Plasmapheresis - ndi chiyani? Plasmaphoresis wa matenda ashuga

Plasmapheresis - njira yoyeretsa magazi a anthu

Mukuchita izi, magazi amagawidwa m'magawo awiri: ma cell ndi ma plasma ake. Kenako chomaliziracho, limodzi ndi zinthu zovulaza, chimachotsedwa kwathunthu ndipo cholowa m'malo mwake chimayambitsidwa. Maselo am'magazi amabwerera ndipo magazi amakhala oyera, opanda ziphe.

Mwazi wa munthu wodwala matenda ashuga umachulukana ndi lipoproteins, samalola wodwalayo kuchepetsa shuga momwe angathere. Chifukwa chake, pogwiritsa ntchito plasmapheresis, amachotsedwa ndi plasma. Izi zimathandizira wodwalayo, zimapangitsa kuti chithandizo chithandizike komanso zimawonjezera chidwi cha mankhwala.

Njira za Plasmapheresis

Njira zimatengera luso lomwe limagwiritsidwa ntchito pochita:

1. Kalimbidwe
2. Cascading - nthawi zambiri amagwiritsidwa ntchito ngati atherosulinosis. Apa, plasma ndi maselo amasinthana ndikuchitika magawo awiri
3. Membrane
4. Njira ya cryo imakhala pakuzizira kozizira kenako ndikuwotha. Pambuyo pake, imayendetsedwa mu centrifuge, ndiye kuti phompho lidzachotsedwa. Koma enawo adzabwezeretsa malowo.
5. Kukonza - kutengera mphamvu yokoka ndipo kumachitika popanda kugwiritsa ntchito ukadaulo. Ubwino pakupezeka kwa njirayi: mtengo wake ndi wochepetsetsa kwambiri poyerekeza ndi ena. Koma pali zofunika zina: kulephera kwake kusanja magazi onse nthawi yomweyo.

Zothandiza zimatha beets mu shuga. Werengani zambiri mu nkhaniyi.

Kodi lipodystrophy ndi chiyani? Kodi matendawa amagwirizana bwanji ndi matenda ashuga komanso momwe mungapewere?

• liwiro
• ster la cell iliyonse,
• kuthekera kochizira oncology,
• chitetezo chathunthu ku matenda
• kukhala ndi maselo athanzi panthawi yopatukana.

Kodi njira zimayenda bwanji? Mtengo. Kuchulukitsa

Kuti mupeze njirayi ndizotheka pokhapokha poika akatswiri. Ngakhale kuti kuphunzitsidwa kwapadera sikofunikira, wodwalayo ayenera choyamba kuyesa mayeso ochepa. Zitatha izi, munthuyo amakwanira bwino, ma catheter osalimba amawaika m'mitsempha. Sizopweteka ngati namwino wodziwa zambiri. Kenako chipangizocho chimalumikizidwa ndikuyendetsa kumayambira.

Ndondomeko idapangidwa kwa mphindi 90, kutengera kuchuluka kwa magazi ndi njira yothandizira. Mpaka 30% yamagazi imatha kubwezeretsedwanso panthawi. Ngati mukufuna kuyeretsa kwathunthu, ndiye kuti muyenera kuyendera njirayi kawiri.

Chimodzi mwazovuta zazikulu za matenda a shuga ndi kuwonongeka kwa phazi. Ndi matenda ati am miyendo omwe amatuluka komanso momwe mungathanirane nawo?

Lingaliro la njirayo ndi mitundu yake

Plasmapheresis - komanso plasmapheresis ndi plasmapheresis, ndi njira ina yomwe imagwiritsidwa ntchito poyeretsa magazi a poizoni. Tanthauzo la njirayi ndilosavuta: magazi omwe amachokera kwa wodwalayo amaikidwa mu chidebe cha hemo, momwe amawagawa m'magulu a plasma ndikupanga zinthu - maselo ofiira amwazi, maselo oyera am'magazi ndi mapulateleti. Kenako maselo am'magazi amabwerera m'thupi, ndipo plasma imagwiritsidwa ntchito kapena kugwiritsidwa ntchito pazinthu zina - kuthiridwa, kupanga zinthu zamagazi, ndi zina zotero.

Kubwerera kwa wodwala kuchuluka kwa magazi ofanana ndi omwe atengedwa, kusowa kwa plasma kumapangidwa ndi saline yanyama kapena madzi ena, ngati chithandizo cha matendawa chikufuna. Chifukwa chake, magazi amatsukidwa ndi poizoni yemwe amasungunuka m'madzi a m'magazi, ndipo sataya maselo ake ogwirira ntchito.

Plasmapheresis amasankhidwa malinga ndi njira zingapo.

Pochita kusankha

Ndondomeko imagwiritsidwa ntchito kuthana ndi mavuto awiri:

• achire plasmapheresis - cholinga chake ndendende ndikuyeretsa magazi ku zinthu zapoizoni. Pankhaniyi, plasma imagwiritsidwa ntchito, ngakhale zimachitika kuti pambuyo pakufafaniza kowonjezera, plasma imabwezedwa ndi magazi,
• wopereka - pamenepa, njirayi imagwiridwa kuti apeze plasma yoyera. Maselo amwazi amabwerera, ndipo madzi a m'magazi amagwiritsidwa ntchito poika magazi kapena mankhwala ena.

Cryophoresis imasiyananso. Potere, plasma yomwe idayambapo imapanga mazira oyamba, ndikubwerera pambuyo pa kuzizira.

Mwa kuyeretsa

Njira zonse zoyeretsera magazi zimagawika m'magulu awiri: zolemba zamanja komanso zodziwikiratu.

• Zolemba - kapena zomatula. Mwazi wambiri umatengedwa kamodzi, womwe umayikidwa mu chidebe chosalimba cha hemo ndikutsukidwa. Maselo otsala pambuyo pa kuchotsa plasma amachepetsa ndi saline ndikupatsidwa kwa wodwala. Njira yam'manja imagawidwa m'mitundu iwiri:
  • sedimentation - plasma imasiyanitsidwa ndi cell pokhazikika, yotsirizira,
  • yokoka - kapena chapakati. Mwazi mumtsuko umayikidwa mu centrifuge, pomwe umagawika muzinthu, popeza liwiro lawo limasintha. Njirayi imawonedwa ngati yatha ndipo imagwiritsidwa ntchito moperewera.
• Hardware ndi njira yopangira mpanda. Kuyeretsa ndi kubwerera magazi kumachitika mosalekeza. Magazi amatengedwa m'magawo ang'onoang'ono, amawadyetsa zida zopatula ndikubwezeretsedwanso m'magawo ang'onoang'ono. Njirayi ndiyosavuta kwa odwala kulolera, chifukwa sizipanga katundu.

