Yini iNesiritide: Ukusetshenziswa, Umthamo, Imiphumela Eceleni nokuningi

INesiritide iyinguqulo yokwenziwa yehomoni yemvelo ekhiqizwa yinhliziyo yakho ebizwa nge-B-type natriuretic peptide (BNP). Lo muthi usiza inhliziyo yakho ukuba ipompe ngempumelelo futhi unciphisa ukucindezela ohlelweni lwakho lwe-cardiovascular uma uhlangabezana nokuhluleka kwenhliziyo okukhulu.

Udokotela wakho angase ancome i-nesiritide lapho inhliziyo yakho idinga ukwesekwa ngokushesha ngesikhathi sokulaliswa esibhedlela. Yenzelwe ngokuqondile ukusiza umzimba wakho ukuba ulawule ukwakheka koketshezi futhi uthuthukise ukuhamba kwegazi lapho ezinye izindlela zokwelapha zinganikezi ukukhululeka okwanele.

Yini iNesiritide Esetshenziselwa Yona?

I-Nesiritide iphatha ukuhluleka kwenhliziyo okubangelwa ngokushesha, okusho ukuthi inhliziyo yakho ngokuphazima kweso ayikwazi ukumpompa igazi ngempumelelo. Lokhu kuvamile ukwenzeka lapho ukuhluleka kwenhliziyo okungamahlalakhona kuba kubi ngokushesha, okuvame ukudinga ukunakekelwa esibhedlela ngokushesha.

Ngesikhathi seziqephu zokuhluleka kwenhliziyo, umzimba wakho ugcina uketshezi oluningi kakhulu, okwenza kube nzima ukuthi inhliziyo yakho isebenze kahle. I-Nesiritide isiza ngokuphumuza imithambo yegazi futhi ikhuthaze izinso zakho ukuba zikhiphe uketshezi oluningi ngomchamo. Lesi senzo esiphindwe kabili sinciphisa umsebenzi wenhliziyo yakho elwela.

Ithimba lakho lezokwelapha lizosebenzisa lo muthi kuphela ezindaweni zesibhedlela lapho lingaqapha eduze ukusebenza kwenhliziyo yakho nomfutho wegazi. Akuyona into ongayithatha ekhaya, njengoba idinga ukugadwa ngokucophelela kwezokwelapha ngaso sonke isikhathi sokwelashwa.

Isebenza Kanjani iNesiritide?

I-Nesiritide isebenza ngokulingisa ihomoni inhliziyo yakho eyikhiqiza ngokwemvelo uma ingaphansi kwengcindezi. Lapho inhliziyo yakho ilwela, ikhipha i-BNP ukusiza ukuzivikela, kodwa ngezinye izikhathi ayikhiqizi okwanele ngesikhathi seziqephu ezinzima.

Umuthi usebenza kuma-receptors athile emithanjeni yakho yegazi, uwenze aphumule futhi ande. Lokhu kwenza kube lula ukuthi inhliziyo yakho ipompe igazi emzimbeni wakho wonke. Ngesikhathi esifanayo, uthumela izimpawu ezinso zakho ukuthi zikhiphe usawoti namanzi amaningi, okunciphisa ukugcwala kwamanzi okucindezela inhliziyo yakho.

Cabanga ngakho njengokunikeza inhliziyo yakho usizo ngezikhathi zayo ezinzima kakhulu. Umuthi uthathwa njengomuthi onamandla ngokulinganisela futhi usebenza ngokushesha, yingakho ochwepheshe bezokwelapha bewusebenzisela izimo eziphuthumayo kunokuthi bawusebenzise ekwelapheni inhliziyo isikhathi eside.

Kufanele Ngiyithathe Kanjani I-Nesiritide?

Ngeke uzithathele wena i-nesiritide ngoba inikezwa kuphela ngomugqa we-intravenous (IV) endaweni yasesibhedlela. Ithimba lakho lezempilo lizofaka ishubhu elincane emthanjeni, ngokuvamile engalweni yakho, futhi linikeze umuthi ngqo emsingeni wakho wegazi.

