Plasmapheresis - He aha ka mea? Plasmapheresis: pono a me kaʻino, contraindications, kala a me epekema. pākōlea plasmapheresis

He nui kēia nā keʻena lāʻau lapaʻau ma ka hopeʻumi makahiki, hoomaka ae la e kaumaha aku i kekahi kumu ina hana - plasmapheresis. He aha ka mea, a ma lalo o ka maʻi ka mea, ua hōʻike 'ia nei? Ina keia iaoiaeii ka pilikia, a pehea ia ua pau keia la? Eia nō i ka papa kuhikuhiE nīnūnē e ala aʻeʻoe i loko o nā mea maʻi, i ka wa e waiho aku i kū hoʻokahi, ke ala e hoomaemae i ke koko mai ka "slags".

He aha ka plasmapheresis?

Kēia kēia hana o ka hoʻomaʻemaʻe i ke kino ma ka ke kelepona hele kiʻekiʻe ma nā kānana i ke koko ma kūikawā manaʻo. Ua Ua manaoia no ka iapaau ana o ka maʻi he nui a me ka mea i ka wale ke ola no kekahi mea pohihihi keia maʻi. Kaʻia "plasmapheresis" he o nā hua'ōlelo elua - ". Wai koko pōpilikia '" "plasmas" a me ka "apheresis" i Roma hiki ke literally unuhi like

Ke kaʻina hana i lawe mai i loko o ka haukapilaʻo lehulehu, a pilikino nā keʻena lāʻau lapaʻau, a hiki i kekahi manawa ma ka home. Plasmapheresis koko hoʻolimalima i iaia ma ka pau ana o ka hope ke kenekulia, akā, ua mua kauoha aku e hoola haneri o na tausani kanaka ka ola o.

Mōʻaukala o ka me Kinohi iaoia

Kēia papa hana nā lā hoʻi i ka hoʻohana 'ana o ke koko-ka hoʻokuʻuʻole i like me ka hana ana i kekahi maʻi. No ka lōʻihi manawa, keia "barbaric" aoao o ka Inc i ua poina e na kumu, akā, ma ka kualapa waena XX kenekulia, loea, ua hoʻomaka e hoao e hana i kekahi mea no ka hookaawale ana i ke koko i loko o kūlana a me ka wehe 'ana o kona wai a hapa e paka i ka pākōlea hopena.

Ua i loko o ka 70-80 makahiki o ka plasmapheresis i ua 'Imi hoʻohana ma o ka US, a loaa hiʻona i loko o ka USSR. Akā, i ka conclusiveness o ka laulā o ka iaoiaeii i ole i kiʻekiʻe lawa, no ka mea, lapaʻau hoao e noi mai ana na makahiki o ka hana. Eia naʻe,ʻepekema i ole hoi, a hoomau iho la oia i ka noiʻi i plasmapheresis. He aha ka mea lawe mai i ke kanaka? Epekema manaopaa i lapaau i ka pono a me ka pono ka ke ala e hoʻomaʻemaʻe i ke koko. Currently wehe ' "ua hoʻohaumiaʻia" wai koko ua noʻonoʻo i ka loa ka hoʻokō hana i na mea he nui pathological Hawaii i komo pū' ia e likeʻole intoxications meaola.

He aha ano a me kāu kiʻina hana nei plasmapheresis

Aia i ekolu papa kuhikuhiE Mea Maluna o ka plasmapheresis.

1. Ma ka manawa i oleloia ai

Inā koko huikala mea pākōlea ma ke ano maoli, a ua hoʻohana 'ia e wehe i kekahi maʻi a ana, ia mea - pākōlea plasmapheresis. i hoi Pela i wae 'hoʻokino oihana mua i ke ahonui, a me ka wai koko ua UAIAaIN ma ka pou koko a he kupaianaha pāʻoihana.

Inā ke kaawale ana o ke koko me ka mākaʻi e loaa ka wai koko mai ola kanaka no ka hou ana, ua kapaia ia ka ina hana plasmapheresis mau pou.

2. Ma ala o

Aia He He discrete plasmapheresis a me ka 'akomi. Ma ka hihia mua i ka hoʻomanawanui i lawe i ka nui o ke koko e waiho i loko o ka sterile ipu me preservatives a me ka hana wai koko kaawale ana ma ka centrifugation ole ke kimu ole. A laila, i ka hoʻomanawanui ua injected intravenously koe ma hope o kona wehe 'ia o ka halepaahao nuipa o ka wai koko, nāu kekahi me ka Saline. Kēia papa hana ua kekahi kapa o ka manuale.

