Method of therapeutic plasmapheresis
SUBSTANCE: treatment of the patients with chronic heart disease and obliterating atherosclerosis of lower limb is ensured by a course of plasmapheresis consisting of 5-6 sessions every 3-5 days. Each session starts with introduction of 50-60 ml of physiologic saline and removal of 300 ml to 900-1200 ml of plasma prepared by centrifugation in a cold centrifuge at rotary speed 1500-1800 rpm and temperature +4 ° - + 6°C within 15-20 minutes. Plasma is compensated with physiologic saline at the ratio 1:1. The course involves gradual increase of the volume of removed plasma starting with the minimal amount in the first session to the maximal amount to the middle and following decrease of this volume to minimum by the end. Total amount of removed plasma is 1-1.5 volumes of circulating plasma.
EFFECT: method allows administering out-patient continuous treatment of said group of the patients, including in case of resistance to drug therapy.
4 tbl, 2 ex
The invention relates to medicine, transfusion medicine, angiology and cardiovascular surgery and can be used for treatment plasmapheresis with coronary heart disease (CHD) and obliterating atherosclerosis of the lower extremities (OANC).
There is a method of therapeutic plasmapheresis, in which eksponirovannoi from the patient's blood is centrifuged in a system of plastic containers at t=22-23° for 18-20 minutes at a speed of 2000 rpm, thus obtained erythrochlamys diluted saline solution in a 2:1 ratio and injected intravenously inkjet and received during the last procedure erythrochlamys additionally irradiated with ultraviolet rays at a dose of 520-560 j/m2[EN 2220746 C2, 01.10.2004]. This method adopted by the authors for the prototype.
The disadvantage of the prototype is a high temperature selected for centrifugation, which can lead to hemolysis plasma and erythrocytes, as well as bolus injection of large volumes of data for plasmodesmata, from the point of view of the authors, the calculation of plasmodesmata 2:1 is for outpatient chronic patients excessive, may cause hypervolemia and lead to congestion in the small circle of blood circulation. Breeding received erythrocyte mass saline solution is unjustified, as may also the damage to the red blood cells and at too rapid introduction of saline solution into the package may cause hemolysis, and also once again disrupted the integrity of the container with the red blood cells, which increases the risk of infectious complications. The implementation of the method requires inpatient treatment. The method does not allow for the treatment of patients with a history of CHD and OINK, resistant to drug therapy, and are not designed for prolonged use in 5-10 years in outpatient treatment.
The technical result of the invention is to increase the efficiency of therapeutic plasmapheresis in patients with ischemic heart disease and OINK, resistant to drug therapy, and the possibility of its long-term use in outpatient treatment with a minimum of medication therapy.
This technical result is achieved by the fact that patients with CHD and OINK remove 1-1 .5 volume of circulating plasma (CGO) for the course of treatment consisting of 5-6 sessions with an interval of 3-5 days, while at the beginning of each session, the patient is injected 50-60 ml of physiological solution; remove session from 300 to 900-1200 ml plasma, gradually increasing the amount of plasma from a minimum at the first session to the maximum by the middle of the course with the subsequent reduction of this volume to the minimum by the end of the course; the plasma is obtained by centrifugation on a refrigerated centrifuge at a speed of 1500 -1800 rpm at a temperature of +4°to+6°C for 15-20 min, wasmes the tion produce a physiological solution at a ratio of 1:1.
Based on many years of experience in the management of chronic patients with CHD and OANK with the use of therapeutic plasma exchange in the proposed method revealed that these patients for a long period of time can be treated as outpatients by using this method, running courses at intervals of 4-12 months depending on the patient's condition.
This example 586 patients proved that within 5-10 years, such patients may be at a minimum of maintenance therapy. Thus, the dose used to stabilize the lipid metabolism of Liprimar was reduced twice, lipid profile in these patients remained within the normal range, no protein loss was not required compensation of donor plasma, was not required to conduct sedation before plasmapheresis. During the 5-year observation period no complications when using this method of plasmapheresis. During the observation the majority of patients, approximately 70%, was not required re-admission to hospital, and if patients received plasma exchange after previous reconstructive surgery was not required repeated surgical treatment, in patients with increased distance walk without pain (decreased intensity intermittent claudication), decreased shortness of breath, decreased casota occurrence of arrhythmic episodes, less frequent is the occurrence of angina.
