kab lus, xav txog cov npe ntawm cov tee los ntawm glaucoma. Qhov no yog kab mob qhov muag txaus ntshai uas ua rau tsis pom kev. Raws li kev txheeb cais, cov kab mob no cuam tshuam txog kwv yees li 3% ntawm cov pej xeem, thiab hauv 15% ntawm cov neeg dig muag tus kab mob no tau ua rau dig muag. Cov pab pawg muaj kev pheej hmoo rau kev loj hlob ntawm tus kab mob no suav nrog cov neeg muaj hnub nyoog 40 xyoo, txawm li cas los xij, hauv kev coj ua ophthalmic, muaj cov kab mob uas cuam tshuam rau cov neeg mob hluas (congenital thiab juvenile glaucoma). Qhov tshwm sim ntawm tus kab mob no nce zuj zus nrog lub hnub nyoog.
Glaucoma yog ib qho mob ntev ntawm lub qhov muag, tshwm sim tas li lossis ib ntus nce hauv qhov siab ntawm lub paj hlwb, kev cuam tshuam ntawm cov kua dej tawm hauv lub cev, kev mob trophic hauv cov paj hlwb thiab retina, uas yog nrog los ntawm qhov tshwm sim ntawm qhov tsis xws luag. nyob rau hauv marginal disc excavationoptic paj hlwb thiab cov duab pom.
Raws li cov txheej txheem ntawm kev nce siab hauv lub qhov muag, lub kaum sab xis kaw thiab thawj qhov qhib-lub qhov muag glaucoma yog qhov txawv. Nrog lub kaum sab xis kaw, muaj kev cuam tshuam sab hauv hauv cov kua dej ntawm lub qhov muag. Nrog rau txoj kev loj hlob ntawm daim ntawv qhib lub kaum sab xis - lub kaum sab xis ntawm lub anterior chamber yog qhib, tab sis lub outflow ntawm cov kua yog impaired. Dab tsi suav nrog hauv daim ntawv teev cov tee rau glaucoma?
Ntau yam tshuaj rau glaucoma
Daim ntawv teev cov tshuaj qhia kom nce IOP suav nrog ntau pawg tshuaj. Cov no yog cov tshuaj los txhim kho cov dej ntws tawm hauv qhov muag. Cov no suav nrog:
- prostaglandins ("Travatan");
- cholinomimetics ("Aceclidin");
- sympathomimetics ("Irifrin").
Txhua tus xav ua ib daim ntawv teev cov qhov muag zoo tshaj plaws rau glaucoma. Cov tshuaj uas txo cov kev tsim cov aqueous lom zem kuj siv:
- carbonic anhydrase inhibitors ("Trusopt");
- tshuaj ntawm hom sib xyaw ("Azarga");
- beta-blockers (Timolol).
Carboanhydrase inhibitors los ntawm daim ntawv teev cov tshuaj tee rau glaucoma inhibit zus tau tej cov carbonic anhydrase, ib qho enzyme uas tsim los ntawm ciliary lub cev ntawm lub qhov muag los tsim intraocular noo noo. Sympathomimetics ua rau kom cov dej ntws hauv lub qhov muag los ntawm kev ua haujlwm ntawm kev sib koom tes ntawm lub paj hlwb. Cholinomimetics txo qis intraocular siab thiab normalize kua outflow los ntawm qhib lub kaum sab xis ntawm lub qhov muag anterior chamber.
Prostaglandins pab txhawb rau qhov normalization ntawm lub qhov muag tso dej, vim li ntawdQhov tsim nyog tshem tawm cov kua dej tshwm sim.
Tseem mob glaucoma drops
Kev xaiv cov tshuaj tiv thaiv kab mob glaucoma yog tsim los ntawm tus kws kho qhov muag tom qab ua qhov kev kuaj mob thiab txheeb xyuas qhov ua rau tus kab mob no. Txhawm rau taug qab ntawm ntau yam tshuaj rau glaucoma tsim nyob rau hauv daim ntawv ntawm cov tee, nws yog ib qho tsim nyog yuav tsum nkag siab qhov twg ntawm lawv pab daws qee yam ua rau ntawm pathology thiab nws tshwm sim. Ntawm cov tshuaj siv tau zoo tshaj plaws yuav tsum raug sau tseg:
- Timolol.
- Azopt.
- Betaxolol.
- Xalathan.
- YPilocarpine.
- Travatan.
- "Aceclidin".
- Irifrin.
- Fotil.
- Xalacom.
- Azarga.
Daim ntawv teev cov qhov muag te rau glaucoma yog nthuav mus tas li.
