Zowonjezera chitsulo pa hemoglobin otsika akuluakulu: a review, malangizo ntchito ndi mayankho

Kusowa kwa ayironi mu thupi la munthuyo mavuto ambiri. mankhwala amakono ndi hemoglobin otsika kudzakuthandizani lembani chinthu chofunika m'matangadza.

magazi m'thupi Kodi

chikhalidwe ichi amakhala ndi pamlingo wochepa wa nyumba hemoglobin. Osauka magazi, imene mpweya okwanira kuti zimakhala chatsitsa maselo. Pali mankhwala kuwonjezera hemoglobin m'thupi la munthu.

Pali mitundu yambiri ya zinthu magazi ochepa amene kulibe zomanga thupi, mankhwala chitsulo kapena cyanocobalamin.
Mawonekedwe ambiri akusowa chitsulo magazi m'thupi imatengedwa, chifukwa mismatch mu ankafuna ndi kulandira Fe-ayoni.

Pali magulu awiri a matenda:

1. Zobisika kusowa kwa ayironi imene yafupika hemoglobin ndi woipa ferritin, ndi okhutira transferrin, ndi zizindikiro matenda a akusowa Fe.
2. Kwenikweni zinthu magazi ochepa ndi makhalidwe zoonekeratu kuchepa zitsulo za ziwalo, pamene pali siudzalandilidwa ngathi lamulo mapangidwe himogulobini.

Mtengo wa chitsulo m'thupi

M'pofunika kuti anthu amafotokozera. 70% ya thunthu zili m'gulu hemoglobin lapansi. ziwalo sangathe lithe ayoni zachitsulo, zimakambidwa okha ndi chakudya.

Hemoglobin mapuloteni chimamanga okosijeni mu maselo erythrocytic.

Osakwanira zili chitsulo amachititsa mpweya njala. Kuchepetsa anali adatchithisira hemoglobin mankhwala ndi mankhwala, kuti muli Fe-ayoni.

Kapangidwe ka hemoglobin

Kapangidwe ka Mankhwala lili anayi heme munali mapuloteni subunits. Protomers kumachitika pakati pawiri hydrophobic, amaayoni, haidrojeni-mtundu tsiku wowonjezera.

The zikuchokera heme pano divalent zitsulo ion, amene kuwonjezekeredwa mu gulu apulasitiki.

Zizindikiro za kuchepa magazi

zowonjezera chitsulo pa hemoglobin otsika akuluakulu yoikidwiratu hypotension, pallor akugona mitsempha, kufooka, tulo, chizungulire, utachepa ntchito, palpitations, kupuma movutikira.

chifukwa kumwa mankhwala ndi kusintha mu khungu ndi dryness kwambiri, ukuchoka. The mbale msomali amakhala striated ndi Chimaona, ndi tsitsi si mphamvu zokwanira, ndi imfa awo ndi gawo. Iron akusowa tingaone ndi mawonekedwe kupotozedwa zokonda kukoma.

Mu maphunziro choyezera, m'munsi malire mwazi wa hemoglobin yachibadwa kuti magalamu 130 pa lita kwa thupi mwamuna, ndi magalamu 120 pa lita kwa mkazi.

Kuwala magazi ochepa digiri ya HB ndi mtengo umene uli magalamu kuposa 90 pa lita koma magalamu zosakwana 110 pa lita, ndi zolimbitsa adzatero HB index wa magalamu 70 90 pa lita, ndi aakulu msinkhu HB zosakwana magalamu 70 pa lita.

Zimaonetsa wosankhidwa wa mankhwala

Kuthetsa magazi ochepa akusowa chitsulo dokotala amasankha mankhwala kuwonjezera hemoglobin, potengera makhalidwe a kagayidwe wa ayoni chitsulo kuloŵerera makhalidwe, zikuchokera ndi mawonekedwe a mlingo.

Icho chinakhazikitsidwa kuti akuluakulu a intramuscularly mankhwala amapereka zotsatira zoipa kwambiri kuposa pamene pakamwa kutumikiridwa mitundu piritsi. Zimenezi zalongosoledwa mwa kuloŵerera wa ayoni zitsulo, limene limayamba m'matumbo. Mu njira woyamba, utsogoleli amapezeka zochita zambiri osafunika.

Kukonzekera chitsulo ndi hemoglobin otsika akuluakulu ayenera amapanga zili akadakwanitsira wa amafotokozera mu maonekedwe ake angwiro, amene ranges ku 80 160 mg. Zoterezi kuchuluka lofanana 320 mg wa sulphate, ndi okwanira kubala kufunika kwenikweni achire. The kupatuka pa mlingo anasankha kapena discontinuation mankhwala adzachititsa zotsatira osafunika.

