Yini i-Alteplase: Ukusetshenziswa, Umthamo, Imiphumela Eceleni nokuningi

I-Alteplase iyimithi enamandla, esindisa impilo esiza ukuncibilikisa amahlule egazi ayingozi emzimbeni wakho. Yilokho odokotela abakubiza ngokuthi umuthi othi "clot-buster" ongabuyisela ukuhamba kwegazi uma une-stroke noma ukuhlaselwa yinhliziyo. Lo muthi usebenza ngokulingisa iphrotheni yemvelo umzimba wakho oyenzayo ukuze uchithe amahlule, kodwa ukwenza ngokushesha nangempumelelo kakhulu kunomzimba wakho ongenza uwedwa.

Yini i-Alteplase?

I-Alteplase iyinguqulo eyenziwe ngofuzo yephrotheni ebizwa ngokuthi i-tissue plasminogen activator, noma i-tPA ngamafuphi. Cabanga ngayo njengokhiye okhethekile ovula futhi uchithe imicu ye-fibrin ebamba amahlule egazi ndawonye. Ngokungafani neminye imithi ongayithatha ekhaya, i-alteplase inikezwa kuphela nge-IV ezindaweni zasemtholampilo ngaphansi kokugadwa kwezokwelapha okuseduze.

Lo muthi ungowesigaba semithi ebizwa ngokuthi i-thrombolytics, okusho ngokoqobo ukuthi "ama-clot dissolvers." Okwenza i-alteplase isebenze ngempumelelo ukuthi yenzelwe ukugxila kuma-clots ngokuqondile, kunokuthinta yonke inqubo yakho yokujiya kwegazi. Noma kunjalo, isathathwa njengomuthi onengozi enkulu, onomvuzo omkhulu odinga ukuqashwa ngokucophelela.

Isetshenziselwani i-Alteplase?

I-Alteplase isetshenziswa ikakhulukazi ezimweni ezintathu ezisongela impilo lapho amahlule egazi evimba ukuhamba kwegazi okubalulekile. Ukusetshenziswa okuvame kakhulu kungokushaya unhlangothi okungathi sína, okwenzeka lapho i-clot ivimba ukuhamba kwegazi engxenyeni yobuchopho bakho. Isetshenziselwa futhi ukuhlaselwa yinhliziyo okubangelwa amahlule egazi emithanjeni ye-coronary, kanye nama-pulmonary embolisms amakhulu lapho amahlule evimba ukuhamba kwegazi emaphashini akho.

Iqembu lakho lezokwelapha lingase futhi lisebenzise i-alteplase ukuqeda ama-catheters avalekile noma imigqa ye-IV, nakuba lokhu kuhilela imithamo emincane kakhulu kunaleyo esetshenziselwa ukwelashwa kwesifo sohlangothi noma ukuhlaselwa yinhliziyo. Kwezinye izimo, odokotela bayayisebenzisela i-deep vein thrombosis noma ezinye izimo ezinzima zokujiya kwegazi, kodwa lezi zinto ezisetshenziswayo azivamile futhi zidinga izimo ezithile.

Isebenza Kanjani I-Alteplase?

I-Alteplase isebenza ngokwenza isistimu yakho yemvelo yokuncibilikisa igazi, kodwa ngesivinini esisheshayo nesihloswe ngaso. Uma uneqhubu legazi, lenziwa iphrotheni ebizwa ngokuthi i-fibrin esebenza njengentambo ebamba konke ndawonye. I-Alteplase iguqula into ebizwa ngokuthi i-plasminogen ibe yi-plasmin, ebe isiqeda intambo ye-fibrin.

Lokhu kuthathwa njengomuthi onamandla kakhulu ngoba usebenza ngokushesha nangamandla. Ngenkathi lawa mandla enza ukuthi isindise ukuphila ezimweni eziphuthumayo, futhi kusho ukuthi kunengozi enkulu yezinkinga zokopha. Umuthi uvame ukuqala ukusebenza ngemizuzu yokunikezwa kwawo, nemiphumela ephezulu yenzeka ngaphakathi kwehora lokuqala.

Kufanele Ngiyithathe Kanjani I-Alteplase?

Ngeke uzithathele wena i-alteplase - inikezwa kuphela ochwepheshe bezokwelapha abaqeqeshiwe ezindaweni zasemtholampilo ngomugqa we-IV. Umuthi uza njengempushana enakekeli noma odokotela abayixuba ngamanzi ahlanzekile ngaphambi nje kokukunika. Umthamo nesikhathi kuncike ngokuphelele esimweni sakho esithile nesisindo somzimba.

