Extracorporeal detoxification yog ib txoj hauv kev kho cov ntshav los ntawm kev lim cov ntaub so ntswg los ntawm centrifugation, irradiation, ntxuav nrog sorbents sab nraum cov hlab ntsha. Nws yog nqa tawm nyob rau hauv thiaj li yuav tshem tawm cov khoom uas provoke los yog txhawb lub chav kawm ntawm ib tug kab mob. Nyob rau hauv cov ntaub ntawv no, cov tshuaj yog ntxiv rau cov ntshav los hloov nws fluidity. Cov txheej txheem kev kho mob no yog siv nyob rau hauv ntau yam kev kho mob, tab sis feem ntau nyob rau hauv toxicology thiab rheumatology.
Txoj kev xaiv kom raug ntawm detoxification txoj kev, uas yog txiav txim los ntawm cov kws tshwj xeeb thiab nyob ntawm lub physicochemical thaj chaw ntawm cov tshuaj lom, plays lub luag hauj lwm tseem ceeb nyob rau hauv lub zoo tshwm sim ntawm kev kho mob.
Lub hom phiaj ntawm qhov kev tshwm sim
Lub hom phiaj tseem ceeb ntawm kev tshem tawm cov kab mob hauv lub cev yog:
- txhim kho electrolytes, dej thiab roj hauvntshav, cov txheej txheem metabolic, enzyme, hormonal thiab cellular muaj pes tsawg leeg;
- tshem tawm cov khoom lag luam metabolic;
- tshem tawm ntau yam tshuaj lom;
- txo cov roj cholesterol nrog nws ntau dhau;
- tshem tawm cov protein ntau txawv txav thiab triglycerides los ntawm cov ntshav, nrog rau kev ua haujlwm ntawm lub cev tiv thaiv kab mob, antigens, tshuaj tiv thaiv kab mob (nrog rau cov ua haujlwm tawm tsam nws tus kheej cov ntaub so ntswg);
- tshem tawm cov inflammatory stimulants.
Kev lim ntshav ntshav siv cov cuab yeej siv niaj hnub tso cai rau koj xaiv tshem tawm cov khoom tsis tsim nyog uas ua rau muaj kev loj hlob ntawm cov kab mob hauv lub cev. Tsis tas li ntawd, cov txheej txheem no tso cai rau koj nkag mus rau hauv cov ntshav cov tshuaj pharmacological rau kev kho mob ntawm qee yam kab mob. Ua tsaug rau cov txheej txheem no, kev tiv thaiv kev ua xua, tiv thaiv kab mob, immunomodulatory thiab detoxifying nyhuv yog tiav.
Cov txheej txheem detoxification Extracorporeal pab txo qhov hnyav ntawm cov txheej txheem pathological, tiv thaiv cov teeb meem, thiab txo qhov yuav muaj kev tuag. Cov txheej txheem tseem tiv thaiv kev hloov pauv ntawm tus neeg mob tus mob mus rau hauv daim ntawv ntev, pab txo qis kev xav tau ntawm cov tshuaj thiab kev nyob hauv tsev kho mob ntev, rov ua haujlwm poob haujlwm thiab txhim kho lub neej zoo ntawm cov neeg mob.
Txoj kev detoxification Extracorporeal muaj ntau heev hauv kev phais mob plab thaum muaj xwm ceev.
txheej txheem no tuaj yeem ua tausiv los ua txoj hauv kev tseem ceeb ntawm kev kho mob lossis suav nrog kev kho mob ua ke. Ua ntej nws lub sijhawm teem sijhawm, kev kuaj xyuas tag nrho ntawm lub cev yog ua tiav, kev txiav txim siab ntawm Rh yam, pawg ntshav thiab cov ntsuas ntawm nws cov muaj pes tsawg leeg. Ib coagulogram thiab kev tshawb fawb txog kab mob thiab kab mob kis tau kuj tau sau tseg.
Thaum twg yog extracorporeal detoxification qhia hauv kev phais?
