Plasmapheresis - a ... Cascade plasmapheresis. ndizayo plasmapheresis

Plasmapheresis - indlela ndihambe ndikhetha ukuhamba plasma yegazi. Ekuhambeni inkqubo bangabi isuswe iiseli igazi, yaye plasma indawo ezingamanzi krovozamenyayuschimi. Oku, kunye ne-plasma ukusuka isuswe umzimba izinto eziyingozi (njengabalamli nangokurhala, cholesterol, lipids, endotoxins), viscosity igazi lehla, ukwanda novakalelo iziyobisi, ulungiso nezifo kwenzeka.

Yintoni plasma?

Yinto eyaziwayo ukuba igazi liqulathe iiseli ezibomvu nezimhlophe igazi, zegazi (thrombocytes) kunye ulwelo apho izinto data zikhona esiseleni ukumiswa. Le nto ilulwelo nesisombululo iiprothini kunye electrolytes yaye ubizwa ngokuba "plasma" (ifoto ziyafumaneka kweli nqaku).

Iindlela plasma zokuhlanjululwa

Plasma zokuhlanjululwa enokwenziwa ngamandla imikhosi omxhuzulane okanye amacebo ezizodwa. Kwimeko yokuqala, igazi idlule icentrifuge, kwimeko yesibini, a aneentunja izihluzi ndizayo.

Ukuze ukwahlula plasma negazi usebenzisa plasmapheresis ndizayo. Ebudeni ngenkqubo, iiseli igazi kususwe zokulinganisa kunye izinto eziyityhefu. Ukuze benze oku, i-plasma Yek ngokusebenzisa izihluzi ezizodwa. Inwebu plazmeferez - indlela ephumelelayo ngokwaneleyo ekunyangeni izifo ezahlukahlukeneyo, nto leyo iyahluka ngenxa okusingqongileyo yangaphakathi emzimbeni womntu. Amayeza kule meko abanamandla.

Ezi zifo ziquka:

• ukuphatheka;

• ukutsha kakhulu;

• ukukrala etsolo ngamalungu angaphakathi;

• ukunxila;

• izifo kakhulu.

Ngoncedo lwe inwebu plasmapheresis sifo eqhelekileyo, iyasebenza iiseli hematopoietic, ibalekisa inkqubo impiliso, ezi ngcanjana kwi intshukumo igazi yimithwalo, ukuba nokwenzeka ukufa eliphantsi kakhulu.

Xa igazi zokuhlanjululwa ngokuthi iiseli omzimba bungaveli iimpawu zezifo sokuhlasela. Ayihlambulule igazi namanqatha kwemfuneko, ibe lula ngenxa yegazi. Inwebu plasmapheresis unako ukuphucula imeko yomguli ngayo impilo emva radiation okanye nechemotherapy unyango. yimpumelelo kakhulu kuba iimeko ezifana nokusetyenziswa kakubi kweziyobisi, RH impixano okhulelweyo, usulelo enzala, sokubuyisa ixesha ekuphulukenwe emva hepatitis wentsholongwane egazini. Plasmapheresis ikuvumela ukuba zokunciphisa yeengxaki yesibini seswekile.

Yehlisa plasmapheresis - indlela nyulu igazi, owakhiwa lokuphumelela plasma nge lokucoca ezizodwa pores ezincinane ngokwaneleyo. Ngexesha inkqubo, i-plasma kususwa molekyuli ezinkulu kwamafutha kunye protini. Developed ubuchule ngo-1980 zizazinzulu Japanese. Namhlanje ke esisetyenziswa ngokubanzi kwi unyango ngenxa yamafutha a lot of lipids egazini, kwakunye nokuthintela ezimbi ezifana ngesibetho, kwemithambo, stroke. Inzuzo engqinekayo of plasmapheresis Cascade in systemic lupus zomzimba, isifo samathambo, isifo Crohn kaThixo, sisilonda sikabhobhosi, ezigula ezininzi , kunye nezinye izifo ezininzi.