Ukwelashwa ngokuvamile kuqala ngomthamo omncane wokuqala olandelwa ukumnika okuqhubekayo okungathatha amahora angu-24 kuya kwangu-48 noma ngaphezulu, kuye ngokuthi inhliziyo yakho isabela kanjani. Ithimba lakho lezokwelapha lizolungisa umthamo ngokusekelwe ekucindezelweni kwegazi lakho, izinga lokushaya kwenhliziyo, nokuthi izinso zakho zisebenza kahle kangakanani.

Akudingeki ukhathazeke ngokuhlela ukudla noma ukuthatha eminye imithi nge-nesiritide ngoba idlula ngqo ohlelweni lwakho lokugaya ukudla. Kodwa-ke, abahlinzeki bakho bezempilo bazoyihlela ngokucophelela nanoma iyiphi eminye imithi yenhliziyo oyitholayo ukuze baqinisekise ukuthi konke kusebenza ngokuphepha.

Kufanele Ngiyithathe Isikhathi Esingakanani I-Nesiritide?

Abantu abaningi bathola i-nesiritide isikhathi esifushane, ngokuvamile amahora angu-24 kuya kwangu-48 ngesikhathi sokuhlala kwabo esibhedlela. Ubude obuqondile buxhomeke ekutheni izimpawu zakho zokuhluleka kwenhliziyo zithuthuka ngokushesha kangakanani nokuthi umzimba wakho usabela kanjani ekwelashweni.

Iqembu lakho lezokwelapha lizoqhubeka nokubheka isimo sakho futhi lehlise imithi kancane kancane njengoba umsebenzi wenhliziyo yakho uzinzile. Bazobheka izimpawu zokuthi amazinga akho oketshezi aya ngcono, ukuphefumula kwakho kulula, futhi inhliziyo yakho iphampa ngempumelelo ngaphambi kokuyeka ukufakwa.

Uma usuzinzile, odokotela bakho cishe bazokushintshela emithini yomlomo yokuhluleka kwenhliziyo ongayithatha ekhaya. I-Nesiritide yenzelwe ngqo njengokwelashwa kwesikhashana ukukusiza ukuthi udlule enkingeni ebukhali, hhayi njengesu lokwelashwa lesikhathi eside.

Yiziphi Imiphumela Eceleni ye-Nesiritide?

Umphumela ovamile ongase uwuthole ukwehla kwengcindezi yegazi, okungakwenza uzizwe unesiyezi noma ukhathele. Lokhu kwenzeka ngoba imithi iphumuza imithambo yakho yegazi, futhi ngezinye izikhathi ingcindezi yakho yegazi ingehla ngaphezu kwalokho obekuhloswe.

Nansi imiphumela eseceleni iqembu lakho lezokwelapha elizoyibheka ngokucophelela ngesikhathi sokwelashwa kwakho:

• Ukwehla kwengcindezi yegazi (hypotension) - kungase kubangele isiyezi noma ukuzizwa uphelelwa amandla
• Ikhanda - ngokuvamile liba lula noma libe phakathi nendawo
• Isicanucanu - singase size futhi sihambe ngesikhathi sokwelashwa
• Ubuhlungu emhlane - ngokuvamile besikhashana
• Isiyezi - ikakhulukazi uma ushintsha izikhundla
• Ukukhathazeka noma ukungazinzi - kungase kwenzeke njengoba umzimba wakho uzivumela

Iqembu lakho lezempilo liqapha le miphumela ngokucophelela futhi lingashintsha umthamo wakho uma kudingeka. Imiphumela eminingi eseceleni iyaphathwa futhi iyathuthuka njengoba umsebenzi wenhliziyo yakho uzinzile.

Ngokuvamile, abanye abantu bangase babe nemiphumela engathi sína edinga ukunakwa ngokushesha:

• Ukwehla okukhulu kwengcindezi yegazi okudinga ukulungiswa kwemithi
• Ukushaya kwenhliziyo okungajwayelekile noma izinguquko zesigqi senhliziyo
• Ushintsho lomsebenzi wezinso - oluqashwe ngezivivinyo zegazi
• Ukuphendula komzimba ngendlela engavamile - akuvamile kodwa kungenzeka nganoma iyiphi imithi

Isibhedlela siqinisekisa ukuthi noma yiziphi izimpawu ezikhathazayo zibanjwa futhi zixazululwe ngokushesha, zikunikeza ulwazi lokwelashwa oluphephe kunalo lonke.