Pali mitundu ingapo ya ma plasmapheresis othandizira - membrane, cascade, ndi zina zotero.

Muzipangizo ndi maofesi akompyuta, njira ziwiri za kuyeretsa magazi zimachitika, motero njira zonse zimagawika m'magulu awiri.

• Centrifugation - imagwiritsidwa ntchito nthawi zambiri. Ma centrifuges amakono amayendetsedwa ndi mapulogalamu apadera omwe amakupatsani mwayi kuti muwone kuthamanga kwenikweni kwa kasinthidwe ndi braking. Chifukwa chake, maselo am'magazi, komanso mapuloteni ndi mapuloteni ena am'madzi amawonongeka. Pambuyo pa centrifugation, maselo am magazi okhala ndi choloweza m'malo mwa magazi kapena ndi plasma oyeretsedwa kudzera mu zosefera amabwezeretsa m'thupi la wodwalayo. Masiku ano, njirayi imagwiridwa mwachangu kwambiri ndipo sikuti imalemetsa thupi la munthu. Kuyeretsa kwa magazi ndi centrifugation kumagwiritsidwa ntchito mwachangu mu pulmonology matenda angapo apamwamba a kupuma, mu endocrinology pochiza matenda a shuga mellitus, mwachitsanzo, matenda a Addison, komanso, mu dermatology ya dermatitis ndi herpes, okwiyitsidwa ndi kusokonekera kwa chitetezo cha m'thupi.
• Kupatukana kudzera mu zosefera zimagwira ndi njira yopweteka komanso yotetezeka kwathunthu. Magazi amalowa mumtsempha wamagazi ndikudutsa mu fyuluta yoyeserera. Pankhaniyi, madzi a m'magazi amalekanitsidwa pamodzi ndi zidutswa za makoma a cell, poizoni, allergen, lipoproteins ndi ena.

Njira zingapo zamtundu wamkati ndimasamba. Potere, magazi amadutsa pazosefera ziwiri: koyamba, maselo amasungidwa, chachiwiri, mamolekyulu akuluakulu. Plasma yoyeretsedwa mwanjira imeneyi imatha kubwezeretsedwanso m'thupi la wodwalayo. Cascade plasmapheresis imawoneka yogwira mtima kwambiri m'matenda oopsa a autoimmune.

Zotsatira pa plasmapheresis

Plasmapheresis ndi njira yoyeretsa magazi yomwe imachitidwa kunja kwa thupi. Amapangidwa kuti achotse zinthu zapoizoni zomwe zimayambitsa thupi kapena kugwiritsa ntchito plasma mtsogolo - wopereka plasmapheresis.

Plasmapheresis ali ndi zotsutsana zingapo. Zina mwazo sizingawonongeke mulimonse, nthawi zina, chiwopsezo ndi phindu lake ziyenera kuyesedwa.

Zopanda malire kwathunthu zimaphatikizapo:

• magazi - mkati kapena kunja. Katundu wotere ndi woposa mphamvu ya thupi,
• masinthidwe osasintha pamtima ndi ubongo,
• kuvulala kwambiri kwamkati,
• kutseka magazi kumapangitsa kuti njirayi ikhale yosatheka.

Sikovomerezeka kugwiritsa ntchito plasmapheresis pa matenda otere:

• arrhasmia ndi kuthamanga kwa magazi, chifukwa gawo litatha, kupanikizika kumachepa.
• zilonda zam'mimba
• kuchepa magazi, makamaka ukalamba,
• matenda opatsirana pachimake
• dziko lodzidzimutsa.

Magnetotherapy

Hydrotherapy ikuyerekeza bwino ndi njira zina zochizira ndi kupezeka kwake komanso kuphweka. Chithandizo chotere chimakhala choyenera kwa odwala omwe ali ndi mtundu woyamba komanso wachiwiri wa matenda ashuga. Nthawi zambiri, m'magulu azachipatala, njira zotsatirazi zimalimbikitsidwa:

1. kusamba
2. osambira
3. balneotherapy
4. mafuta madzi chithandizo
5. hydrokinesis mankhwala,
6. kusisita, kusenda,
7. bafa, bauna.

Chinsinsi cha chithandizo cha matenda ashuga ndikusamba ndizothandiza pamthupi la ndege yamadzi pansi pa kutentha ndi kukakamiza. Kusamba kumatha kukhala kosiyana: fumbi, singano, kukwera, Scottish, mvula ndi zina.

Mabafa amathanso kukhala osiyana, adotolo amatha kuyambitsa kusamba wamba, komwe thupi lonse la odwala matenda ashuga limamizidwa m'madzi, kupatula mutu. Nthawi zina kusamba kwanuko kumakhala koyenera pamene gawo limodzi la thupi limamizidwa (mkono, mwendo, pelvis). Panthawi ya ndondomekoyi, madzi osambira nthawi zonse amasungidwa pamlingo wina wotentha komanso kutentha.

Balneotherapy iyenera kumvetsedwa ngati chithandizo ndi mchere wam'madzi, ndipo hydrokinesitherapy ndi njira yovuta kwambiri yochitira masewera olimbitsa thupi posambira komanso kusambira.

Madzi otentha (kutentha pamlingo kuchokera pa madigiri 37 mpaka 42), kutikita, kusamba (madzi ozizira), ma saunas ndi malo osambira (otentha otentha) kumathandizanso thupi.

Njira zonse zozizira za matenda a shuga a 1 ndi 2 zimapangitsa kuti maselo apangidwe komanso kuwonongeka. Mphamvu ya hydrotherapy yamadzi ochepa kutentha imaperekedwa ndi kuthamanga kwa kagayidwe m'thupi la anthu odwala matenda ashuga, koma izi sizimatenga nthawi yayitali.

Physiotherapy imapereka chifukwa chabwino chifukwa cha njirazi:

• kuchuluka kagayidwe kachakudya kumawonjezera kufunika kwa zolimbitsa thupi,
• Kuwongolera momwe wodwalayo amathandizira kumathandizanso kagayidwe kake ka zinthu.