It should be noted that for treatment using the proposed method have been selected patients resistant to medicamentous therapy, with initially high values of total cholesterol and its fractions, often with inherited hypercholesterolemia, as well as patients who have had previous surgery, to avoid re-operation. Some of the patients needed plasmapheresis due to intolerance of drugs for diseases of the liver and various polyallelic States.
The results of this research with clinical examples below confirm the achievement of the technical result of the invention in the implementation of all essential attributes.
Studies have shown that deleting therapeutic plasmapheresis less than 1 CGO (Patient F. 62 years of age with CHD and OANC) had no positive clinical effect was not reliable data about the improvement of microcirculation, has not been significant reduction in total cholesterol and low density lipoprotein (LDL). Deleting a course more than 1.5 CGO (Patient W. 40 years with CHD and OANC) was revealed hypoproteinemia, which required three plasmodesmata with donor plasma. It was also marked by a very rapid increase in total cholesterol and LDL from session to session, the e was obtained reliable data about the improvement of microcirculation during treatment.
Positive results were achieved with the removal of 1-1,5 CGO from course to course: there are surveillance up to 10 years. For example, in a patient So 49 years with CHD and OINK lipid levels remained stable, close to normal, and clinical condition of the patient did not require repeated surgical intervention.
When conducting predisposing training in more than 60 ml, namely 250 ml of saline, the patient A. 61 years with ischemic heart disease, previous heart attack in history and OINK had an unpleasant sensation in the chest, tachycardia, headache.
Research confirms that the introduction at the beginning of each session low doses of saline, namely 50-60 ml is optimal, well tolerated and is an essential characteristic of the proposed method.
When plasmodesmata 1:1.5 to the patient P. 56 years with coronary heart disease, myocardial infarction in anamnesis, OINK caused swelling of the lungs, which had to be cut short by the introduction of cardiac glycosides and diuretics. The patient's condition was unstable and had to be hospitalized in the hospital, while the remaining patients well tolerated the procedures are usually performed in outpatient their plasmodesmata 1:1.
Research has helped to identify the most optimal fence plasma from session to session. Essential for the study of pain who's turned out to be the volume of the collected plasma in the first procedure, namely, no more than 300 ml. So, the patient M 65 years with coronary heart disease and OINK when the first procedure took 450 ml of plasma, which resulted in a drop in blood pressure, grazianos, tachycardia, I had to stop jet physiological solution and solution Haemohes. For subsequent sessions of plasmapheresis in patients with such unpleasant hemodynamic phenomena did not occur. Further change in the amount of exfuze from session to session made gradually to avoid sudden changes in hemodynamics, which is very important for patients with ischemic heart disease.
Clinical researches have allowed to identify the optimal intervals between sessions of plasmapheresis. When the interval between sessions 2 days in a patient, 54 years of age with CHD and AANC has arisen phenomena gipoproteinemii that demanded compensation for expensive donor plasma, which is also undesirable due to the possibility of intrusion by various types of hepatitis and other infections transmitted by blood.
When the interval between sessions over 5 days 6-7 days a patient J. 42 years with CHD and OANK not there was a steady decrease in cholesterol and LDL, and no apparent improvement of microcirculation in peripheral tissues (toes), there was no pronounced positive effect of plasmapheresis procedures that have questioned their effectiveness.
In table 1,2 presents the parameters of microcirculation, confirming the effectiveness of plasma exchange offer by way of immediately after plasmapheresis, and in the remote period after 1 year and 5 years.
|Period||The parameters of microcirculation|
|Vas, cm/sec||Vam, cm/sec||Vakd, cm/sec||Qam, ml/sec||RI, usled||AVK, usled|
|before the session||2,7133±0,76||1,5633±0,12||1,44±0,56||0,0119±0,0041||0,7967±0,075||0,6133±0,071|
|after the session||2,69±0,22||1,5633±0,19||1,5267±0,26||0,0122±0,0016||0,6967±0,0359||0.74±0,022|
|Period||The parameters of microcirculation|
|Vas, cm/sec||Vam, cm/sec||Vakd, cm/sec||Qas, ml/sec||Qam, ml/sec||RI, usled||AVK, usled|
From table 1, 2 shows that, immediately after plasmapheresis parameters of microcirculation is improved, and over time (after 1 year through 5 years) practically does not change, which indicates the stabilization of the microcirculation in the treatment process.
