ImpiloImithi

Plasmapheresis - a ... Cascade plasmapheresis. ulwelwesi plasmapheresis

Plasmapheresis - indlela ukususa kwegazi legazi plasma. Ngokuhamba inqubo kungukuthi isuswe egazi, ne-plasma esikhundleni uketshezi krovozamenyayuschimi. Lokhu, kanye plasma kusukela umzimba zisuswe izinto eziyingozi (mediators ukuvuvukala, i-cholesterol, lipids, endotoxins), igazi viscosity kwehle, ukwanda kokusetshenziswa ukuzwela, amasosha omzimba ukulungiswa kwenzeka.

Uyini-plasma?

Kuyaziwa ukuthi igazi yakhiwa obomvu nomhlophe egazi, izinhlayiya zegazi (thrombocytes) futhi uketshezi lapho okuhlala khona izakhi idatha abakhona ekumisweni cell. Lo luketshezi yisisombululo amaprotheni electrolyte futhi ubizwa ngokuthi "plasma" (isithombe esitholakalayo esihlokweni).

Izindlela plasma uhlanzekile

Plasma uhlanzekile kungaba kwenziwe ngamandla amandla adonsela phansi noma okuhlungayo ekhethekile. Esimweni sokuqala, igazi idlule Centrifuge, esimweni sesibili, a ukungena nakwamanye amazwe ulwelwesi izihlungi.

Ukuze ukwehlukanisa plasma egazini usebenzisa plasmapheresis ulwelwesi. Ngokuhamba inqubo, amaseli weengazi ziyasuswa isikebhe sizinze futhi ezinobuthi. Ukuze wenze lokhu, plasma is distilled kuzihlungi ekhethekile. Ulwelwesi plazmeferez - indlela ngokwanele ngempumelelo ekwelapheni izifo ezihlukahlukene, okuyinto kuyehluka ngenxa imvelo yangaphakathi zomzimba womuntu. Imithi kulesi simo abanamandla.

Lezi zifo zihlanganisa:

  • ukuhlukumezeka;

  • ukusha ebanzi;

  • ukuvuvukala okukhulu kwezitho zangaphakathi;

  • ukudakwa;

  • ngamagciwane okunzima.

Ngosizo ulwelwesi plasmapheresis amasosha omzimba abaphilile, amangqamuzana hematopoietic yasebenza, esheshisa inqubo ukuphulukiswa, ama-capillary kulengqungquthela igazi yanda, amathuba ukufa ancipha kakhulu.

Lapho igazi uhlanzekile amasosha omzimba iqedwe owabona izimpawu zezifo sokuhlasela kwamasosha omzimba. Ahlanze igazi fat ngokweqile, kungenziwa lula i-atherosclerosis. Ulwelwesi plasmapheresis angathuthukisa isimo lesiguli zempilo ngemva ngemisebe noma imiphumela emibi yokwelashwa ngamakhemikhali ukwelashwa. ngempumelelo kakhulu izimo ezifana nokusetshenziswa kwezidakamizwa, RH ukungqubuzana ukhulelwe, urogenital ukutheleleka, isikhathi emumva ukusha kwesibindi kohlobo ezibangelwa amagciwane. Plasmapheresis ikuvumela zokunciphisa izinkinga yesibili sikashukela.

Cascade plasmapheresis - indlela ukuhlanza igazi, owakhiwa pass plasma ngokusebenzisa lemifanekiso obukhethekile ikhule ezimbotsheni sincane ngokwanele. Ngesikhathi inqubo, plasma kususwa amangqamuzana omoya ezinkulu fat and amaprotheni. Sikhanyisiwe inqubo kwaba ngo-1980 ososayensi Japanese. Namuhla abantu abaningi esetshenziselwa ukwelapha isifo sokuqina kwemithambo yegazi kanye eziningi lipids egazini, kanye nokuvimbela pathologies ezifana nesifo sohlangothi, isifo sokuvuvukala kwemithambo, isifo sohlangothi. izinzuzo bokuthi plasmapheresis Yendlala omzimba izicubu erythematosus, i-rheumatoid arthritis, isifo Crohn, izilonda emathunjini, myeloma amaningi , kanye nezinye izifo eziningi.

