Plasmapheresis - he aha te mea te reira? Plasmapheresis: painga me te kino, contraindications, utu me ngā tikanga. plasmapheresis whakaora

He maha haumanu hou i roto i te tekau tau whakamutunga, ka anga ki te whakahere i te tukanga utu - plasmapheresis. He aha te mea te reira, a i raro i te mea mate kua whakaaturia reira? Ahakoa he mōrearea tenei tikanga, me te pehea te pau ai? Tenei ko nga take matua e ara ake i roto i tūroro ina tūtohu ratou he ara auaha ki te pure i te toto i "slags".

He aha te mea plasmapheresis?

Tenei tikanga hou o te pure i te tinana i te taumata pūtau mā te tātari i te toto te whakamahi i ngā pūrere motuhake. Ko te tikanga mo te maimoatanga o maha mate, me te he anake te whakaoranga mo etahi rawa mate onge. Ko te wā "plasmapheresis" ngā o kupu e rua - "plasmas" me "apheresis" e taea te mooni whakamaoritanga Latin rite "tango wē."

kawea te tukanga i roto i roto i ngā hōhipera tūmatanui, haumanu tūmataiti, me te ara te tahi mau taime i te kāinga. Plasmapheresis toto roaa āhukahuka i te mutunga o te rau tau whakamutunga, engari kua kua whakahaere ki te whakaora rau o nga mano o te hauora o te iwi.

History o tikanga takenga

rā i tēnei tikanga hoki ki te whakamahi o te toto-tuku rite te maimoatanga o tetahi mate. Hoki te wa roa, tenei "whakarihariha" ara o te therapy kua wareware e taote, engari na te rau tau waenga XX, kua timata tohunga ki te ngana ki te waihanga i tētahi pūrere mō te wehe toto ki ngā wāhanga, me te tango o tona wahi wai ki te whakaputa i te pānga haumanu.

Kua i roto i nga tau 70-80 o plasmapheresis kua kaha whakamahia i roto i te US, a riro rongonui i roto i te USSR. Otiia e kore e te conclusiveness o te whai huatanga o te tikanga e nui ano nui, no te mea e rapu mau tamataraa haumanu maha nga tau o te mahi. Heoi, e kore i aivanaa mutu, ka tonu ki te ako plasmapheresis. Aha kawea reira ki te huitaata? hoatu Scientists te tuutuu ore rongoā te ara tino tika, me te whai hua ki te horoi i te toto. I tēnei wā whakaaro tango "poke" wē te he tikanga tino whai hua i roto i te maha āhua pathological e e haere tahi e ngā intoxications rauropi.

He aha ngā momo me ngā tikanga te tīari plasmapheresis

E toru whakarōpū matua o plasmapheresis.

1. Na roto i te whakarite

Ki te purenga toto he haumanu i roto i te āhua me te te whakamahia ki te tango i tetahi mate huru ranei, he reira - plasmapheresis whakaora. E hoki mai te kupu tātari āhuatanga āhua ki te manawanui, ka whakakapia te wē e toto kaituku he otinga motuhake ranei.

Ki te whakahaere i te wehenga o te toto ki te whiwhi i te tangata hauora wē mo te whakamahi anō, ka karanga te hātepe taua te plasmapheresis kaituku.

2. I te ara o

He he he plasmapheresis motuhake, me te aunoa. tangohia i roto i te take tuatahi kua te manawanui he nui o te toto e whakanohoia i roto i te ipu horomata ki korotutu me whakahaere wē wehenga i te centrifugation rerenga ranei. Katahi ka patia te manawanui kei te pâmuhia toe i muri i tango o papatipu pūtau o wē, diluted ki saline. Kei te karanga a hoki tenei tikanga te buka haapiiraa.

Ki te kohinga toto plasmapheresis aunoa, filtration me te hoki reira ki te ipu tū i roto i te wahi iti i te tikanga o te pūrere wehenga. Ano, te tango tukanga katoa wahi tonu. Ko maitai atu hoki te manawanui tenei tikanga, ko te nui ake pūkoro me ārai kino ki ngā pūtau, rite te ātete ki te ā-.

3. Na roto i te tango i tikanga, me te tukatuka wē

Tei runga i te tikanga i i nekehia atu te wahi wai te, e tahuri iho plasmapheresis ki:

• Ko te centrifuge.
• Membrane.
• Whiria.
• Parataiao (bezapparatny plasmapheresis).
• Krioplazmaferez.

He ona pai me ngā raruraru ia tikanga. whakaaro ana te tino rongonui te ki hei plasmapheresis membrane. Ko whakaritea e kore whakamahia tikanga parataiao, engari ko reira nui iti atu ētahi atu.