Mankhwala akachitika ndi madzi ofunda, zoterezi zimachitika. Pochita njirayi ndi madzi otentha kwambiri, omwe amayambitsa kutentha kwambiri, kagayidwe kake kamathandizanso.

Ngakhale kuphweka kwake kodziwikiratu, physiotherapy ya matenda a shuga imatha kukhala ndi vuto. Mwachitsanzo, hydrotherapy ndibwino kuti musagwiritse ntchito ngati pali kuphwanya ubongo, magazi, kuchuluka kwa matenda oopsa, chiwopsezo chachikulu cha angina pectoris, kuchulukitsa kwa matenda otupa, matenda a thrombophlebitis, kulephera kwa magazi, gawo 1-B kapena apamwamba.

Muyenera kudziwa kuti odwala omwe ali ndi matenda ashuga amitundu iwiri ndi mtundu 1 amaletsedwa kachitidwe kovutirapo, monga ziwonetsero:

Chithandizo cha matenda ashuga ndi madzi chimafunika kukambirana ndi dokotala ngati wodwala ali ndi vuto la mtima la mitsempha panthawi yoyembekezera.

Kuchiza kwambiri matenda ashuga kumaphatikizanso kugwiritsa ntchito magnetotherapy, zomwe zimapangitsa kuti njirayi ikhale yopindulitsa kwa odwala matenda ashuga. Monga lamulo, magnetotherapy imayikidwa kwa kapamba.

Pafupifupi, nthawi ya mankhwalawa ndi njira khumi ndi zisanu, ndipo pakatha magawo atatu oyamba, wodwala matendawa azindikira kuchepa kwamphamvu kwa shuga m'magazi.

Magnetotherapy ndi chithandizo chabwino kwambiri ngati wodwala wapezeka ndi matenda a shuga, chifukwa mphamvu zamagetsi zimalimbitsa mitsempha ya magazi bwino, imapangitsa kuti magazi asamayende bwino.

Kuyendetsa miyendo ndi miyendo kumathandizira kuthana ndi neuropathy ndi angiopathy, njira iyi imaphatikizapo kugwiritsa ntchito maginito apamwamba pafupipafupi.

Ndondomeko amathandizira kuwonjezera kukoka kwa magazi, mwanabele, kusintha mkhalidwe wa anthu odwala matenda ashuga.

N`zosatheka kuonjezera physiotherapeutic zotsatira za acupuncture mu matenda ashuga neuropathy, chifukwa:

• kukonza kwamitsempha yamagalimoto,
• kuchuluka kwa miyendo,
• Kuchepetsa ululu.

Katemera, acupuncture, acupuncture ndi matenda a shuga amalimbikitsidwa kwa odwala matenda ashuga ambiri.

Mavuto a shuga m'magazi akaphatikizidwa ndi zovuta za septic ndi kulephera kwa aimpso, tikulimbikitsidwa kuti odwala matenda ashuga azikumana ndi plasmapheresis. Njirayi imathandizira kuyeretsa magazi, madzi a m'magazi a wodwalayo amasinthidwa ndi zinthu zapadera.

Panthawi ya ozone chithandizo cha matenda ashuga, kupezeka kwa mphamvu ya maselo a glucose kumawonjezera, komwe kumachepetsa hyperglycemia. Ozone idzakulitsa kagayidwe ka shuga m'maselo ofiira, chifukwa, minofu imalandira mpweya wambiri, ndipo hypoxia idzathetsedwa pakapita nthawi.

Njira yothandizira mankhwalawa imathandizira kupewa zovuta:

Kuphatikiza apo, odwala matenda ashuga amalandira immunomodulatory effect. Aliyense amadziwa kuti ndi matenda amtundu wa 1 shuga, odwala ali ndi vuto lodzaza ndi zotupa komanso matenda opatsirana chifukwa cha chitetezo chokwanira. Pazifukwa izi, chithandizo cha ozone ndi imodzi mwazinthu zothandiza kwambiri pakuchotsa matenda ashuga a mtundu woyamba. Kanemayo munkhaniyi akupitiliza mutu wa chithandizo cha matenda ashuga ndi physiotherapy.

Magazi plasmapheresis - kuyeretsa magazi ndi njira yoopsa

- Yuri Alexandrovich, tiuzeni momwe plasmapheresis imachitikira.

Chida chapadera chimagwiritsidwa ntchito pochita plasmapheresis - Ndimagwira ntchito ya Hemos-PF. Ndi zida zoyambirira za Unduna wa Zadzidzidzi zithandizo zadzidzidzi.

Wodwalayo atagona pabedi, dokotalayo amaika catheter pulasitiki kudzera mu mtsempha pa mkono wake womwe magazi amatuluka.

- Ndi mtsempha umodzi wokha womwe umakhudzidwa?

Pali njira zosiyanasiyana: zina, mitsempha imodzi imakhudzidwa, ina - ziwiri, mwachitsanzo, zotumphukira komanso pakati. Njira ya membrane plasmapheresis yomwe ndimachita imakhudza mtsempha umodzi wokha. Monga momwe madokotala amanenera, uku ndikuwukira kochepa.

Komanso, magazi a wodwala "amayenda" kudzera pazida.

Kuchuluka kwa magazi omwe amatengedwa kumabwezedwa. Munthu aliyense ali ndi buku lamagazi ake. Chifukwa chake, kuchuluka kwa magazi omwe "amathamangitsidwa" gawo limodzi, kwa wodwala aliyense, adokotala amawerengera payekhapayekha, poganizira kusanthula kwa magazi, thupi ndi kutalika. Pali pulogalamu ya pakompyuta yowerengera kotero.

- Kodi njirayi imatenga nthawi yayitali bwanji?

Pafupifupi ola limodzi. Munthawi imeneyi, mkhalidwe wa wodwalayo umayang'aniridwa: kuthamanga kwa magazi, kupuma, kutsika ndi mpweya wamagazi amayeza. Ndiye kuti, wodwalayo samangoyang'aniridwa ndi dokotala, komanso amayang'aniridwa ndi zida.

- Kodi ndingachite plasmapheresis pamaziko apadera?