Assessment of the microcirculation was produced using ultrasonic microvascular Doppler "minimax-Doppler To".
Estimated detected device blood flow speed characteristics: Vas-max system is aliaska speed along the curve of the average velocity, Vam - average speed along the curve of average speed, Vakd - end-diastolic velocity curve average speed; indicators of volumetric blood flow - Q or the average speed of the blood flow along the curve of average speed (ml/sec) and the peripheral resistance index (the index Pursel, reflecting the state of the resistance to blood flow distal to the measurement RI in conventional units RI=(Vs-Vd)/Vs,
where Vs- maximum systolic velocity curve maximum speed (envelope) in cm/sec;
Vd- end-diastolic velocity curve maximum speed in cm/sec.
As well as the indices of systolic blood pressure at the ankle and forearm determined during Doppler, with subsequent determination of the coefficient of Windsor (K)
AVK=TO=hell on the ankle/HELL on his forearm.
In table 3 presents indicators of atherosclerotic process in the long term.
|Period||Indicators of atherosclerotic process|
|obsol., mmol/l||LDL, usled||HDL, mmol/l||To haemoglobin, usled|
As can be seen from table 3, the levels of total cholesterol over time will degrade somewhat, i.e stabilize its growth, however, due to the progression ateroskleroticheskoe process increases the amount of LDL (low density lipoprotein) and decrease HDL (high density lipoprotein), which is To increase haemoglobin in both groups of patients. However, the growth of the haemoglobin is not as significant as in untreated group of patients,
In table 4 presents the performance of the atherosclerotic process directly after plasmapheresis.
|Period||Indicators of atherosclerotic process|
|obsol., mmol/l||LDL, usled||To haemoglobin, usled|
|Before the session||6,816667±0,5||76,25667±0,76||1,636667±0,49||3,436667±0,43|
|After the session||6,09±0,52||67,77667±0,85||1,48±0,45||3,083333±0,56|
As can be seen from table 4, the levels of total cholesterol, LDL, HDL and atherogenic immediately after plasmapheresis reduced.
The method is as follows.
After puncture of the cubital vein carry out short predisposing training in the volume of 50-60 ml of saline intravenous (IV) drip. Then provide exposio 500 ml of blood in plastic containers Gamecon 500/300" and after equilibration containers centrifuged last in the centrifuge RC-3BP at speeds 1500-1800 rpm at a temperature of +4° to +6°C for 15-20 minutes. At this time, saline medlenno continues to flow to the patient via the cubital vein. The plasma was transferred to a small container (300 ml) using plasmacytoma PE-01. Remaining in big bags RBC mass injected to the patient/drip. The plasma loss refund at the end of proceduralization the solution at a ratio of 1:1. This is limited to the first session. Volume remote plasma for the first session does not exceed 300 ml During the second or third session, it is possible to re-exfuze blood in the same amount of pre-closing the plasma loss/infusion of saline at a rate of 1:1. The plasmapheresis performed after 3-5 days, at the rate of approximately 5-6 sessions, over the course of treatment it is necessary to remove not more than 1.5 CGO, but not less than 1 recipient.
In the course of treatment is monitored indicators red blood parameters of coagulation and lipid metabolism.
No heparinization or sedation when performing this procedure is not carried out. At the end of 3 to 6 sessions depending on the condition of the patient at the end of procedures to produce infusion reopoligliukina with answered and subsequent plasmodesmata rate of 1:1) include this amount. Between sessions, patients are at a minimum of maintenance therapy. Courses repeat every 6 months depending on the condition of the patient, sometimes with the deterioration of the earlier 4 months, with regular treatment can increase the interval between courses up to 8-12 months.
