Plasmapheresis - a ... Cascade plasmapheresis. Kamudzira plasmapheresis

Plasmapheresis - nzira achibvisa kubva riparadzirwe ropa plasma. Nokufamba nzira hadzina kubviswa masero eropa, uye plasma anotsiviwa krovozamenyayuschimi mvura. Izvi, pamwe plasma kubva muviri akabvisa zvinokuvadza (nevamiririri venyika kuzvimba, remafuta akawandisa, lipids, endotoxins), ropa viscosity kunoderedza, wakawedzera zvinodhaka wanda, kutapata kururamiswa kunoitika.

Chii yeplasma?

Zvinozivikanwa kuti ropa unotora matsvuku masero eropa, maplatelet (thrombocytes) uye mvura umo mashoko zvinhu varipo muchitokisi kuturika. mvura iyi iri mhinduro kwemapurotini uye electrolytes uye anonzi "yeplasma" (mufananidzo zvinowanikwa munyaya).

Nzira yeplasma yokuzvinatsa

Plasma yokunatsa anogona kuitwa nesimba rinokweva mauto kana chinokosha filters. Muchiitiko chokutanga, ropa riri vakapfuura centrifuge, kana yechipiri, munhu porous Kamudzira filters.

Kuti vaparadzanise yeplasma kubva ropa achishandisa Kamudzira plasmapheresis. Nokufamba nzira, masero ropa vanobviswa kutsigisa igwa uye zvine chepfu. Kuti aite izvi, plasma iri kwakadonhera kuburikidza chaiwo filters. Kamudzira plazmeferez - nzira zvakakwana inobudirira kurapa zvirwere zvakasiyana-siyana, izvo dzinosiyana nokuda dzomunyika ezvinhu womunhu muviri. Mishonga iyi ezvinhu simba.

zvirwere izvi zvinosanganisira:

• kunotevera;

• nyanya Unopisa;

• chenjera kuzvimba zvomukati;

• kudhaka;

• chakakomba noutachiona.

Achibatsirwa Kamudzira plasmapheresis kwagara kutapata, kusashanda masero hematopoietic, Inowedzera apore, asi capillaries iri kufamba ropa nokukurumidza, mukana wokuti rufu ipfupi kwazvo.

Kana yokunatswa nemasero zvirwere ropa yakapedza zviratidzo autoimmune zvirwere. Natsai ropa yebongozozo mafuta, inogona akwanise kuti atherosclerosis. Kamudzira plasmapheresis kunogona kuvandudza murwere ezvinhu utano pashure nemwaranzi kana mishonga kurapa. Very zvakabatsirawo ezvinhu akadai kushandisa zvinodhaka, kusawirirana kweropa raamai kusawirirana pamuviri, urogenital utachiona, kupora nguva pashure nemavhairasi chiropa. Plasmapheresis unokubvumira kurerutsa mukana wokuti yechipiri yematambudziko ose cheshuga.

Cascade plasmapheresis - nzira achinatsa ropa, wakaumbwa plasma vanopfuura kuburikidza rinokosha Sefa pamwe pores diki zvakakwana. Munguva nzira, plasma rinocheneswa huru mamorekuru mafuta uye mapuroteni. Kunotangwa magadzirirwo akanga 1980 nemasayendisiti Japanese. Nhasi rinoshandiswa chaizvo pakurapa atherosclerosis ine zvakawanda lipids muropa, uyewo kudzivisa pathologies akadai sitiroko, aneurysm, sitiroko. Itariro zvakanakira plasmapheresis Cascade mune chinonzi systemic lupus erythematosus, dzinonzi rheumatoid arthritis, Crohn, chirwere maronda colitis, vakawanda myeloma , uye zvimwe zvirwere zvakawanda.

