ABSTRACT
【Objective】 To investigate the clinical efficacy and safety of centrifugal plasma separation combined with plasma adsorption in the treatment of hypertriglyceridemia. 【Methods】 The data of 42 patients with hypertriglyceridemia from February 2019 to October 2020 were retrospectively collected and analyzed. The patients were treated with plasma component exchange by centrifugal plasma separation combined with plasma adsorption (PA) lipid-lowering therapy. The plasma was separated by an automatic blood cell separator, and was then adsorbed by membrane plasma component absorber. Conditions for plasma component exchange were sodium citrate as anticoagulant, the whole blood flow rate at (30~80) mL/min, the plasma circulation volume 2 500 mL, the treatment time 2 h, and the discarded plasma 200 mL. The treatment was performed once every two weeks, twice in total, and the efficacy was evaluated 6 weeks later. The changes of serum total protein (TP), blood lipid indexes and hemorheology indexes before and after treatment were observed, and the adverse reactions during treatment were recorded. 【Results】 The effective rate of 42 patients after treatment was 95.24%. The values of TP, TC, TG and LDL-C decreased significantly (82.53±6.37 vs 74.26±5.91, 7.46±1.83 vs 3.88±1.06, 5.91±2.16 vs 2.20±1.13, 4.23±1.02 vs 3.17±0.85) while HDL-C increased significantly(0.92±0.15 vs 1.23±0.26) after the treatment (P<0.05). After the treatment, the levels of whole blood high-cut viscosity, whole blood low-cut viscosity, plasma viscosity, hematocrit and fibrinogen decreased significantly (7.53±1.21 vs 5.16±0.88, 18.27±3.15 vs 12.04±2.32, 2.46±0.37 vs 1.68±0.29, 52.24±5.31 vs 32.53±4.42, 4.28±0.76 vs 3.14±0.45)(P<0.05). The incidence of adverse reactions was 14.3%, and no serious adverse reactions were observed. 【Conclusion】 The centrifugal plasma separation combined with plasma adsorption in the treatment of hypertriglyceridemia is safe and effective.
ABSTRACT
Objective Explore the sodium citrate anticoagulation in the continuity of plasma adsorption closed-circuit circulation of anticoagulation therapy method and effect. Methods Line into the continuity of plasma adsorption treatment of 156 cases of acute drug poisoning patients were randomly(random number) divided into two groups, 78 cases in each group, respectively adopt low molecular heparin (group A), sodium citrate anticoagulation (group B). Contrast analysis of two groups after the therapy began 30 min, 3 h, 6 h before the filter in patients with pressure, transmembrane pressure, pressure drop, at the same time to compare two groups of 10 min before the start of treatment, after treatment began to 3 h, 6 h platelet, coagulation time live enzymes, vein in the body of free Ca2+, Na+and HCO3- 24 h and internal bleeding. Results Two groups in gender, age, clinical diagnosis, blood purification time comparative differences had no statistical significance (P>0.05);Two groups of 30 min after the start of treatment, 3 h, 6 h patients before pressure, transmembrane pressure, filter pressure drop compared differences were no statistical significance (P>0.05); Part of coagulation treatment after low molecular heparin group live enzymes the sodium citrate group significantly prolonged (P<0.01);Platelets, HCO3- the two groups after treatment, intravenous free Ca2+ and Na+ differences had no statistical significance (P>0.05). Conclusions In the continuous plasma adsorption treatment process using sodium citrate anticoagulation with clinical feasibility, safety.
ABSTRACT
Objective To study how to use the machine of B.BRAUN's Diapact continuous renal replacement therapy (CRRT) to achieve multiple models of plasma treatment by analyzing the characteristics of the machine.Methods Based on the machine of B.BRAUN's Diapact CRRT,assisted by extra single pump,the pipeline connection of the machine was reformed and the appropriate parameter was reset.Results After the reconstruction,the new equipment could succeed in achieving special plasma treatment such as double filtration plasmpheresis (DFPP)and plasma adsorption (PA).Conclusions The reconstructed equipment can attain special plasma treatment.Compared with plasma exchange (PE),the equipment has some characteristics such as few syndromes and without external plasma.According to its safety and stability,this new method is suitable for clinical application.
ABSTRACT
Objective To compare the different types of physical artificial liver support system(ALSS) applied in the treatment of patients with early stage of chronic severe hepatitis in order to evaluate the therapeutic effect and look for the most effective one.Methods One hundred and twenty patients of chronic severe hepatitis B in early stage were randomly divided into 4 groups(each n=30).The patients in group 1 were treated by 3 000 ml plasma exchange;in group 2,by 2 000 ml plasma exchange combined with plasma adsorption for 2 hours;in group 3,only by plasma adsorption for 3 hours and in group 4,by molecular adsorbent re-circulating system(MARS).The observation time lasted for 2 weeks and the therapy twice a week,the interval between two times of treatment being 2-3 days.The improvement of symptoms,the fade away and rebound of icterus,the changes of albumin and prothrombin activity(PTA),side effects(anaphylaxis,hepatic encephalopathy,edema of conjunctiva,burp,fluid and electrolyte balance failure,changes of blood routine test and ammonia level,etc) were compared before and after the treatment.Results The symptoms of 27 cases in group 1 were improved,the rate of decrease of total bilirubin(TBil) of group 1 was 51.8% and the range of icterus rebound was 14.4% to 46.7% with comparatively more side effects.The symptoms of 24 cases of group 2 were improved,the rate of decrease of TBil in group 2 was 62.2% and the range of icterus rebound was 2.8% to 28.5% with comparatively less side effects.The symptoms of 16 cases of group 3 were improved,the rate of decrease of TBil in group 3 was 38.8% and the range of icterus rebound was 2.8% to 6.8% with less side effects.The symptoms of 26 cases of group 4 were improved,the rate of decrease of TBil in group 4 was 60.1% and the range of icterus rebound was 7.8% to 27.4% with comparatively more side effects,moreover the cost was higher than that in the other groups.Conclusion The method of reduced plasma exchange combined with plasma adsorption with macroporous resin used to cure chronic severe hepatitis at early stage has the characteristic of good effects for the fade away of icterus,little rebound of icterus and side effects.It is the reasonable method of artificial liver to cure the early stage of chronic severe hepatitis.