Whakaahuatanga o te ngā tukanga

E hāngai ana te tikanga centrifuge te i runga i nga ture o te mahara. Ko te pūrere whakarato huri toto i te tere tiketike, kia e te wehea ai ki hautau. E hoki mai ngā āhuatanga te kupu āhua ki te tinana, ka nekehia atu te wē. Ko tenei tikanga tawhitotia, kua reira he rota o contraindications, ano, maha puta i roto i whara centrifugation pūtau.

Ko tā tikanga kiriuhi te whakamahi o te taputapu rawa ki whiriwhiringa motuhake ki kōputaputa e tukua te wē, āhuatanga i hanga, me te whakaroa. He ona painga tenei tikanga:

• plasmafilters sterility.
• Parenga ki te mate.
• Ko te oioi o te tikanga.
• Torutoru contraindications.
• E kore e nga pūtau pakaru.
• Taea o tono o te tukanga mō te maimoatanga o te tūroro mate pukupuku.

āhuatanga tikanga whiria te i roto i e haere i te toto tukatuka rua. Tuatahi, ka wehea te papatipu pūtau kei te me te ka te wē tātarihia e pure rāpoi nui, pūmua me lipids. Ko rongonui i roto i te maimoatanga o te atherosclerosis tenei tikanga.

kawea Bezapparatny plasmapheresis (parataiao ranei) i roto i kahore te whakamahi i tetahi whakaaro motuhake. Kei te wehea te toto ki e rua ngā wāhanga i raro i te mana o te mahara. Ko te plasmapheresis tino māmā, me te ngāwari tenei. Ko tino rerekē i te utu o ētahi atu tikanga tōna utu. Otiia kihai ia e tukua ki te tukatuka i ngā pukapuka nui o toto.

Krioplazmaferez Ko tā te tango o te wē i ona tio i -30 ^{° C,} i aru e painaina ana ki te 4 ^{° C} aru i te centrifugation. i nekehia atu wāhanga o te wai i Nā, ka hoki mai te toe wē kei te hoki ki te manawanui.

Ko te pānga whaiaroaro o te tikanga

plasmapheresis tukanga taea ki te ūkui i te tinana o nga hua wäriu o te pākia e (Urea, creatinine, waikawa uric), he paturopi, antigens, hormones, macromolecular kaitakawaenga lipid o mumura me ētahi atu matū kino. Tangohanga o wē tāwhaiwhai ai hypovolemia e whakaoho te vai me te whakaurunga o parepare o te tinana katoa. I tua atu, te wiwi wai i nga kopa ki te oko, ki te whakahoki komuhumuhu rōrahi toto. arata'i tenei ki te hekenga i roto i ngawhatanga me te whakaiti i nga pānga paitini o pollutants i roto i te torutoru haora.

Heoi, kotahi te ra whakahokia te ano te nui o tāoke i roto i te toto. Na reira, tūtohu tohunga akoranga plasmapheresis, hangaia hoki 3-4 toronga. Ki ia taumata ngā o te tikanga hou e horoia, kuhunga tuatahi, na te papanga, a ka te pūtau. Kua puta ke nga āhuatanga rheological o te toto i roto i te aronga pai, whakakore pokey nui, rere toto nui haere me te rere hāora ki whēkau me te kopa. Ka āta whakarite tēnei i whakapai ake i roto i te āhua whānui o te rauropi, ake i kaha urutau, a ka tango hoki kino tohu pūhui haurangi.

Heoi, e kore te mea e tika ana te ti'aturi anake i runga i te utu toto wē, no te mea he mea nui tonu ki te kawe i roto i te maimoatanga whānui o tetahi mate, e whai ake nei whakahau a te tākuta.

Hei whakaatu i tēnei tukanga

Na, whakahau maha kaiwhakaako plasmapheresis. He aha te mea tenei tukanga - e kore e te nuinga o ngā tūroro noa ite. Na ano, ki mohio i raro i te mea e hiahiatia ana tino āhuatanga e tika ana ki te whakaae i runga i te tikanga o te maimoatanga. Plasmapheresis - he purenga o te tinana, tūtohutia nei mo te maimoatanga o tata katoa whekau, me ngā pūnaha tangata. Heoi, i reira e he maha o pathologies i i plazmoobmenom therapy ko te tohu tino. tikanga o tēnei e te kore o te tikanga e taea arahi ki te mate o te manawanui. Taua mate ngā:

• anemia pūtau toronaihi ;
• thrombocytosis me leukocytosis;
• erythroleukemia;
• porphyrin mate;
• hypercholesterolemia (tuku iho);
• mate o Rupuha;
• hoki;
• syndrome hyperviscous;
• gravis myasthenia;
• Guillain-Barre syndrome;
• roa thrombocytopenia;
• mioglobinemiya;
• hemolysis intravascular;
• syndrome o Goodpasture ;
• syndrome o Gasser;
• te purapura thrombocytopenic thrombotic;
• cryoglobulinemia;
• polyneuropathy ma'i;
• paihana paihana.

