Urografine: imiyalelo yokusetshenziswa, ama-analogs, izibuyekezo, ukuphikisana. Urografin 76%: imiyalelo yokusetshenziswa

Ukwenza ucwaningo emzimbeni, kusetshenziswe izindlela ezisuselwa kumisindo ye-x ray. Isingeniso emzimbeni womuntu we-agent ehlukile uthuthukisa amathuba okuxilongwa. Ukwengeza ama-molecule e-iodine kuya kumuthi ukwandisa umphumela wabo.

Incazelo

Izidakamizwa "Urografine" imiyalelo yokusetshenziswa njengendlela yokuhlolisisa i-radiopaque ngesakhiwo se-ionic. Ijojowe ezitsheni nasemigodini.

Isidakamizwa sisho izixazululo ezingenakulungiswa, itholakala njengetshezi ecacile, engenambala noma enemibala emincane.

Ukwakhiwa

Emithethweni yezidakamizwa "Urografine" yokusetshenziswa anqume izingxenye ezisebenzayo ezisuselwe ku-acid 3,5-bis (acetylamido) -2,4,6-triiodobenzoic. Ukwakhiwa kuhlanganisa namanoni awo amabili: i-sodium ne-meglumine. Kunezilinganiso ezimbili zomuthi ezingama-60 no-76 amaphesenti.

I-milliliter yesisombululo ingaqukatha u-0.292 g noma u-0.370 g wezinhlayiya ze-iodine. Isilinganiso se-meglumine amidotrizoate ku-ampoule eyodwa ngu-10.4 g noma i-13.2 g, futhi i-amidotrizoate ye-sodium ingu-1.6 g noma u-2 g. Ukuhlushwa kosawoti wokuqala ku-milliliter eyodwa ku-0.52 g noma u-0.66 g, kanti okwesibini kuyi-0 , U-08 g noma u-0.1 g.

Ukuze uthole isisombululo esilungile, izithako ezingasebenziyo zisetshenziselwa uhlobo lwe-calcium sodium edetate, i-sodium hydroxide ne-aqueous injection medium.

Lesi sidakamizwa sihlanganiswe ngo-20 ml ngamabhulebhu.

Izindlela ezifanayo

Imiyalelo yezokwelapha "Urographin" yokusetshenziswa ibhekisela kumalungiselelo okwandisa umehluko wesithombe ngenxa yokungenisa ama-X ray nge-iodine ions, ezifakwe ku-amidotrizoate usawoti.

Ukuze usebenzise lesi sidakamizwa, udinga ukwazi izici zesisombululo somjovo, ezihlobene ne-osmolality, i-viscosity, ubukhulu kanye nenani le-index ye-hydrogen.

Iqukethe yonke idatha engenhla yemiyalelo ye "Urografin" yokusetshenziswa. Ama-analogs ngesimo samalungiselelo "Triombrast" nethi "Trazograph" nawo asetshenziswa njengamathuluzi okuhlola asebenzisa i-radiopaque aqukethe izinhlayiya ze-iodine.

Ngokusungulwa kwesidakamizwa esinjalo, isithombe sesitho senza umehluko omkhulu.

Yini esetshenziselwa?

Umuthi "Urographin 76" kunconywa ukuthi usebenzise ukuvuselelwa kabusha kwe-urography, ukuhlolwa kwe-angiographic, i-arthrography, i-endoscopic retrograde ye-cholangiopancreatography.

Lesi sidakamizwa sithathwa ngaphambi kokusebenza kwe-cholangiography, i-sialography, i-fistulography, i-hysterosalpingography.

Indlela yokusebenzisa

Ngaphambi kokusebenzisa i- "Urographin 76", imfundo yokusetshenziswa iluleka ukulungisa isiguli kusengaphambili. Kudingeka ukuhlanzwa kwe-gastric ephelele ekuhlolweni kwe-angiographic kwezitho zangasese kanye nezinqubo ze-urographic. Izinsuku ezimbili ngaphambi kokuxhaphaza, ungathathi ukudla okubangela ukuqhuma. Le mikhiqizo ifaka izitshalo, ama-saladi, izimpahla ezimnyama nezinhlobonhlobo eziphekiwe, imifino eluhlaza.