Me ka 'akomi plasmapheresis koko ohi, kānana, a hoʻi ia i ka ipu e paa ana ma ka liʻiliʻi apana ma ke kumu o ke kaawale ana noonoo. A, a pau keʻano o ka hanaʻana lawe wahi noke. Kēia iaoia Ua oiʻoluʻolu no ka hoʻomanawanui mea nui oi lawe lima, a ua ālai 'poho i keena, i kū'ē i ka manuale.

3. Ma ka wehe iaoia, a me ka wai koko aaioee

Ke kaumaha ma muli o ka 'ana i kūpono ana i ka hapa wai a ua wehe', plasmapheresis ua maheleia i:

• Ka centrifuge.
• ʻili lahilahi.
• Wili.
• Sedimentation (bezapparatny plasmapheresis).
• Krioplazmaferez.

Kēlā me kēia papa hana i kona pros a me Con. Ka loa Popular ua manaoia e eʻili lahilahi plasmapheresis. Sedimentation iaoiaeii mea kokoke i hoʻohana 'ia, akā, ka mea, ua nui ho'ēmi ma mua o na mea e ae.

Description o nā kaʻina hana

Ke centrifuge iaoiaeii ua muli ma luna o nā kānāwai o ka umekaumaha. Ka mea eaaaony koko ka ao ka ma kiʻekiʻe wikiwiki, no laila, i ka mea, ua kaawale i mahele. e hoi aku i ke kino Penei hoʻokino hehee wale, a me ka wai koko wehe. Kēia hana i obsolete, ka mea, i ka hailona o contraindications, eia hoi, pinepine ia lŘlŘ i centrifugation aeea eha.

ʻili lahilahi iaoia komo ai i ka hoʻohana 'ana i ka mea hana i hoʻolako pono me ka kūikawā kānana me ka ili i ae i ka wai koko, hana oihana mua a me ke kali ole. Kēiaʻano hana i kona pono.

• Sterility plasmafilters.
• Ka palekana i ka maʻiʻaʻai.
• Ke rapidity o ka hana.
• Mau contraindications.
• Ke keena mea iʻino wale.
• Manawa kūpono no ke noi ana o ke kaʻina hana no ka iapaau ana o ka maʻi 'aʻai nā mea maʻi.

Wili iaoiaeii ua wehewehe aku i loko i ke koko hele papalua aaioee. Mua, o ka halepaahao nuipa a ua hoʻokaʻawaleʻia, a me ka wai koko ua laila, wae 'ia e hoomaemae no ia i nui nā lātoma, nā polokina a me lipids. Kēiaʻano hana i mea mahaloia ma ka iapaau ana o ka atherosclerosis.

Bezapparatny plasmapheresis (ole sedimentation) ua lawe mai me ka hoʻohana 'ana i kekahi hana manaʻo. Ua kaawale ke koko i loko o nā kūlana ma lalo o ka aoao o ka umekaumaha. He He loa mea a inexpensive plasmapheresis. Kona kumukuai mea me ka nui loa okoa mai ka waiwai e lilo aku mai o nā ki ina hana like. Akā,ʻo ia, aole ia e ae i ke kō nui puke o ke koko.

Krioplazmaferez komo ai i ka wehe 'ana o ka wai koko mai kona paʻahau ma -30 ^{° C,} i ukali ia e lalana ana ia ia i ka 4 ^{° C} hahai ma centrifugation. Ua wehe Part o ka wai i precipitated, a ua hoʻi hou mai hoʻi i loko o ka hoʻomanawanui wai koko ka i koe.

Ke physiological hopena o ke kaʻina hana

plasmapheresis ke kaʻina hana no apono 'ae hoomaemae loa oia i ke kino o ke koena huahana o ka pūnao (urea, creatinine, uricʻakika), nā mea'aʻaʻa, antigens, hormones, macromolecular lipid uao o ka li nui, a me na palapala waiwai. Removal oʻimi hoʻopunipuni wai koko ke kumu hypovolemia e hoʻonāukiukiʻana mai o ka uku ', a me ka inclusion ke kino i ka pale aku ia lakou a pau. Eia hou kekahi, loli ke kome mai na nā'aʻaʻa i loko o ka ipu, e hoʻihoʻi ai hoʻolahaʻia ke koko ka leo. Ua hiki aku i ka emi ma ka nani a me ka ho'ēmi i kā kaʻawahia hopena o pollutants i loko o kekahi mau hola.