tohu Pātahi mō te plasmapheresis e:

• Māuiuitanga o te wahi gastrointestinal: colitis ulcerative, mate a Crohn.
• mate Cardiovascular: he huru i muri i te whakaeke ngakau, myocarditis, rūmātiki me te pera i runga i.
• Pāwera: atopic deramatit, pollinosis me etahi atu.
• mate Dermatological: psoriasis, pemphigus, herpes, me ētahi atu
• mate tākihi: Glomerulonephritis, mimi mate roma, a pera atu.
• Diseases o te pūnaha romahā: huangō, hemosiderosis.
• raruraru ate: kakā autoimmune me ētahi atu.
• pōauautanga ero i muri i te pokanga.
• vasculitis pūnahanaha.
• pāpaka paitini i roto i te matepukupuku.
• Atherosclerosis.

Aita i maoro a'e, gynecologists tohutohu moni plasmapheresis i roto i hapūtanga, ki te mamae o te wahine toxicosis, i reira he Rhesus-pakanga iti hoki fetoplacental ranei. Ko te tino roa tenei rārangi. I muri i te katoa, i reira e pā ana ki 200 mate i roto i e taea te pai te whakamahi plasmapheresis. E wātea ana hoki Contraindications mō tenei tikanga.

Ko wai i ki te hoatu ki runga i te hātepe taua

Hoki tenei tukanga, e kore e maha contraindications reira. Otira kei te tino i te reira rāhuitia ki te kawe i roto i te aroaro o pāpaka tina heke o whēkau, kihai mutu toto, coagulation te whakararuraru, me te whewhe pekitīlia.

Ehara i purenga toto tūtohutia i roto i te ofatiraa o te manawataki me te auau ngakau, ongo pēhanga, te whakaiti i te pokey o te toto o te paheke, whakapeka mate hopuhopu, hypoproteinemia, anemia i roto i ngā tūroro paari, te momo rerekē o te ru, mate ate kino, "kino" uaua.

whakamahia te reira ki te kia e plasmapheresis i roto i te hapū, ko te kino ki te hauora o te tamaiti, engari io rangahau tata te kore. Noatia, te kaupapa o te tukanga tino i runga i te taunakitanga, me te rite ki ngā tohutohu.

Ko te kupu, etahi o te kāwanatanga ekore te whakamahi o te plasmapheresis rite te tikanga o te therapy. kia Contraindications kia arotakea e te rata haere, rawa ki te reira ko te mōrea o te ino o te hauora o te manawanui i roto i te take o te kore o te tikanga.

Kia pehea te Ko te therapy

Hoki plasmapheresis kore e rapua e whakangungu motuhake. Ko te tikanga kawea te tikanga i roto i roto i ngā tari whawhe motuhake ranei tika i roto i te ruma o te manawanui. Ki te mahi i tenei, takoto he manawanui i runga i te moenga motuhake, me te tango i te tūranga whakamarie. Tei runga i te tikanga, he pū tōngāmimi motuhake (fleksulyu) whakahaeretia i roto i te kotahi e rua ranei ringa. Nuinga o ngā wā mahi tenei kei te whakamahi i te rua i roto i te piko o te whatīanga. Ki te ko te manawanui i roto i te huru taumaha, kua whakanohoia te pū tōngāmimi ki te rua subclavian. Ki te toto e kore e katinga me hanga e thrombus, i roto i te tua fleksulyu heparin whakahaere.

Ko te tukanga pumau e pā ana ki 1-2 haora. Tei te reira i runga i te tikanga me te nui o te toto ki te kia horoia. I roto i whawhe katoa o te manawanui ko nga wa katoa i raro i te tirotiro hauora. whanganga ia auau pini, pēhanga toto, respiration me tirohia hoki te hāora supply ki te kopa.

He kawe pahoho ranei Apparatuses mō plasmapheresis. Ko te tuatahi, ko te nui ake watea hoki e taea te kawea ratou ki tetahi wahi i roto i te fare ma'i kāinga ranei mo te manawanui. Ko te pūrere e portionwise toto ki pā ana ki 40 ml i te wa, cleans hoki reira hoki i roto i te pū tōngāmimi, me te ano e toto. whakamahi ētahi pūrere te whakahaere aunoa o anticoagulants. I roto i te meneti kotahi, te taputapu plasmapheresis e taea ki te tukatuka e pā ana ki te 100 ml o te toto, ka taea e ie. E. Per haora tango e pā ana ki 800 mL o te wai i te taikaha.

Tohunga tūtohu tango kotahi wātū iti iho i te hauwhā o te wē komuhumuhu. titau Doctors tenei ahua i runga i te takitahi rānei: te taimaha me te rōrahi toto (CBV).

