Cov tsev kho mob thoob ntiaj teb siv nyiaj ntau rau kev hloov ntshav. Yog li ntawd, cov teb chaws uas muaj cov tshuaj siab heev yog tibneeg hu tauj coob tsim cov ntshav hloov pauv. Lawv tsis ua haujlwm tag nrho ntawm cov ntshav, vim tias lawv tsis muaj cov ntsiab lus tsim. Yog li ntawd, kev hloov pauv cov xov xwm siv los ua kom cov ntshav ua haujlwm zoo dua yog hu ua plasma-substituting daws. Muaj ntau txhiab tshuaj, thiab lawv tau siv dav hauv ntau yam kab mob.
Infusion-transfusion therapy
Txoj kev kho mob uas qhov ntim thiab muaj pes tsawg leeg ntawm cov ntshav, cov kua dej hauv cov ntaub so ntswg thiab cov kua dej hauv lub cev tau raug kho los ntawm parenteral (feem ntau intravenous) kev tswj hwm cov kua roj ntsha hu ua infusion-transfusion therapy.
Txoj kev kho mob infusion tau nkag siab tias yog kev tswj hwm cov tshuaj plasma hloov pauv, nyob rau hauv kev kho mob ntshav - ntshav, nwscov khoom xyaw thiab tshuaj. Cov tshuaj hloov ntshav tsuas yog siv raws li kev saib xyuas nruj ntawm tus kws kho mob.
kev kho mob yog dab tsi?
Kev kho mob-hloov ntshav muaj ntau yam teebmeem. Nws yog nqa tawm tsuas yog los ntawm cov tshuab pov tseg rau kev hloov pauv ntawm cov tshuaj infusion. Cov kua tshuaj uas muaj nyob rau hauv lub hnab yas ntws tawm sai dua los ntawm lub khob iav. Pace tuaj yeem tswj tau siv lub tshuab computer tswj infusion twj.
Lub Hom Phiaj Kho Mob:
- Kev tshem tawm ntawm hypovolemia.
- Taw qhia ntawm cov cellular Cheebtsam ntawm cov ntshav (leukocytes, platelets, erythrocytes) yog tias lawv tsis txaus.
- Kev tshem tawm cov dej-electrolyte thiab KS tsis txaus.
- Normalization ntawm cov tshuaj muaj pes tsawg leeg ntawm cov ntshav nrog qhov tsis txaus ntawm cov ntshav coagulation yam lossis platelets.
- Kev tso ntshav ntawm cov as-ham bypassing utilities.
- Kev tshem tawm ntawm kev ua txhaum cai ntawm cov ntshav rheological.
- Kev tshem tawm cov kab mob coagulation.
- Kev kho cov kab mob tiv thaiv kab mob.
- YKev tshem tawm cov kab mob metabolic thiab microcirculation tsis zoo.
- Kev mob ntshav siab.
Nyob ntawm qhov muaj pes tsawg leeg ntawm cov cuab yeej kho mob, cov tshuaj infusion tau muab faib ua cov ntshav, nws cov khoom siv thiab kev npaj, cov tshuaj hloov ntshav plasma. Cov yav tas muaj lub neej txee ntev thiab yog unpretentious hauv kev thauj mus los.
Kev hloov ntshav ntshav yog dab tsi?
Lub ntim ntawm cov ntshav ncig tuaj yeem tsuas yog ntxiv nrog cov ntshav. Plasma hloov pauvkev daws - cov tshuaj zoo sib xws nyob rau hauv muaj pes tsawg leeg rau ntshav, siv nrog ib tug deficiency ntawm lub Cheebtsam ntawm nws cov kua ib feem. Txhais tau hais tias tau noj nyob rau hauv cov koob tshuaj loj yog hu ua infusions. Txog niaj hnub no, cov txheej txheem polymer pov tseg rau kev hloov ntshav ntawm PK-11-01, PK-22-02, PR-11-03 hom tau siv.
Plasma hloov pauv tau dav siv los ua kom muaj nuj nqis ntawm homeostasis hauv ntau yam kab mob. Cov kev daws teeb meem yog siv rau kev lim ntshav extrarenal, hloov khoom nruab nrog cev, cais thaj chaw perfusion. Kev tswj cov hemodilution (ntshav dilution) yog ua los ntawm kev siv cov plasma hloov pauv.
Cov kev daws teeb meem yog siv los kho thiab tiv thaiv kev poob siab ntawm ntau yam etiologies, normalize ntshav siab, txhim kho hemodynamic tsis. Plasma hloov pauv yog siv rau kev poob ntshav, kub hnyiab heev, tiv thaiv thromboembolism tom qab phais, thiab rau ntau yam intoxications. Cov nyiaj tau txais txiaj ntsig zoo, lawv tau nchuav yam tsis xav txog kev koom nrog pab pawg.