Eia naʻe, ka lā hoʻokahi ua hoihoi hou i ka nui o toxins i loko o ke koko. Nolaila, poe akamai i waiho aku plasmapheresis papa, papahana no 3-4 kipa. Me kela a me keia ka mea i hahai ana ka mea mamuli o kekahi kiʻekiʻe o ka hou kaʻina hana ua ua holoiʻia, mua wahi, alaila, o ka lole, a laila, i ka halepaahao. Ke rheological waiwai o ke koko e hoʻololi i ka 'oluʻolu hema, ke kāpaeʻana excessive (viscosity), mahuahua koko a me ka oxygen ma pele i nā loko a me nā'aʻaʻa. Kēia e hōʻoiaʻiʻo hou i loko o ka mau ana o ka meaola, mahuahua adaptive uea, a me ke hooneenee aku i nā palapala i huiʻia intoxication symptoms.

Eia naʻe, e hilinai wale nō ma ke koko wai koko mail mea,ʻaʻole e pono, no ka mea, mea mau nui e lawe mai i ka hulina lapaʻau o kekahi mai, e hahai ana i ke kauka mau kauoha.

No ka ÷ ike i kēia kaʻina hana

Ano, he nui na kumu i hoakaka ia plasmapheresis. He aha ka keia ina hana - loa nā mea maʻi e ole e ike. Oia la, aka, i ka ike ma lalo o ka hana pono e ae ma ke ano o ka lapaʻau ua maopopo leʻa pono. Plasmapheresis - he maemae o ke kino, i ka mea i pono ai no ka iapaau ana o aneane pau kanaka nā loko, a nenoai. Eia naʻe, loaʻa nō ka nui o nā pathologies ma i plazmoobmenom Inc mea he piha aupuni PAaIEN. Kēia 'o ia hoʻi i ka ole o ke kaʻina hana ke alakai i ka make ana o ka hoʻomanawanui. Na maʻi nā:

• pahikakiwi aeea anemia ;
• thrombocytosis a me ka leukocytosis;
• erythroleukemia;
• porphyrin maʻi;
• hypercholesterolemia (hereditary);
• Aku ia Rupo, i ka maʻi;
• DIC;
• hyperviscous maʻi pale;
• myasthenia gravis;
• Guillain-Barre maʻi pale;
• hoolohi thrombocytopenia;
• mioglobinemiya;
• intravascular hemolysis;
• Goodpasture ka maʻi pale ;
• Gasser ka maʻi pale;
• thrombotic thrombocytopenic purpura;
• cryoglobulinemia;
• maʻi polyneuropathy;
• hoomake iho no hoi kaʻapu kōheoheo.

Pili nāʻikepili no ka plasmapheresis mea:

• Pathology o ka gastrointestinal'āpana: ulcerative colitis, Crohn ka maʻi.
• Mea'ōnaehana mānowai koko maʻi: he ano ma hope o ka naau kaua, myocarditis, ka rumatika, a no laila, ma luna o.
• Allergy: atopic deramatit, pollinosis a me na mea e ae.
• Dermatological maʻi: psoriasis, pemphigus, herpes, etc.
• ʻaʻa puʻuwai maʻi: Glomerulonephritis, urinary'āpana maʻiʻaʻai, a pela aku.
• Maʻi o ka naehana'ōnaehana: asthma, hemosiderosis.
• Ake pilikia: autoimmune hepatitis a me na mea e ae.
• Septic complications ma hopeʻoki kino.
• Systemic vasculitis.
• ʻawahia lesions ma oncology.
• Atherosclerosis.

Nei, gynecologists kūkā iho Kailiokalauokekoa plasmapheresis i hāpai keiki ina o ka wahine poino toxicosis, he mea Rhesus-kue ole fetoplacental insufficiency. Kēia papa inoa He loa lōʻihi. Ma hope o nā mea a pau, aia nō ma kahi o 200 maʻi ma i hiki ke ana hoʻohana plasmapheresis. Contraindications no keia iaoia mea i loaʻa.

Owai ka i, e haawi mai ia i ka hana

No keia ina hana, ma laila nō i nui contraindications. Akā, ka mea, ua pololei ole, e lawe mai i loko o ke alo o irreversible lesions o nā loko, i papani ai hoi i kahe ana ke koko, coagulation kāna hana a me ka gastric ulcer.

