Plasmapheresis - abin da yake da shi? Plasmapheresis: amfanarwa da cutarwa, contraindications, farashin da kuma hanyoyin. warkewa plasmapheresis

Mutane da yawa zamani kananan dakunan shan magani a cikin shekaru goma, ya fara bayar da m hanya - plasmapheresis. Mẽne ne, kuma a karkashin abin da cututtuka da shi da aka nuna? Ko wannan hanya ne m da kuma yadda aka kashe? A nan ne babban al'amurran da suka shafi cewa taso a marasa lafiya a lokacin da suka bayar da shawarar wani m hanya zuwa tsarkake jini daga "slags".

Mene ne plasmapheresis?

Wannan zamani Hanyar tsarkakewa jiki a salon salula matakin da tace da jini ta amfani da musamman na'urorin. Yana ne aka yi nufi ga lura da yawa cututtuka da kuma shi ne kawai ceto ga wasu sosai rare cututtuka. Kalmar "plasmapheresis" kunshi biyu kalmomi - "plasmas" da "apheresis" cewa Latin za a iya zahiri fassara a matsayin "jini kau."

A hanya da aka za'ayi a jama'a asibitoci, masu zaman kansu da dakunan shan magani da kuma ko da wani lokacin a gida. Plasmapheresis jini sanã'anta fitarwa a karshen karni na karshe, amma ya riga ya gudanar ya ajiye dubban daruruwan mutane ta kiwon lafiya.

Tarihi na asalin Hanyar

Wannan hanya Dates baya ga yin amfani da jini-bar a matsayin magani daga wani cuta. Na dogon lokaci, wannan "dabbanci" hanya na far an manta da likitoci, amma ta tsakiyar XX karni, masana sun fara ƙoƙari ya haifar da na'urar for raba jini a cikin bulan da kuma kau da ta ruwa kashi don a samar da warkewa sakamako.

Tuni a cikin 70-80 shekaru na plasmapheresis an rayayye yi amfani da Amurka da kuma tsiwirwirinsu shahararsa a cikin Tarayyar Soviet. Amma da conclusiveness na da tasiri na da hanyar da ba tukuna high isa, saboda gwajinsu bukatar shekaru masu yawa na aiki. Duk da haka, masana kimiyya sun ba ritaya da kuma ci gaba da karatu plasmapheresis. Abin da ya kawo wa 'yan adam? Masana kimiyya juriya ba magani a cikakke kuma tasiri hanyar tsaftace jini. A halin yanzu kau "gurbata" jini yana dauke mai matukar tasiri Hanyar da yawa a cikin pathological jihohin da suna tare da daban-daban intoxications kwayoyin.

Abin da iri da kuma hanyoyin zama plasmapheresis

Akwai uku main sukayi fassara da plasmapheresis.

1. By ganawa

Idan jini tsarkakewa ne warkewa cikin yanayi da ake amfani da su cire duk wani cuta ko yanayin, shi ne - warkewa plasmapheresis. Kamar haka tace siffa abubuwa suna koma zuwa haƙuri, da kuma jini aka maye gurbinsu bayarwa jini ko wani musamman bayani.

Idan rabuwa da jini da aka gudanar a samu jini daga lafiya mutum domin kara amfani, irin wannan hanya ake kira plasmapheresis bayarwa.

2. Ta hanyar

Akwai wani mai hankali plasmapheresis kuma atomatik. A cikin farko idan haƙuri ya dauka babba adadin jini da aka sanya a cikin wani bakararre ganga tare da adana da kuma hali jini rabuwa da centrifugation ko hazo. Sa'an nan da mãsu haƙuri ne allura intravenously sauran bayan kau na cell taro na jini, diluted tare da Saline. Wannan hanya kuma ya kira da manual.

Tare da atomatik plasmapheresis jini tarin, tacewa da kuma dawo da shi zuwa ganga da aka gudanar a kananan rabo ta wajen rabuwa na'urar. Haka kuma, duk matakai dauki wuri ci gaba. Wannan hanya ita ce mafi dadi ga mãsu haƙuri shi ne mafi yawa mobile da kuma hana lalacewar Kwayoyin, kamar yadda tsayayya da manual.

3. By cire Hanyar da wani jini aiki

Dangane da dabara da wanda ruwa rabo an cire, plasmapheresis ne zuwa kashi:

• The yara.
• Matattarar.
• Threaded.
• Sedimentation (bezapparatny plasmapheresis).
• Krioplazmaferez.

Kowane hanya yana ta ribobi da fursunoni. A mafi m aka dauke su membrane plasmapheresis. Sedimentation Hanyar ne kusan ba amfani, amma shi ne da yawa mai rahusa fiye da wasu.

