The method of therapeutic plasmapheresis

 

(57) Abstract:

The invention relates to medicine, transfusion medicine and intensive care and can be used for therapeutic plasmapheresis. Spend 3-4 session exposee 450-500 ml of blood, which is subjected to centrifugation at 2000-2200 rpm and a temperature of 22-23oC for 18-20 min, thus obtained erythroleukemias diluted saline solution in a 2:1 ratio and injected intravenously jet; the procedure is repeated, that is one session hearingimpaired, erythrochlamys received during the last treatment, in the amount of 2-3 ml/kg diluted with saline 1:1, and return to the patient after ultraviolet irradiation dose 520-560 j/m2. This invention contributes to improving therapeutic properties of autotransfusion, plasmapheresis and reduction time heprincipalreci. 3 C.p. f-crystals.

The invention relates to medicine and can be used in endocrinology, blood transfusion and intensive care.

The closest technical solution to the claimed is a method of therapeutic plasmapheresis, which is obtained from the patient to whom ESU of leukocytes and platelets, cast, while substitution alloplazmaticheskimi and autoerythrocyte (see Gravitational surgery blood / Ed. by O. K. Gavrilova; the Academy of medical Sciences of the USSR. - M.: Medicine, 1984, S. 42).

The disadvantage is that in therapeutic plasmapheresis arises the need to fully compensate the qualitative composition of the blood in large amounts of donor plasma with the risk of development of a syndrome of massive transfusion viral infection of the patient.

The technical result is to increase therapeutic properties of autotransfusion UV irradiated blood, plasmapheresis and reducing the time of heprincipalreci, cost, speed and distance run.

The invention consists in that in a method of therapeutic plasmapheresis by separation of blood by centrifugation on plasma and erythroleukaemia, diluted with isotonic sodium chloride with subsequent return to the blood stream, erythroleukaemia obtained by centrifugation at 2000-2200 rpm and a temperature of 22-23oC for 18-20 min, followed her, in the amount of 2-3 ml/kg, ultraviolet irradiation at the dose of 520-560 j/m2.

The method is as follows.

After puncture of the cubital vein carry out short predisposing training volume vnutrivennoi drip infusion 800-1000 ml or saline solution with 5000 units of heparin. Then provide exposio 450-500 ml of blood in plastic containers "Gamecon 500/300" and, after equilibration containers, centrifuged last in the centrifuge RS-6 at 2200 rpm and a temperature of 22oC for 20 min Plasma translate into a small (300 ml) bag container using plasmacytoma PE-01. Remaining in large (500 ml) bags erythroleukemias diluted saline solution in a 2:1 ratio and injected intravenously jet.

In small bags, previously detached from large, introducing heparin at a dose of 20 IU/ml of plasma, seal, and place them in the refrigerator at a temperature of 3-4oC. the Procedure was repeated 3-4 times, which is one session hearingimpaired. Erythroleukemias of the last container in the amount of 2-3 ml/kg, diluted saline solution in a ratio of 1:1 and Vostochno quartz lamp [DRB]-8 with predominantly short-wave (254 nm) UV light. Dose, taking into account the variability of the mode of irradiation and in vitro hemodynamics is 520-560 j/m2. During the first transfusiological operation, the plasma loss is compensated by an intravenous infusion of blood substitutes, subsequent taken during the previous session of heparinized plasma is removed from the refrigerator, the precipitated cryoprecipitate by centrifugation at 3600 rpm, a temperature of +5oWith over 25 min, transfer the supernatant, which represents the purified plasma using plasmacytoma in sterile vials and poured the patient nutrivene drip instead of a remote. The last portion hearingimpaired autoplasma injected 24 h after the last operation hearingimpaired. The total number of sessions from three to five.

Compared with the known solutions, the proposed method can improve the efficacy of therapeutic plasma exchange, has a strong detoxification and immune modulating effects, leads to a slight decrease in total protein, but compared with therapeutic plasma exchange, not beyond the limits of physiological norm, shortened duration of preoperative preparation and stay ebogo plasmapheresis, namely, what are exposio 450-500 ml of blood, which is subjected to centrifugation at 2000-2200 rpm and 22 - 23C for 18-20 min, thus obtained erythroleukemias diluted saline solution in a 2:1 ratio and injected intravenously jet; the procedure is repeated 3-4 times, which is one session hearingimpaired, erythrochlamys received during the last treatment, in the amount of 2-3 ml/kg diluted with saline 1:1, and return to the patient after ultraviolet irradiation dose 520-560 j/m2.

2. The method according to p. 1, characterized in that during the first procedure, the plasma loss is compensated by the blood.

3. The method according to p. 1, characterized in that the plasma obtained during the procedures, together with heparin rate of 20 U/ml, plasma, sealed, placed in a refrigerator at 3-4C and is used to compensate for the blood loss during the procedures.

4. The method according to p. 1, characterized in that last bit hearingimpaired autoplasma injected 24 h after the last treatment.

 

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