Yini i-Reteplase: Ukusetshenziswa, Umthamo, Imiphumela Eceleni Nokunye

I-Reteplase iyikhambi elinamandla lokuchitha amahlule angasindisa impilo yakho ngesikhathi sokuhlaselwa yinhliziyo. Kuyiphrotheni eyenziwe ngofuzo esebenza ngokuchitha amahlule egazi ayingozi emithanjeni yakho ye-coronary, okusiza ukubuyisela ukuhamba kwegazi emsipheni wenhliziyo yakho lapho iminithi ngalinye libalulekile.

Lo muthi ungowodwa ohlwini lwemithi ebizwa ngokuthi i-thrombolytics, okusho ukuthi "izichithi zamahlule." Cabanga nge-reteplase njengensiza ekhethekile odokotela abaphuthumayo abayisebenzisela ukuvula ngokushesha imithambo evaliwe nokuvimbela ukulimala kwenhliziyo unomphela.

Yini i-Reteplase?

I-Reteplase iyi-recombinant tissue plasminogen activator, okusho ukuthi inguqulo eyenziwe e-lab yeqoqo lamaprotheni umzimba wakho owenza ngokwemvelo ukuze uchithe amahlule. Ingxenye ethi "recombinant" imane nje isho ukuthi ososayensi baye bayenza ngobunjiniyela besebenzisa ubuchwepheshe be-genetic ukuze bayenze isebenze kahle futhi ihlale isikhathi eside kunezinhlobo zamaprotheni omzimba wakho wokuchitha amahlule.

Lo muthi wenzelwe ngqo ukusetshenziswa eziphuthumayo ezibhedlela ngesikhathi sokuhlaselwa yinhliziyo okukhulu. Akuyona into ongayithatha ekhaya noma oyisebenzisela ukuvimbela. Kunalokho, iyikhambi lokuhlenga elisetshenziswa ngamaqembu ezokwelapha lapho ukuhlinzekwa kwegazi kwenhliziyo yakho kuvaleke kakhulu.

Isetshenziselwa Ukuthini I-Reteplase?

I-Reteplase isetshenziswa ikakhulukazi ukwelapha i-acute myocardial infarction, okuyigama lezokwelapha lokuhlaselwa yinhliziyo okubangelwa yihlule legazi. Lapho ihlule livimba enye yemithambo enikeza umsipha wenhliziyo yakho, leyo ngxenye yenhliziyo yakho iqala ukufa ngenxa yokuntuleka komoya-mpilo kanye nezakhamzimba.

Lo muthi usebenza kahle kakhulu uma unikezwa emahoreni ambalwa okuqala ngemva kokuba izimpawu zokuhlaselwa yinhliziyo ziqala. Odokotela abaphuthumayo bawusebenzisa njengengxenye yalokho okubizwa ngokuthi "i-reperfusion therapy" - ngokuyisisekelo ukugijimela ukubuyisela ukuhamba kwegazi ngaphambi kokuba kulimale unomphela.

Kwezinye izimo, odokotela bangasebenzisa i-reteplase ukwelapha ama-pulmonary embolisms amakhulu, okuyizigaxa zegazi eziyingozi emathunjini. Nokho, lokhu akuvamile futhi kudinga ukuhlolwa ngokucophelela kwezingozi nezinzuzo.

Isebenza Kanjani I-Reteplase?

I-Reteplase isebenza ngokwenza kusebenze iphrotheni egazini lakho ebizwa ngokuthi i-plasminogen, iyiguqule ibe yi-plasmin. I-Plasmin ifana nezikelo zomzimba wakho zemvelo zokusika i-fibrin, iphrotheni eyakha isakhiwo esifana nenetha sezigaxa zegazi.

Lokhu kuthathwa njengomuthi onamandla kakhulu ngoba usebenza ngokushesha futhi ngamandla kuyo yonke imithambo yakho yegazi. Ngokungafani nezinye izinciphisi zegazi ezithambile, i-reteplase ayigcini nje ngokuvimbela ukwakheka kwezigaxa ezintsha - iyancibilikisa ngempela lezo ezikhona.

Umuthi uqala ukusebenza ngemizuzu embalwa ngemva kokuphathwa, futhi imiphumela yawo ingahlala amahora amaningana. Lesi senzo esisheshayo sibalulekile ngesikhathi sokuhlaselwa yinhliziyo, lapho

Ukwelashwa nge-Reteplase kuqedwa cishe ngemizuzu engama-30 kuya kwelilodwa. Ngokungafani nemithi ongase uyithathe nsuku zonke ekhaya, lokhu ukwelashwa kwesikhashana, okunamandla okunikezwa kuphela ngesikhathi esibukhali sokuhlaselwa yinhliziyo.