Description na hanyoyin

The yara hanyar dogara ne a kan dokokin nauyi. The na'urar samar da jini juya a high gudun, sabõda haka, an rabu cikin kasarun adadi. Kamar wancan siffa abubuwa suna koma zuwa ga jiki, da kuma jini cire. Wannan hanya ne aka rabu amfani, shi yana da yawa contraindications, haka ma, sau da yawa yakan faru a lokacin centrifugation cell rauni.

Matattarar Hanyar ya shafi yin amfani da na'ura sanye take da musamman tace da pores wanda yarda da jini, kafa abubuwa da bata lokaci ba. Wannan dabara yana da abũbuwan amfãni:

• Sterility plasmafilters.
• Kariya da kamuwa da cuta.
• A rapidity na hanyar.
• 'Yan contraindications.
• Kwayoyin ba su lalace.
• Yiwuwar aikace-aikace na hanya domin lura da ciwon daji marasa lafiya.

Threaded Hanyar ne halin a cewa jini ya wuce biyu aiki. Na farko, da cell mass aka raba da jini da aka sa'an nan tace ta tsarkake manyan kwayoyin, sunadaran da lipids. Wannan dabara ne m da magani daga atherosclerosis.

Bezapparatny plasmapheresis (ko sedimentation) ne da za'ayi ba tare da yin amfani da wani musamman na'urorin. A jini da aka rabu cikin biyu bulan a ƙarƙashin rinjayar nauyi. Wannan ne mai matukar sauki da kuma m plasmapheresis. Its farashin ne muhimmanci daban-daban daga cikin kudin na wasu hanyoyin. Amma ya ba da damar aiwatar babban kundin na jini.

Krioplazmaferez ya shafi kau da jini daga ta daskararre a -30 ^{° C,} bi da jin wuta to 4 ^{° C} bi ta centrifugation. Sashe na daga cikin ruwa wanda precipitated aka cire, da kuma sauran jini aka koma baya a cikin haƙuri.

A physiological sakamako daga cikin hanya

plasmapheresis hanya damar share jiki na saura kayayyakin da metabolism (urea, creatinine, uric acid), antibodies, antigens, hormones, macromolecular sia shiga tsakani na kumburi da kuma sauran abubuwa masu cutarwa. Cire na wucin gadi jini sa hypovolemia cewa tsokani da compensatory kuma hada da duk jikin ta defenses. Bugu da kari, m rushes daga kyallen takarda a cikin tasoshin mayar zagawa da jini girma. Wannan take kaiwa zuwa wani karu a kumburi da kuma rage mai guba sakamakon gur ~ a 'yan sa'o'i.

Duk da haka, wata rana da adadin da gubobi a cikin jini da aka mayar da sake. Saboda haka, masana bayar da shawarar plasmapheresis Hakika, tsara don 3-4 ziyara. Tare da kowane m matakin na sabon hanya ake tsabtace, da farko receptacles, sa'an nan masana'anta, sa'an nan da cell. A rheological Properties na jini an canza a wani m shugabanci, kawar da wuce kima danko, ta ƙara jini ya kwarara da kuma oxygen da kwarara zuwa gabobin da kyallen takarda. Wannan tsiraru da tabbatar da kyautata a cikin janar jihar da kwayoyin, kara Na'urar damar, da kuma kuma ta kawar da cutarwa mahadi maye bayyanar cututtuka.

Duk da haka, dogaro kawai a kan jini jini musayar ba lallai ba ne, domin shi ne ko da yaushe da muhimmanci a gudanar da wani m lura da wani cuta, wadannan likita ya umarta.

Don nuna wannan hanya

Yanzu, mutane da yawa likitoci rubũta plasmapheresis. Menene wannan hanya - mafi yawan marasa lafiya da ba su ma yi. Kuma duk da haka, ya san a karkashin abin da yanayi dole su yarda a kan wata hanyar da magani aka shakka da ake bukata. Plasmapheresis - mai tsarkakewa na jiki, wanda aka shawarar domin lura da kusan duk mutum gabobin da kuma tsarin. Duk da haka, akwai wani yawan pathologies a wadda plazmoobmenom far ne mai cikakkar nuni. Wannan yana nufin cewa gazawar da hanya na iya kai ga mutuwa na haƙuri. Irin cututtuka sun hada da:

• sickle cell anemia .
• thrombocytosis da leukocytosis.
• erythroleukemia.
• porphyrin cuta.
• hypercholesterolemia (hereditary).
• Rufus ta cutar.
• DIC.
• hyperviscous ciwo.
• myasthenia gravis.
• Guillain-Barre ciwo.
• jinkirta thrombocytopenia.
• mioglobinemiya.
• intravascular hemolysis.
• Goodpasture ta ciwo .
• Gasser ta ciwo.
• thrombotic thrombocytopenic purpura.
• cryoglobulinemia.
• kullum polyneuropathy.
• poisons guba.