Anenge apa wacho anoderedzerwa uye zvokurapa plazmeferez

Anenge apa wacho anoderedzerwa plasmapheresis - muitiro randinogara mune plasma inounganidzwa kubva anyatsoronga (vanhu kureva hwakanaka). Number ropa zvinhu iri zvachose nokudzorwa mutemo pamusoro kuzozvidzorerwa. Vari wakasuduruka ropa romunhu akanga achipfuura chaiwo midziyo, vakaumba zvinhu yakadirwa shure, uye kunoguma yeplasma akanga pasi rimwe richengetedzwe uye rinoshandiswa kuti vaunze zvinogadzirwa neropa kana tevera ropa.

Panguva yezvokurapa nzira panguva chinogadzirwa uye ropa 30% romurwere. migove Its vanobviswa kubva mumuviri, vakayambuka midziyo akadururira shure kupinda Yakanatswa mamiriro.

Zvairatidza kuti nzira

Plasma Exchange haisi kurapwa, izvo zvinogona kuitwa zvose pamusara. Opsioneel ebetsero kurapwa nzira iyi, kana mukuru kurapa Haapi achida mugumisiro.

Kunze kubva pamusoro nezvirwere, kurapa plasmapheresis pavanotsvaka:

• kudhakwa;

• kupindwa muropa;

• Árbol asima;

• oncology;

• nechirwere chemwoyo;

• angina;

• neBP;

• thromboembolism;

• trophic nemaronda of zvomudumbu turakiti;

• cirrhosis;

• chiropa kutadza;

• glomerulonephritis pamwe nephrotic urwere ;

• neBP refractory zvokurapa;

• septic kuvhunduka mu purulent kwacho;

• dermatological zvirwere.

Contraindications

NeMhedziso contraindications nzira iri duodenal urikanwi uye dumbu, pamwe nekudeura ropa uye pakugwamba zvirwere.

Nokuti hama contraindications dzinosanganisira:

• zvinorwadza, anaphylactic kuvhunduka uye mamwe marudzi;

• zvakakomba chiropa chirwere, kusachengeteka kukuru chimiro rwarisa chiropa;

• Varwere makore vakuru 70 okuberekwa, achitambura kupererwa neropa pachiimbwa mwoyo chirwere;

• insufficiently zvakakomba peripheral venous network.

Possible nemishonga

Zvikurukuru, muitiro wacho kwazvo Akashivirira. migraine ezvinhu anogona kuitika chaizvo kashoma kana vanyoro svoto. Zvisinei zvisingafadzi zviitiko zvakadaro pachavo munguva pfupi.

The nzira iri nengozi chete panyaya murombo kweropa iri murwere: ropa zvinogona kuitika. Kana processing ropa kudzivirira kubva tikaisa uchishandisa anticoagulants. Kana zvakaipa pakugwamba yokuvirisa kwakadaro kunogona kukonzera wakakwana nesvorachivaniya ropa.

kushandiswa michina

Mano umo plasma anosiiwa (kurudyi), ndivo inotakurika uye mira. The chegungano plasmapheresis wokutanga anobvumira musha kunyange murwere. Modern mano kutora chikamu chiduku ropa uye kuchenesa mumwe wavo mumwe. Portable michina iri nyore nokuti hunogona kungoparara Kutamiswa uye akaisa pamusoro pomubhedha, pasina tama kuti nzira mune rimwe kamuri.

Pashure dzinokwana 40 ml wakasuduruka ropa, ropa riyerere kukurukurirana kwacho chaiko vharafu. Ropa anatswa ndokudzokera kunyika muviri. Ipapo mugove mutsva fenzi unouya. Saka, mukufamba nzira asingadi kunzwa chero kusanzwa.

muchina Good chete vanokwanisa rokuchenesa miniti ndokudzokera muviri murwere 100 ml ropa. Nokudaro awa rimwe anogona kubereka vanenge 800 ml plasma.

Development of nzira

Duration kurapwa anenge 90 maminitsi. No kusagadzikana apo akabata haina akanzwa. Murwere anoiswa rinokosha cheya, ari mutsinga vose maoko anobudisa mushonga zvishoma nezvishoma kupinza. Next, murwere anogona kuteerera mumhanzi kana vakarinda TV, kana pane mumwe ari kiriniki. Zvimwe zvose zvichaita kuti mudziyo. Kusvikira pakupedzisira nzira, murwere nemamiriro kunoramba kuongororwa: kuyera ropa rake kumanikidzwa, kufema, mwoyo mwero uye kuvapo okisijeni muropa.