Anikelelwe futhi plazmeferez yezokwelapha

Anikelelwe plasmapheresis - inqubo esakhiwa ngo-plasma eqoqwe esibuya (abantu ie okunempilo). Inombolo ukopha impahla akuvunyelwe kulawulwa umthetho phezu umnikelo. Ingabe kuhoxiswe kusukela igazi engabantu idlule apharathasi ekhethekile, kwakheka izakhi kuthululwe emuva, futhi plasma wafakwa sesimeni ukulondolozwa futhi lisetshenziselwa ukukhiqiza imikhiqizo yegazi noma ngokumpontshelwa okwalandela.

Ngesikhathi inqubo yezokwelapha ngesikhathi icutshungulwe negazi 30% lesiguli. izingxenye zayo isuswa umzimba, badabula apharathasi wathela esimweni ukuhlanzwa.

Izinkomba inqubo

Plasma exchange akuyona indlela evamile yokwelapha, okungase kwenziwe yonke ilandelana. Lokhu akuphoqelekile asizayo ukwelashwa indlela, lapho ukwelashwa main akukuniki elamukelekile.

Ngaphandle nje kokuthi izifo ngenhla, ukwelapha plasmapheresis eboniswe lapho:

  • ukuluthwa utshwala;

  • yizidakamizwa;

  • isifuba somoya bronchial;

  • Oncology;

  • isifo senhliziyo,

  • angina;

  • nomfutho wegazi ophezulu;

  • thromboembolism;

  • izilonda trophic ka ipheshana wokugaya ukudla;

  • isifo sokusha;

  • yokwehluleka kwesibindi ukusebenza;

  • glomerulonephritis nge nephrotic syndrome ;

  • nomfutho wegazi ophezulu refractory ekukhetheni izindlela zokwelapha;

  • ukushaqeka ukonakala inqubo ubovu;

  • izifo dermatological.

Izimo

Izimo Ingabe Ohulumeni Banalo Lonke isebenzisa le nqubo kukhona isilonda duodenal nasesiswini, ephelezelwa ukopha futhi ekunqandeni iziyaluyalu.

Ukuze Izimo isihlobo zihlanganisa:

  • esibuhlungu, ukushaqeka anaphylactic kanye nezinye izinhlobo;

  • isifo sesibindi ezinzima, ifomu acute kwesibindi samafayela;

  • Iziguli abaneminyaka engaphezu kuka-70 ubudala, ohlushwa isifo sokulahlekelwa igazi ngokuhlanganyela isifo senhliziyo;

  • insufficiently ezinzima neuropathy inethiwekhi emithambo yegazi.

Imiphumela engemihle

Empeleni, le nqubo ibizwa kahle ibekezelelwe. isimo migraine singenzeka kakhulu akuvamile noma isicanucanu omnene. Nokho izenzakalo ezingemnandi abanjalo bangabaphostoli ngokwabo ngesikhathi esifushane.

Inqubo Uyingozi kakhulu kuphela uma abampofu igazi ekunqandeni e isiguli: ukopha singenzeka. Lapho kucutshungulwa igazi ukuze ngikuvimbele kubelethwa usebenzisa anticoagulants. Lapho ekunqandeni ezimbi izithasiselo ezinjalo kungabangela ephelele nesvorachivaniya igazi.

imishini esetshenziswa

Amadivayisi lapho plasma ahlukaniswa (kwesokudla), kukhona ephathekayo futhi umile. Kokuqala plasmapheresis uvumele ekhaya ngisho lesiguli. amadivaysi Modern ukuthatha ingxenye encane igazi nokuhlanza ngayinye ngayinye. imishini ephathekayo kuyinto elula ngoba angadluliselwa kalula bese usetha mayelana eliseceleni kombhede, ngaphandle kokunikezela ke inqubo kwelinye ikamelo.

Ngemva ingqikithi 40 ml igazi likhishwa, ukugeleza kwegazi ivinjelwe Isivalo esikhethekile. Igazi zihlanjululwa futhi wabuya libuyiselwa emzimbeni. Bese kuba ingxenye entsha kocingo. Ngakho-ke, ngokuhamba inqubo engazizwa yimuphi kabi.

umshini Good kuphela abazokwazi yokuhlanza kancane bese babuyela umzimba lesiguli 100 ml igazi. Ngakho ihora elilodwa angakhiqiza mayelana 800 ml plasma.