'Aʻole i paipai koko maʻemaʻe ma ka' aʻe 'ana o pāpana a me ka naau ana, puʻe kēia, hoemi i ka (viscosity) o ka koko o ka menstruation, huʻi infectious maʻi, hypoproteinemia, anaemia maʻelemākule e hoʻomanawanui iki mai, i keʻano o ka hawewe, loa ake maʻi, "heʻino paha" aa koko.

Ua hoʻohana 'ia e ia plasmapheresis i hāpai keiki i nā palapala i ke keiki ka ola, akā, nā noiʻi proves ole. Maoli ai, i ke kumuhana o ke kaʻina hana ikaika ma luna o ka hoike, a ma muli o ke kauoha.

Penei, kekahi o ka moku'āina preclude i ka hoʻohana 'ia o plasmapheresis like me ka ano o ka Inc. Contraindications E e ana kūpono ma ka hele ana i kahuna lapaau, o ka oi aku ina he mea kekahi pilikia o ka mea hōʻemi o ke ahonui i ka ola ma ka hihia o ka hoʻokō 'ole' ana o ke kaʻina hana.

Pehea o ka Inc

No ka plasmapheresis 'Aʻole e koi kuikawa aʻo. I hookuu i ke kaʻina hana ua lawe mai i loko o kūikawā manipulation oihana paha 'ana i loko o ka hoʻomanawanui ka lumi. E hana i kēia, he ahonui ke moe ma ka kūikawā wahi moe, a lawe i ka oluolu kūlana. Ke kaumaha ma muli o ka hana, he kūikawā catheter (fleksulyu) lawelawe i loko o kekahi a mau lima. Loa pinepine keia ua hana ka hoʻohana 'ana i kekahi aa koko i loko o ka hoʻohei o ke kuʻekuʻe aku. Inā i ka hoʻomanawanui i loko o mea ana, i ka catheter ua waiho i loko o ka subclavian aa koko. I ke koko, aole ia i clot a me ka thrombus i hanaia, ma ka hou fleksulyu lawelawe heparin.

Ka hana mau no 1-2 hola. Ua hilinaʻi nui ma luna o ka iaoiaeii a me ka nui o ke koko e e ua holoiʻia. I loko o nā manipulations o ka hoʻomanawanui mea mau ma lalo o 'inikua hooponopono. He ana pana ana, ke koko, ka hanu, a kulana kupono no ka o oxygen lako i na nā'aʻaʻa.

Apparatuses no ka plasmapheresis mea lawe paha wahi. Ka mua Ua nui aku kūpono no ka mea, hiki e kaʻi aku ai i kekahi wahi i loko o ka haukapila a me ka hale no ka hoʻomanawanui. Ka mea i ke koko portionwise me kahi o 40 ml i kekahi manawa, lākou ma ka hoʻomaʻemaʻe mea huli hoʻi ma ka catheter, a lawe i ke koko hou. Kekahi mau mea i hoʻohana i ka 'akomi hooponopono o anticoagulants. I kekahi minuke, ka plasmapheresis nakeke mea hiki ke kō e pili ana i 100 ml o ke koko, oa. E. Per hora ke wehe i kahi o 800 ML o oi loli.

Poe akamai i Paipai 'wehe i kekahi kau ahaolelo emi ma mua o ka hapaha o ka hoʻolahaʻia wai koko. Kauka manao keia huahelu ke kaumaha ma muli o ka kanaka: i ke kaumaha a me ke koko ka leo (CBV).

Ua ua ike ia i ka wai koko o 55% o BCC. A ma ka mea e hooholo i ka hope huahelu, ia mea pono e hoonui i ke kino kaumaha e 75. Eia kekahi laʻana, he kanaka he 80 kg i loko o kekahi kau ahaolelo oe makemake e kāpae i ka kēia helu o ka wai koko:

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

He nui e like me nā mea a pau i ka huliāmahi, e mālama nei plasmapheresis. Ia e pōmaikaʻi ai a me ka ia i hoeha mai o pākōlea i kūpono hilinaʻi ma na mea he nui aʻe, a me ka pololei o ka helu.

Hiki plasmapheresisʻeha?