Ukwelashwa kwesifo sohlangothi, odokotela bavame ukunikeza i-alteplase phakathi kwamahora angu-3-4.5 ngemuva kokuqala kwezimpawu, nakuba ngezinye izikhathi inganikezwa kuze kube ngamahora angu-9 ezimweni ezikhethekile. Ukuhlaselwa yinhliziyo, iwindi livame ukuba ngaphakathi kwamahora angu-12. Akudingeki ukhathazeke ngokuyithatha nokudla noma amanzi ngoba iya ngqo egazini lakho.

Ngesikhathi sokwelashwa, uzoqashwa eduze ngokuhlolwa kwengcindezi yegazi njalo nokuhlolwa kwemizwa. Ithimba lezokwelapha lizobheka noma yiziphi izimpawu zokopha noma ezinye izinkinga kuyo yonke inqubo.

Kufanele Ngiyithathe Isikhathi Esingakanani I-Alteplase?

Ukwelashwa nge-Alteplase kuvamile ukuba yisenzakalo esisodwa kunokuba umuthi oqhubekayo. Ezimweni eziningi, uzothola umthamo ogcwele ngemizuzu engama-60-90 nge-IV yakho. Lapho ukufakwa sekuqediwe, umuthi uqhubeka usebenza emzimbeni wakho amahora amaningana njengoba umzimba wakho uwucubungula.

Imiphumela ye-alteplase ngokuvamile ibaluleke kakhulu emahoreni ambalwa okuqala ngemuva kokunikezwa. Ithimba lakho lezokwelapha lizoqhubeka likuqapha okungenani amahora angama-24 ngemuva kokwelashwa ukuze libheke noma yimiphi imiphumela elibazise noma izinkinga, ikakhulukazi ukopha.

Ziyini Imiphumela Eceleni Ye-Alteplase?

Umphumela oceleni onzima kakhulu we-alteplase ukopha, okungahluka kusuka kokuncane kuya ekuphileleni impilo. Lokhu kwenzeka ngoba umuthi uthinta ikhono legazi lakho lokujiya, hhayi nje endaweni yenkinga kodwa emzimbeni wakho wonke. Ukuqonda lezi zingozi kukusiza ukuthi wazi ukuthi yini ongayilindela nokuthi nini okufanele uxwayise ithimba lakho lezokwelapha.

Imiphumela ejwayelekile ongase uyithole ihlanganisa:

• Ukulimala endaweni ye-IV noma izindawo zokujova
• Ukuphuma igazi okuncane emicutshweni noma emihuzukweni
• Isicanucanu noma isisu esincane esicasukile
• Umkhuhlane olinganiselwe
• Ikhanda elibuhlungu

Le miphumela ejwayelekile ivamise ukulawuleka futhi ibe yesikhashana, inyamalale ngosuku olulodwa noma ezimbili zokwelashwa.

Imiphumela emibi kakhulu idinga ukunakekelwa kwezokwelapha ngokushesha futhi ihlanganisa:

• Ukuphuma igazi ngaphakathi esiswini, ebuchosheni, noma kwamanye amalunga omzimba
• Ukuphuma igazi okukhulu okungami
• Izimpawu zokuphuma igazi ebuchosheni njengekhanda elibuhlungu elingazelelwe, ukudideka, noma izinguquko embonweni
• Ukuphendula komzimba ngaphandle kokuphefumula noma ukuvuvukala
• Ukwehla okungazelelwe kwengcindezi yegazi

Izinkinga ezingavamile kodwa ezinzima zingabandakanya ukushaywa unhlangothi okubangelwa ukuphuma kwegazi ebuchosheni, okwenzeka cishe kuma-3-7% eziguli eziphathwa ukushaywa unhlangothi. Eminye imiphumela engavamile ihlanganisa ukusabela okukhulu komzimba, izinkinga zesigqi senhliziyo, noma ukuphuma kwegazi ezindaweni ezingavamile njengamehlo noma amalunga.

Ubani Ongafanele Athathe I-Alteplase?

Izimo eziningana zenza i-alteplase ibe yingozi kakhulu ukuyisebenzisa, ngisho nasezimweni eziphuthumayo. Ithimba lakho lezokwelapha lizobuyekeza ngokushesha umlando wakho wezokwelapha nesimo sakho samanje ukuze linqume ukuthi i-alteplase iphephile yini kuwe. Lesi sinqumo sivame ukubandakanya ukulinganisa ingozi esongela impilo ngokushesha ngokumelene nethuba lokuba nezinkinga ezinzima zokuphuma kwegazi.

