Plasmapheresis dzimwe nguva inoshandiswa sechirapa mune zvirwere zvinokonzerwa neurological zvinosanganisira MS, kunyanya panguva yehutachiona hwehutachiona huri kupindura kurticosteroids . Izvo zvinoratidzika kusina maturo, uye migumisiro yakaipa haigoneki.
Chii Chinonzi Plasmapheresis?
Plasmapheresis, inozivikanwawo sekurapwa kweplasma , ndiyo nzira iyo makina kunze kwemuviri wemunhu anobvisa ropa kubva kumunhu ndokubva aparadzanisa kunze kwechikamu che plasma cheropa-plasma iyo inenge yakasvibiswa kana mvura inoshandiswa ropa.
Zvadaro plasma inodzwa uye inotsiviwa nemhando yakasiyana yemvura, inowanzopa plasma mhinduro kana chirongwa che albumin, isati yadzorerwa kumunhu.
Chinangwa Chei Plasmapheresis?
Chinangwa che plasmapheresis ndechokubvisa zvinhu zvinokuvadza kana "zvakaipa" kubva muropa. Mune nyaya ye MS, izvi zvinogona kuva nemaune masimba ezvirongwa izvo zviri kurwisa hutachiona hwehurumende.
Nzira
Munguva ye plasmapheresis, netafura dzichaiswa mumaoko ako maviri, kana dzimwe nguva kune imwe nzvimbo, semutsipa, kana mitsetse iri muruoko isingagoni kuwanikwa. Ropa richabva rabudiswa kubva mumuviri wako kuburikidza nesingano mune imwe ruoko. Anticoagulant (kazhinji citrate) inowanikwa kuropa kuitira kuti irege kubvisa. Ropa rako rinozobva raenda kuburikidza ne tube kusvika mu "sendipa rega separator." Ropa rekuparadzanisa sero ndiro centrifuge iyo inoparadzanisa plasma kubva kune dzimwe nhengo dzeropa rako, iyo inhengo dzemagetsi (zvinosanganisira masero matsvuku eropa, masero masero eropa, uye maplatelets).
Izvo zvikamu zvemashure zvino zvinosanganiswa nemudzikinuri weplasma anotsiva uye akadzokazve kwauri kuburikidza nesingano mune imwe yoruoko. Mune zvimwe zviitiko, izvi zvinoitwa kuburikidza nesimbi imwechete uye kupatsanurwa nekudzokorora kunoitwa mudiki mabhati.
Inonzwa Sei?
Zvose zvitanhatu zvinotaurwa pamusoro apa zvinowanzoitika uye zvinoramba zvichiitika.
Zvakaitika kune murwere zvakangofanana nekuve nemaviri ane-IV-nendira / catheter panzvimbo uye kuona ropa richibuda kune rumwe rutivi, kuburikidza nemashini, uye kumashure kune rimwe divi. Zvose izvi zvinotora maawa maviri ne4 kuti apedzise.
Vanhu vangave vachinzwa zvishoma zvisinganzwisisiki kana zvinyoro-bve kubva pane zvaitika. Uyezve, vamwe vanhu vanotaura kuti anticoagulant yakawedzerwa kuropa kana zvimwe zvekushandiswa kwemvura zvinoshandiswa zvinokonzera kukomba kana pini-uye-nenyuchi kunzwa mune zvigunwe nezvigunwe. Ikoko kunogona kuvawo ruvara rwakaoma mumuromo. Panogona kuva nekufunganya zvishoma uye kuneta.
Ngozi
Zviremera zvinokonzerwa nemaplasmapheresis hazviwanzoitiki. Iyo inoshamisa zvikuru iyi ndeye anaphylaxis, iyo inokonzerwa nehutachiona hwehutano kune plasma inotsiviwa mvura. Ichi ndicho chimwe chezvikonzero nei kushandiswa kwemaplasma kuchiitwa mukati mekugadziriswa.
Zvirwere zveplasmapheresis hazvishamisi, kunyanya kushandisa shanduro itsva uye yakashata inoshandura mvura. Zvisinei, vanhu vangangodaro vanogona kutora chimwe chinhu mushure memaplasmapheresis, sezvo masero akawanda ezvirwere zvemusununguko abviswa, uye munhu wacho anogona kunge asina kunyatsozivikanwa.
Mimwe migumisiro inogona kuitika inosanganisira:
- Kusava nemanzwiro ekugadzirisa, izvo zvinonzwa sechills, fever kana kuputika zvishoma
- Kuwedzerwa kuteura ropa
- Ropa rakavhara
- Inoratidzika mwoyo rhythm
- Drop in blood pressure
- Kupfupika kwemhepo
- Kuvhiringidza kana kupfugama
Pasi Pasi
Plasmapheresis inowanzochengeteka uye yakanyatsorambidzwa nzira yakagadzirwa. Izvo zvinotaurwa, hazvishandiswi kakawanda muSMS - apo apo munhu anonzi MS akadzoka zvakare akaoma uye haapinduri kune imwe nzira yekurapa steroid regimen. Plasmapheresis haisati yashandiswa kubata mushonga wekutanga kana wechipiri MS.
Sources
Cortese I et al. Evidence-based based guideline update: Plasmapheresis muhutano hwehutano: Rapport yeTherapeutics uye Technology Test Subcommittee yeAmerican Academy of Neurology. Neurology . 2011 Jan 18; 76 (3): 294-300.
Fridey JL, Kaplan AA. "Chirongwa uye nzira yekurapa plasma inoshandiswa." Kusvika pari zvino. Yakarongwa musi waMarch 31, 2010.