The method of treatment of ischemic heart disease
The invention relates to medicine, cardiology, and can be used to treat ischemic heart disease. As a therapeutic solutions administered crystalloid, hemodynamic, detoxification, protein solutions, and plasmapheresis spend membrane centrifuge method without hemodynamic load with the removal of 40% of the circulating plasma during the course of treatment from 1 to 3 sessions within 72 hours, This invention contributes to the stabilization of hemodynamics as during plasmapheresis, and after it, reduces the workload of the heart, which further prevents the occurrence of repeated heart attacks. table 1. The invention relates to medicine and can be used in cardiology.The closest technical solution is a method of treatment of progressive angina, including blood, holding thrombocytopathies using a refrigerated centrifuge TO-26D, plastic containers "Gamecon" 500/300 with the removal of 30% of plasma and platelet mass for 1 session and leukocytapheresis by exfuze leukocyte mass of the same volume of blood, thus producing the introduction of the treatment solution in the form of chloride NAT is aetsa duration of treatment of coronary heart disease.The objective of the proposed method is the reduction of treatment, reducing the risk of repeated heart attacks and reducing mortality.This object is achieved in that in the method of treatment of ischemic heart disease, including analysis of blood rheology, introduction of therapeutic solutions, conducting plasmapheresis, the new method is that as a therapeutic solutions administered crystalloid, hemodynamic, protein, and plasma exchange are membrane-centrifuge without hemodynamic load with the removal of 40% of the circulating plasma during the course of treatment from 1 to 3 sessions within 72 hours.As a result of membrane plasmapheresis centrifuge improves blood rheology and its transport function through better delivery of oxygen to tissue cells, thus reducing excessive blood viscosity, which is determined by a high content of fibrinogen, soluble hybridmonolith complexes, von Willebrand factor, D-dimer, antihemophilic protein.The method is as follows.Intravenous crystalloid, hemodynamic, detoxification, protein solutions, depending on biochemical data and peripheral blood. Zanno-centrifuge method without hemodynamic load with the removal of 40% of the circulating plasma during the course of treatment from 1 to 3 sessions within 72 hours. During the procedure to measure blood pressure, determine the heart rate. Blood rheology control in 5-6 days.Examples confirming the ability of the proposed method: Example 1. Patient G, 49 years. Diagnosis: ischemic heart disease, recurrent myocardial infarction in the acute period, CH 2 tbsp. 2 GB. Upon receipt of a complaint of a burning retrosternal pain lasting more than 30 min, intractable nitroglycerin, fear, weakness, swelling in the legs, sweating. Electrocardiographic pattern was consistent with acute period of myocardial infarction of anterolateral wall of the left ventricle. Pain is controlled by injection of narcotic drugs. Level; fibrin monomer complex in plasma was 1710-2g/l, PV - 210%. DD - 1000 ng/ml, F8 - 190%. The patient in the infusion program included crystalloid solutions (quintal - 400,0), protein (albumin 10% - 200,0), hemodynamic (eagleman 300,0), then conducted the session hardware PF with the removal of 980 ml of blood plasma, which accounted for 40% of the CGO. The plasmapheresis lasted 4 hours. On the following day showed a significant clinical improvement: the attacks of chest pain stopped, swelling in the legs disappeared. On the second suck the mg>10-2g/l, DD to 0 ng/ml, F8 - up to 130%, the PV - up to 160%. Thus, the course of treatment was 24 hours.Example 2. Patient, 52 years of age, CHD. Progressive angina. Postinfarction cardiosclerosis. CH 1. GB 2. Upon receipt of a complaint by pressing pain in the chest during physical activity and at rest, intractable taking nitroglycerin. The number of attacks reached 25 per day, consumption of nitroglycerin 40 tablets per day. Electrocardiographic pattern was consistent with acute ischemic changes on the anterolateral wall of the left ventricle with capture septal area. Level; fibrin monomer complex in plasma was 1510-2g/l, FW - 190%, DD - 500 ng/ml, F8 - 208%. The patient entered crystalloid solutions (quintal - 500,0), hemodynamic (eagleman - 300,0), detoxification (gemodez - 200,0), then conducted the session hardware plasmapheresis to remove 950 ml of plasma, which corresponds to 40% CGO. The plasmapheresis lasted 5 hours. On the following day marked clinical improvement, which was characterized by reduction of angina for up to 7 a day, nitroglycerine decreased to 12 tablets per day. Held the second session of the hardware plasmapheresis. In the infusion program included: quina is the stupa of angina was reduced to 2 times per day, nitroglycerine was down to 2 tablets per day. Level; fibrin monomer complex decreased to 710-2g/l, PV - up to 125%, DD - 0 ng/ml, PE - to 148%. Thus, the course of treatment was 48 hours.The effect of treatment of coronary heart disease on the rheological properties of blood, the clinical course and mortality shown in the table.From the presented data it can be concluded reliable and significant reduction factors for disseminated intravascular coagulation (fibrinogen, soluble hybridmonolith complexes, D-dimer, antihemophilic protein) in comparison with the known method of treatment through the use of membrane plasmapheresis centrifuge, allowing you to remove a large volume of circulating plasma without hemodynamic load, thus reducing in-hospital mortality by 76% and to improve the clinical course of disease in patients with acute coronary syndrome, accompanied by disseminated intravascular coagulation.