Panguva imwe anogona kunatsa kusvika 25-30% ropa, saka munhu wandei zvinoda kushoma 3 nokurapwa. Huwandu ropa kucheneswa kuti chirongwa, chiremba inosarudza nomunhu, kufungisisa kurema murwere, zera rake uye mukuru ezvinhu muviri.

Kuchenesa ropa iri yakaoma muitiro, saka yangopedzwa murwere unofanira kugara pasi pokudzora nyanzvi maminitsi 30-60.

Plasmapheresis kuita pasina dzidzo chinhu chinokosha. Uye hazvina zvakakodzera kuomerera nzira pashure chero chipi zvacho kurumbidzwaka. Zvisinei, mune zvimwe zviitiko, chiremba wako anogona kupa vamwe mazano.

Plasmapheresis panguva pamuviri

The nzira inogona kupiwa pakugadzirira pamuviri uye kudzivirirwa, uyewo mumwe kurapa. Asati pamuviri, unyanzvi ichi rinoshandiswa kubvisa tsvina kuti Makawana mumuviri mumwe mukadzi fodya. Kana panguva pakutakura mwana mumwe mukadzi anoshushikana ane simba toxicosis, kare purogiramu maviri plasmapheresis rubatsiro yekudyidzana kuvandudza mamiriro amai vanepamuviri.

Plasmapheresis runoita vakadzi zvikuru toxicosis uye placental insufficiency nokubudirira kutakura uye kubereka mwana ane utano.

nzira iyi kunoderedza ngozi matambudziko akadai intrauterine utachiona, LBW uye anoxia, 1.5 nguva. Plasmapheresis waanodzikisira mukana ropa pakusununguka, sezvo kuipa Zvinoumba ropa uye zvinoderedza mukana wokuti thrombus inotungamirwa.

Kana zvikuru preeclampsia, nzira iyi anopa nemigumisiro yakanaka chaizvo. Kushandiswa plasmapheresis akaratidza zvinotevera nyaya:

• idzokororo chimiro preeclampsia;

• Kushomeka kunyatsoshanda zvinodhaka;

• zvakakomba kuzvimba.

Per chechikamu vari kupatsanurwa kuti 40% ropa. Zvakakosha kuita 2 kana kupfuura kurapwa pane zvikamu mazuva 3-4.

Ko nzira ngozi?

Plasmapheresis - a husingakuvadzi ngozi.

1. Shandisa kuraswa sepombi chete, catheters. Kits ose chena zvachose uye rakanamwa.

2. Murwere anogara pasi zvokurapa achitarisirwa.

3. The nzira iri nyarara. Kweropa rikavapo hariwaniki kwacho vari: rutapudzo rimwe myocardial ropa wakasuduruka mumuviri, kana kuwedzera - inoyerera shure.

4. In plasmapheresis hazvirevi kushandisa mishonga anogona kukonzera marwadzo kana matambudziko. Sesaline inoshandiswa pakushambidza sepombi, kuburikidza icho chinopinda muropa.

Plasmapheresis: Mari nzira

Usati wasarudza pane imwe plasmapheresis nzira zvakafanira nechokwadi mukurumbira kuchipatara zvakanaka. Contact anofanira bedzi mune kushandiswa zvokurapa masangano pamwe hwakasimba ruzivo mukuita nzira iyi. Inofanira tiite chete ruzivo nenyanzvi zvikuru vakadzidziswa. Unofanira kuona achinyumwira yakaderera mitengo kuti plasmapheresis. Mari imwe chete muMoscow makiriniki riri pakati 4-5 zviuru. Rubles. Course mutengo 5 plasmapheresis nzira Paavhareji zviuru 19-22. Rubles.