Ixabiso lomxhasi kunye plazmeferez zonyango

Kubalizi plasmapheresis - inkqubo enala kwi plasma iqokelelwe exhasanayo (abantu okt besempilweni). izinto Inani kukopha kulawulwa ngokungqongqo ngumthetho phezu umnikelo. Ngaba ingatsalwa igazi lomntu ligqithise kusetyenziswa izixhobo ezikhethekileyo, kwasekwa izinto obegalelwe umva, kwaye plasma kubangele yathotyelwa Preservation kwaye isetyenziswe ukwenza iimveliso igazi okanye igazi elandelayo.

Ngexesha inkqubo zonyango ngexesha kusetyenzwa negazi-30% yesigulane. nezabelo zayo zisuswe emzimbeni, balityhutyha izixhobo, wathulula emva zibe kwimeko okuhlamba.

Izinto ezibonisa ukuba inkqubo

Plasma unaniso hayi impatho, leyo yenziwe yonke emgceni. Le ndlela abangabancedani ozikhethelayo unyango, xa uthomalaliso ephambili ayiniki isiphumo oyifunayo.

Ngaphandle izifo ngasentla, unyango plasmapheresis eboniswe xa:

• utshwala;

• ukuziyeka;

• isifuba inyumoniya;

• Oncology;

• isifo sentliziyo;

• angina;

• wegazi;

• thromboembolism;

• nezilonda trophic le wokugaya;

• ukuqina;

• isibindi;

• glomerulonephritis kunye nephrotic syndrome ;

• lwegazi eliyinjubaqa ukuba unyango;

• mothuko yokubolisa kwinkqubo ubovu;

• izifo dermatological.

Izimo

Izimo Absolute kule nkqubo zezi isilonda duodenal kunye nesisu, ekhatshwa ukopha kunye ekunqandeni ukuphazamiseka.

Kuba Izimo isihlobo ziquka:

• kubuhlungu, ukothuka anaphylactic kunye nezinye iintlobo;

• isifo sesibindi kakhulu, uhlobo yayiyazi sohlobo esosulelayo;

• Izigulane kweminyaka engama-70 ubudala, abaphethwe anaemia libambisene kunye nesifo sentliziyo;

• inethiwekhi ngokwaneleyo kakhulu lwemithambo peripheral.

ziphumo bezingalindelekanga kunokwenzeka

Ngokusisiseko, le nkqubo ukunyamezeleka kakuhle. imeko migraine kungenzeka kunqabile kakhulu okanye isicaphucaphu wobulali. Kodwa iziganeko ezinjalo angazithandiyo ngokwabo ngexeshana elifutshane.

Le nkqubo ke kuyingozi enkulu kuphela kwimeko igazi amahlwili abangamahlwempu isigulana: ukopha zinokwenzeka. Xa kulungiswa igazi nokuthintela ukuba oku Mhise usebenzisa anticoagulants. Xa ekunqandeni embi ongeziweyo ezinjalo kunokubangela ngokupheleleyo igazi nesvorachivaniya.

izixhobo ezisetyenziswayo

Izixhobo apho plasma siyahlukana (ekunene), abaphathwayo nezinto zokubhala. Iseshoni yokuqala plasmapheresis kuvumela ekhaya yesigulana. izixhobo Modern uthathe inxalenye encinane igazi ucoce nganye nganye. izixhobo eziphathekayo Kuyinto elula kuba kube lula ukudluliselwa ethile kwebhedi, ngaphandle kokunikezela kwi inkqubo kwelinye igumbi.

Emva abangama-ml 40 yegazi iyatsalwa, ukuhamba kwegazi ivaliwe valve okhethekileyo. Igazi nyulu kunye Wabuya waya emzimbeni. Emva koko kuza inxalenye entsha ucingo. Ngoko ke, ngethuba inkqubo angacingi waziva.

umatshini Good kuphela ekwaziyo ngcaciso wokucoca wabuyela 100 ml igazi emzimbeni wakhe. Ngaloo ndlela iyure enye ukuvelisa malunga 800 ml plasma.

Ukuphuhliswa kwenkqubo

Ubude unyango imalunga 90 imizuzu. Akukho kabi ngexesha ubambe ukuba akukho ngayo. Le isigulane ibekwe esihlalweni ekhethekileyo, imithambo zombini izandla catheter yokufaka umfanekiso. Okulandelayo, isigulana uyakwazi ukumamela umculo okanye ukubukela TV, ukuba kukho omnye eklinikhi. Yonke into iza kwenza icebo. De inkqubo yokugqibela, imeko yomguli ithe rhoqo esweni: umlinganiselo uxinzelelo igazi lakhe, ukuphefumla, izinga lentliziyo kunye kukho ioksijini egazini.