ClaimsA method of treating ischemic heart disease, including analysis of blood rheology, introduction of therapeutic solutions and conducting hardware plasmapheresis, from the basic protein solution, plasmapheresis spend membrane centrifuge method without hemodynamic load with the removal of 40% of the circulating plasma during the course of treatment from 1 to 3 sessions within 72 hours
FIELD: medicine, cardiology.
SUBSTANCE: the suggested method should be performed at the background of medicinal therapy with preparations out of statins group, tevetene, polyoxidonium and conducting seances of plasmapheresis by removing 800 ml plasma twice weekly with N 5 due to additional intramuscular injection of immunophan 0.005%-1.0 with N 10 and fluimucyl 300 mg intravenously daily with N 5-10, total course of therapy lasts for 2 mo. The method provides modulation of leukocytic functional activity, moreover, due to altered cytokine profile and, thus, through disintegration of protein-lipid complexes participating in the development of atherosclerotic platelets.
EFFECT: higher efficiency of therapy.
SUBSTANCE: method involves using apparatus supporting washed erythrocyte reinfusion as far as the erythrocytes become available. Reinfusion duration is limited with 3-4 h of the nearest postoperative period. The device has valve for preventing excessive rarefaction to occur. The valve is connected to main pipe for taking blood via T-shaped connector. The valve has membrane member which inlet flow nipple is connected to valve nozzle, shutter and upper and lower strap springs connected to each other. Screw for setting zero on the upper strap providing membrane member displacement. Adjusting screw is mounted on the lower strap allowing detaching shutter from the nozzle to make communication to atmosphere.
EFFECT: enhanced effectiveness in compensating postoperative blood losses with full-valued formed blood elements.
2 cl, 2 dwg
FIELD: medicine, endocrinology.
SUBSTANCE: one should introduce heparin into plasma separated during plasmapheresis at 9000-11000 U/l plasma to incubate it at 4-6 C for 12 h, not less, separate precipitate due to plasma centrifuging at 7-9 C for 15-25 min and introduce the rest plasma into patient's blood. Such procedures should be carried out every other day 5-7 times. The present innovation enables to decrease glomerulosclerosis progressing, avoid excessive heparinization and heparinization-associated complications and, also, those associated with introduction of donor's plasma.
EFFECT: higher efficiency of therapy.
FIELD: medicine, anesthesiology-resuscitation, infectology, detoxication.
SUBSTANCE: the innovation suggested interrupts infectious-toxic shock, moreover, after that it is necessary to prescribe peroral intake of Reaferon-EC-Lipint at the dosage of 10000 - 15000 U/kg. Then one should sample patient's blood to obtain leukocytes to be washed and diluted in 0.9%-NaCl solution, activated due to incubation with immunophan and intravenously injected for a patient. Then comes peroral intake of Reaferon-EC-Lipint at the dosage of 10000 - 15000 U/kg once daily for 5 d. The innovation enables to decrease the number of complications and lethality due to decreasing immunodeficiency.
EFFECT: higher efficiency of therapy.
3 ex, 1 tbl
FIELD: medicine, obstetrics.