Plasmapheresis si njira yosavuta kuchitikira pa nthawi ya nkhomaliro. Izi si jakisoni: jekeseni - ndipo adapita. Anthu amalekerera plasmapheresis mosiyanasiyana, kotero pali nthawi inayake pambuyo pa njirayi (kuyambira theka la ola mpaka ola) pomwe ndimayang'ana momwe wodwalayo alili. Ngati zizindikiro zonse ndizokhazikika - munthu akhoza kupita kwawo.

Njira yoyeretsa magazi - plasmapheresis, yatchuka kwambiri, mawu oti "kuyeretsa" amabweretsa ndalama kwa ovala zovala zoyera, kumangokhala ngati malingaliro, m'malo mwake "kuyeretsa" ma wallet a nzika zathu, chifukwa njirayi ndi yodula kwambiri, kuwonjezera apo, malinga ndi chitsimikiziro cha "madokotala", muyenera kudutsa njira zosachepera zisanu . Chifukwa chake, a MED - Centers amalemeretsedwa.

Plasmapheresis - kuyeretsa magazi kwina. Amagawidwa kukhala centrifugal, hardware ndi nembanemba.

Membrane Kusintha kwa madzi am'magazi m'magazi, pogwiritsa ntchito nembanemba ina yomwe mamolekyu ambiri amakhala: mapuloteni a chitetezo, lipoprotein, antibodies.

Centrifuged, magalamu 450-500 a magazi amatengedwa ndikulekanitsidwa ndi centrifuge kukhala plasma ndi cell cell. Mu cellular, mchere kapena mchere wina umawonjezeredwa ndipo wodwalayo amawatsanulanso. Ndipo plasma imawonongedwa.

Mwambiri, tanthauzo la njirayi ndikuti magazi amatengedwa kuchokera kwa wodwala ndipo amagawidwa kukhala plasma ndi erythrocyte misa. Ndi plasma yomwe imakhala ndi mapuloteni okhala ndi tizilombo, ma virus, maselo akufa, ndi ena. Plasma imatayidwa (ngati iyi si njira yakudziyeretsera), ndipo magazi osakanizidwa ndi mankhwala kapena magazi omwe aperekedwa amakankhiridwa m'malo mwake. Dziwani zambiri za njira za plasmapheresis kuchokera ku Wikipedia.

Pa nthawi imodzi, pafupifupi ma ¼ onse amadzi am'magazi amachotsedwa m'thupi la munthu.Plasma yonse imatenga theka loposa la magazi, pomwe kuchuluka kwake kwa magazi kumadalira kuchuluka kwa wodwala. Chifukwa chake, mwa wodwala wolemera makilogalamu 70, pafupifupi 700 g yamagazi amadzachotsedwa munthawi ya plasmapheresis. Chiwerengero cha magawo zimatsimikiziridwa ndikuzindikira kwa matendawa komanso kuwuka kwa matendawa, koma makamaka amachokera magawo awiri mpaka atatu mpaka 12.

• Zosangalatsa. Pogwiritsa ntchito fayilo yapadera, zigawo za ma cell ndi ma plasma zimasiyanitsidwa ndi magazi. Kenako, gawo lamaselo limapukusidwa ndi yankho la 0.9% sodium chloride ndi kubwezeretsedwa m'thupi, gawo la plasma limachotsedwa.
• Mphamvu yokoka. Wodwalayo amapereka 0,5 l magazi kuchokera m'mitsempha kupita ku chidebe chapadera, chomwe chimatumizidwa kwa centrifuge. Mmenemo, maselo am'magazi amakhala, pambuyo pake amabwezeretsedwa m'thupi la wodwalayo monga mbali yamchere wamankhwala. Kuti mukwaniritse zochizira, ndikofunikira kuchita magawo atatu a mphamvu yokoka ya plasmapheresis.
• Kuyamwa kwa plasma. Mtundu uwu wa plasmapheresis sunakhazikike chifukwa chowonjezera ma plasma, koma pakuyeretsedwa kwake m'magazi. Carbon activated imagwiritsidwa ntchito ngati sorbent wapadera poyeretsa.

Ngati akuwonetsa, njira zonse za kuyeretsa magazi kwa magazi zimatha kuperekedwanso mwa njira yomwe maselo amwazi amayatsidwa ndi kuwala kwa ultraviolet.

Tsoka ilo, ngakhale njira yowoneka ngati yothandiza monga plasmapheresis imakhala ndi mavuto. Tikuyankhula zakuti popanga magazi a m'magazi thupi limasiyanso zinthu zina zofunika m'thupi: mapuloteni (kuphatikizapo ma immunoglobulins) ndi zigawo zina za magazi omwe amapanga magazi (prothrombin, fibrinogen). Pachifukwa ichi, kuyeretsa magazi sikumachitika ngati wodwala wapezeka ndi mapuloteni ochepa m'magazi, komanso atha kutuluka kwambiri magazi (nthawi zambiri zimachitika ngati chiwindi chikukhudzidwa kwambiri).

• Kuchuluka kwa mtima wama mtima (makamaka, mtima wamanja).
• Kumwalira kwatsoka kwamatumbo a ziwalo chifukwa cha kufooka kwa magazi.
• Kuchuluka kwambiri kwa kuthamanga kwa magazi.
• Mankhwala osokoneza bongo komanso zovuta zina za neuropsychiatric.
• Anemia
• Mwazi wambiri.
• Pachimake kapena matenda a chiwindi kukanika.

Gawo loyeretsa magazi pamaso pa matenda omwe atchulidwa limatha kupangitsa kuti wodwalayo afe.

Monga momwe machitidwe awonetsera, thupi laumunthu, lomwe lilibe zotsutsana ndi plasmapheresis, limatha kuyankha njira iyi yoyeretsa magazi m'njira yosadalirika. Nazi zovuta zomwe zikuwonetsedwa mwa odwala chifukwa cha chithandizo:

• Kugwedezeka kwa anaphylactic. Momwe thupi lawo siligwirizana limawonetsedwa ndi kuzizira, zovuta zingapo za autonomic, kusokonezeka kwa hemodynamic ndipo kumabweretsa kufa mu 60% ya milandu.
• Hypotension. Kupsinjika kwa magazi kumatsika kwambiri, zomwe zimapangitsa kuti mpweya ubwerere mu ubongo. Pafupifupi 60% ya milandu imabweretsa kupunduka kapena kufa kwa moyo wonse.
• Kutulutsa magazi kwambiri (ndi kukokoloka komanso zilonda zam'mimba), komwe nthawi zina kumakhala kovuta kwambiri kuletsa, motero wodwalayo amasinthidwanso. Milandu yakupha anthu ena idanenedwa.
• Kuledzera kwa citrate. Sizichitika kawirikawiri - wodwalayo amagwa ndikomoka.