Clinical examples illustrating the inventive
Example 1. Patient G., 61 years with CHD and OINK. The course of treatment consisted of 5 sessions and what tervalon 3-4 days. Predictiona preparation before each session was 50-60 ml of physiological solution. For the first session removed 300 ml of plasma per second 600 ml, for the third - 900 ml, for the fourth - 600 ml and for the fifth - 300 ml-reimbursement saline 1:1. Over the entire course of treatment was removed 1 CGO. Plasma was obtained by centrifugation at refrigerated centrifuge at a speed of 1500 rpm and at a temperature of +4°C for 20 minutes as a result of treatment decreased the frequency of angina attacks, increased distance walk without pain, normalized processes of microcirculation in the feet, decreased the content of total cholesterol in the blood and decreased haemoglobin rate.
Example 2. Patient O. 57 years with coronary heart disease, acute myocardial infarction in anamnesis and OINK. Treatment with plasmapheresis proposed method. Conducted 6 sessions at intervals of 3-5 days. Predictiona preparation amounted to 50-60 ml of physiological solution. For the first session was removed 300 ml of plasma per second 600 ml, for the third - 900 ml, for the fourth - 1200 ml, for the fifth - 900 ml, for the sixth - 300 ml filling with saline 1:1. During the course of treatment was removed 1,5 CGO. Plasma was obtained by using a centrifuge at a temperature of +6°C, the rotation speed of 1800 rpm for 15 minutes as a result of treatment the patient improved ECG data, the patient stopped jalow is sterile on the nightly attacks of chest pain. Decreased intensity intermittent claudication, significantly improved circulation, decreased haemoglobin rate.
Compared with the known solutions, the proposed method can improve the efficacy of therapeutic plasma exchange in ambulatory patients with chronic diseases, has a strong detoxification and improves microcirculation, stabilizing lipid metabolism effect, allows plasmapheresis procedure in an outpatient procedure quite difficult group of patients, prolongs the lifetime without surgical treatment and improves their condition, if necessary, waiting operational berths, no complications with long-term use and with minimal medical therapy. And helps to reduce the cost of the procedure, the simplicity and accessibility of execution.
The method of therapeutic plasmapheresis, including exposio blood, centrifugation and recovery of plasma, characterized in that in patients with ischemic heart disease and atherosclerosis obliterans of the lower limbs removed 1-1 .5 volume of circulating plasma during the course of treatment consisting of 5-6 sessions with an interval of 3-5 days, while at the beginning of each session, the patient is injected 50-60 ml of physiological solution; remove session from 300 ml to 900-1200 ml plasma, the gradual is but increasing the volume of removed plasma from a minimum at the first session to the maximum by the middle of the course with the subsequent reduction of this volume to the minimum by the end of the course; plasma is obtained by centrifugation on a refrigerated centrifuge at a speed of 1500-1800 rpm at a temperature of +4 - +6°C for 15-20 min, compensation produce a physiological solution at a ratio of 1:1.
SUBSTANCE: treatment of depression in the patients suffering from coronary heart disease is ensured by introduction of essential fatty acids or a related drug containing eicosanpentanoic acid ether or docosahexaenoic acid ether, either separately, or mixed in the developed effective doses.
EFFECT: improved cardioprotective and antidepressive action in the given group of patients.
SUBSTANCE: invention relates to a novel compound or its salt of formula 1: , where A, E, D, R0, R1-R4 and a assume values given in the formula of invention. The invention also relates to an antioxidant medicinal agent.
EFFECT: effectiveness during treatment of ischemic diseases of organs, during treatment of diseases caused by oxidation cell disorders and when inhibiting disorders of the retina.
4 cl, 1 tbl, 6 ex
SUBSTANCE: treating of lipidosis and body-weight reduction in the patients with cardiovascular diseases is ensured by diet therapy based on the lacto-vegetarian diet. It involves introduction of proteins in daily amount of 67-79 g, including animal 48-57%, fats in daily amount of 32-49 g, including animal 40-52%, carbohydrates in daily amount of 240-257 g, cholesterol in daily amount of 40-268 mg, cellulose in daily amount of 18-20 g, dietary fibers in daily amount of 150 mg, potassium (K) in daily amount of 4567-6433 mg, magnesium (Mg) in daily amount of 535-693 mg, vitamin E in daily amount of 44-53 mg, arginine in daily amount of 3.9-5.2 g, dehydrated powdered maral meat in daily amount of 1200 mg, microcrystalline cellulose in daily amount of 900 mg. Duration of the diet therapy course is 33 days.