Mkhalidwe zofunika mankhwala oyenera ndi kugwilizana umphumphu wa piritsi pa phwando. Si fodya ameneyu amatafunidwa, ndi kumeza pomwepo ndi madzi. Bwinobwino madzi chitsulo mankhwala otsika piritsi mawonekedwe a dzuwa.

Zovuta vitamini ndi mchere kukonzekera sangathe zoperewerazo kwathunthu kwa chosowa amafotokozera mu thupi chifukwa wokhutira otsika.

Otetezeka amaonedwa encapsulated ndi TACHIMATA mankhwala ndi chitsulo kuonjezera hemoglobin. Chotero mawonekedwe kumathandiza mucosal epithelium wa kapepalako m'mimba Mavuto mankhwala.

Mankhwala a magazi m'thupi

Malinga mtundu wa magazi m'thupi ntchito mankhwala osiyanasiyana. Izi zikhoza kukhala njira kupanga chitsulo kapena vitamini mankhwala mu mawonekedwe a cyanocobalamin, kupatsidwa folic acid ascorbic, alpha-tokoferrola, riboflavin kapena pyridoxine.

Pamene aplastic matenda mawonekedwe ntchito mankhwala glucocorticosteroid, medicaments zochokera anabolic mankhwala, androgens, cytostatics.
Mankhwala ndi erythropoietin Cholinga chake kukondoweza kwa hematopoiesis ndi kuwonjezeka hemoglobin.

Iron zipangizo

Amapezeka kawirikawiri amagwiritsidwa ntchito pofuna kuchiza boma magazi ochepa. Kwa gulu ili zikuphatikizapo kukonzekera chitsulo kusintha otsika hemoglobin. Kawirikawiri saline mankhwala omwe bwino chosakanikirana khoma matumbo kwa kukhazikitsidwa wotsatira mu kapangidwe ka heme. Mapangidwe hemoglobin amachititsa kusintha zoyendera oxygen.

Pali mankhwala ndi atatu kapena akakhala chitsulo. Kusintha kupezeka kwa woyamba mawonekedwe kwa amino pawiri anafunika kulola Fe ²⁺ ayoni ali kusamutsidwa kwa m'mafupa. mayamwidwe chitsulo ndi valence II kumatheka mchikakamizo cha ascorbic asidi amene amathandiza ion kutengerapo ndi kukhazikitsidwa mu kapangidwe ka heme ndi.

Kuyambira mfundo zokhudza thupi la view, kukonzekera piritsi zambiri yochezera. Dongosolo Parenteral wa mankhwala ntchito chiwalo machulukitsidwe kudya pamene pali matumbo kudwala ndi mankhwala palibe kusintha kwa mitundu olimba.

Mkulu Mlingo wa mankhwala ntchito yopanga mfundo yachibadwa hemoglobin, kenako kukatenga yokonza mlingo. Yafupika kuchuluka kwa mankhwala ikuchitika kupewa magazi m'thupi.

Mankhwala ndi divalent chitsulo

Anthu ndi magazi m'thupi amakonda kufunsa dokotala funso lokhudza zimene kuonjezera hemoglobin m'magazi. Kukonzekera ndi sulfates ndi mavitamini. Recent zimathandiza patsogolo mayamwidwe ndi kupezeka.

Ambiri ntchito mankhwala "Sorbifer Durules", mu kapangidwe kake panopa chitsulo akakhala akumwa ndi C-vitamini.

njira inanso zofanana "Tardiferron" miyala imene ascorbic asidi m'malo kupatsidwa folic. Kumwa mankhwala mmawa ndi madzulo, Mphindi 30 musanadye. Mapiritsi tiyenera kutsukidwa pansi ndi 200 ml ya madzi.

Kudzera formulations kapisozi monga:

• "Ferrofolgamma" ndi divalent chitsulo sulphate cyanocobalamin, vitamini C.
• "Ferretab" ndi fumarate ndi folic acid.
• "Fenyuls" ndi FeSO _4, B9, B5, C, B2 , B6 mavitamini.

Medicament "Aktiferrin" mu mawonekedwe a makapisozi, madontho a madzi azichitira magazi m'thupi ana.

Yotchipa mankhwala kuonjezera hemoglobin "Hematogen" mu kapangidwe kake ali albumin mapuloteni ndi FeSO _4.

"Totem" mankhwala mu njira okhala chitsulo (II) gluconate, mkuwa, manganese.