Ubani Ongafanele Athole I-Nesiritide?

I-Nesiritide ayifanele wonke umuntu onezinkinga zenhliziyo. Odokotela bakho bazobuyekeza ngokucophelela umlando wakho wezokwelapha kanye nesimo sakho samanje ngaphambi kokunquma ukuthi lokhu kwelashwa kulungile yini kuwe.

Akufanele uthole i-nesiritide uma unezimo ezithile zenhliziyo ezingenza ukwelashwa kube yingozi:

• I-Cardiogenic shock - lapho inhliziyo yakho ingakwazi ukumpompa igazi elanele ezingxenyeni ezibalulekile zomzimba
• Umfutho wegazi ophansi kakhulu ongazange uphendule ekwelashweni okuhlukile
• Izimo zenhliziyo ezivinjelayo noma ezivimbayo ezithinta ukugeleza kwegazi
• Ukungezwani okwaziwayo ne-nesiritide noma imithi efanayo

Ithimba lakho lezokwelapha lizosebenzisa ukuqapha okwengeziwe uma unezinkinga zezinso, njengoba imithi ithinta indlela izinso zakho ezicubungula ngayo uketshezi. Bazoqapha ukusebenza kwezinso zakho ngokucophelela ngesikhathi sokwelashwa ukuze baqinisekise ukuthi kuhlala kuphephile kuwe.

Ukukhulelwa nokuncelisa ngamabele kudinga ukucatshangelwa okukhethekile, nakuba ukuhluleka kwenhliziyo ngesikhathi sokukhulelwa kuyisimo esibucayi esingase sidinge lokhu kwelashwa naphezu kokungaziwa. Odokotela bakho bazohlola izingozi nezinzuzo ngokucophelela uma ukhulelwe noma uncelisa.

Amagama Omkhiqizo we-Nesiritide

I-Nesiritide ivame ukwaziwa ngegama layo lomkhiqizo elithi Natrecor e-United States. Lena yinguqulo ongase uhlangane nayo ezibhedlela, njengoba iyona fomula eyinhloko etholakalayo yokusetshenziswa emithini.

Umuthi ungase ubhekiselwe ngegama lawo elivamile (nesiritide) noma igama lomkhiqizo (Natrecor) emarekhodini akho ezokwelapha kanye nemibhalo yokukhishwa. Womabili amagama abhekisela emuthini ofanayo, ngakho-ke ungadideki uma ubona amagama ahlukene esetshenziswa ngamalungu ahlukene eqembu lakho lokunakekelwa kwezempilo.

Ngokungafani nemithi eminingi enezinhlobo eziningi zemikhiqizo, i-nesiritide inezinhlobo ezilinganiselwe zemikhiqizo ngoba iyimithi ekhethekile esetshenziswa esibhedlela kunokuba ibe yimithi ejwayelekile ekhishwa ngaphandle.

Ezinye Izindlela Zokwelapha Nge-Nesiritide

Eminye imithi eminingi ingelapha ukuhluleka kwenhliziyo okungazelelwe, nakuba ngamunye esebenza ngendlela ehlukile futhi kungase kufaneleke kakhulu kuye ngesimo sakho esithile. Odokotela bakho bakhetha ngokusekelwe ekusebenzeni kwenhliziyo yakho, umfutho wegazi, kanye nempilo yezinso zakho.