Kev qhia rau kev coj ua
Tus kws tshaj lij tuaj yeem sau cov txheej txheem rau kev saib xyuas hnyav ntawm cov kab mob hauv qab no:
- antiphospholipid syndrome;
- kab mob rheumatological: vasculitis, mob caj dab, granulomatosis, lupus erythematosus, scleroderma, dermatomyositis;
- nyob rau hauv cov ntaub ntawv ntawm kev lom nrog tshuaj, tshuaj compounds nyob rau hauv ntau lawm;
- tshuaj lom nrog cawv, tshuaj;
- tom qab kev puas tsuaj ib puag ncig;
- hluav taws xob puas rau lub cev;
- toxicosis hauv cov poj niam cev xeeb tub;
- Rhesus tsis sib haum;
- kab mob genitourinary;
- Yglomerulonephritis;
- ua haujlwm tsis txaus ntawm daim siab lossis raum;
- mob ntshav qab zib;
- autoimmune thyroiditis;
- Ythyrotoxicosis;
- kab mob ntawm daim tawv nqaij: psoriasis, txheej txheem eczematous, neurodermatitis, furunculosis;
- myasthenia gravis;
- polyneuropathy lossis polyneuritis;
- Parkinson's disease;
- ntau yam sclerosis;
- cirrhosis ntawm daim siab;
- pancreatitis nrog thaj chaw ntawm necrosis hauv pancreas;
- kev ua txhaum ntawm txoj hnyuv microflora;
- focal mob lossissuppuration nyob rau hauv lub ntsws;
- bronchial hawb pob;
- myocardial ischemia;
- ntshav siab;
- siab.
Cov txheej txheem detoxification Extracorporeal hauv kev saib xyuas hnyav yog siv nrawm, tsis muaj cov txheej txheem kuaj mob, thaum muaj xwm txheej ceev, xws li sepsis. Hauv kev phais mob plab thaum muaj xwm txheej ceev, cov txheej txheem yuav ua tau rau cov mob xws li ruptured appendicitis, peritonitis, mob siab thiab kab mob pancreatic.
Tsis tas li ntawd, kev siv cov txheej txheem kev tshem tawm cov kab mob ntxiv rau hauv kev phais hniav yog paub: rau abscesses ntawm cov nqaij mos ntawm qhov ncauj kab noj hniav, lub puab tsaig pob txha, thiab lwm yam.
Contraindications rau cov txheej txheem
Lub ntsiab contraindications rau extracorporeal detoxification yog:
- muaj los ntshav, cov txheej txheem malignant hauv lub cev, nrog rau lub davhlau ya nyob twg (irreversible) cov xwm txheej lossis ua tiav decompensation ntawm cov hlab ntshav;
- ua xua rau ntshav plasma thiab nws cov khoom, nrog rau cov tshuaj uas txo cov peev xwm coagulation;
- kab mob lossis foci ntawm suppuration hauv daim ntawv mob;
- pronounced arterial hypotension;
- tachycardia, poob siab lossis qaug zog;
- qis ntim ntawm cov ntshav ncig;
- phlebitis.
Thaum cev xeeb tub, cov txheej txheem ntxuav lub cev tuaj yeem ua tau tsuas yog hauv cov mob hnyav, nruj me ntsis rau kev kho mob, suav nrogRisk-benefit ratio.
Txoj kev
Cov kev siv ntau tshaj plaws ntawm kev tshem tawm cov kab mob hauv lub cev hauv cov kev kho mob ntawm cov xwm txheej tseem ceeb yog lymphocytopheresis, plasmapheresis, hemosorption, cryoapheresis, photopheresis, cascade filtration.
Nrog cov plasmapheresis tsis sib xws, cov ntshav tau coj los ntawm tus neeg mob (txog li 0.8 l), muab tso rau hauv lub thawv tshwj xeeb, thiab tom qab ntawd xa mus rau lub cuab yeej uas nws tau sib cais los ntawm centrifugation rau hauv cov ntshav thiab cov hlwb. Plasma raug tshem tawm nrog rau lub cev tiv thaiv kab mob, autoantibodies, cov khoom lag luam metabolic, cov tshuaj lom neeg, cov tshuaj tua kab mob. Hloov cov ntshav plasma, ntsev tov, protein thiab colloidal Cheebtsam, pub ntshav plasma ntxiv rau cov ntshav.