Kukonzekera kwapadera njira yoyeretsa magazi musanaperekedwe, komanso palibe malingaliro apadera pambuyo pake.

• Kodi ndiyenera kukaonana ndi dokotala wamatsenga kuti ndikhumudwitsidwe?
• Momwe mungamvetsetse kuti ndewu zayamba
• Mowa ndi zotsatira zake pamakhalidwe a anthu

Makamaka a: Medical portal - http://pomedicine.ru

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Kwenikweni kukonzekera kugwirira ndikosavuta. Masiku angapo gawo lisanayambe, muyenera kusiya mowa ndi khofi ndikumwa madzi ambiri. Pamaso pa gawo muyenera kudya chakudya - chopepuka komanso chokwanira.

Plasmapheresis ndi njira yayitali, koma yopweteka, kukhazikitsa kwake sikumapangitsa vuto lililonse. Gawoli limachitikira muofesi yokonzekera mwapadera.

1. Wodwalayo amaikidwa pabedi kapena pampando - atagona kapena atakhala pansi.
2. Singano kapena catheter amayikidwa m'mitsempha pomwe magazi amatengedwa. Nthawi zambiri, mpandawo umachokera ku mtsempha pakulowera mutu wake.
3. Muzipangizo zamakono, ndikofunikira kukhazikitsa masingano awiri: kudzera woyamba pali sampuli ya magazi, kudzera m'magazi achiwiri amabwerera m'thupi la wodwalayo.
4. Mwazi umasamutsidwira kuchidebe cha hemo kenako ndikugawika zigawo zing'onozing'ono. Njira yopatulira imatengera mtundu wa zida zomwe zimagwiritsidwa ntchito. Pankhaniyi, plasma imachotsedwa, m'malo mwa saline, yankho la glucose, potaziyamu wa potaziyamu, wopereka plasma kapena malo ena m'malo mwa magazi.
5. Kudzera mu singano yachiwiri, magazi amabwezeredwa kwa wodwala chimodzimodzi kuchuluka komweko. Ndikothekanso kulowa m'mankhwala omwe amafanizidwa limodzi ndi kubwerera kwa magazi.

Kutalika kwa gawoli ndi maola 1-2. Kuchuluka kwa magazi oyeretsedwa kumatsimikiziridwa ndi njira yotsukidwa ndi upangiri wa zamankhwala. Njirayi imagwiridwa ndi opaleshoni ya opaleshoni yomwe yaphunzitsidwa mwapadera kapena dokotala wamisala. Pafupifupi, gawo limodzi limafulumira mpaka 30% ya magazi.

Panthawi yonseyi, dokotala kapena namwino amakhala pafupi ndi wodwalayo. Mkhalidwe umayang'aniridwa nthawi zonse: zowonetsera, kuthamanga kwa mtima, kapangidwe ka magazi ndi zina zotero.

Ngakhale kuti plasmapheresis ndiyotetezedwa, komabe imakhudza mkhalidwe wa wodwalayo, motero, kuti muchepetse zomwe zingachitike, malamulo angapo osavuta ayenera kutsatiridwa.

• Pambuyo pa gawoli, tikulimbikitsidwa kukhalabe pamalo apamwamba mpaka ola limodzi, kutengera ndi momwe zinthu ziliri.
• Tsiku lotsatira simungathe kusamba madzi otentha, komanso kupewa kupewa kutenthetsera dzuwa.
• Ndikofunika kupatula zakudya zotentha ndi zakumwa.
• Nthawi zina, kugona pabedi kumayikidwa.

Zotheka zovuta za njirayi

Cholinga cha njirayi ndikuyeretsa magazi. Plasmapheresis imakulolani kuti muchotse ma antibodies, ma antijeni, ma cell a immune cell, mankhwala owola, oyimira pakati otupa, ndi zina zambiri. Chifukwa chake, ndikotheka kuthana ndi kuledzera thupi mwachangu, kubwezeretsa chitetezo chokwanira, kuponderezana ndi mitundu yosiyanasiyana yodana ndi zinthu zosiyanasiyana.

Kuphatikiza apo, plasmapheresis imayendetsa kayendedwe ka magazi, kuphatikizapo zotumphukira, komanso zimathandizira kukoka kwamadzi, kumachepetsa kuchuluka kwa edema. Pa nthawi yobereka, plasmapheresis nthawi zambiri imafotokozedwa ngati njira yolepheretsa. Izi ndizowona makamaka kwa azimayi omwe amasuta.

Komabe, njirayi ingakhale ndi zotsatirapo zoipa:

• ndi kuyambitsa kwa mankhwala omwe amalepheretsa mapangidwe amwazi, komanso plasma wopereka, angayanjane chifukwa cha kufooka kwa anaphylactic,
• hypotension - ndi kuchoka kwa magazi ambiri, kuponya kwakuthwa kwambiri ndikotheka. Izi zimakonda kugwira ntchito zamanja,
• magazi - angayambike ndi kuyambitsa kwa mankhwala omwe amachepetsa kutheka,
• magazi - osakwanira ndi mankhwalawa, ma magazi amatha kufalikira ndikulowa m'matumbo okhala ndi mainchesi ang'ono,
• matenda - mwina kuphwanya njirayi. Munjira zamachitidwe, zotheka zotere sizimachotsedwa,
• Kulephera kwa aimpso - ndikotheka ngati opereka plasma amagwiritsidwa ntchito m'malo mwa saline, chifukwa pamakhala chiopsezo chosagwirizana.

Plasmapheresis: ndemanga, zabwino ndi zovulaza, zikuwonetsa ndikutsutsana

Mosakayikira, ndizofunikira pakutha kuyeretsa magazi amunthu mwachangu

Zachidziwikire, kuchipatala chabwino inu

, ndikuyesedwa kuti athe kunyamula. Komabe, muyenera kusankha chipatalacho mosamala, kuti musakafike kwa akatswiri a Mediocre.