Ngaphambi kokuhlolwa, ungadla isikhathi esingaphezu kwamahora angu-18, emva kwalokho uthatha ama-laxatives. Izincomo zokugcina azisebenzi ezinganeni ezincane.

Ukuthakazelisa, ubuhlungu obunzima buqinisa izinqubo zokwelapha emithini, ngakho-ke umuntu uyathuthukiswa ngokwengqondo ngengxoxo noma ngemithi.

Nge-myeloma, i-glucose eyandayo egazini enegazi elibi, i-polyuria, i-oliguria, i-hyperuricemia, izingane kanye nabantu asebekhulile yi-hydrated manipulations yokubuyisela izinga le-electrolyte.

Ukulungiswa okulungiselelwe "Urografin" kunconywa ukuthi kusetshenziswe kuphela lapho izakhiwo zomzimba zesisombululo zigcinwa. Uma kunesidumbu, umthunzi ushintshile noma kukhona ukulimala kwiphakheji, ayisetshenzisiwe. Leli ketshezi liqoqwe ngaphambi kokuphathwa, futhi izinsalela zesisombululo zilahlwe.

Isilinganiso sinqunywa yobudala, isisindo somzimba kanye nenhlalakahle yenhlalakahle yomuntu. Uma kwenzeka umsebenzi onganele ngokwanele izinso noma inhliziyo, isamba esincane semithi sisetshenziswa. Emva kwenqubo, lezi zitho kufanele zihlolwe izinsuku ezintathu.

Ukuze kuqhutshwe izenzakalo ze-angiographic, i-catheter eqhubekayo ihlanza ngokudinga isisombululo somzimba ukuvimbela izingozi ze-thromboembolic. Uma isidakamizwa sijova ezitokisini, kubalulekile ukuhlinzeka ngesimo esiphezulu. Ngemuva kwesigamu sehora ngemva kokujola, isiguli sigcinwa ngokucophelela ukuze sibone imiphumela emibi ngesikhathi.

Ukuze uqinisekise lesi sifo, phinda ukusetshenziswa kwe-ejenti ngamanani amaningi ngezikhathi ezinemizuzu engu-10 kuya ku-15 ukukhokhela ukwanda kwe-serum osmolarity nge-fluid interstitial. Ngokusungulwa kwesilinganiso somuntu oyedwa omdala we-0.3300 kuya ku-0.350 amalitha wemithi, izixazululo ze-electrolyte kumele zithathelwe.

Imiyalelo yezokwelapha "Urographin" yokusetshenziswa iseluleka ukushisa kuze kufike kuma-degree angama-36, okuzovumela ukuthi i-agent ehlukile ijojowe futhi ilula ukubekezelela ngenxa yokuncipha kwe-viscosity. Akuwona wonke ama-ampoules ashisa, kodwa kuphela inani elifanele.

Leli thuluzi alihloliswanga ngenxa yemiphumela engathembekile.

Ukuqhuba ucwaningo

Uma ukuxilongwa kwe-urographic emangalisa, lesi sidakamizwa senziwa ngo-20 ml ngomzuzu owodwa. Uma kukhona ukwephulwa komzimba wenhliziyo, imithi iqaliswa kancane kancane, okuyinto isigamu sehora.

Isiguli esidala sinikezwa u-0.02 l wezidakamizwa "Urografine 76" noma 0.05 l wezidakamizwa ezingu-60%. Ukwenyuka kwemali yesidakamizwa esinamazinga aphezulu okufika ku-0.05 L kunomthelela ekwandeni kokunemba kokuhlonza.