The dragees "Prolongatum gemofer" Fe sulphate pano.

Mankhwala ndi chitsulo ferric

Zikuphatikizapo mankhwala kuonjezera hemoglobin m'magazi. Mwachidule mankhwala gulu kudziwa mlingo mawonekedwe ndi mbali ya yogwira zosakaniza ndalama chifukwa kwa magazi m'thupi.

The medicaments ndi zitsulo yogwira ndi ferric chitsulo ndi ino monga polimaltozata hydroxide. Choncho zikuchokera ali:

• mankhwala "Maltofer" omwe amapangidwa mu mawonekedwe a madzi ndi, jakisoni, ndi miyala.
• mankhwala "Fenyuls", kupanga madontho madzi.
• amatanthauza "Ferrum lek" - mapiritsi kapena amadzi otsekemera, ndi njira m'jekeseni.

The medicament "Biofer" polimaltozata hydroxide Komanso, lili folic acid. Alembedwe piritsi.

Mu kapangidwe ka mankhwala "Ferlatum" yogwira pophika njira ndi succinate mapuloteni.

Intramuscularly kutumikiridwa kukonzekera chitsulo ndi hemoglobin otsika akuluakulu, ngati pali zizindikiro. Iwo yodziwika ndi wotsikirapo mayamwidwe ayoni chitsulo thirakiti m'mimba mwa pathologies zosiyanasiyana aakulu mu mawonekedwe a enteritis, kapamba aakulu, ndi osakwanira kuloŵerera syndrome.

mankhwala Parenteral ayenera idzachitika pa aggravation zilonda mu duodenum kapena m'mimba, anam'peza matenda a m'matumbo, hypersensitivity munthuyo mankhwala ndi chitsulo, kuchotsa mbali ya m'mimba kapena intestine yaing'ono.

Pakuti mofulumira machulukitsidwe zitsulo thupi minofu pa imfa lalikulu mwazi, lisanadze ntchito chikugwirizana ndi zotupa, chithandizo fibromioticheskih formations ndi pathologies zina, anaika kumayambiriro mankhwala mu minofu. Kuchuluka kwa chitsulo mankhwala omwe ntchito mankhwala jekeseni, sayenera upambana 100 mg pa tsiku. Ndi wokwanira kwathunthu kukhutitsa transferrin tinthu malinga zitsulo.
Mu mawonekedwe a njira m'jekeseni, mankhwala kumasulidwa "Venofer", "Argeferr", "Likferr", "Kosmofer".

zosiyanasiyana chokhwima mankhwalawa

Kukonzekera chitsulo ndi hemoglobin otsika akuluakulu imfayo mavuto omwe amayamba ndi tilinazo wodwala aliyense ndi mawonekedwe a medicament lapansi.

Zida zina zingachititse mitundu yonse ya njira, chikhalidwe matupi awo sagwirizana chifukwa cha tsankho la pophika yogwira.

The mucosa cha ziwalo m'mimba dongosolo ndi mtima zotsatira wothandizila okhala chitsulo koma si ataphimbidwa ndi m'chimake zozitetezera. Nkhani imeneyi, mumakhala ndi zizindikiro za ululu m'dera epigastric, komanso vuto kutaya m'matumbo.

Kulandira piritsi ndi kukonzekera madzi chifukwa asiyane pa mano enamel.

Mtsempha njira ya ntchito njira amakwiya boma thrombophlebitis, mmene zotengera chofuna m'dera la jekeseni.

Zotsatira za chithandizocho

zowonjezera chitsulo pa hemoglobin otsika akuluakulu anayamba kukhala gwero masabata atatu okha atalandira mankhwala, imene pali kuyambiranso yaing'ono HB. Mphamvu ya pharmacotherapeutic zotsatira za mankhwala imatengedwa zabwino pamene yachibadwa hemoglobin mfundo kwa masiku 60. Pambuyo mlingo kusintha mankhwala yokonza.

Mankhwalawa akusowa chitsulo odwala magazi m'thupi ndi kutumikiridwa mu kufanana ndi mankhwala kudya zakudya zomera, timadziti, amene alipo zambiri zinthu vitamini. Pakuti ayambe thupi ayenera kuchita mapuloteni ndi mkaka ndi nyama.

Chinthu chofunika kwambiri - mankhwala a kusankha zochizira magazi ayenera kulimbana ndi dokotala amachitira. Self sudzapereka ndi patsogolo zofunika, koma adzachititsa zochita osafunika kuti kukulitsa matenda.