Pali ma pathologies omwe plasmapheresis ndiyofunikira. Nthawi zina pamkhalidwewu, chiyembekezo chokhacho, mwachitsanzo, ndikofunikira kuchotsera mapuloteni a myeloma kapena monoclonal gammopathy (awa ndi matenda angapo omwe immunoglobulins amapangika mu thupi), matenda a cellleia, kapena matenda a Julian-Barré. Ngakhale pali mndandanda wa matenda omwe njirayi imalimbikitsidwa, koma uku ndi mwayi wa akatswiri omwe akufuna kupewetsa, si dokotala aliyense amene angamvetse.

Munthu amene akufuna kuyeretsa magazi amatembenukira pa intaneti ndi cholinga (monga momwe akuwonekera). Makina osakira apereka maulalo mazana ambiri pazomwe zafunsidwa: "kuyeretsa magazi" kapena "plasmapheresis" ndikutsatsa malo azachipatala omwe amapereka njira zowopsa kwa aliyense, pofotokoza plasmapheresis ngati yotetezeka komanso 100% yogwira mtima pafupifupi matenda onse wamba: dermatitis ndi matenda ena aliwonse a pakhungu, matenda ashuga , ndi ena. Kuphatikiza apo, akuwonetsa kuti njirayi itha kuchitika popanda kusanthula koyambirira ndikuwunika zaumoyo.

Madotolo sananene kanthu kuti njirayi ili ndi zambiri zoyipitsidwa ndipo ndi zakupha. Mankhwala aliwonse amakhala ndi malingaliro ake komanso zotsutsana. Kuchokera pamndandanda wamatenda omwe plasmapheresis imagwiritsidwa ntchito, zikuwonekeratu kuti njirayi siyophweka, koma chidziwitso chakuti "akatswiri" ena amadzipereka kuti athetse kutopa kwakuthupi, kupweteka kwa kuphatikizika kapena kuyeretsa kuchokera ku poizoni ndizowopsa kwa moyo wa wodwalayo komanso osati moyenera kwa "Dotolo".

Kuti timvetse izi, titembenuzire ku ziwerengero: ndipo akuti 0.05% ya odwala omwe atsatira njira yoyeretsa magazi amafa chifukwa chake.

Imfa pakati pa iwo omwe ali ndi vuto lofiirira la thrombocytopenic ndi oposa 30%, ndipo m'modzi wa iwo adzafa chifukwa cha njira yoyeretsera magazi. Koma, ndi kuchuluka kwambiri kwaimfa kumeneku, izi ndizopepuka, chifukwa plasmapheresis ndi chinthu chokhacho chomwe chithandizira kupulumutsa miyoyo.

Koma, titenge anthu 10,000 athanzi, 5 a iwo afa mchitidwewu. Uwu ndi milandu yambiri, muyenera kuweruza.

Akatswiri (ma charlatans, okonzekera ndalama chifukwa cha chilichonse), omwe amadziwa zoyeretsera magazi ndi ziwerengero za anthu, komabe amalengeza kwa aliyense, mwakutero kuwulula munthu pangozi yaumunthu.

Mtengo wa plasmapheresis umapangidwa mosiyanasiyana m'chipatala chilichonse. Komabe, njirayi imawonedwa ngati yokwera mtengo.

Mwachitsanzo, ku Moscow, plasmapheresis imachitika m'makliniki azachipatala ambiri. Ubwino wamabungwe apadera ndikupezeka kwa dongosolo losinthika kuchotsera kwa makasitomala wamba. Mtengo wa plasmapheresis ku Moscow ndi pafupifupi rubles 5-8,000. M'mizinda ina, malo apansi ndi ochepa. Mwachitsanzo, mtengo wamba wa plasmapheresis ku Khabarovsk ndi ma ruble 3-7,000.

Monga lamulo, madokotala amalimbikitsa kuti muthe kuchita njira zisanu kuti mukwaniritse zochizira zambiri. Kutengera izi, mtengo womaliza wa magawo angapo ungakhale ma ruble 15 ndi 40 zikwi.

Mtengo wa njirayi ndi gawo limodzi, kuyambira 4300 mpaka 7000 p. Maphunzirowa nthawi zonse amakhala ndi njira zingapo. Monga lamulo, zipatala zimapereka kuchotsera ngati kuchuluka kwa magawo kupitilira 5.

Plasmapheresis ndi njira yachipatala yomwe madokotala okha ndi omwe angaweruze kuyenera kwake. Komabe, maphunzirowa atangochitika, anthu ambiri amawonetsetsa kuti akukhala bwino, kuchepa mphamvu, kapena kuzimiririka kwa zizindikiro za matenda omwe alipo.

Plasmapheresis ndi imodzi mwazinthu zothandiza kwambiri pakuyeretsa magazi ndikuchotsa ma allergen. Komabe, njirayi ndi yothandiza, popeza palokha ilibe chithandizo. Plasmapheresis imaphatikizidwa ndi chithandizo chovuta kwambiri, ndipo nthawi zina, m'njira zodzitetezera.

Plasmapheresis sanalembedwe mpaka njira zosagwiritsa ntchito zowononga zachilengedwe zitatha. Ngakhale zili choncho, njirayi imawonedwa ngati cholowererapo cha opaleshoni, chifukwa chake, nchoyenera kupereka chida ichi pokhapokha ndikuwonetsa zoyenera.

Pindulani ndi kuvulaza

Ndi plasmapheresis, magazi amayeretsedwa kuchokera kuzinthu zama protein ndi ma antijeni omwe alipo, ma immune immune.

Ndondomeko amathandiza thupi ndi matenda a mtima ndi matenda ena angapo: colitis, atherosclerosis, chibayo, mphumu. Amathandizanso impso kudwala komanso matenda amtundu.

Mwazi wotengedwa kuchokera mu mtsempha umatsukidwa ndi zinthu zovulaza zomwe zimathandizira kukulitsa matenda ndi kutupa. Pambuyo pakuyeretsa, magazi amabwerera m'mitsempha.

Ndikofunika kukumbukira kuti plasmapheresis sangathe kumaliza pompopompo. Njira izi zimafunikira kupulumutsidwa. Popeza njira zomwe zimakhudzana ndikuchotsa magazi m'thupi nthawi zonse zimakhudzana ndi zoopsa, njirayi silingawonedwe ngati zosangalatsa zamachitidwe.

