Plasma exchange2014-03-12 16:48
Plasma exchange therapy can eliminate existing immune complex plasma, but it can’t prevent these material regeneration, treatment should match hormone and immune inhibitors to ensure the safety, it can decease the process of the treatment. Therapeutic method: Every time the displacement is 1-1.5 litres, 2-6 litres per week, it is divided into 2-4 times, repeat 2-3 weeks as a course of the treatment.
1、 The action principle
It will put the patients’ blood in vitro derivation, it can abandon the plasma from the whole blood of patients through membrane plasma separation method, then it can supply the same amount of fresh frozen plasma and blood albumin replacement fluid, if so , it can eliminate all kinds of metabolic toxins and pathogenic factors in the body to get the purpose of treatment. Plasma exchange can not only eliminate medium and small molecular metabolic toxins, but also eliminate protein, immune complex materials and other large molecules, so clearance of harmful substances is better than hemodialysis, hemofiltration and blood perfusion. It can supply the lack of albumin, blood coagulation factor and the required materials, it is better to replace the function of liver. The characteristic is to remove the molecules of the small molecule and macromolecule materials, it has prominent effect on the toxin combined with protein; it has effect on the common electrolyte imbalance and disorder of acid- base balance correction, but is worse than hemoidialysis and hemofiltration; it can not improve the situation of water load. Using the method need to a lot of plasma to supply the human body necessary required materials such as a lot of protein, blood coagulation factors. It is possible to induce all kinds of new viral diseases through a large number of inputs such as blood plasma adjuvant therapies for many times.
2、 Adaptation disease
The kidney disease：Goodpastures syndrome, lupus nephritis, purpura nephritis, IGA nephropathy, membranoproliferative GN and acute rejection of kidney transplantation. These diseases can use plasma exchange to improve the clinical symptoms and protect renal function when the diseases can not be fully controlled.
Autoimmune disease: systemic lupus erythematosus, nodular polarteritis, dermatomyositis,rheumatoid arthritis, etc. The kind of patients have autoantibody and immune complex in the body. Plasma exchange can eliminate a variety of autoantibodies and immune complex.
Hematological system disease: Autoimmune hemolytic anemia, hemolytic uremic syndrome, etc. These disease can use plasma exchange to eliminate red blood cell antibodies in the patients’ body to decease to appear hemolysis; plasma exchange is the most effective means for thrombotic thrombocytopenic purpura, it can eliminate the small blood clots in the patients’ body to save the life of patients.
Nervous system disease: Myasthenia gravis, multiple nerve root inflammation, neurological damage to the systemic lupus erythematosus, multiple sclerosis, etc. Theses disease can use plasma exchange to eliminate poisonous substance in the plasma to make the nervous tissue damage down to a minimum to make patients stay from danger.
Infection: Low immune globulin hematic disease is always present when patients use plasma exchange for many times especially using albumin as replacement fluid , it will last for several weeks, if patients share the immune inhibitors in the same period, especially appearing white blood cells deceased and the chance of infection increased, high-dose immunoglobulin intravenous injection can make for control of infection.
Anaphylactic rection: The major performance are chills, skin rashes, fever and hypotension, laryngeal edema and cardiorespiratory failure in the process of FFP infusion.
Drugs are cleared at the same time. Regular hemodialysis technology influence less on the problem of high rate of protein drugs, but plasma replacement can reduce blood drugs concentration in theory like ring phosphoryl.
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