Timolol
Cov tshuaj tiv thaiv kab mob glaucoma no tau muab cais ua beta-blockers rau kev siv hauv zos. Cov khoom xyaw nquag yog timolol maleate. Cov tshuaj yog ib qho blocker ntawm cov tsis xaiv beta-adrenergic receptors. Nws tsis muaj kev ua haujlwm sympathomimetic. Thaum instilled rau hauv lub qhov muag, nws yuav pab txo qis IOP los ntawm kev txo cov khoom ntawm aqueous lom zem thiab me ntsis nce nws outflow. Los ntawm kev txo qis intraocular siab, cov tshuaj tsis cuam tshuam rau qhov loj ntawm cov menyuam kawm ntawv thiab kev pabcuam, vim tias tsis muaj qhov tsis zoo ntawm qhov pom kev pom lossis txo qhov tsis pom kev hmo ntuj. Cov tee rau kev kho mob glaucoma pib ua tom qab li 20 feebTom qab txhaj tshuaj rau hauv lub qhov muag, thiab qhov kev kho mob siab tshaj plaws tau pom tom qab 1-2 teev. Lub sijhawm ntawm cov tshuaj yog 1 hnub.
Cov lus qhia rau kev siv "Timolol" yog:
- nce ophthalmotonus;
- kaw-angle thiab qhib-angle glaucoma (raws li ib feem ntawm kev kho ua ke nrog miotics);
- uveal, post-traumatic lossis aphakic secondary glaucoma.
Raws li contraindications rau kev siv cov tee, cov lus qhia rau cov tshuaj qhia: dystrophic pathologies ntawm lub cornea, rhinitis, sinus bradycardia, plawv tsis ua hauj lwm, cardiogenic poob siab, lactation lub sij hawm, hypersensitivity.
Cov tshuaj noj raws li hauv qab no - 1 poob ob zaug ib hnub.
Yuav ua li cas ntxiv yog nyob rau hauv daim ntawv teev cov tee rau glaucoma thiab cataracts?
Azopt
Cov tshuaj tiv thaiv kab mob qog noj ntshav no muaj cov txiaj ntsig tseem ceeb - txo qhov muag siab. Nws muaj cov khoom nquag - brinzolamide, uas yog suav tias yog ib qho inhibitor ntawm carbonic anhydrase II. Kev tshem tawm ntawm nws cov khoom ua rau inhibition ntawm kev tsim ntawm bicarbonate ions, thiab txo qis hauv kev hloov pauv ntawm sodium thiab kua dej, uas thaum kawg ua rau txo qis ntawm cov kua dej hauv lub cev thiab lub siab lub ntsws..
Qhov taw qhia tseem ceeb rau kev siv Azopt yog siab intraocular siab nyob rau hauv qhib-angle glaucoma los yog kub siab. Raws li cov lus qhia rau kev siv, cov tshuaj tsis raug tso cai siv rau tus kheejrhiab heev rau qhov muaj pes tsawg leeg, nrog rau mob hnyav ntawm lub raum ua haujlwm. Nrog ceev faj, nws raug sau tseg rau kab mob siab thiab lub kaum ntse ntse glaucoma. Cov lus qhia rau kev siv: 1 poob 2 zaug hauv ib hnub.
Betaxolol
Daim ntawv teev cov tee rau glaucoma suav nrog cov tshuaj "Betaxolol". Cov tshuaj muaj nyob rau hauv cov pab pawg neeg ntawm beta-blockers, yog siv nyob rau hauv kev kho mob ntawm glaucoma thiab nyob rau hauv thiaj li yuav normalize intraocular siab. Cov tee yog ua raws li cov khoom nquag - betaxolol hydrochloride. Thaum siv tshuaj pleev ib ce, cov tshuaj no txo qhov siab hauv lub qhov muag los ntawm kev ua kom cov kua dej hauv lub qhov muag qeeb. Tsis zoo li lwm cov β-blockers, kev siv cov tshuaj no tsis txo cov ntshav ntws hauv cov hlab ntsha optic. Cov khoom tseem ceeb tsis provoke contractions ntawm ciliary thiab ncig cov nqaij ntshiv, kev loj hlob ntawm hemeralopia, zoo li "daim ntaub thaiv" nyob rau hauv ob lub qhov muag.
Betaxolol yog qhia rau kev kho mob ntawm qhov qhib glaucoma thiab ocular hypertension. Contraindications rau nws siv yog:
- myasthenia gravis;
- kev poob siab;
- arterial hypotension;
- bronchial hawb pob;
- obstructive ua pa tsis ua hauj lwm hauv chav kawm hnyav;
- sinus bradycardia;
- sinus node tsis muaj zog;
- lub plawv tsis ua hauj lwm;
- qis dua 18;
- rhiab rau cov khoom xyaw.
Cov lus qhia rau kev siv: 1 poob ob zaug ib hnub.
Daim npe tshuaj kho mob glaucoma zoo duanrog koj tus kws kho mob.