Izithombe zezingxube ze-renalyrinal renal zenziwa ekupheleni komjovo wokubonisa kangcono. Ukubona ngeso lengqondo isakhiwo se-pelvis ne-urinary tract, isithombe esingu-1 sithathwe ngemva kwemizuzu engu-5, nemizuzu engu-2 - 12 ngemva kokukhipha uketshezi.

Ngokwemitha yamaminithi angu-0.1, imithi yenqubo ivela kumaminithi angu-5 kuya kwangu-10. Kubantu abanesifo somzimba we-myocardial izifo ezinjalo zithelelwa emithanjeni ngesigamu sehora. Izithombe zokuqala zithathwe ekupheleni kwesingeniso, futhi okulandelayo kwenziwa imizuzu engu-20.

Ekuhlolweni kwe-radiographic ye-system circulatory, lapho i-aortography, i-angiocardiography noma i-coronary angiography eyenziwa, isisindo esikhulu se "Urografine" sisetshenziswa. Ukusetshenziswa kwesisombululo se-76% kuphakanyisiwe. Inani lemithi lithathwa yizici zeminyaka, isisindo, imizuzu emincane yenhliziyo, isisindo senhlalakahle, izindlela zokubamba.

Uhlelo lwe-urinary lufundwa ngosizo lokubuyisa ukuhlolwa kwe-urographic, lapho i-substance ehlukile ilawulwa yi-catheter indlela eya ku-lumen ye-urethra. Kusetshenziselwa uketshezi lwamaphesenti angu-30, olutholakala ngokuhlunga isisombululo samaphesenti angu-60 ngomjovo wamanzi ngesilinganiso esingu-1 kuya ku-1. Ukuze ugweme ukuphazamiseka kokumangalisa ngomuthi obandayo, ukulungiswa kokuphambene kushisa kuya emazingeni angu-36.

Kweminye uphenyo, okungu-60% wezinto ezingaguquki kufanele zenziwe. Ukwelashwa okuphezulu kwemithi ngezinye izikhathi kubangela izimpawu ezicasulayo.

I-agent ichithelwa ngaphansi kokulawulwa kwe-fluoroscopic ukwenza i-arthrographic, i-hysterosalpingographic examination kanye ne-retrograde ye-cholangiopancreatography.

Indlela yokuphuza kahle

Ukwenza amakhompiyutha amathumbu amathumbu nezinye izitho, odokotela banquma ukuphathwa ngomlomo kwesidakamizwa "Urografine". Imiyalo yokusetshenziswa ayiluleki ukuthatha, ayichazi le ndlela yokusebenzisa. Uma udokotela oya khona engazange azise isiguli ngemithetho yokusetshenziswa nokubuyisela, isiguli siyothola kunzima ukuthola ulwazi.

Izisebenzi zezokwelapha zincoma ukuphuza isisombululo se-"Urografine" ngaphambi kokucwaninga. Imiyalo yokusetshenziswa kwe-CT ikhombisa ukuthi okuqukethwe kwe-ampoule eyodwa (20 ml) kufanele kuhlanjululwe ngetitha elilodwa lamanzi ahlanzekile, thatha lokhu ketshezi ngezigaba.

Ukusetshenziswa kuqala amahora angu-24 ngaphambi kokuxilongwa, ngenxa yalokho amathumbu nezinye izitho zitholakale. I-200ml yokugcina yesisombululo se-"Urografine" sinconywa nge-CT isingeniso uma ungena ekamelweni. Amasampuli okuqala okusetshenziselwa ngomlomo ayinqunyiwe.

Uma ungasebenzisi

Ngokuba izidakamizwa "Urografins" contraindications zihlotshaniswa nokwanda okubonakalayo ekusebenzeni gland yegciwane, ekhokhiswa umsebenzi okwanele wenhliziyo.

I-pancreatitis enhle ngeke ivumele ukuhlolwa kwe-cholangiopancreatographic.