Kev faib cov tshuaj hloov ntshav plasma
Raws li cov khoom siv thiab kev taw qhia ntawm kev kho mob, cov neeg ua haujlwm tau muab faib ua ntau pawg.
- Hemodynamic cov kev daws teeb meem yog kev npaj ua los ntawm ntuj lossis hluavtaws colloids. Lawv siv rau kev kho mob los tiv thaiv kev poob siab, rov qab los ntawm cov kab mob hemodynamic.
- Cov tshuaj tua kab mob yog qhov hnyav molecular dextrans uas tuaj yeem tshem tawm toxins ntawm lub cev.
- Saline daws thiabosmodiuretics kho cov tshuaj muaj pes tsawg leeg ntawm cov ntshav hauv lub cev qhuav dej los ntawm cerebral edema, nce lub raum hemodynamics, raws plab.
- Cov khoom noj khoom haus Parenteral muab cov khoom noj hauv cov hlab ntsha.
- Cov neeg nqa pa oxygen pab txhawb kev rov ua haujlwm ntawm kev ua pa ntawm cov ntshav.
- Cov kev daws teeb meem - biodegradable broad-spectrum khoom.
Hemodynamic daws
tshuaj hemodenamic kho cov ntshav hauv nruab nrab thiab cov hlab ntsha hauv nruab nrog. Lawv ncig hauv cov hlab ntsha ntev ntev, tswj cov ntshav siab. Muaj peb pawg ntawm hemodynamic plasma-substituting daws: hydroxyethyl starch npaj, gelatin, dextran derivatives.
Dextrans yog polysaccharides tsim los ntawm cov kab mob Leuconostok mesenteroides. Tshuaj:
- Polyglukin.
- Macrodex.
- Neorondex.
- Intradex.
- Reopoliglyukin.
- Lomodex.
- "Dextran 40".
Hydroxyethyl starch npaj yog infusion agents raws li hydroxyethyl starch.
- Volekam.
- Plasmasteril.
- Refortan.
- "Stabizol".
- YPlasmotonin.
Gelatin npaj yog cov tshuaj colloidal raws li cov protein denatured gelatin. Feem ntau yog: "Gelatinol", "Gelofusin", "Physiogel," Plazmogel "," Zhelofuzin ".
tshuaj tua kab mob
Infusion daws ntawm detoxification kev txiav txim yog siv rau dag detoxification. Cov khoom yog tsim los ntawm ib tug polymer tsim los ntawm N-vinylpyrrolidone, uas yog heev soluble nyob rau hauv dej. Cov tshuaj muaj kev tiv thaiv kev sib sau ua ke, khi co toxins hauv cov ntshav thiab tshem tawm ntawm lub cev.
Kev qhia rau kev siv tshuaj yog: intoxication ntawm ntau yam genesis, hluav taws xob mob, mob plab, leukemia, kab mob kub hnyiab, sepsis. Cov tshuaj tseem ceeb:
- "Hemodez-N". Vim muaj kev pheej hmoo siab ntawm cov kev mob tshwm sim hauv xyoo tas los no, kev kho mob sim nrhiav kev hloov.
- Polydez.
- YEnterodesis.
- "Neohemodes".
- Neocompensated.
Regulators of water-electrolyte balance thiab acid-base balance
Cov tshuaj no suav nrog cov tshuaj ntsev thiab cov tshuaj electrolyte. Lawv muaj peev xwm ua kom sai thiab ua tau zoo ntxiv qhov tsis txaus ntawm cov kua nruab nrab, rov qab osmotic siab ntawm plasma, ua kom lub cev muaj dej, thiab kho cov dej ntsev metabolism.
Thaum ua kev kho mob, nws yuav tsum tau coj mus rau hauv tus account cov electrolyte muaj pes tsawg leeg ntawm cov ntshav hloov pauv, lub tshuab ua haujlwm, thiab kev ua haujlwm kinetics. Lub ntsiab tseem ceeb ntawm kev npaj crystalloid yog sodium. Nws yog lub ntsiab electrolyte, 80% ntawm nws yog sab nraum lub vascular txaj nyob rau hauv cov kua ntawm lub extracellular qhov chaw, yog li cov sodium tov nkag mus rau hauv cov ntshav sai sai tig tawm mus rau sab nraum cov hlab ntsha.
Infusions ntawm kev daws teeb meem nrog acidic zog, txawm tias nyob rau hauv cov koob tshuaj ntau, tsis txhob cuam tshuam lub xeev acid-base, tab sis nrog tsim metabolic alkalosis, kev tso ntshav ntawm cov ntshav uas muaj bicarbonate los yog ntau tshaj sodium tuaj yeem nce qhov sib piv ntawm hydrogen thiab hydroxyl. pab pawg. Cov tshuaj siv ntau tshaj plaws yog:
- Saline sodium chloride tov 9%.