EFFECT: method provides suppression of cholesterol biosynthesis and intensification of excretion thereof that reduces the atherogenic index, reduces manifestations of oxidative stress, with reduced risk of realisation of the modified factors of a cardiovascular pathology.
SUBSTANCE: as additional components, a new medicinal form contains stearic acid or its pharmaceutically acceptable salt, succinic acid or its pharmaceutically acceptable salt, microcrystalline cellulose, magnesium carbonate, starch and hydroxypropyl cellulose.
EFFECT: extended range of storage-stable preparations of 3-oxy-6-methyl-2-ethylpyridine as solid oral dosage forms without by-effects of existing preparations.
14 cl, 2 tbl
SUBSTANCE: invention concerns a solid oral dosage form composition containing therapeutically effective amount of aliskiren or its pharmaceutically acceptable salt in amount exceeding 46 wt %. The oral dosage form represents a tablet or a film-coated tablet. Aliskiren tablet is made by wet granulation with using mixed organic solvents or organic binding solutions.
EFFECT: elimination of aqueous granulation provides high stability of the dosage form of aliskiren and prolonged shelf-life.
18 cl, 2 ex
SUBSTANCE: there is offered to apply 4-(2-hydroxyethyl)phenol(n-thyrozol) as a medicinal agent with anti-ischemic properties.
EFFECT: intravenous introduction of n-thyrozol improves the survival rate of animals with old myocardial ischemia and reperfusion, reduces a region of myocardial ischemia, and enables higher integrity of myocardial tissue.
3 tbl, 3 ex
SUBSTANCE: described are novel triazole derivatives with general formula where values of radicals are given in the formula of invention, a pharmaceutical composition containing said derivatives, and a method of treating autoimmune diseases. Compounds with general formula (1) and their pharmaceutically acceptable salts have inhibition effect on S1P and its Edg-1 receptor (S1P1).
EFFECT: possibility of use as a pharmaceutical product.
43 cl, 10 ex, 1 tbl
SUBSTANCE: for treatment of left ventricle hypertrophy (HLV) in patients with coronary disease in combination with hypertension during 6 months standard drug therapy, consisting of IATA, beta-blocker, aspirin and stanin is realised. Additionally ivabradin in day dose 5 - 15 mg is introduced in two intakes daily.
EFFECT: method ensures transformation of HLV in concentric remodeling of left ventricle and in such way reduces degree of cardiovascular complications risk.
2 ex, 1 tbl
SUBSTANCE: pharmaceutical compositions include divalent, namely calcium, magnesium or zinc salt, of pravastatin or fluvastatin and omega-3 fat, for prevention, reduction or treatment of increased cholesterol levels, atherosclerosis, hyperlipidemia, cardio-vascular disorders and diseases, coronary heart disease and/or cerebrovascular disease.
EFFECT: improved bioavailability of compositions, easily obtained and introduced.
40 cl, 33 dwg, 2 tbl, 8 ex
SUBSTANCE: invention refers to medicine, namely to cardiology, and concerns treating of myocardial infarction (MI). That is ensured by primary transcutaneous transluminal coronary angioplasty with underlying standard conservative therapy is followed with myocardial unload with beta-blocker Carvedilol. Said myocardial unload is combined with introduction of Levosimendan at first administered as a bonus intravenously at 16 mcg/kg during 10 min, and then in stable AP it is infused intravenously within 20-38 hours in total dose 12.5 mg/kg at the rate 0.05 to 0.2 mcg/kg/minutes.
EFFECT: method provides higher survival rate and ensured clinical compensation in the MI patients of elderly and senile age with cardiac failure complications due to combination of endovascular revascularisation and myocardial unload with underlying introduction of inotropic stimulator Levosimendan in the developed doses and regimen.
SUBSTANCE: there are offered device and method used to identify and recover various blood-dissolved particles of biological origin and biomolecules from liquids with applying suitable carriers and common immobilisation techniques. The device can be used both for discontinuous, and for direct and continuous processing of liquids.
EFFECT: background of the invention involves application in animals, biotechnology, including biological tests, and clinical diagnostics.