Ngexesha leseshoni enye nyulu ukuya kwi 25-30% kwegazi, ngoko ke ukucoca ngokucokisekileyo ifuna ubuncinane zonyango-3. Imali wegazi ukuba icocwe ukuba iseshoni, ugqirha umisela isiseko ngamnye, kuthathelwa ingqalelo ubunzima umguli, ubudala bakhe kunye nemeko ngokubanzi umzimba.

Ukuhlanjululwa ngegazi utyando oluntsonkothileyo, ngoko emva kokuba igqityiwe isigulane kufuneka uhlale phantsi kweliso abaziingcali imizuzu 30-60.

Plasmapheresis angenza ngaphandle uqeqesho olulodwa. Kwaye akukho mfuneko yokuba balandele ngqo le nkqubo emva nayiphi na ingcebiso ethile. Noko ke, kwezinye iimeko, ugqirha wakho ukunika ingcebiso ethile.

Plasmapheresis ngexesha lokukhulelwa

Le nkqubo iya kulawulwa ukulungiselela ukukhulelwa kunye nothintelo, kwakunye enye unyango. Phambi ukukhulelwa, le ndlela isetyenziswa ukususa obuba- wayiqokelela emzimbeni womfazi ukutshaya. Ukuba ngethuba ephethe usana umfazi bathuthunjiswe a toxicosis nkqi, sele iiseshoni ezimbini plasmapheresis uncedo ngcono imeko umama okhulelwe.

Plasmapheresis ukuba amabhinqa kunye toxicosis kakhulu kwaye insufficiency placental baphathe ngempumelelo uze uzale umntwana onempilo.

Le nkqubo lunciphisa ubungozi beengxaki ezifana usulelo intrauterine, LBW kunye anoxia, amaxesha 1.5. Plasmapheresis kunciphisa amathuba ukopha ngexesha lokuzalwa komntwana, njengoko ubume eqhelekileyo igazi kwaye unciphisa amathuba okuba thrombus Ukwakheka.

Kwimeko yokukhulelwa kakhulu, le ndlela kuba neziphumo ezihle kakhulu. Ukusetyenziswa plasmapheresis saba kwezi meko zilandelayo:

• uhlobo nezolo yokukhulelwa;

• ukusebenza Ukunqongophala yemithi;

• Ukudumba kakhulu.

ngeseshoni zilungiswa kwi-40% igazi. Kuyimfuneko ukwenza zonyango-2 okanye ngaphezulu emva kwesithuba seentsuku 3-4.

Ingaba le nkqubo iyingozi?

Plasmapheresis - inkqubo phantse ekhuselekileyo.

1. Sebenzisa ngemibhobho ezilahlwayo kuphela, catheters. Zonke Kits engenazintsholongwane ngokupheleleyo kwaye atywinwe.

2. kusoloko isigulana phantsi kweliso zonyango.

3. Le nkqubo into elula. ukuphazamiseka yegazi akwenzeki kule nkqubo: ukuncitshiswa igazi engabalulekanga urhoxile emzimbeni, xa ukwandisa - ayajika umva.

4. Xa plasmapheresis ayisebenzi amayeza inokubangela iziphumo ebezingalindelekanga okanye iingxaki. Saline esetyenziselwa ihlamba iityhubhu, udlula kuyo igazi.

Plasmapheresis: iindleko zale nkqubo

Phambi kokuba uthathe inkqubo plasmapheresis kuyimfuneko ukuqinisekisa igama elihle ekliniki. Iinkcukacha kufuneka ibe kuphela kumaziko ezikhethekileyo zonyango kunye namava esiluqilima ekwenzeni le nkqubo. Kufuneka enze kuphela ziingcali abaqeqeshiweyo nabanamava ngokukhethekileyo. Kufuneka baqaphele amaxabiso zathi zavela ephantsi plasmapheresis. Ixabiso elinye ezikliniki Moscow iphakathi 4-5 amawaka. Engange. Ikhosi ixabiso iinkqubo 5 plasmapheresis kwi-avareji 19-22 amawaka. Engange.