Xalathan
Tshuaj nrog cov teebmeem antiglaucoma, raws li cov tshuaj nquag - latanoprost. Cov tshuaj no ua raws li ib qho analogue ntawm prostaglandin F2α, uas muaj nyob rau hauv cov qeb ntawm xaiv prostaglandin F agonists. Cov tshuaj no txo intraocular siab, accelerates lub outflow ntawm noo noo los ntawm lub qhov muag los ntawm trabecular meshwork thiab uveoscleral txoj kev. Cov nyhuv tau sau tseg kwv yees li 3-4 teev tom qab instillation, thiab kav li 8-12 teev. Cov kev tshawb fawb tau pom tias latanoprost muaj kev cuam tshuam me ntsis ntawm cov kua dej thiab ntawm cov hlab ntshav-ophthalmic barrier. Thaum siv cov tshuaj no hauv cov tshuaj kho mob, tsis muaj cov tshuaj muaj txiaj ntsig zoo rau lub ntsws thiab lub plawv.
Cov lus qhia rau kev siv Xalatan tee yog: txo IOP nrog nce ophthalmotonus thiab qhib-angle glaucoma. Contraindications: hypersensitivity rau cov tshuaj thiab hnub nyoog qis dua 1 xyoos. Cov lus qhia rau kev siv: instill 1 nco ib hnub ib zaug (nyiam dua yav tsaus ntuj).
YPilocarpine
Cov tshuaj nquag ntawm tib lub npe nyob rau hauv cov tshuaj no qhov muag rau glaucoma yog ib qho derivative ntawm methylimidazole, uas muaj cov nyhuv ncaj qha m-cholinomimetic. Cov tshuaj muaj antiglaucoma thiab miotic zog, yog ib qho m-cholinomimetic. Thaum lub sij hawm nws daim ntawv thov, muaj ib tug contraction ntawm ncig thiab ciliary nqaij, permeability ntawm trabecular cheeb tsam thiab lub kaum sab xis ntawm lub anterior chamber ntawm lub qhov muag nce,lub outflow ntawm noo noo los ntawm lub qhov muag yog normalized. Raws li qhov tshwm sim, muaj qhov txo qis hauv IOP.
Cov lus qhia rau kev siv Pilocapin yog:
- mob qog nqaij hlav glaucoma;
- mob qhib lub qhov muag glaucoma;
- thib ob glaucoma (kev cuam tshuam ntawm cov hlab ntsha ntawm lub retina, nws cov pigmentary degeneration los yog thrombosis ntawm lub hauv paus hlab ntsha, nrog rau atrophy ntawm lub paj hlwb);
- pob kws pob kws.
Cov tshuaj yub qhov muag no kuj tau sau tseg tom qab kev qhia txog mydriatics, yog tias tsim nyog rau cov menyuam mos.
Contraindications rau kev siv cov tshuaj yog: iritis, iridocyclitis, qhov muag mob nyob rau hauv uas miosis yog undesirable, hnub nyoog qis dua 18, rhiab heev rau cov khoom.
Cov lus qhia rau kev siv: rau thawj glaucoma - 1-2 tee 2-4 zaug ib hnub twg. Nrog rau kev tawm tsam ntawm lub kaum sab xis kaw glaucoma: rau 1 poob txhua 15 feeb (1 teev), 1 poob txhua 30 feeb (2 thiab 3 teev), 1 poob ib teev (los ntawm 4 mus rau 6 teev ntawm kev tawm tsam). Tsis tas li ntawd, cov tshuaj yog siv 1 poob mus rau 6 zaug ib hnub twg. Thiab dab tsi yog suav nrog hauv daim ntawv teev cov tee rau qhov qhib-angle glaucoma?
Travatan
Cov no yog prostaglandin qhov muag te rau glaucoma. Travoprost yog cov khoom tseem ceeb ntawm cov khoom siv kho mob no, ib qho analogue ntawm F2a prostaglandin, nws cov antagonist xaiv, uas muaj qib nce ntawm qhov zoo sib xws rau prostaglandin receptors. Cov cuab yeej zoo txo IOP, ua kom cov kua dej tawm ntawm qhov muag.
Cov tshuaj no tau qhia txhawm rau txhawm rau txo qis hauv lub cev, qhov nce ntxivvim qhib-angle glaucoma los yog siab ophthalmotonus. Contraindications yog hnub nyoog txog li 18 xyoo thiab intolerance rau cov khoom.
Cov lus qhia rau kev siv: 1 poob 1 zaug hauv ib hnub.