Ukuxilongwa kwe-hysterosalpingographic akukwenziwanga esimweni sokukhulelwa kwengane futhi kusabela ngokuvuthayo okuvuthayo esifundeni sezintambo.

I-Myelography, i-ventriculography nezifundo ze-ecistormography azikwenziwanga uma izidakamizwa zihluke ngenxa yomphumela wayo we-neurotoxic.

Ukusabela okungathandeki

Ukuze ulungiselele "u-Urographin", imiyalelo yokusetshenziswa ihlanganisa ulwazi ngezenzakalo ezimbi ngesikhathi sokungenwa kwe-intravascular. Ukusabela okubi okuphefumulayo kuhlobana nokuphefumula, ukukhwehlela, ukuvuvukala kwamaphaphu, ukuyeka umsebenzi wokuphefumula.

Ukuphazamiseka ohlelweni lokugaya umzimba kubonakala ngokuhlanza, izimpawu zobuhlungu esiswini.

Izinguquko kumsebenzi we-cardiac kanye ne-vascular zihlotshaniswa nokushintsha komfutho wegazi kanye nemvamisa yezivumelwano. Ngezinye izikhathi kunokwenzeka ukuhlakulela izimo eziyingozi ezibhekene ne-thromboembolic ezenza i-infarction ye-myocardial ivuke.

Ukusabela okungathandeki kwesistimu ye-urinary kubonakaliswa umsebenzi ongasebenzi kahle we-hepatic and renal.

Izinguquko esimisweni sezinzwa ezisemaphakathi zibhekene nezinsizwa, ukungalingani, ukulahlekelwa ukuqonda, ukuwohloka kokuphendula okubukwayo nokubukwayo, ukuhlukunyezwa okukhulu, ukwesaba ukukhanya, i-coma, ukulala.

Izenzakalo zendawo zihlanganisa izinqubo zokuvuvukala, inhlanzi ye-venous, i-thrombophlebitis izilonda, izicubu ze-necrosis.

Izici zokwelapha

Imithi ye-"Urographin" isetshenziselwa ukuthi isetshenziswe ngokuqapha uma kunesisindo esikhulu ngokweqile kokuqukethwe nge-iodine. Isingeniso esifanele sidinga ukulimala okukhulu ezinsoweni nasesibindi, umsebenzi obanele we-muscle ye-heart, isifo se-emphysema lungaphazamiseka, isifo esibi segulane, izifo ze-vasrosclerotic vascular, ukukhushulwa ngokweqile kweshukela egazini, ukuqiniswa kwamagciwane we-thyroid kanye ne-myeloma jikelele. Imiphumela engathandeki kulezi zimo ingathuthuka kusukela ekungeneni kweminye imithi emithanjeni.

Ukusetshenziswa kwemithi ye-radiocontrast kungabangela i-hypersensitivity, ebonakaliswa ukuphefumula kanzima, i-erythema ibuyela kabusha isikhumba, imivimbo, ukushisa noma ukuvuvukala kwengxenye ebusweni ekhanda. Ngezifo ezibucayi, i-angioedema iqala, i-spasm ye-bronchi kanye ne-anaphylactic state shock. Imiphumela engathandeki ingase ibe khona ngemva kwamaminithi angu-60 ngemuva kokusetshenziswa kwezidakamizwa.

Ngokuvamile, imiphumela emibi ivela ezigulini eziphikisana nezidakamizwa zasolwandle nezinsimbi ezifakwe i-iodinated eziye zaba nezinkinga ze-hay fever, i-urticaria, noma i-asthma bronchial. Ngaphambi kokubeka imithi ye-radiopaque, udokotela kufanele ahlole izifo zomuntu ezedlule. Uma kunamathuba aphakeme enqubo yokwelapha, i-antihistamine therapy isetshenziselwa ukuyivimbela.

Ukuziphendulela komuthi kumuthi kuthuthukiswa ukusetshenziswa kwe-beta-blockers. Izidakamizwa ezinjalo zibangela ukumelana nokuphathwa okuvamile kwemithi.