SUBSTANCE: at the first stage of pregravidic training one should introduce leukinferon per 10000 IU intramuscularly every other day 10 times, at the second stage it is necessary to perform 3 seances of discrete plasmapheresis. The present innovation enables to decrease the frequency in developing gestosis and the risk for abortion due to normalized activity of female immune system, that in its turn, enables to stop virusemia and virusuria, prevent fetoplacental failure and intrauterine fetal infectioning.
EFFECT: higher efficiency of training.
3 ex, 1 tbl
SUBSTANCE: method involves administering combined sanatorium-and-spa treatment after patient acclimatization on low altitude mountain resort takes place. The treatment comprises mineral carbonic acid water baths physical training exercises on terraincour according to generally applied methods and plasmapheresis procedures. Hypercholesterolemia of 5,0-6.5 mmole/l being the case or cholesterol level being higher than target value of 3.6 mmole/l, it is enough to give 3-4 procedures with exfusion to 1-1.5 times circulating plasma volume. Total cholesterol level being from 6.5 to 7.8 mmole/l, plasma exfusion volume is equal to 1.5-2 times circulating plasma volume. Hypercholesterolemia being higher than 7.8 mmole/l, plasma exfusion volume is equal to 2-2.5 times circulating plasma volume.
EFFECT: enhanced effectiveness of treatment.
1 dwg, 3 tbl
SUBSTANCE: the present innovation deals with ways for purifying blood plasma in burnt patients followed by applying the plasma obtained either while carrying out the next plasmapheresis or as independent transfusion medium. For this purpose, it is necessary to carry out plasmapheresis in burnt patients. Heparin should be added into plasma removed during plasmapheresis and, additionally, hemodesis, followed by incubation at +4° C for about 5-18 h, then it should be centrifuged for depositing cryoprecipitate. The innovation suggested enables to alter conditions of cryoprecipitation so, that it is possible to increase precipitation of fibrinogen and fibrin-monomeric complexes, the quantity of which is sharply observed in burnt patients.
EFFECT: higher efficiency of purification.
FIELD: medical equipment.
SUBSTANCE: device can be used for medicinal and donor blood separation to erythromass and plasma, for removal of plasma, return of erythromass to patient and introduction of plasma-substituting solutions and anticoagulant. Device has blood taking conduct provided with accumulating container, erythromass returning conduct with air trap, anticoagulant and hemodilution agent supplying conduct and plasma collecting conduct provided with removable containers and clamps. Blood taking conduct has injection unit for additional introduction of medicines, which unit is disposed close to needle for blood taking. Blood taking conduct is joined permanently with accumulating container which is made of film material. Accumulating container has additional tube provided with clamp. One end of tube is joined permanently with accumulating container and the other end is connected with connector and plug. Dropping bottles with polymeric two-channeled needles are mounted at hemodilutant agent and anticoagulant supply conducts. Plasma collecting conduct has container for collection plasma which container is made of film material. Polymeric needles at conducts for supplying hemodilution agent and anticoagulant are made with two channels. Extracorporal close circuit is made to provide higher sterility of plasmapheresis.
EFFECT: better comfort at operation; higher degree of sterility.
2 cl, 1 dwg
FIELD: medicine, oncology.
SUBSTANCE: method involves autoblood sample taking off in the amount 200-250 ml into a sterile flask with hemopreserving agent "Glugitsir" followed by centrifugation at 1500 rev/min for 30 min. Then supernatant plasma is placed into another sterile flask with a hemopreserving agent and cellular precipitate is reinfused. A single dose of a cytostatic agent is mixed with 10-100 ml of autoplasma, incubated at temperature 37°C for 1 h and administrated through catheter in abdominal cavity by puncture in lower quadrant of abdomen. Procedure is repeated if necessary. Method provides decreasing toxicity of chemotherapy, simple method and uniform distribution of volume of injected preparation for all abdomen cavity. Invention can be used in carrying out chemotherapy of abdomen cavity tumors with ascites.
EFFECT: improved method for treatment.
SUBSTANCE: method involves administering 1-2 interrupted plasmapheresis sessions before performing radical operation. Next to it, seven low intensity intravasal blood laser radiation sessions and 1-2 interrupted plasmapheresis sessions are given in postoperative period.
EFFECT: reduced risk of periuterine stump inflammation, rise in temperature and adaptation syndrome occurrence.