Dangi alamomi ga plasmapheresis ne:

• Pathology na gastrointestinal fili: ulcerative colitis, Crohn ta cuta.
• Cututtukan zuciya da: a yanayin bayan wani ciwon zuciya, myocarditis, rheumatism da sauransu.
• Alerji: atopic deramatit, pollinosis da sauransu.
• Dermatological cututtuka: psoriasis, pemphigus, herpes, da dai sauransu
• koda cuta: Glomerulonephritis, urinary fili kamuwa da cuta, da sauransu.
• Cututtuka na numfashi tsarin: fuka, hemosiderosis.
• Hanta matsalolin: autoimmune hepatitis da sauransu.
• Kwamin na tara rikitarwa bayan tiyata.
• Tsari vasculitis.
• Mai guba raunuka a Oncology.
• Atherosclerosis.

Kwanan nan, gynecologists shawara bayar wa plasmapheresis a lokacin daukar ciki idan mace shan wahala toxicosis, akwai Rhesus-rikici ko fetoplacental insufficiency. Wannan jerin sosai tsawon. Bayan duk, akwai game da 200 cututtuka a wanda za a iya samu nasarar amfani da plasmapheresis. Contraindications ga wannan hanya ne kuma samuwa.

Wanda dole daina irin wannan hanya

Domin wannan hanya, akwai mutane da yawa ba contraindications. Amma shi ne tsananin haramta a gudanar da wani a gaban komowar raunuka na gabobin, ba tsaya zub da jini, coagulation cuta da kuma ciki miki.

Ba da shawarar jini tsarkakewa a take hakkin launi da kuma zuciya rate, matsa lamba surges, rage danko jinin haila, m cututtuka, hypoproteinemia, anemia a tsofaffi da marasa lafiya, da daban-daban na buga, mai tsanani cutar hanta, "bad" jijiyoyinmu.

Yana amfani da su zama cewa plasmapheresis a lokacin daukar ciki ne cutarwa ga yaro ta kiwon lafiya, amma kwanan nan bincike ya tabbatar da in ba haka ba. Da sauƙi, batun da hanya tsananin a kan shaida da kuma bisa ga umarnin.

Saboda haka, wasu daga cikin jiha hana yin amfani da plasmapheresis matsayin Hanyar far. Contraindications kamata a kimanta da halartar likita, musamman idan akwai wani hadarin tabarbarewar haƙuri da kiwon lafiya a hali na maye daga hanya.

Ta yaya ne far

Domin plasmapheresis ba ya bukatar horo na musamman. Yawancin lokaci da hanya ne da za'ayi a cikin na musamman magudi ofisoshin ko kai tsaye a cikin haƙuri ta dakin. Don yin wannan, a haƙuri ta'allaka ne a kan wani musamman kujera kuma daukan wani wuri dadi. Dangane da hanyar, musamman catheter (fleksulyu) anyishi a daya ko biyu hannuwanku. Mafi sau da yawa wannan ne yake aikata ta amfani da jijiya a cikin lanƙwasa na gwiwar hannu. Idan haƙuri yake a cikin tsanani yanayin, da catheter aka sanya a cikin subclavian jannayẽnsa. Don da jini ba gudan jini, kuma thrombus kafa, a Bugu da kari fleksulyu gudanar heparin.

A hanya yana game 1-2 hours. Ya dogara da hanyar da adadin jini da za a tsabtace. A lokacin duk jan na haƙuri ne ko da yaushe a karkashin likita dubawa. Ya auna bugun jini kudi, jini, numfasawa da ya bari ga oxygen samar da kyallen takarda.

Apparatuses for plasmapheresis ne šaukuwa ko na kullum. Na farko shi ne yafi dace domin su za a iya hawa zuwa wani wuri a asibiti ko gida ga mãsu haƙuri. The na'urar daukan jini portionwise tare da game da 40 ml a lokaci, wanke ta koma ta hanyar da catheter da kuma sake daukan jini. Wasu na'urorin amfani da atomatik gwamnatin anticoagulants. A minti ɗaya, da plasmapheresis inji shi ne iya aiwatar game da 100 ml na jini, watau. E. Per hour iya cire game da 800 ml na wuce haddi da ruwa.

