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CARBETOCIN ʻO ka pauka Hemorrhage Postpartum
Ka wehewehe kikoʻī
Hoʻolauna:
ʻO Carbetocin, kahi analog oxytocin hana lōʻihi, hōʻike i nā waiwai e like me ka oxytocin maoli. Hana ʻo ia ma ke ʻano he agonist, hoʻopaʻa ʻia i nā ʻiʻo ʻiʻo maʻemaʻe o ka ʻōpū a hoʻoulu i ka ʻoki ʻana o ka ʻōpū. ʻO ka Carbetocin ka mea nui i ka hāpai ʻana a me ka hānau hou ʻana, no ka mea, ʻoi aku ka kiʻekiʻe o ka ʻike o ka oxytocin receptor i kēia mau manawa. Ma kēia ʻatikala, e ʻimi mākou i nā waiwai lapaʻau a me nā lāʻau lapaʻau o ka carbetocin, e kālele ana i kona hoʻohana ʻana i ka hoʻomalu ʻana i ka hemorrhage postpartum a me ka pale ʻana i ka ʻoki ʻana o ka ʻōpū ma hope o ka pauku cesarean.
ʻO ka mālama ʻana i ka hemorrhage postpartum:
ʻO Carbetocin kahi lāʻau waiwai nui i hoʻohana ʻia e mālama i ka hemorrhage postpartum, e pili ana i ke kahe nui ʻana ma hope o ka hānau ʻana. Ma ka hoʻoulu ʻana i ka ʻōpū o ka ʻōpū, kōkua ka carbetocin i ka hoʻihoʻi ʻana i ke kani o ka ʻōpū, e hōʻemi ana i ka nui o ke kahe koko. Aia kona pono i kona hiki ke hoʻonui i ka pinepine a me ke ʻano o ka hoʻopaʻapaʻa ʻana o ka ʻōpū, pale a hōʻemi paha i ka hemorrhage postpartum.
Hoʻohana pinepine ʻia ʻo Carbetocin ma hope o ka epidural a i ʻole spinal anesthesia i ka wā o nā kaʻina hana cesarean e pale ai i ka ʻoki ʻana o ka ʻōpū a me ka hemorrhage postpartum. Mālama kēia hana i ka hoʻopaʻa ʻana o nā ʻiʻo o ka ʻōpū, e hōʻemi ana i ka nui o ke koko. Eia naʻe, ʻaʻole i aʻo nui ʻia ka hoʻohana ʻana i ka carbetocin i nā ʻāpana cesarean pilikia, nā ʻāpana cesarean maʻamau, a ma lalo o nā ʻano anesthesia ʻē aʻe a i ʻole ke alo o nā kūlana olakino. No laila, pono e makaʻala i ka wā e noʻonoʻo ai i ka hoʻokele carbetocin i kēia mau kūlana.
Mechanism o ka hana:
Hoʻohana ʻo Carbetocin ma ke ʻano he oxytocic, antihemorrhagic, a me ka lāʻau uterotonic, e kuhikuhi nui ana i ka ʻōnaehana nerve peripheral. Hana ʻo ia ma ke ʻano he agonist ma nā ʻāpana oxytocin receptors, ʻoi loa i ka myometrium (ʻiʻo ʻōpū). ʻO kēia mau oxytocin receptors he G protein-coupled, a ʻo kā lākou hoʻoulu ʻana e pili ana i nā ʻelele ʻelua a me ka hana ʻana o inositol phosphates. Hoʻohālikelike ʻo Carbetocin i kēia ʻano hana, e hoʻopaʻa ʻole i ka N-terminus extracellular a me nā puka lou E2 a me E3 o ka oxytocin receptor. ʻOiai he like like ka carbetocin a me ka oxytocin no nā mea loaʻa, ʻo ka hopena olaola o carbetocin ma kahi o 50% o ka oxytocin endogenous a i ʻole exogenous. ʻO ka mea nui, ʻoi aku ka lōʻihi o ka hopena o ka carbetocin ma mua o ka oxytocin, pono hoʻokahi wale nō. Hoʻopilikia pū ia i ka hoʻokuʻu ʻana o ka oxytocin endogenous, e hoʻopau i ka loop feedback uterine me ka hypothalamus a e hōʻemi ana i ka hoʻokuʻu ʻana o ka oxytocin waena a me ka peripheral. Hiki ke noʻonoʻo ʻia ʻo Carbetocin he agonist biased o ka oxytocin receptor.
I ka wā o ka hāpai ʻana, piʻi nui ka synthesis o ka oxytocin receptors i loko o ka ʻōpū, a hiki i kona kiʻekiʻe i ka wā o ka hana a me ka hānau ʻana. No laila, ʻo ka hoʻohana ʻana i ka carbetocin a i ʻole nā mea like oxytocin i ka wā a i ʻole ma hope koke o ka hānau ʻana e hoʻonui i ka hopena uterotonic a me ka contractile. Eia nō naʻe, ʻaʻohe hopena o ka carbetocin i nā ʻōpū hānau ʻole me ka haʻahaʻa haʻahaʻa o ka oxytocin receptor. Hoʻohui hou, hāʻawi ka carbetocin i ka mānoanoa o ke koko, e hōʻemi hou i ka hopena o ka hemorrhage postpartum.
Hoʻopaʻa a me nā palena:
He mea nui e hoʻomaopopo ʻaʻole pono e hoʻohana ʻia ka carbetocin no ka hoʻokomo ʻana a i ʻole ka hoʻonui ʻana i ka hana, no ka mea hiki ke alakaʻi i ka puʻuwai a i ʻole ka hanu ʻana i ka makuahine a me ka pēpē.
Ka hopena:
ʻO Carbetocin, kahi analog oxytocin synthetic, hāʻawi i kahi ala kūpono i ka mālama ʻana i ka hemorrhage postpartum a me ka pale ʻana i ke kahe nui ʻana ma hope o ka pauku cesarean. Ma ka hoʻohālikelike ʻana i nā hana o ka oxytocin kūlohelohe maoli, hoʻoulu ʻo carbetocin i ka ʻoki ʻana o ka ʻōpū a hoʻoikaika i ke kani o ka ʻōpū. Eia nō naʻe, pono e noʻonoʻo pono ʻia kona hoʻohana ʻana i nā hiʻohiʻona kikoʻī, a pono e mālama pono nā limahana mālama ola i ka wā e lawelawe ai i ka carbetocin.
E hoʻomanaʻo e hoʻokaʻaʻike mai iā mākou no ke kumu kūʻai pololei o Carbetocin Factory.
Hōʻike