- Ringer-Locke daws.
- Bieffe sodium lactate tov.
- "Disol", "Atsesol", "Kvartasol", "Trisol.
- YLactasol.
- Sanasol.
Means for parenteral food
Tshuaj yog siv thaum nws tsis tuaj yeem pub cov neeg mob hauv qhov ncauj vim muaj ntau yam kab mob, raug mob, thiab kev phais mob. Rau kev kho mob, siv cov kua protein hloov ntshav, roj emulsions thiab carbohydrates.
Protein npaj yog lub hauv paus ntawm parenteral khoom noj khoom haus. Protein hydrolysates thiab sib tov ntawm amino acids yog cais. Cov muaj pes tsawg leeg ntawm kev npaj yuav tsum muaj xws li 8 qhov tseem ceeb amino acids, yog tias tsawg kawg yog ib qho ntawm lawv ploj lawm, ces protein synthesis yuav cuam tshuam. Kev npaj rau cov khoom noj muaj protein ntau hauv cov hlab ntsha:
- Y"Hydrolysin".
- YCosein Hydrolyzate.
- "Aminosteril".
- "Aminotroph".
- YInfusamine.
- Vam.
- YPolyamine.
- YVaminolact.
- "Fibrinosol".
Neframin Neframin
Kev siv cov roj emulsions tso cai rau cov calorie ntau ntau kom txhaj rau hauv cov kua me me. Nrog kev pab ntawm rogemulsions, cov synthesis ntawm phospholipids yog nqa tawm, uas yog ib qho tseem ceeb nyob rau hauv cov protein thiab lipid metabolism. Nyob ntawm seb muaj pes tsawg leeg, 3 tiam ntawm emulsions yog qhov txawv:
- I tiam (ntev saw): Intralipid, Lipofundin S, Lipovenosis, Lipozan.
- II tiam (nruab nrab cov saw triglycerides): Liquidgen, Medialipid.
- III tiam (emulsions nrog qhov tseem ceeb ntawm omega-3 fatty acids): Structolipid, LipoPlus, Omegaven. Carbohydrates yog siv los ua kom tau raws li qhov xav tau ntawm lub zog. Cov kev daws teeb meem feem ntau hauv kev kho mob yog cov piam thaj, fructose, Sorbitol, Xyliton.
Oxygen carriers
Kev thauj oxygen yog ib qho tseem ceeb ntawm cov ntshav. Oxygen-carrying npaj pab txhim kho nws cov khoom rheological, txo viscosity, thiab nce fluidity. Txawm hais tias feem ntau ntawm cov nyiaj tab tom txhim kho, tab sis cov kev mob tshwm sim twb tau txheeb xyuas. Cov kab mob ua pa zoo teb zoo rau cov ntshav plasma hloov pauv los ntawm lub cev rau kev hloov pauv ntawm cov tshuaj infusion. Yog li ntawd, kev siv tshuaj ntev ntev ntawm cov khoom nqa oxygen tuaj yeem ua rau kev puas tsuaj ntawm capillaries hauv lub ntsws. Tshuaj muab faib ua ob pawg:
- Synthetic perfluoroorganic compounds: Perftoran, Perfucol.
- Hloov pauv cov protein nqa oxygen: Gelenpol, hemoglobin daws.
tshuaj muaj zog ntau
Txoj kev hloov ntshav plasma yog cov kev npaj uas tuaj yeem muab ntau yam teebmeem. Yeej lawv muajhemodynamic, detoxifying, rheological zog. Cov ntshav hloov pauv ntau tshaj plaws: Reogluman, Polifer, Rondferrin.
Zoo kawg
Kev txhim kho cov ntshav hloov pauv tau ua kom txo qis kev siv cov ntshav pub dawb. Tsis tas li ntawd, cov neeg mob feem ntau xav tau kev hloov pauv tsis xav tau tag nrho cov khoom muaj nyob hauv tag nrho lub cev kua. Kev siv cov ntshav pub dawb yog qhov txaus ntshai rau cov neeg mob lub raum thiab lub plawv tsis ua haujlwm. Tsis zoo li cov tshuaj plasma hloov pauv, cov ntshav tuaj yeem hloov pauv yam tsis tau poob, suav nrog kev koom nrog pab pawg. Rau kev khaws cia thiab kev thauj mus los, cov xwm txheej tshwj xeeb yog xav tau, rau kev tsim cov khoom siv nyiaj ntau heev. Nws yog ib qho tsim nyog sau cia tias nws tsis tuaj yeem tsis lees txais cov ntshav kom txaus siab rau cov tshuaj hloov ntshav plasma.