Membrane plasmapheresis
Nyob rau hauv daim nyias nyias plasmapheresis rau kev tshem tawm cov kab mob extracorporeal, ob lub catheter tau muab tso rau hauv cov hlab ntsha. Cov ntshav yog coj los ntawm thawj tus, dhau los ntawm cov ntaub ntawv pom thiab txhaj rov qab los ntawm lub catheter thib ob. Txoj kev no tso cai rau koj cais cov plasma, thiab cov qe ntshav rov qab mus rau lub cev. Cov kua dej yog pub dawb los ntawm co toxins, allergic, inflammatory thiab autoimmune tshuaj. Cov tshuaj tuaj yeem txhaj rau hauv nws, nws yog irradiated nrog lub teeb laser, ultraviolet, ozonized.
Lymphocytopheresis
Lymphocytopheresis tshem tawm cov lymphocytes ntawm cov ntshav. Txoj kev no yog siv rau kev ua txhaum ntawm lub cev tiv thaiv kab mob,Kev tsim tawm ntau dhau ntawm cov hlwb uas rhuav tshem lub cev cov ntaub so ntswg thaum lub sijhawm ua haujlwm ntawm cov txheej txheem autoimmune. Nws yog qhia rau pathologies ntawm connective cov ntaub so ntswg. Cov txheej txheem tuaj yeem ua ke nrog kev ua haujlwm ntawm tes los ntawm cytokines thiab ntshav irradiation.
Hemosorption
Thaum lub sijhawm hemosorption, cov ntshav venous nkag mus rau cov adsorbents, tom qab ntawd nkag mus rau hauv lub cev. Nws yog siv nyob rau hauv kis kab mob thiab ua xua, autoimmune pathologies (collagenosis). Tej zaum yuav nrog rau cov ntshav siab, kev puas tsuaj rau cov qe ntshav, thiab cov leeg tremors.
Photopheresis
Nyob rau hauv photopheresis, tus neeg mob siv tshuaj uas ua rau kom lub rhiab heev rau lub teeb, thiab tom qab ntawd sab nraum lub cev, cov ntshav yog irradiated nrog ntev-yoj ultraviolet rays thiab rov qab mus rau lub cev. Nws yog siv rau cov kab mob ntawm cov ntaub so ntswg, daim tawv nqaij, psoriasis thiab fungal kab mob. Cov ntshav tuaj yeem centrifuged thiab tom qab ntawd irradiated, lossis cov txheej txheem no tau ua tiav ntawm cov tshuab tib lub sijhawm.
Immunosorption
Thaum immunosorption tau ua tiav kev xaiv ua kom huv ntawm cov ntshav los ntawm cov proteins tshwj xeeb - antigens, toxins, tshuaj tiv thaiv kab mob, thiab nws cov khoom tseem ceeb tsis hloov pauv. Cov txheej txheem no yog ua rau lom, kab mob raum, ua xua, autoimmune pathologies. Qhov tsis zoo ntawm cov txheej txheem no yog txwv tus naj npawb ntawm sorbents thiab tus nqi siab heev.
Cryoapheresis zoo ib yam li plasmapheresis, tsuas yog cov ntshav khov thiab heparinized, thiab cryoprecipitate raug tshem tawm. Nws yog siv rau atherosclerosis, eczema, gout, autoimmunevasculitis.
Lub sijhawm twg tsis tau teem sijhawm?
Tsis muaj contraindications rau cov txheej txheem saum toj no yog:
- xiav;
- mob hlwb hnyav;
- lub plawv tsis ua hauj lwm ntawm theem decompensation;
- oncological pathologies nrog metastases;
- Neuro-psychiatric disease.
Cov npe ntawm cov txheeb ze txwv suav nrog:
- ntshav txhaws ntshav;
- arrhythmia;
- hypotension;
- txo qis hauv plasma protein;
- ulcerative lesion ntawm lub plab zom mov;
- kab mob sib kis;
- menstruation.