Mu gawo limodzi, magazi a anthu amasulidwa ku 20% ya zinthu zovulaza. Pankhani imeneyi, njirazi sizipereka mphamvu nthawi zonse ngati munthu wadwala kwambiri.

Zoyipa za njirayi ndikuti, kuphatikiza ma plasma, zinthu zofunika pakugwira bwino ntchito kwa thupi, monga fibrinogen, immunoglobulins, ndi zina zotere, zimachotsedwa m'magazi. Pankhani imeneyi, njira yothandizira mankhwalawa singagwiritsidwe ntchito ndi ma protein ochepa m'magazi komanso zinthu zina. Pambuyo pa njirazi, kuchepa kwa chitetezo chokwanira, maphunziro sanakhazikitsidwe.

Ndi matenda ashuga

Makina a autoimmune omwe ali ndi matenda ashuga amtundu woyamba amakhala chisonyezo cha njira imodzi ya plasmapheresis. Ndi matenda a shuga a mtundu 2, njirayi ingagwiritsidwenso ntchito, koma pokhapokha ngati adokotala amupangira.

Ndi njirayi, mu shuga mellitus, lipoproteins imachotsedwa m'magazi ndipo chodabwitsa cha insulin chikugonjetsedwa.

Pali kusintha kwa kayendedwe ka magazi mwa odwala, momwe mankhwalawa amachepetsa shuga, komanso mankhwala ena omwe amatengedwa ndi matendawa, amawonjezeka.

Pa nthawi yoyembekezera

Pa nthawi yoyembekezera, kuyeretsa magazi nthawi zambiri kumagwiritsidwa ntchito pofuna kuthana ndi kupewa matenda osiyanasiyana opatsirana ndimatenda a autoimmune (makamaka mikangano ya rhesus) komanso kuperewera kwa placental.

Njirayi imalimbikitsidwa kuti igwiritsidwe ntchito poyeretsa thupi, pokonzekera boma la mimba. Izi ndizofunikira makamaka kwa azimayi omwe amasuta.

Plasmapheresis amagwiritsidwa ntchito pazolinga za prophylactic, pofuna kupewa kuwonekera nthawi yapakati yomwe mayi ali ndi vuto losagwirizana ndi thupi.

Phindu lalikulu la beets limagona mu mawonekedwe ake okhala ndi zofowoka zovuta.

Ndi matenda a shuga, mpunga wa bulauni umaloledwa. Zambiri za izi zalembedwa apa.

Njirayi ndiyofunika kwambiri pakakhala matenda opatsirana, owopsa kwa mwana wosabadwa, monga herpes, chlamydia, cytomegalovirus, toxoplasmosis.

Njira

Kwa njirayi, kukonzekera ndikofunikira. Muyenera kudya bwino ndikukhala ndi nthawi yokwanira yopumira, onse musanayambe plasmapheresis ndi pambuyo. Chigawo choyamba chisanachitike, adokotala ayenera kusankha mankhwala omwe amayenera kusiya.

Ndondomeko iyi imaphatikizanso magawo angapo:

• Kutenga magazi ofunika kwa wodwala,
• Mtengo wamagazi m'magawo ake ndi gawo lamadzi, lomwe ndi madzi am'magazi, ndi zinthu zina, monga ma cell oyera am'magazi ndi ma cell ena amwazi.
• Kuwonongeka kwa zinthuzi m'magazi amalo am'magazi ndikubwerera kwawo kuzinthu zoyenda magazi.

Kuti izi zitheke, munthu ayenera kulowa muubongo wambiri. Mankhwala apadera - anticoagulant omwe amapanga magazi, samalola kuti angozizira pakuchotsa.

Kodi plasmapheresis ingachitike kangati?

Anthu omwe samadwala matenda aliwonse, chithandizo chachipatala chino sichofunikira. M'malo azachipatala, maphunzirowa amachitika kamodzi kapena kawiri pachaka.

Zotsatira zoyipa ndi zovuta

Akatswiri akuti kuyeretsa magazi sikuwopseza moyo, pokhapokha ngati mayeso onse omwe adafunidwa kale, kuphatikizapo kuyezetsa magazi, amachitidwa.

Zowopsa plasmapheresis ndi zotsatira zake:

• Kupezeka kwa pulmonary edema.
• Kuwonetsedwa kwa thupi lawo siligwirizana ndi isanayambike anaphylactic mantha.
• Kuzindikira kwa coagulability wamagazi ndi kupezeka kwa magazi.
• Kupezeka ndi chitukuko cha matenda.
• Kuchepetsa kwambiri kuthamanga kwa magazi.
• Kuthekera kwa kufa: imodzi mwa njira 5000.

Malinga ndi akatswiri, zovuta ndizotheka ngati mayeso onse ofunikira sanachitike asanachitike, kapena wodwalayo sananene za matenda onse omwe anali nawo.

Zizindikiro ndi contraindication

Plasmapheresis imagwiritsidwa ntchito pazovuta za metabolic, kutulutsa kwawo kosayenera kwa thupi. Mavuto oterewa amapezeka m'matenda a chiwindi, impso, mapapu ndi ndulu kapena amayamba chifukwa cha kupsa kwambiri, matenda a chitetezo chamthupi, matenda osiyanasiyana, komanso kupsa mtima.

Plasmapheresis amagwiritsidwa ntchito pa matenda ashuga, leukemia, matenda a bronchitis, matupi awo sagwirizana ndi mankhwala, etc. Ndi matenda awa, njirayi imawonjezera zotsatira za mankhwala, zotsatira za chithandizo zimawoneka bwino.

Si anthu ambiri omwe amadziwa kupanga phula la phula, nthawi zambiri amagula mankhwala omwe amakhala okonzeka.

Njira zochizira lipodystrophy mu shuga zafotokozedwera patsamba lino. Uku ndikuvutikira kwakukulu komwe nthawi zina kumachitika mu insulin.

Simungatenge njira yoyeretsa magazi chifukwa cha zovuta zomwe zimakhudzana ndi kuchulukana kwa magazi, ndi kulephera kwa mtima m'mapapo, aimpso - kuchepa kwa magazi kwa chiwindi ndi mitundu yayikulu ya kuchepa magazi.