Nazi ezinye izindlela eziyinhloko ithimba lakho lezokwelapha elingazicabangela:

• I-Dobutamine - iqinisa ukushaya kwenhliziyo kodwa ingase ikhulise izinga lokushaya kwenhliziyo
• I-Milrinone - ithuthukisa ukumpompa kwenhliziyo futhi iphumulele imithambo yegazi
• I-Furosemide (Lasix) - isusa uketshezi oluningi ngokwandisa ukuchama
• I-Nitroglycerin - iphumulele imithambo yegazi ukunciphisa umsebenzi wenhliziyo
• I-Dopamine - isekela umfutho wegazi nokusebenza kwenhliziyo

Ngamunye wale mithi unamandla ahlukene kanye nezinto okufanele zicatshangelwe. Ezinye zisebenza kangcono kubantu abanomfutho wegazi ophansi, kanti ezinye zithandwa uma ukusebenza kwezinso kuyinkinga. Ithimba lakho lokunakekelwa kwezempilo lizokhetha inketho evumelana nezidingo zakho ngazinye nesimo sezokwelapha.

Ingabe i-Nesiritide Ingcono Kune-Dobutamine?

I-Nesiritide ne-dobutamine zisebenza ngendlela ehlukile ukusiza inhliziyo yakho, ngakho-ke ukuthi "kungcono" kuncike esimweni sakho esithile sezokwelapha. I-Nesiritide igxila ekuphumuleni imithambo yegazi nasekususeni uketshezi, kuyilapho i-dobutamine iqondisa ngokuqondile isenzo sokumpompa kwenhliziyo yakho.

Odokotela bakho bangase bakhethe i-nesiritide uma unomfutho wegazi ophezulu kanye nokuhluleka kwenhliziyo, ngoba isiza ukwehlisa umfutho wegazi ngenkathi isekela ukusebenza kwenhliziyo. I-Dobutamine ingase ikhethwe uma inhliziyo yakho idinga ukukhuthazwa okuqondile ukuze iphompe ngempumelelo, ikakhulukazi uma umfutho wegazi wakho usuvele uphansi.

Abanye abantu bayazuza ekutholeni imithi yomibili ndawonye, njengoba igcwalisana nemiphumela yayo. Ithimba lakho lezokwelapha lizocabangela umfutho wegazi lakho, isigqi senhliziyo, ukusebenza kwezinso, kanye nesimo sakho esiphelele lapho linquma ukuthi iyiphi indlela esebenza kahle kakhulu ekululameni kwakho.

Imibuzo Evame Ukubuzwa Mayelana ne-Nesiritide

Ingabe i-Nesiritide iphephile kubantu abanezifo zezinso?

I-Nesiritide idinga ukuqashwa ngokucophelela kubantu abanezinkinga zezinso, kodwa ingasetshenziswa ngokuphepha ezimweni eziningi. Umuthi uthinta indlela izinso zakho eziphatha ngayo uketshezi nosawoti, okuyingxenye yendlela esiza ngayo ukuhluleka kwenhliziyo yakho.

Ithimba lakho lezokwelapha lizohlola ukusebenza kwezinso zakho ngokuhlolwa kwegazi ngaphambi kokuqala ukwelashwa futhi liqhubeke nokuqapha ngesikhathi sokuhlala kwakho. Bangase balungise umthamo noma bakhethe omunye umuthi uma izinso zakho zingasebenzi kahle ngokwanele ukuze zisingathe izinguquko ezibangelwa yi-nesiritide.

Kwezinye izimo, ukuhluleka kwenhliziyo ngokwayo kubeka ingcindezi ezinso zakho, futhi ukwelapha ukuhluleka kwenhliziyo nge-nesiritide kungasiza ngempela ukuvikela ukusebenza kwezinso zakho ngokuhamba kwesikhathi.

Ngingenzani uma ngizwa imiphumela emibi ngesikhathi sokwelashwa?

Njengoba uzobe usesibhedlela ngenkathi uthola i-nesiritide, kufanele utshele ngokushesha umhlengikazi wakho noma udokotela mayelana nanoma yiziphi izimpawu ezingakhululekile ozitholayo. Ungalindi noma ucabange ukuthi izimpawu zizonyamalala zodwa.

Ithimba lakho lezempilo lilindele ukukuqapha eduze ngesikhathi sokwelashwa futhi lifuna ukwazi nganoma yiziphi izinguquko endleleni ozizwa ngayo. Bangakwazi ukulungisa ngokushesha umthamo womuthi wakho, bakunikeze ukwelashwa okwengeziwe ukuze ulawule imiphumela emibi, noma bashintshele komunye umuthi uma kudingeka.