Kei te mohiotia te reira e te wē, ko te 55% o BCC. A i roto i te tikanga ki te whakatau i te ahua o muri, he mea e tika ana ki te tini i te taimaha tinana e 75. Hei tauira, he tangata kotahi 80 kg i roto i te kotahi wātū e hiahia ana koe ki te muku i te maha e whai ake nei o te wē:

80 x 75 x 825 ml = 0,55h0,25.

He mea nui ki te ū ki te hanganga katoa, whakahaere plasmapheresis. Hua me raru e o tikanga haumanu whakawhirinaki i runga i ngā āhuatanga maha, tae atu i te tika o te tātaitanga.

Ka taea e plasmapheresis kino ia?

Aita i maoro a'e, tūnga tenei hātepe utu te rite te raau no te mau ma'i katoa. haumanu Private kaha rawa i roto i te whakatairanga plasmapheresis. Hua me raru e o tenei tikanga, ko te tika ti'aturi i runga i te ngaiotanga o taote. Otiia rite noa tetahi atu tikanga o te maimoatanga, te mea ona pānga taha me ngā huakore:

• ru Anaphylactic.
• Mate pāwera ki te wē kaituku me whakakapi reira ki te wai.
• mate tākihi Autoimmune rite te tauhohenga ki te kaituku wē.
• Belgium i te kaituku wē.
• Ko te whanaketanga o te sepsis whai Waeine o ngā iroiti.
• Toto (ki te reira e raruraru ki te upoo-).
• Thrombosis (ki te kore tono anticoagulants).
• maturuturu i roto i te pēhanga toto.
• Tangohanga tāoke kore anake, engari ano hoki tahi nga matūkai me te wē.
• Toutou wātea i te mate.
• whakararuraru, pūkoro me te maha o ngā rongoā i roto i te toto.
• Whakapairuaki.
• Ānini.

Ko te tukanga tino nui, me te uaua tenei, na e hiahia ana koe ki te kia tupato i roto i te kōwhiri i te pae no te maimoatanga. He maha ngā hōhipera tūmataiti whakahere tūroro plasmapheresis. He aha te momo o pūtahi e mahi i reira tohunga, ahakoa o te taumira ko te tukanga? Katoa me te reira ki te mohio i mua i te whakaae ki te maimoatanga, kia rite kore ki te taka ki roto ki te ringa o ngā pāme ite ore. I muri i te katoa, ka taea e arahi i te reira ki te putanga kino.

Ka taea te tūmanakohia aha hua

Ko te tōtika o te plasmapheresis whakamatauria i te take o te maha mate. Wā whakaritea tukanga pānga pai noa, no te nga tohu whanaunga. Heoi, kia mohio ki taua mea e kore ai te āwhina tonu monotherapy. Na reira, ko te mea nui ki te tango i te maimoatanga whānui i ngaio aravihi, kahore falala ki whakaora i te akoranga kotahi o te tango i wē.

Hei whakatutuki i ngā hua pai, me waiho e koe mohio o te kounga o te tiaki me te mamae i te whakamātautau tuatahi ki te whakaū i te ngaro o contraindications ki te whakamahi o taua tikanga whakaora pērā i plasmapheresis.

Ko te utu o tenei tikanga, ko te tino nui (4500-5500 ths. Moni), a ka hiahia te manawanui neke atu i te kotahi ranei e rua, me 3-4 wā, te kore e kore e te maimoatanga hanga i tetahi tikanga. kia tenei kia whakaaro. Heoi, he maha haumanu whakahere pä ki te roanga o te akoranga, ko te neke atu i te 5 wā. Me kï reira e kore e taea e tenei tikanga e cheap, t. Ki. Ko te taputapu me ngā rauemi e inaianei tino utu. Heoi e kore e whakawhirinaki te whare hauora i reira whakamana te hātepe kei te i te utu tino iti.

Hei whakarāpopoto

Ae, mamae tenei maimoatanga pute o te manawanui, engari te mea utu reira. Whakapai ake i roto i te huru whānui, te whakaurunga o ngā mahi tiaki, me te vai, māori o ngā tawhā rheological o toto, tango o tohu o te haurangi - e kore te mea he rārangi ki tonu o te pānga pai e whakaaro tatou te tukanga i runga i te tinana tenei.

Ko te Plasmapheresis he mea hangarau hei awhina i te maha o nga turoro e whakatutuki ana i o ratou mate, me te horoi i te toto o te plasma "poke." Kei te whakaatuhia tenei tukanga ki te maha o nga mate, a, he torutoru noa nga whakapae. Ko te whakatinanatanga o te plasmapheresis me te awhina o nga tohunga tohunga me te mahi i nga tohutohu katoa e hua ana i nga hua pai i roto i te maimoatanga o nga mate tino mate.