12 cl, 11 dwg
SUBSTANCE: invention concerns medicine, oncogynaecology. The method involves blood sampling, mixing thereof with oxygen-ozone gas mixture and the following reinfusion thereof. One session involves sampling of 70-120 ml of blood thereafter mixed with 200-250 ml of oxygen-ozone mixture of ozone concentration 5-10 mg/l. Blood reinfusion is followed with introduction of preparation Cernevit in amount 5 ml. Therapeutic course is 10-14 sessions.
EFFECT: method improves clinical effectiveness ensured by stimulation of antioxidant system, normalisation of metabolic processes, hormone-vegetative and immune status of an organism.
SUBSTANCE: to treat patient suffering from hepatitis B or C, body fluid is sorbed by means of flowing through device comprising suspension preparation assembly equipped with ultrasonic dispergator wherethrough nanoparticle suspension shall flow as nanofraction of cobalt ferrospinel CoFe2O4 in spiritus and shall be mixed with body fluid infected by viruses of hepatitis B or C. The device also comprises magnetic filter with entry zone wherein a uniform magnetic field is established rough filtration zone where gradient magnetic field is established from axially magnetised bushing, fine filtration zone wherein alternating high-gradient magnetic field is established. Body fluid, which is free from nanoparticles with sorbed viruses is delivered into vessel for clean body fluid accumulation.
EFFECT: inventions enable to improve sorbtion efficiency relative to antigens and viruses over a wide range of concentrations and concentration weakening in sorbing solution below the limit of poor and positive reaction.
9 cl, 2 dwg
SUBSTANCE: invention relates to field of medicine, namely to fields of surgery and resuscitation science and can be used in treatment of patients with acute destructive appendicitis, confirmed intra-operatively. Draining of right iliac fossa or tamponade and draining of right iliac fossa are performed and anti-bacterial therapy is carried out. In case of performing appendectomy by traditional or laparoscopic method, polyethylene catheter is installed in retroperitoneal space into right iliac fossa, through which additionally introduced is roncoleukin, incubated during 60 minutes at temperature 37°C with obtained by plasmapheresis patient's leukosuspension in amount 70-80 ml on 1,3,5 day of post-operation period.
EFFECT: method allows to increase local immunity, realise prophylaxis of suppurative complications in case of acute destructive appendicitis.
SUBSTANCE: invention refers to medicine and can be used for post cosmetic surgery rehabilitation that is ensured by introduction of mixed medicinal preparations in lymphoid region of orbit, namely within pterygopalatine fossa and parotid. The mixed preparations introduced in pterygopalatine fossa are lidocaine 50-100 mg, dexamethasone 4-8 mg, glucose 400-800 mg, dalargin 1-2 mg and Lydasa 16-32 UN. And parotid injection contains lidocaine 50-100 mg, aminophylline 24-28 mg, hystochrom 10-20 mg and Lydasa 16-32 UN. Introduction of the mixed preparations is carried out on right or left side of face alternately every 4-5 hours daily within the course 6-8 procedures. Then 3-5 procedures of discrete plasmapheresis follow with using no more than 20-25% of total blood volume for exfusion. The prepared cell mass is incubated with 250-350 cm3 of ozone-oxygen mixture of ozone concentration 3000-3200 mkg/l.
EFFECT: method allows reducing post cosmetic surgery rehabilitation time owing to stimulation of regional lymph flow ensured by high local concentration of medical preparations.
SUBSTANCE: invention concerns medicine, namely to neurology, and can be used for treatment of a chronic fatigue syndrome. For this purpose hemosorption and plasma depletion are performed in the form of the alternating procedures accompanied with exfusion of 5-7% of volume of circulating blood. The procedures are alternated under the scheme: 1st day of the cycle - hemosorption, 6th day of the cycle - plasma depletion, 12th day of the cycle - hemosorption, 18th day of the cycle - plasma depletion.
EFFECT: rising of efficiency of treatment, depression of frequency of relapses, improvement of quality of a life of patients at the expense of occurrence as a result of treatment of the compensatory mechanisms promoting homing of system regulation of an organism to physiological norm.
SUBSTANCE: invention refers to medicine, particularly to phthisiology and urology, and concerns therapy of prostatic tuberculosis that involves introduction of antituberculous remedies combined with daily instillations of autoblood 5 ml into urethra. Preliminary said autoblood is exposed to IR-laser radiation within 25 minutes at wavelength 0.86 mcm, radiation frequency 3000 Hz and power 10 mW. The therapeutic course takes 10 procedures.