Ngemuva kokuthola i-reteplase, ngokuvamile uzoqashwa eduze esibhedlela okungenani amahora angama-24 kuya kwangama-48. Ngesikhathi lesi, abasebenzi bezokwelapha bazobheka izimpawu zokuthi ukwelashwa kusebenze futhi baqaphe noma yiziphi izinkinga zokopha.

Ngemuva kokwelashwa kwakho nge-reteplase, udokotela wakho cishe uzoqoka eminye imithi yokuvikela inhliziyo yesikhathi eside, njenge-aspirin, ama-beta-blockers, noma ama-ACE inhibitors. Le mithi eqhubekayo isiza ukuvimbela ukuhlaselwa yinhliziyo okuzayo futhi isekela ukululama kwakho.

Yiziphi Imiphumela Eceleni ye-Reteplase?

Ingozi enkulu nge-reteplase ukopha, ngoba umuthi uthinta ikhono legazi lakho lokuvimba kuyo yonke imizimba yakho. Lokhu kungahluka kusuka ekopheni okuncane ezindaweni zokujova kuya ekopheni okungaphakathi okungathi sína.

Nawa amanye imiphumela ejwayelekile ongase uyithole ngesikhathi noma ngemuva kokwelashwa:

• Ukuphuma igazi endaweni yokufakwa kwe-IV noma ezinye izindawo zokubhoboza
• Ukulimala kalula kunokujwayelekile
• Isicanucanu noma ukuhlanza
• Ukwehla kwegazi
• Ukushaya kwenhliziyo okungajwayelekile
• Umkhuhlane noma ama-chills

Le miphumela ngokuvamile iyaphathwa futhi ilindelekile njengengxenye yenqubo yokwelashwa. Ithimba lakho lezokwelapha lizokubheka eduze nganoma yiziphi izimpawu zezinkinga.

Imiphumela engathi sína kodwa engavamile ingabandakanya:

• Ukuphuma igazi okukhulu ebuchosheni (i-intracranial hemorrhage)
• Ukuphuma igazi okukhulu ngaphakathi esiswini noma emathunjini
• Ukuphendula komzimba ngaphandle, nakuba lokhu kungavamile
• Ukwehla okukhulu kwegazi okudinga ukungenelela kwezokwelapha
• Ukulimala kwe-Reperfusion, lapho ukugeleza kwegazi okubuyiselwe ekuqaleni kubangela ukuvuvukala

Noma lezi zinkinga ezingathi sína zikhathaza, khumbula ukuthi i-reteplase isetshenziswa kuphela uma ubungozi bokungawelaphi ukuhlaselwa yinhliziyo budlula lezi zingozi ezingaba khona. Ithimba lakho lezokwelapha linolwazi oluningi lokuphatha lezi zimo.

Ubani Ongafanele Athathe I-Reteplase?

I-Reteplase ayifanele wonke umuntu, ngisho nalapho kuhlaselwa yinhliziyo. Udokotela wakho uzohlola ngokushesha ukuthi ungumuntu ofanelekayo yini ngokusekelwe emlandweni wakho wezokwelapha kanye nesimo sakho samanje.

Akufanele uthole i-reteplase uma unesinye salezi zimo:

• Ukuphuma kwegazi okusebenzayo ngaphakathi noma isifo sokopha
• Ukuhlinzwa okukhulu kwakamuva ezinsukwini eziyi-10 ezedlule
• Umlando wokushaywa unhlangothi noma ukulimala kobuchopho ezinyangeni ezi-3 ezedlule
• Umfutho wegazi ophezulu ongagadiwe (ngaphezu kuka-180/110)
• Umdlavuza wobuchopho owaziwayo noma imithambo yegazi engajwayelekile ebuchosheni
• Ukwelashwa kwekhanda okukhulu kwakamuva

Udokotela wakho uzosebenzisa ukuqapha okwengeziwe uma unezimo ezithile ezandisa ingozi yokopha, ngisho noma zingezona izinto ezingavunyelwe ngokuphelele.

Lezi zimo zidinga ukucatshangelwa ngokucophelela:

• Ubudala obungaphezu kweminyaka engama-75
• Ukuhlinzwa okuncane kwakamuva noma izinqubo zezokwelapha
• Ukukhulelwa noma ukuzalwa kwakamuva
• Isifo samathumba esisebenzayo
• Isifo esibi sesibindi noma sezinso
• Ukusetshenziswa kwakamuva kwemithi yokunciphisa igazi

Kulezi zimo, udokotela wakho uzohlola izingozi nezinzuzo ngokucophelela, ngezinye izikhathi ekhetha ukwelashwa okuhlukile njengokufakwa kwe-catheter yenhliziyo esheshayo esikhundleni salokho.