Izimpawu ezivamile njengokugajezela okulula noma ikhanda elibuhlungu zivame ukulawuleka ngokungenelela okulula, kuyilapho izimpawu ezingathi sína zingase zidinge izinguquko zemithi ngokushesha ukuze zikugcine uphephile.

Ngingawuthatha imithi yami yenhliziyo ejwayelekile ngenkathi ngithola i-Nesiritide?

Odokotela bakho bazobukeza ngokucophelela yonke imithi yakho ejwayelekile bese benquma ukuthi iyiphi okufanele iqhubeke, imiswe, noma ilungiswe ngenkathi wamukela i-nesiritide. Eminye imithi yenhliziyo isebenza kahle ne-nesiritide, kanti eminye ingadinga izinguquko zesikhashana.

Imithi yokwehlisa umfutho wegazi ivame ukudinga ukulungiswa ngoba i-nesiritide inganciphisa umfutho wegazi. Ithimba lakho lezokwelapha lizobheka umfutho wakho wegazi ngokucophelela futhi lilungise eminye imithi njengoba kudingeka ukuze kugcinwe amazinga aphephile.

Ungayeki noma uqale imithi ngokwakho ngenkathi wamukela i-nesiritide. Njalo xoxa nganoma yikuphi ukukhathazeka ngemithi yakho nethimba lakho lezempilo, njengoba kudingeka bahlele konke ngokucophelela ukuze uqinisekise ukuphepha kwakho.

Ngingahamba nini ekhaya ngemva kokwelashwa nge-Nesiritide?

Abantu abaningi bangahamba ekhaya emahoreni angama-24 kuya kwangama-48 ngemva kokuphela kokwelashwa kwabo nge-nesiritide, kodwa lokhu kuncike ekutheni ukuhluleka kwenhliziyo yakho kuthuthuke kangakanani nokuthi uzinzile yini emithini yakho emisha.

Odokotela bakho bazofuna ukubona ukuthi amazinga akho oketshezi athuthukile, ukuphefumula kwakho kulula, nokuthi ukusebenza kwenhliziyo yakho kuzinzile ngaphambi kokukhishwa. Bazophinda baqinisekise ukuthi uzizwa ukhululekile nganoma iyiphi imithi emisha ozoyithatha ekhaya.

Ushintsho esibhedlela oluya ekhaya luhlanganisa ukuhlela ngokucophelela ukuqinisekisa ukuthi ukuhluleka kwenhliziyo yakho kuqhubeka kulawulwa kahle. Ithimba lakho lezokwelapha lizohlela ama-aphoyintimenti okulandelayo futhi linikeze imiyalelo ecacile yokuphatha isimo sakho ekhaya.

Ngizoyidinga futhi i-Nesiritide esikhathini esizayo?

Ukuthi uzoyidinga yini i-nesiritide futhi kuncike ekutheni ukuhluleka kwenhliziyo yakho kulawulwa kahle kangakanani ngemithi yakho eqhubekayo nokuphathwa kwendlela yokuphila. Abanye abantu banesigameko esisodwa esidinga i-nesiritide bese benza kahle ngemithi yomlomo isikhathi eside.

Abanye abanezinkinga zenhliziyo eziqhubukayo bangase badinge ukulaliswa esibhedlela ngezikhathi ezithile futhi bangase bathole i-nesiritide futhi ngesikhathi sezigameko zesikhathi esizayo. Udokotela wakho wenhliziyo uzosebenza nawe ukuthuthukisa uhlelo lwakho lokwelashwa lwesikhathi eside ukunciphisa amathuba okudinga ukwelashwa okusekelwe esibhedlela.

Umgomo uhlala ukugcina ukuhluleka kwenhliziyo yakho kulawulwa kahle ekhaya ngemithi ongayithatha ngomlomo, ukuqapha njalo, nokulungiswa kwendlela yokuphila okusekela impilo yenhliziyo yakho.