EFFECT: due to specified irradiation mode, disclosed therapy provides effective immunomodulatory action of autoblood and therefore rapid normalisation of clinicolaboratory indices.
2 tbl, 1 ex
SUBSTANCE: invention concerns medicine, particularly orthopedics and extracorporal treatment methods, and can be applied in aseptic whirlbone necrosis and Perther disease treatment. Method involves venous blood sampling in amount of 300 ml with further blood separation into erythrocyte mass and plasma. Obtained erythrocyte mass is diluted by 200 ml of 0.9% physiological solution and administered intravenously to patient. 100 ml or patient's plasma is placed in thermostat and incubated for 20 minutes at 37°C. Further 20 mg of vasoprostan medicine is added to incubated plasma, and obtained mix is administered to patient by drop infusion for 1.5-2 hours once a day for 10 days.
EFFECT: enhanced efficiency of the pathology treatment due to vasoprostan binding to plasma proteins and prolonged vasoprostan circulation in blood, resulting in arterial blood circulation improvement, venous stasis blocking in aseptic necrosis zone and significant acceleration of whirlbone acceleration.
2 tbl, 2 ex, 4 dwg
FIELD: medicine; transfusiology.
SUBSTANCE: method of autoblood treatment before reinfusion includes separation of the blood taken from the patient, into plasma and packed red cells. A blood sampling at the patient carry out twice on 350-450 ml, in the beginning for 10-15 days, and second time 3-5 days prior to reinfusion, with placing hemocomponents in containers with haemopreservative. The obtained autoplazma is frozen at temperature -36°-42°C. Before reinfusion the autoplasma is heated up to temperature +37°C, passed through a polymeric or organic haemosorbent (type SKN or KAU). The autologous packed red cells before reinfusion are unitary washed in 300 ml of 1% NaCL solution. The method allows raising quality of prepared autoblood components before planned surgical interventions or before coming cytoscopic therapy.
EFFECT: increase of strain capacity and osmotic firmness of red blood cells, their reduction of thrombolytic activity and aggregation, improvement of quality of clearing at the expense of removal of fraction of inactive old forms of red blood cells, endo- and ectotoxins.
FIELD: medicine; gastroenterology.
SUBSTANCE: before pharmacotherapy course including Ribavirin and Interferon alpha-2a, 5 cryoplasmasorbtion procedures (CPS) are performed every 2 days. Thereafter these procedures are repeated once a month until pharmacotherapy termination.
EFFECT: method provides intensified effect of specified medicines in combination within viraemid pre-reduction by initial stage of therapy and improves efficiency of treatment within the whole course.
2 cl, 7 dwg, 4 tbl, 2 ex
SUBSTANCE: to ensure optimal preparation of children to spinal operation is ensured by the preclinical analysis of iron metabolism parametres, detection of the latent iron deficiency to be corrected, and also making an individual autodonation program included acute normovolemic hemodilution. Two days before the first donation, iron preparations are introduced in a dose 1/2 of a daily dose to be continued with a complete dose during the whole preoperative and thereafter postoperative period. After donation, the exfused autoblood volume is compensated in the equivalent volume with a plasma substitute solutions: crystalloids - 6-10 ml/kg and colloid of hydroxyethylated starch - 5 ml/kg. On the second days following the donation, epocrine is administered in a single dose 150 units/kg; it is followed with the nutritional supplementation with using enteral mixtures, for cause, parenteral support of protein exchange is applied. On the third day after the first donation, the biochemical analysis of blood serum, the hemostasis system analysis and the complete blood count and clinical urine analysis are used to control the case. The hemoglobin level 110 g/l, and packed cell volume 33% and decreased hemoglobin by 15 g/l and less of the reference level enables to perform the second blood donation. If the reference hemoglobin has decreased by 15 g/l and more, autodonation represents autoplasma giving. On the operation day, the acute normovolemic hemodilution is performed.
EFFECT: method provides the short-term preparation of autoblood components, including the cases of potential latent iron deficiency in the patient, not leading to the failure of adaptive reserves of an organism.