sindrom gipertermii i preparati primenyaemie dlya ego lecheniya

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powerpoint presentation sindrom gipertermii i preparati primenyaemie dlya ego lecheniya xamraeva charos 1. upravlenie i profilaktika zlokachestvennoy gipertermii 2. zlokachestvennaya gipertermiya: patofiziologiya i genetika 3. lekarstvennie preparati dlya lecheniya zlokachestvennoy gipertermii plan: etiologiya i patofiziologiya mg bolee 1000 mutatsiy v gene ryr1 svyazani s mg, chto ob'yasnyaet shirokiy spektr klinicheskix proyavleniy i razlichnuyu stepen tyajesti zabolevaniya, oslojnyaya rannyuyu diagnostiku i prognozirovanie. patofiziologicheski mg xarakterizuetsya povishennoy chuvstvitelnostyu k ingalyatsionnim anestetikam i depolyarizuyushim miorelaksantam, chto zapuskaet povishennoe potreblenie kisloroda, produktsiyu laktata i povishenie temperaturi tela bolee chem na 1°c v chas. profilaktika zlokachestvennoy gipertermii adekvatniy premedikatsionniy anamnez, vklyuchayushiy detalizatsiyu semeynogo anamneza na predmet mg, kritichen dlya predotvrasheniya triggerov, snijaya risk razvitiya epizoda na 90%. ispolzovanie ingalyatsionnix anestetikov, takix kak sevofluran, s kontsentratsiey menee 1 mac, znachitelno umenshaet veroyatnost razvitiya zlokachestvennoy gipertermii. zaklyuchenie i voprosi-otveti postkrizisniy period trebuet tshatelnogo monitoringa funktsii pochek i pecheni, tak kak vozmojni oslojneniya v vide ostroy pochechnoy nedostatochnosti …

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im povisheniem temperaturi tela bolee chem na 1°c v chas, vizvannoe vozdeystviem opredelyonnix anestetikov. genetika zlokachestvennoy gipertermii mutatsii v gene cacna1s, kodiruyushem α1s-sub'edinitsu kanala l-tipa, takje assotsiirovani s mg, no vstrechayutsya znachitelno reje, chem mutatsii v ryr1, sostavlyaya okolo 1-2% sluchaev. bolee 80% sluchaev zlokachestvennoy gipertermii svyazani s mutatsiyami v gene ryr1, kodiruyushem retseptor rianodina, privodyashimi k ego disfunktsii i povishennoy visvobojdeniyu kaltsiya v mishtsax. lechenie zlokachestvennoy gipertermii: obshie printsipi klyuchevim preparatom v lechenii yavlyaetsya dantrolen, kotoriy vvoditsya vnutrivenno v doze 2.5 mg/kg s posleduyushim titrovaniem do kupirovaniya simptomov; skorost infuzii ne doljna previshat 10 mg/min. lechenie zlokachestvennoy gipertermii nachinaetsya s nemedlennogo prekrasheniya anestezii galotanom ili suksametoniem, i posleduyushey giperventilyatsii 100% kislorodom dlya korrektsii giperkapnii. klinicheskaya kartina mg pristup mg xarakterizuetsya stremitelnim povisheniem temperaturi tela (do 42°s i bolee) v techenie pervix 10-15 minut posle nachala anestezii, chto yavlyaetsya kriticheskim pokazatelem. rannie simptomi vklyuchayut taxikardiyu (bolee 150 udarov v minutu), …

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a xa, prepyatstvuyushiy obrazovaniyu trombina i snijayushiy svertivaemost krovi na 70-80%. dozirovka rivoroksabana individualna, zavisit ot pokazaniy i sostavlyaet ot 10 mg do 20 mg odin ili dva raza v sutki, i trebuet tshatelnogo monitoringa. dantalen (dantdrolon): mexanizm deystviya i primenenie dantrolen okazivaet svoyo deystvie putyom konkurentnogo ingibirovaniya visvobojdeniya kaltsiya, snijaya vnutrikletochnuyu kontsentratsiyu ca²⁺ priblizitelno na 50%, chto kriticheski vajno dlya kontrolya mishechnogo spazma pri zlokachestvennoy gipertermii. effektivnaya doza dantrolena pri lechenii zlokachestvennoy gipertermii sostavlyaet 2.5 mg/kg vnutrivenno, s posleduyushim vvedeniem podderjivayushix doz v zavisimosti ot klinicheskoy kartini i urovnya serdechno-sosudistoy i dixatelnoy stabilnosti patsienta. kvotirovanie i monitoring v lechenii mg dlya kontrolya za razvitiem oslojneniy i svoevremennoy korrektsii terapii pri mg neobxodim strogiy monitoring ekg, arterialnogo davleniya i urovnya elektrolitov v krovi, s zapisyu pokazateley ne reje chem kajdie 15 minut v kriticheskoy faze. monitoring effektivnosti lecheniya mg vklyuchaet v sebya regulyarniy analiz pokazateley, takix kak temperatura tela, laktat, …

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powerpoint presentation sindrom gipertermii i preparati primenyaemie dlya ego lecheniya xamraeva charos 1. upravlenie i profilaktika zlokachestvennoy gipertermii 2. zlokachestvennaya gipertermiya: patofiziologiya i genetika 3. lekarstvennie preparati dlya lecheniya zlokachestvennoy gipertermii plan: etiologiya i patofiziologiya mg bolee 1000 mutatsiy v gene ryr1 svyazani s mg, chto ob'yasnyaet shirokiy spektr klinicheskix proyavleniy i razlichnuyu stepen tyajesti zabolevaniya, oslojnyaya rannyuyu diagnostiku i prognozirovanie. patofiziologicheski mg xarakterizuetsya povishennoy chuvstvitelnostyu k ingalyatsionnim anestetikam i depolyarizuyushim miorelaksantam, chto zapuskaet povishennoe potreblenie kisloroda, produktsiyu laktata i povishenie temperaturi tela bolee chem na 1°c v chas. profi...

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