Masana sun bayar da shawarar cire daya zaman kasa da kwata na zagawa da jini. Doctors sa ran wannan adadi dangane da mutum: nauyin da jini girma (CBV).

An sani cewa jini ne 55% na Bcc. Kuma don ƙayyade karshen adadi, shi wajibi ne don ninka da jiki nauyi da 75. Alal misali, wani mutum yin la'akari 80 kg a daya zaman kana so ka share da wadannan yawan jini:

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

Yana da muhimmanci a bi da dukan rabbai, gudanar da plasmapheresis. Amfanin da kuma illolin da warkewa dabaru dogara ne a kan al'amurra da dama, ciki har da daidaito da lissafin.

Iya plasmapheresis m?

Kwanan nan, wannan tsada hanya tana wurinta kamar yadda wani da dama, domin duk mũnãnan ayyukansu. Private kananan dakunan shan magani musamman aiki a inganta plasmapheresis. Amfanin da kuma illolin da wannan hanya shi ne kai tsaye dogara a kan kwarewa da na likitoci. Amma kamar wani Hanyar magani, da shi yana da nasa gefen illa da kuma rashin amfani:

• Anaphylactic buga.
• Alerji zuwa bayarwa jini da kuma maye gurbin shi da wani ruwa.
• Autoimmune koda cuta kamar yadda a dauki wani jini mai bayarwa.
• Kamuwa da cuta daga bayarwa jini.
• A ci gaba da sepsis wadannan standardization na aseptic.
• Zub da jini (idan akwai matsaloli tare da clotting).
• Thrombosis (tare da ba da ake ji anticoagulants).
• sauke a jini.
• Cire ba kawai gubobi amma kuma da na gina jiki tare da jini.
• Dips rigakafi.
• Rayuwa cuta da kuma yawan magunguna a cikin jini.
• Tashin zuciya.
• Ciwon kai.

Wannan ne mai matukar tsanani da kuma rikitarwa hanya, don haka ka bukatar ka yi hankali a zabar wani site domin magani. Mutane da yawa masu zaman kansu asibitoci bayar da marasa lafiya plasmapheresis. Abin da irin cibiyoyin wanda masana aiki a can, ko na ƙuduri ne hanya? All shi bukatar ya san kafin bayan amincewarsa da magani, don haka kamar yadda ba su fada a hannun m zamba. Bayan duk, zai iya kai wa ga m sakamako.

Abin da sakamakon za a iya sa ran

A tasiri na plasmapheresis tabbatar a cikin hali na da yawa cututtuka. A kai a kai gyarawa kyau sakamako hanya ko a lokacin da dangi alamomi. Duk da haka, shi ya kamata a fahimci cewa monotherapy iya ba ko da yaushe taimaka. Saboda haka, yana da muhimmanci a yi wani m magani daga m kwararru, ba tare da dogaro da waraka daga wata guda Hakika na cire jini.

Don cimma sakamako mai kyau, dole ne ka tabbatar da ingancin kula da sha wani na farko jarrabawa tabbatar babu contraindications da yin amfani da irin wannan warkewa dabaru irin plasmapheresis.

Farashin wannan hanya ne quite high (4500-5500 ths. Rubles), da kuma haƙuri bukatar fiye da daya ko biyu, da kuma 3-4 zaman, in ba haka ba da magani ba zai yi wani hankali. Wannan kamata a yi la'akari. Duk da haka, da yawa kananan dakunan shan magani bayar da rangwamen idan duration daga cikin shakka ne fiye da 5 zaman. Ya kamata a lura cewa wannan hanya ba zai iya zama cheap, t. Don. A kayan aiki da kuma kayan su yanzu quite tsada. Sabõda haka kada ka amince da asibitin inda hanya aka yi a wani sosai low price.

don takaita

Na'am, wannan magani ciwo haƙuri da aljihu, amma yana da daraja da shi. Inganta a general yanayin, da hada da m kuma compensatory ayyuka, daidaita rheological sigogi na jini, kau na bayyanar cututtuka na maye - wannan ba cikakken jerin da kyau tasiri muna la'akari da hanya a jiki.

Plasmapheresis - wani m Hanyar cewa taimaka da yawa marasa lafiya jimre da cututtuka da kuma tsabtace da jini daga cikin "gurbata" jini. Wannan hanya da aka nuna ga wata babbar dama cututtuka, kuma yana da sosai 'yan contraindications. Aiwatar da plasmapheresis da taimakon m kwararru da kuma a yarda da duk umarnin samar da gwaggwabar riba da sakamako mai kyau a lura da ko mafi m cututtuka.