Amagama Omkhiqizo we-Reteplase

I-Reteplase yaziwa kakhulu ngegama layo lomkhiqizo elithi Retavase e-United States. Lolu uhlobo oluyinhloko lokuthengisa lomuthi oqashwa yizibhedlela futhi olusetshenziselwa ukwelashwa okusheshayo kokuhlaselwa yinhliziyo.

Ngokungafani neminye imithi enamagama amaningi emikhiqizo, i-reteplase ihlale ifana kakhulu ekubekweni kwayo uphawu. Ezinye izindawo zingase zisebenzise amagama ahlukene emikhiqizo, kodwa isithako esisebenzayo nokwakheka kuhlala kufana.

Uma uthola lo muthi, ungase uvele emarekhodini akho esibhedlela noma ezikweletini njengokuthi "reteplase" noma "Retavase," kuye ngokuthi isikhungo sakho sezokwelapha sibhala kanjani imithi.

Ezinye Izindlela Zokwelapha Nge-Reteplase

Eminye imithi eminingi eqeda amahlule egazi ingasetshenziswa esikhundleni se-reteplase, kuye ngesimo sakho esithile nokuthi yini etholakalayo esibhedlela sakho. Ezinye izindlela ezivamile zihlanganisa i-alteplase (tPA), i-tenecteplase, ne-streptokinase.

I-Alteplase, evame ukubizwa nge-tPA, cishe iyona ndlela esetshenziswa kakhulu. Isebenza ngendlela efana ne-reteplase kodwa idinga isikhathi eside sokufakwa kanye nokulinganisa okuyinkimbinkimbi. Ezinye izifundo zikhomba ukuthi i-reteplase ingase ibe lula kancane ukuyiphatha ezimweni eziphuthumayo.

I-Tenecteplase intsha futhi inganikezwa njengesijovo esisodwa esikhundleni semithamo emibili ehlukene. Kodwa-ke, ayitholakali kabanzi njenge-reteplase noma i-alteplase ezibhedlela eziningi.

Kwezinye izimo, udokotela wakho angase ancome ukungenelela ngomshini esikhundleni somuthi. Lokhu kungabandakanya ukufakwa kwe-cardiac catheterization okuphuthumayo nge-balloon angioplasty, lapho odokotela bevula khona umthambo ovalekile ngokomzimba besebenzisa ibhaluni elincane futhi bavame ukubeka i-stent ukuze iwuvule.

Ingabe i-Reteplase Ingcono Kune-Alteplase?

Kokubili i-reteplase ne-alteplase ziyimithi eqeda amahlule egazi esebenza kahle kakhulu, futhi izifundo zikhombisa ukuthi zisebenza kahle ngokulinganayo ekwelapheni ukuhlaselwa yinhliziyo. Ukukhetha phakathi kwazo kuvame ukwehla ezintweni ezingokoqobo kunokuthi enye ibe "ngcono" kunenye.

I-Reteplase inezinzuzo ezithile ezimweni eziphuthumayo ngoba inikezwa njengemijovo emibili esheshayo kunokuba kube ukumnika okuqhubekayo ngaphezu kwemizuzu engama-90 njenge-alteplase. Lokhu kungaba lula kubasebenzi bezokwelapha ukuthi bakunike futhi kunganciphisa ithuba lamaphutha okulinganisa ngesikhathi sezimo eziphuthumayo ezinxushunxushu.

Kodwa-ke, i-alteplase isikhona isikhathi eside futhi ifundwe kabanzi. Abanye odokotela bazizwa bekhululekile ngayo ngenxa yokuthi banezinto abazithola ngayo ekuyisebenziseni. I-Alteplase nayo ivunyelwe ukwelapha ukushaywa unhlangothi, kuyilapho i-reteplase isetshenziswa ikakhulukazi ekuhlaselweni yinhliziyo.

Into ebaluleke kakhulu akuyona imithi ethile oyitholayo, kodwa ukuthi ufika ngokushesha kangakanani esibhedlela futhi uthole ukwelashwa. Zombili lezi zithako ziyizinqumo ezinhle uma zisetshenziswa ngendlela efanele ngamaqembu ezokwelapha anolwazi.

Imibuzo Evame Ukubuzwa Mayelana ne-Reteplase

Ingabe i-Reteplase iphephile kubantu abanesifo sikashukela?

Yebo, i-reteplase ingasetshenziswa ngokuphepha kubantu abanesifo sikashukela ngesikhathi sokuhlaselwa yinhliziyo. Ukuba nesifo sikashukela akukuvimbeli ukuthi uthole lo muthi osindisa impilo, yize kukubeka engozini enkulu yokuhlaselwa yinhliziyo ekuqaleni.