Ukuthuthukisa inqubo

Ubude besikhathi sokwelashwa imayelana 90 imizuzu. Ayikho ukungakhululeki ngenkathi ephethe it is hhayi wazizwa. Isiguli is ibekwe esihlalweni esikhethekile, ngemithambo kokubili Ukufakwa izandla ipayipi. Ngokulandelayo, isiguli Ungalalela umculo noma iwashi TV, uma ikhona e emtholampilo. Yonke enye into kuzokwenza idivayisi. Kuze inqubo zokugcina, isimo lesiguli njalo ukugadwa: yokulinganisa umfutho wegazi, ukuphefumula, nokushaya kwenhliziyo kanye khona komoya-mpilo egazini.

Kwesinye isimiso somhlangano zingahlanza kuze kufinyelele 25-30% egazini, ngakho-ke wekulihlanta kudingeka okungenani ube 3 ukwelashwa. Inani igazi ukuba zihlanzwe kwisikhathi, udokotela enquma umuntu ngamunye, ikhumbula isisindo isiguli, ubudala nesikhundla sakhe phambi isimo jikelele zomzimba.

Uhlanza igazi kuyinto inkimbinkimbi, ngakho ngemva kokuqedwa kwalo isiguli kumele uhlale ngaphansi kokuqondisa onguchwepheshe imizuzu 30-60 of.

Plasmapheresis ongakwenza ngaphandle ukuqeqeshwa okukhethekile. Futhi akudingekile ukuba banamathele inqubo ngemuva izincomo ethile. Nokho, kwezinye izimo, udokotela wakho angakunika izeluleko ezithile.

Plasmapheresis ngesikhathi sokukhulelwa

Inqubo ingasatshenziswa belungiselela ukukhulelwa kanye nokuvinjelwa, kanye omunye ukwelashwa. Ngaphambi ukukhulelwa, le ndlela isetshenziswa ukususa ubuthi ezinqwabelene emzimbeni we ukubhema wesifazane. Uma ngesikhathi lokuyisa ingane owesifazane bahlushwe a toxicosis eqinile, kakade ezimbili umhlangano plasmapheresis usizo kakhulu isimo umama okhulelwe.

Plasmapheresis kwenza abesifazane nge toxicosis ezinzima futhi esingamahlalakhona esinomhlapho baphathe ngempumelelo futhi ubelethe ingane ephile saka.

Le nqubo kunciphisa ingozi izinkinga ezifana intrauterine ukutheleleka, LBW futhi anoxia, izikhathi 1.5. Plasmapheresis kunciphisa amathuba ukopha ngesikhathi sokubeletha, njengoba ukwakheka evamile wegazi kunciphe amathuba thrombus kumiswa.

Endabeni ka preeclampsia ezinzima, le ndlela linikeza imiphumela emihle kakhulu. Ukusetshenziswa plasmapheresis wazibonakalisa kulezi zimo ezilandelayo:

  • ifomu yansukuzonke ye preeclampsia;

  • kahle enganele izidakamizwa;

  • ukuvuvukala ezinzima.

Per session okwenziwa 40% igazi. Kuyadingeka ukuba afeze ukwelashwa 2 noma ngaphezulu ngezikhawu 3-4 izinsuku.

Ingabe inqubo eyingozi?

Plasmapheresis - inqubo cishe ephephile.

  1. Sebenzisa amashubhu alahlwayo kuphela, catheters. Zonke kits azinamagciwane ngokuphelele futhi babekwa uphawu.

  2. Isiguli uhlale ngaphansi kweso lwezokwelapha.

  3. Inqubo kobuhlungu. ukuphazamiseka Sokujikeleza ingekho inqubo: zokunciphisa igazi esivimba amanzi kuhoxiswe umzimba, lapho ekwandiseni - ngulona logeleta emuva.

  4. Ngo plasmapheresis asisebenzi imithi kungadala nemiphumela engemihle noma izinkinga. Saline esetshenziselwa ukugeza amashubhu, lapho sihamba igazi.

Plasmapheresis: izindleko inqubo

Ngaphambi kokunquma inqubo plasmapheresis kuyadingeka ukuqinisekisa idumela elihle emtholampilo. Imininingwane kufanele kube kuphela izikhungo ezikhethekile yezokwelapha abanolwazi eziqinile kwenziwa le nqubo. Kumelwe bafeze kuphela ochwepheshe abanolwazi abaqeqeshiwe. Kufanele wazise izintengo eziphansi ezisolisayo ngoba plasmapheresis. Izindleko esisodwa emitholampilo eMoscow esiphakathi ayizinkulungwane 4-5. Ruble. Intengo Inkambo 5 izinqubo plasmapheresis ngokwesilinganiso 19-22 izinkulungwane. ruble.

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