Akufanele uthole i-alteplase uma:

• Ukuphuma kwegazi okusebenzayo ngaphakathi noma ukuhlinzwa okukhulu kwamuva emavikini ama-2
• Umlando wokuphuma kwegazi ebuchosheni noma i-aneurysm yobuchopho eyaziwayo
• Umfutho wegazi ophezulu ongagxiliwe (ngaphezu kwe-180/110)
• Ukwelashwa kwamuva ekhanda noma ukuhlinzwa kobuchopho kungakapheli izinyanga ezi-3
• Ukusetshenziswa kwamanje kwama-blood thinners afana ne-warfarin ngezikhathi zokuqina kwegazi eziphakeme

Ezinye izinto okufanele zicatshangelwe ezingenza i-alteplase ingafaneleki zihlanganisa ukuzala kwamuva, izinhlobo ezithile zomdlavuza, isifo sesibindi esibi, noma umlando wezifo zokuphuma kwegazi. Ithimba lakho lezokwelapha lizobuye licabange ngeminyaka yakho, impilo yonke, kanye nezimo ezithile zesimo sakho.

Amagama Omkhiqizo we-Alteplase

I-Alteplase yaziwa kakhulu ngegama lomkhiqizo elithi Activase e-United States. Kwamanye amazwe, ungase uyizwe ibizwa ngokuthi Actilyse. Le yimithi efanayo - i-recombinant tissue plasminogen activator - imakethwa ngaphansi kwamagama ahlukene ngumenzi ofanayo.

Kungakhathaliseki igama lomkhiqizo, zonke izinhlobo ze-alteplase zisebenza ngendlela efanayo futhi zinezinto ezifanayo nemiphumela nezingozi. Umuthi ukhiqizwa yi-Genentech futhi uyatholakala ezibhedlela emhlabeni wonke ngaphansi kwala magama ahlukene omkhiqizo.

Ezinye izindlela ze-Alteplase

Eminye imithi eminingi yokuncibilikisa amahlule ngezinye izikhathi ingasetshenziswa esikhundleni se-alteplase, nakuba ukukhetha kuncike esimweni sakho esithile kanye nezimo. Lezi ezinye izindlela zihlanganisa i-tenecteplase (TNKase), i-reteplase (Retavase), kanye ne-streptokinase, ngalinye linempahla ehlukile kanye nokusetshenziswa.

Ezimweni ezithile, izinqubo zokususwa kwegazi ngomshini zingase zibe ezinye izindlela zokwelashwa okusekelwe emithini. Lokhu kuhilela ukufaka idivayisi ngemithanjeni yakho yegazi ukuze ususe ngokoqobo noma uchithe ihlule. Ithimba lakho lezokwelapha lingase futhi licabange ezinye izinciphisi zegazi noma imithi yokuvimbela amahlule, nakuba lezi zisebenza ngendlela ehlukile futhi kancane kune-alteplase.

Ukukhethwa kokwelashwa kuncike ezintweni ezifana nesikhathi, indawo yehlule, impilo yakho yonke, nokuthi yini etholakala ngokushesha esibhedlela sakho. Ezimweni eziningi, i-alteplase isahlala iyindlela yokwelashwa yokuqala ekhethwayo ezigulini ezifanelekayo.

Ingabe i-Alteplase Ingcono Kune-Tenecteplase?

Kokubili i-alteplase ne-tenecteplase ziyimithi esebenzayo yokuncibilikisa amahlule, kodwa zinezinye izinto ezibalulekile eziwahlukanisayo. I-Tenecteplase inganikezwa njengesitsha esisodwa esikhundleni sokufakwa okuqhubekayo, okwenza kube lula ukuyiphatha. Ezinye izifundo zikhomba ukuthi i-tenecteplase ingase isebenze kancane ezinhlotsheni ezithile zokushaywa unhlangothi futhi ingase ibe nengozi ephansi yezinkinga zokopha.

Nokho, i-alteplase isetshenziswe isikhathi eside futhi inophenyo oluningi olusekela ukusetshenziswa kwayo ezimweni ezihlukene. Izibhedlela eziningi zijwayelene nemithetho ye-alteplase, futhi isahlala iyindlela yokwelashwa ejwayelekile eminyangweni eminingi yezimo eziphuthumayo. Ukukhetha phakathi kwazo kuvame ukuncika esimweni sakho esithile, imithetho yesibhedlela, kanye nolwazi lukadokotela wakho.

Ucwaningo lwakamuva luphakamisa ukuthi ezigulini eziningi, i-tenecteplase ingase iba yindlela ekhethwayo, kodwa yomibili imithi ingasindisa impilo uma isetshenziswa ngendlela efanele. Ithimba lakho lezokwelapha lizokhetha inketho engcono kakhulu ngokusekelwe ezimweni zakho kanye nalokho okutholakala endaweni yakho yokwelapha.

Imibuzo Evame Ukubuzwa Mayelana ne-Alteplase

Ingabe i-Alteplase iphephile kubantu abanesifo sikashukela?