Aceclidin
Daim ntawv teev cov tshuaj kho qhov muag zoo tshaj plaws rau qhov qhib-angle glaucoma suav nrog "Aceclidin". Nws yog ib qho zoo cholinomimetic uas muaj cov nyhuv miotic. Cov tshuaj muaj cov nyhuv antiglaucoma thiab miotic, yog m-cholinomimetic. Thaum lub sij hawm nws daim ntawv thov, lub voj voog thiab ciliary nqaij daim ntawv cog lus, lub permeability ntawm lub trabecular cheeb tsam thiab lub kaum sab xis ntawm lub anterior chamber ntawm lub qhov muag, thiab cov outflow ntawm cov kua dej los ntawm lub qhov muag normalizes. Raws li qhov tshwm sim, muaj qhov txo qis hauv IOP.
Cov lus qhia rau kev siv tshuaj "Aceclidin" yog:
- mob qhib lub qhov muag glaucoma;
- mob qog nqaij hlav glaucoma;
- pob kws pob kws;
- thib ob glaucoma (kev cuam tshuam ntawm cov hlab ntsha ntawm retina, nws cov pigmentary degeneration lossis thrombosis ntawm cov hlab ntsha hauv nruab nrab, nrog rau atrophy ntawm cov hlab ntsha ntawm optic).
Contraindications: iridocyclitis, iritis, tej yam kev mob nyob rau hauv lub qhov muag miosis yog undesirable, hnub nyoog qis dua 18 xyoo, rhiab heev rau cov muaj pes tsawg leeg. Qhov muag tee "Aceclidin" yog instilled 3-6 zaug ib hnub twg.
Irifrin
Daim ntawv teev cov tee rau lub kaum sab xis kaw glaucoma kuj yog qhov dav heev. "Irifrin" yog ib qho tshuaj uas muaj cov nyhuv alpha-adrenomimetic, ib qho sympathomimetic uas tsis yog tus cwj pwm los ntawm kev txhawb nqa ntawm lub hauv paus paj hlwb. Thaum siv tshuaj pleev ib ce, phenylephrine (cov tshuaj nquag) ua rau cov hlab ntsha conjunctival, txhim khotshem tawm ntawm intraocular noo noo thiab dilates cov menyuam kawm ntawv. Cov tshuaj tiv thaiv tseem muaj cov nyhuv stimulating ntawm postsynaptic alpha-adrenergic receptors, thiab muaj kev cuam tshuam me ntsis ntawm kev ua haujlwm ntawm beta-adrenergic receptors hauv plawv.
Cov lus qhia rau nws siv:
- iridocyclitis;
- glaucoma-cyclic crises;
- qhov muag liab;
- chaw pw spasm;
- rau kev kuaj mob thiab thaum muaj kev cuam tshuam kev phais.
Txhawm rau tshem tawm cov teeb meem glaucoma-cyclic, cov tshuaj yuav tsum tau muab tso rau hauv qhov muag 2-3 zaug hauv ib hnub.
Fotil
Daim ntawv teev cov tshuaj tiv thaiv qhov muag rau glaucoma suav nrog cov tshuaj "Fotil". Qhov no yog ib qho kev sib xyaw ua ke, raws li cov khoom xyaw nquag: pilocarpine hydrochloride thiab timolol maleate. Cov tshuaj no rau glaucoma belongs rau qeb ntawm beta-blockers rau kev siv tshuaj pleev. Cov tshuaj yog ib qho tsis xaiv beta-adrenergic blocker, tsis muaj kev ua haujlwm sympathomimetic. Thaum instilled rau hauv lub qhov muag, nws txhawb ib tug ceev ceev txo nyob rau hauv lub siab nyob rau hauv lub qhov muag los ntawm kev txo zus tau tej cov aqueous lom zem thiab me ntsis nce nws outflow.
Kev txo qis intraocular siab, cov tshuaj tsis cuam tshuam rau qhov loj ntawm cov menyuam kawm ntawv thiab chaw nyob, vim tias tsis muaj kev puas tsuaj ntawm qhov muag pom lossis txo qhov tsis pom kev hmo ntuj. Cov tee pib ua haujlwm kwv yees li 20 feeb tom qab txhaj tshuaj rau hauv lub qhov muag, thiab qhov kev kho mob siab tshaj plaws tau pom tom qab 1-2 teev. Lub sijhawm ntawm cov tshuaj yog 1 hnub.
Cov lus qhia rau kev siv Fotil yog:
- nce ophthalmotonus;
- kaw-angle thiab qhib-angle glaucoma (raws li ib feem ntawm kev kho ua ke nrog miotics);
- uveal, post-traumatic lossis aphakic secondary glaucoma.
Raws li contraindications rau kev siv cov tee, cov lus qhia rau cov tshuaj qhia: dystrophic pathologies ntawm lub cornea, rhinitis, sinus bradycardia, plawv tsis ua hauj lwm, lactation lub sij hawm, hypersensitivity.
Cov tshuaj noj raws li hauv qab no - 1 poob ob zaug ib hnub.
Peb tau tshuaj xyuas cov npe tshuaj tiv thaiv kab mob glaucoma.