Kodwa-ke, uma une-diabetic retinopathy (ukulimala kwamehlo okuvela esifweni sikashukela), udokotela wakho uzodinga ukuqapha ngokwengeziwe ngoba lesi simo singakhuphula ingozi yakho yokopha emehlweni. Bazohlola le ngozi uma iqhathaniswa nengozi esheshayo yokuhlaselwa yinhliziyo yakho.

Amazinga akho kashukela egazini azogadwa eduze ngesikhathi nangemva kokwelashwa, njengoba ukucindezeleka kokuhlaselwa yinhliziyo nokulaliswa esibhedlela kungathinta ukuphathwa kwesifo sakho sikashukela.

Ngingenzani uma ngiphuzile i-Reteplase eningi ngengozi?

Ngeke ube sesimweni sokweqisa i-reteplase ngengozi ngoba inikezwa kuphela ochwepheshe bezokwelapha ezindaweni ezilawulwayo zesibhedlela. Umuthi uza ngemithamo elinganiselwe ngaphambili, futhi abasebenzi abaqeqeshiwe baphethe konke ukulungiswa nokuphathwa.

Uma abasebenzi bezokwelapha bengahlosi banikeze i-reteplase eningi kakhulu, banemithetho eqinile yokulawula lesi simo. Okukhathaza kakhulu kungaba ukwanda kwengozi yokopha, abangayiqapha futhi bayelaphe uma kudingeka.

Lokhu kungenye yezinzuzo zokuthola i-reteplase endaweni yasesibhedlela - unokufinyelela ngokushesha ekunakekelweni kwezokwelapha uma kukhona izinkinga eziphuma ekwelashweni.

Kufanele ngenzeni uma ngiphuthelwa umthamo we-Reteplase?

Lo mbuzo awusebenzi ngempela ku-reteplase ngoba ukwelashwa okuyisimo esiphuthumayo okwenziwa kanye esibhedlela. Ngeke uthathe imithamo ehleliwe ekhaya ongase uyiphuthele.

Ukwelashwa okujwayelekile kwe-reteplase kuhilela imijovo emibili enikezwa ngemizuzu engama-30 ngaphandle. Uma ngasizathu simbe umjovo wesibili ulibaziseka, ithimba lakho lezokwelapha lizothatha isinqumo esingcono kakhulu esisekelwe ekuphenduleni kwakho emthomeni wokuqala kanye nesimo sakho esiphelele.

Ngemuva kokuthi ukwelashwa kwakho kwe-reteplase kuqediwe, cishe uzoqala ukuthatha eminye imithi yokuvikela inhliziyo eqhubekayo. Leyo mithamo izoba nezinhlelo zayo zokulinganisa ukuthi udokotela wakho uzokuchaza.

Ngingayeka nini ukuthatha i-Reteplase?

Ukwelashwa kwe-Reteplase kuqedwa ngokuzenzakalelayo kungakapheli ihora elilodwa ngemuva kokuqala. Lena akuyona imithi oqhubeka uyithatha noma okudingeka unqume ukuthi uyeka nini - kungukungenela kwesikhashana esiphuthumayo.

Ngemuva kokuthola i-reteplase, ukugxila kwakho kuzoshintshela ekululameni nasekuvikeleni inhliziyo kwesikhathi eside. Udokotela wakho uzoqoka eminye imithi okungenzeka ukuthi uzoyithatha izinyanga noma iminyaka ukuvimbela ukuhlaselwa yinhliziyo okuzayo.

Imiphumela ye-reteplase ngokwayo iyaphela emahoreni ambalwa, kodwa izinzuzo zokubuyiselwa kokugeleza kwegazi emsipheni wakho wenhliziyo zingahlala impilo yakho yonke uma ulandela izincomo zikadokotela wakho zokunakekelwa okuqhubekayo.

Ngingashayela ngemuva kokuthola i-Reteplase?

Cha, ngeke ukwazi ukushayela izinsuku eziningana ngemva kokuthola i-reteplase. Uzohlaliswa esibhedlela ukuze uqashwe ngemva kokwelashwa, futhi ngisho nangemva kokukhishwa esibhedlela, uzodinga isikhathi sokululama ekuhlaselweni yinhliziyo.

Udokotela wakho uzokwazisa ukuthi kuphephile nini ukuqhubeka nokushayela, okujwayele ukuncika ekululameni kwakho konke, kunoma yiziphi izinqubo ozenzile, nokuthi inhliziyo yakho isebenza kahle kangakanani. Lesi sinqumo sivame ukwenziwa emhlanganweni wokulandela ngemva kwesonto elilodwa noma amabili ngemva kokulaliswa esibhedlela.

Ngesikhathi sokululama kwakho, uzodinga ukuhlela ukuthi amalungu omndeni noma abangane bakusize ngezokuthutha ekuqokweni kwezokwelapha neminye imisebenzi edingekayo.