Yebo, ukuba nesifo sikashukela akukuvimbeli ngokuzenzakalelayo ukuthi uthole i-alteplase, kodwa kudinga ukucatshangelwa okwengeziwe. Abantu abanesifo sikashukela bangase babe nezici ezengeziwe eziyingozi njengomfutho wegazi ophezulu noma izinkinga zezinso ezingathinta ingozi yokuphuma igazi. Ithimba lakho lezokwelapha lizohlola ngokucophelela impilo yakho yonke, ukulawulwa kukashukela wegazi, kanye nanoma yiziphi izinkinga ezihlobene nesifo sikashukela ngaphambi kokunquma ukwelashwa.

Uma une-diabetic retinopathy (izinkinga zamehlo ezivela esifweni sikashukela), lokhu kungase kwandise ingozi yakho yokuphuma igazi emehlweni. Odokotela bakho bazohlola lezi zingozi ngokumelene nosongo oluqondile oluvela egazini lakho ukuze benze isinqumo esingcono kakhulu esimweni sakho.

Ngingenzani uma ngithola i-Alteplase eningi ngengozi?

Njengoba i-alteplase inikezwa kuphela ochwepheshe bezokwelapha ezindaweni zasemtholampilo, ngeke uthathe eningi ngengozi wedwa. Kodwa-ke, uma kukhona iphutha lemithi, ithimba lakho lezokwelapha liqeqeshwe ukuthi lisabele ngokushesha. Bazoyeka ukufakwa, bakuqaphele eduze ukuze bathole izimpawu zokuphuma igazi, futhi bangase banikeze imithi ukusiza igazi lakho ukuthi ligqame ngokujwayelekile futhi.

Isibhedlela cishe sizokugcina ngaphansi kokubhekwa eduze okungenani amahora angama-24, sihlola umsebenzi wakho wegazi njalo futhi sibheke noma yiziphi izimpawu zokuphuma igazi ngaphakathi. Ezimweni ezinzima, bangase badinge ukukunikeza imikhiqizo yegazi noma eminye imithi ukuze iguqule imiphumela.

Ngingenzani uma ngiphuthelwa umthamo we-Alteplase?

Lo mbuzo awusebenzi ngempela ku-alteplase ngoba akuyona imithi oyithatha njalo ekhaya. I-Alteplase inikezwa njengokwelashwa okuyisimo esiphuthumayo esisodwa esibhedlela. Uma usitholile umthamo ophelele, ukwelashwa kuqediwe, futhi ngeke udinge eminye imithamo.

Uma ngasizathu simbe ukumnika kwakho i-alteplase kuphazamiseka ngesikhathi sokwelashwa, ithimba lakho lezokwelapha lizinquma ukuthi kuphephile yini ukuqala kabusha noma ngabe kudingeka ezinye izindlela zokwelapha. Lesi sinqumo sincike ekutheni usuvele uthole malini nesimo sakho samanje.

Ngingayeka nini ukuthatha i-Alteplase?

Awuyeki ukuthatha i-alteplase ngomqondo wendabuko ngoba ukwelashwa okukodwa okunikezwa ngemizuzu engama-60-90. Uma ukumnika kuqediwe, umuthi uyahamba kancane emzimbeni wakho emahoreni ambalwa alandelayo. Ithimba lakho lezokwelapha linquma ukuthi ukwelashwa kuqediwe nini ngokusekelwe kumthamo obekiwe nokuphendula kwakho.

Ezimweni ezingavamile, odokotela bangase badinge ukuyeka ukumnika i-alteplase ngaphambi kwesikhathi uma uba nezinkinga ezinkulu zokuphuma kwegazi noma ukusabela komzimba. Lesi sinqumo senziwa njalo yithimba lakho lezokwelapha ngokusekelwe ekuphepheni kwakho ngokushesha nokuphendula ekwelashweni.

Ngingayithatha imithi yokunciphisa igazi ngemva kokwelashwa nge-Alteplase?

Ukuthi ungayithatha yini imithi yokunciphisa igazi ngemva kwe-alteplase kuncike esimweni sakho esithile nokuthi uphendule kahle kangakanani ekwelashweni. Ithimba lakho lezokwelapha ngokuvamile lizolinda okungenani amahora angama-24 ngemva kwe-alteplase ngaphambi kokuqala noma yimiphi imithi yokunciphisa igazi ukunciphisa ingozi yezinkinga zokuphuma kwegazi.

Iziguli eziningi ziqhubeka nokuthatha imithi yokunciphisa igazi efana ne-aspirin, i-clopidogrel, noma i-warfarin ukuvimbela amahlule esikhathi esizayo, kodwa isikhathi nokukhethwa komuthi kuncike esimweni sakho ngasinye. Odokotela bakho bazolinganisela ngokucophelela isidingo sokuvimbela amahlule amasha ngokumelene nengozi eqhubekayo yokuphuma kwegazi evela ekwelashweni kwe-alteplase.