Kugwiritsa ntchito plasmapheresis pochiza matenda ashuga

Odwala omwe ali ndi matenda ashuga, njira yozungulira ndiyo malo ovutikirapo kwambiri. Nthawi zambiri, matenda amtundu wa 1 amakhala ndi autoimmune zimachitika. Anthu omwe ali ndi matenda a shuga a mtundu wachiwiri amakhala pachiwopsezo cha matenda atherosulinosis komanso matenda ena. Kuphatikiza apo, magazi awo amakhala ndi kuchuluka kwa lipoprotein otsika ndi triglycerides. Chifukwa chake, plasmapheresis amatha kukhala ndi chothandiza pothandizira matenda.

Pambuyo pa plasmapheresis:

• ziphe, zakumwa zoopsa, mchere, lipoprotein ndi zinthu zina zoyipa zimachotsedwa m'thupi,
• chiwopsezo cha zovuta zimachepa: angiopathy ndi retinopathy,
• lipid metabolism imakhala yofanana.
• shuga ndende imabwezeretseka,
• insulin kukana
• kumawonjezera kuthamanga kwa magazi,
• mamvekedwe amwazi amachepa ndipo madzi ake amakula,
• khungu limazindikira,
• minofu kukomoka kumawonjezeka
• Zilonda za trophic ndi mabala ake
• khungu limayenda bwino
• mapangidwe atherosulinotic kusungunuka,
• kuchuluka kwa chidwi chamankhwala omwe amachepetsa shuga,
• chitetezo cha mthupi chimalimbitsidwa
• Amathandizira ntchito ya chiwindi, impso, mtima, mapapu ndi khungu,
• thupi limapangidwanso.

Mu shuga mellitus, plasma (25-40%) imasinthidwa ndi yankho la crystalloid (saline kapena zina). Mu gawo limodzi, thupi laumunthu limachotsa zofunikira za 10% za poizoni, zomwe zimafananizidwa ndimachitidwe a mankhwala othandiza kwambiri. Chifukwa chake, pambuyo pa njirayi yoyamba, mkhalidwe wa wodwalayo umakhala bwino.

Kuti mupeze phindu lokhazikika, ndikofunikira kuchititsa njira za 3-12, kutenga masiku atatu pakati pawo.

Pazolinga zopewera, plasmapheresis amalimbikitsidwa chaka chilichonse.

Plasmapheresis mu matenda a shuga amaperekedwa ngati wodwala wapezeka ndi:

• mafuta kagayidwe kagayidwe, kuphatikiza kwambiri hypertriglyceridemia,
• kuchuluka kwa lipid, kunenepa kwambiri kapena hypoalphacholesterolemia, komwe kumayendetsedwa ndi insulin kukana,
• kuchuluka kwamitsempha yamagazi
• chikhalidwe cha mtundu woyamba wa matenda ashuga,
• matenda ashuga retinopathy,
• matenda ashuga nephropathy,
• matenda ashuga polyneuropathy,
• matenda ashuga komanso matenda ena oyamba
• chifuwa
• matenda a pakhungu
• matenda a impso ndi chiwindi.

Plasmapheresis adayikidwa mu:

• chifuwa chomwe chimagwiritsidwa ntchito,
• mtima, impso, kapena kulephera kwa chiwindi,
• hemodynamics wosakhazikika,
• kuchepa magazi kwambiri,
• magazi amkati
• pambuyo pogwiridwa ndi pambuyo-infaration zinthu.

Plasmapheresis imatha kuchitika pokhapokha ngati dokotala ndi chipatala atakhala ndi mbiri yabwino. Kupanda kutero, chithandizo chitha kudwala.

Ubwino wotsatira plasmapheresis mu Zachipatala Zabwino Kwambiri:

• Pamaso pa njirayi, dokotala amachititsa maphunziro kuti adziwe kukhalapo kapena kusapezeka kwa ma contraindication. Kenako amasankha payekhapayekha kuchuluka kwa magawo, poganizira matendawo, komanso zaka za wodwalayo, thanzi lawo komanso kupezeka kwa matenda ena.
• Njirayi imachitika pamaso pa katswiri wothira magazi yemwe amayang'anira momwe wodwalayo alili. Imasanja kuthamanga kwa magazi, kugunda, komanso kupumira.
• Otsatsa Transfusi omwe amagwira ntchito kuchipatala chathu amaphunzitsidwa mwapadera ndipo amalandila ziphaso.
• Ngati mungafune, mutha kuphatikiza plasmapheresis ndi mayeso ena ndi upangiri wodziwa akatswiri.
• Mulingo woyenera wa chithandizo ndi mtengo.

Kuti mudziwe nthawi, imbani foni +7 (495) 530-1-530 kapena dinani batani la "Pangani nthawi" ndikusiyira nambala yanu. Tidzakuyimbaninso panthawi yabwino.

Zisonyezero za plasmapheresis mu shuga

1. Mavuto a lipid metabolism amagwirizana ndi mankhwala a hypopidemic mankhwala, makamaka ndi hypertriglyceridemia, kuchuluka kwa Lp (a) ndi hypoalphaolesterolemia, limodzi ndi hyperviscosity ndi insulin kukana.
2. Kukhalapo kwa autoantibodies kwa odwala omwe ali ndi matenda a shuga 1.
3. Matenda a shuga a retinopathy.
4. Matenda a shuga.
5. Matenda a shuga a polyneuropathy.
6. Matenda a shuga ndi matenda ena obwera.

Njira zoyendetsera ntchito

1. Kuchepa kwakuthwa kwa kupangika kwakukulu kwazachipatala pazovuta zomwe zili pamwambapa.
2. Kuwongolera zamadzimadzi kagayidwe kachakudya, kuchotsedwa kwa hyperviscosity, michere yachilengedwe, kuchotsedwa kwa insulin kukhudzana ndi matenda a shuga.
3. Kupititsa patsogolo kunenepa kwa minofu, kuchiritsa zilonda zam'magazi odwala omwe ali ndi phazi la matenda ashuga.
4. Pogwiritsa ntchito njira yayitali ya PA, kukhazikika ndi / kapena kusinthanso kwa malo a atherosulinotic malinga ndi ultrasound kapena angiography.

Konovalov G.A., Voinov V.A.

Plasmapheresis mu shuga mellitus ndi zida zina pamutu "Njira za chithandizo cha vitro"