Nei, ua pipiʻi hana ua hoʻonoho like me ka panacea no a pau ka Maʻi. A pilikino nā keʻena lāʻau lapaʻau ka oi hana i loko o ka paepaeʻana plasmapheresis. Ia e pōmaikaʻi ai a me ka ia i hoeha mai o keia iaoia mea pololei e kaukaʻi ma ka professionalism o kauka. Akā, e like me kekahi 'ē hana o ka lapaʻau, ka mea i konaʻaoʻao mau waiwai, a me nā keakea:

• Anaphylactic kŰia.
• Allergy i ka pou wai koko, a replaces ia me ka wai.
• Autoimmune hakuʻala maʻi like me ka naoh i ka wai koko kona mau pou.
• Maʻiʻaʻai mai kona mau pou wai koko.
• Ka hooulu ana o ka sepsis kēia kūlanaʻano o ka aseptic.
• Kahe ana ke koko (ina he mau pilikia me ka clotting).
• Thrombosis (me ka ole ana anticoagulants).
• papa i loko o ke koko,.
• Removal ole wale toxins akā, i na māhuaola pu me ka wai koko.
• Miki pu e hoʻonele.
• Metabolic kāna hana, a me ka helu o ka lapaʻauʻia i loko o ke koko.
• Nausea.
• Headache.

Kēia mea ia i mea nui a me ka huikau kaʻina hana, no laila, e pono e e mālama i ka koho i ka paena no ka lapaau. He nui a pilikino Ho 'Oponopono kaumaha nā mea maʻi plasmapheresis. He aha ke ano o ka hui i poe akamai i hana ma laila, ina paha o ka olelo hooholo i ke kaʻina hana? A pau e pono e ike mua iʻaelike ai i ka lapaʻau, no laila, i ole e haule i loko o ka lima o ka Malia paha scams. Ma hope o nā mea a pau, ka mea hiki ke alakai i ka disastrous hoʻokūkū.

He aha nā hualoaʻa hiki ke manao

I ka laulā o ka plasmapheresis ho'āʻo ai i loko o ka hihia o ka maʻi he nui loa. Mau kau maikaʻi ia ke kaʻina hana no a hiki i ka wa a ka pili nāʻikepili. Naʻe, ka mea e e hoʻomaopopo i monotherapy i ole mau loa ana me ke kōkua. Nolaila, ia mea nui, e lawe i ka hulina lapaʻau mai ka palapala hōʻoia no 'Oihana, me ka hilinai ana ma ka hoola ana mai o ka hookahi papa o ka wehe wai koko.

E hoʻokō maikaʻi hualoaʻa, e pono eʻoiaʻiʻo o ka pono o ka malama, a undergo i ka mua keia hookolokolo ana, e paa i ka wa e kaawale aku o contraindications i ka hoʻohana 'ana i ka pākōlea i kūpono e like me plasmapheresis.

Ke kumukuai o keia ina hana nei nō kiʻekiʻe (4500-5500 ths. Rubles), a me ka hoʻomanawanui, e pono ai oi aku kekahi a elua, a me 3-4 kau, ai ole i ka iapaau ana e ole e kekahi ano. Kēia E e noʻonoʻo. Eia naʻe, he nui nā keʻena lāʻau lapaʻau kaumaha nā ho'ēmi kālā ina ka lōʻihi like 'ole o ka papa, ua oi aku 5 kau. It E e kaulana i keia ina hana hiki ole e nike, 'ole, no, ka lako a pan a me nā mea i kēia manawa he pipiʻi. No laila, mai paulele i ka? Aaieou ma ke kaʻina hana e hana ma ka loa haʻahaʻa kumukuai.

e hōʻuluʻulu

Ae, ua lapaau eha i ke ahonui o ka eke, akā, e ke kumu kūʻai o ia mea. Hou ma ka mau ana, i ka hoʻi o aiiay a me ka uku 'oihana, normalization o rheological kiko'î o ke koko, ana o symptoms o intoxication - kēia mea,ʻaʻole he piha papa inoa o ka maikaʻi hopena mākou e noonoo i ke kaʻina hana ma luna o ke kino.

'O Plasmapheres he'ano'oko'a hou ia e kōkua ana i nā ma'i he nui e mālama i ko lākou mau ma'i a ho'oma'ema'e i ke koko o ka plasma "poke". Hō'ike'ia kēia alahele me ka nui o nā ma'i a he nui nā hō'ailona. 'O ka ho'okō'ana i nā plasmapheresis me ke kōkua'ana o nā po'e akamai kūikawā a me ka mālama pono'ana i nā kuhikuhi a pau e hā'awi i nā hopena maika'i i loko o ka hō'ailona o nā ma'i'oi loa.