Isixazululo se-iodine esingahlelekile sikwazi ukushintsha ukusebenza kwegciwane le-thyroid. Lezi datha zicatshangelwa lapho zihambisa izidakamizwa ezigulini ezinesimo esifushane se-hyperthyroidism.

Ekugugeni kunesifo sokudongeka kwendonga ye-vascular kanye nesimo sezinzwa ezingenakuqina, okwandisa izinqubo ezingafuneki kwi-iodine equkethe imithi yokuphambene.

Nge-infusion ye-intravascular, ngezinye izikhathi kunesifo sezinso ezinganele. Ukuze uyivimbele, udinga ukutadisha izifo zezinso ezedlule, ukubona ukuthi kunomsoco okwamanje. Ingozi ikwandisa i-myeloma, igugile, i-vascular disease, i-paraproteinemia, izinhlobo ezinzima zomshoshaphansi wegazi, ukufakwa kwe-uric acid emajoyini.

Uma kukhona ingozi yokuthuthukisa ukusabela okunjalo, inqubo ye-hydration iyenziwa ngokuqalwa ngokusebenzisa indlela yokwehlisa i-intravascular. Kubuye kwenziwe ekupheleni kokuxilongwa, ukuze kuhoxiswe i-agent ehlukile ngokusebenzisa izinso.

Ukuze unciphise umthwalo emzimbeni ngesikhathi kususwa izidakamizwa ungasebenzisi imithi yokwelashwa ye-nephrotoxic ne-cholecystografic, ungenzi i-angioplasty yemikhumbi yezinso noma ukuhlinzwa okukhulu.

Ngokuphulwa emagodini enhliziyo nangaphansi kwengcindezi ephakeme emaphashini, ukusebenzisa izidakamizwa kuholela ekuguqulweni kwesimo se-hemodynamic. Abantu asebekhulile abanezifo ze-myocardial esikhathini esidlule banamathele kakhulu ku-ischemic kanye nezilonda zesisu. Uma kukhona ukwehluleka kwenhliziyo, ngakho-ke ngesicelo se-intravascular, lesi sidakamizwa singabangela ukuvuvukala kwamathishu emaphaphu.

Ukubuyekeza

Ngokuvamile iziguli zivame ukubona imithi ye-radiopaque. Zonke ukusabela okungathandeki ngokuthatha imithi kuchaza umuthi "Urographin". Ukubuyekezwa ngokuvamile kubonisa ukubekezela okuhle kwesidakamizwa. Iziguli ngokuvamile zibonisa inqubo yokuhlonza ngokwayo, kunokuthatha i-agent ehlukile.

Kukhona izibuyekezo mayelana nokwethulwa kwesidakamizwa emgodini wesibeletho. Le nqubo ibangela ukuzwa okungathandeki, okungakhululekile.

Akuwona lonke ulwazi ngezindlela zokuphatha oluqukethe imfundo yokusetshenziswa kwisisombululo se "Urografine". Ku-CT, ukubuyekezwa kubonisa isidingo sokuthatha imithi ehlanjululwe ngomlomo ngosuku olulodwa ngaphambi kokuhlolwa kanye negumbi lokuphatha. Ukuze ukunambitheka kufane namanzi avamile angenakubala, angaphunga lutho.

Kukhona izibuyekezo ezingalungile lapho isiguli singenakwazi ukuxilongwa nge-urographic ngenxa yezikhalazo ngokungahambi kahle nokuphathwa kwezidakamizwa. Isiguli sigula, ukucindezeleka kwegazi kuye kwehla kakhulu.

Kunombono wokuthi uma kungekho ukubonakaliswa kwezinto ezibonakalayo zezinhlayiya ze-iodine, ukusetshenziswa komuthi akufanele ukwesatshwe. Le mithi enephrofayili yokuphepha eqinisekisiwe isetshenziswa ochwepheshe abaningi bezohlolwa.