治疗性血浆置换的临床应用(附50例报告)

目的 回顾性分析治疗性血浆置换的适应症、疗效及并发症，为血浆置换的临床应用提供理论依据及实际经验。方法 收集1999年6月至2002年6月三年中在我中心行血浆置换治疗的患共50例，男36例，女14例，年龄9—80岁，治疗次数1—12次，共治疗142例次，其中单重血浆置换39例、111例次，双重滤过血浆置换11例、31例次；血浆置换量一般为1—2个血浆容量；单重血浆置换补充液5／6为新鲜血浆，1／6为血浆代用品；双重滤过血浆置换置换液为4％白蛋白林格氏液500ml，废弃血浆500ml，治疗前后记录病情变化及做相应的生化检查。结果 50例患的临床症状及生化检查均有不同程度的改善，病情重、首次发病效果更明显；共有12例患、18例次出现不同程度的口周及四肢麻木、荨麻疹、寒战、发热和低血压等，经对症处理后好转；4例患、5例次发生体外凝血。结论 血浆置换的临床应用已扩大至内科的各个领域，尤其是神经系统疾病、肾脏疾病、免疫性疾病及其它一些急危重疾病的治疗取得比较满意的疗效，能够迅速缓解症状，为疾病的病因治疗创造时机。

The clinical application of therapeutic plasma exchange (50cases report)

Objective To inrestigate the indications, treatment effects and complications of therapeutic plasma ex-charge (TPE) with retrospective.Methods Fifty cases (male:36, female: 14) who were treated with TPE during June 1999- June, 2002 were investigated. Thirty- nine patients were treated with PE, 11 patients were treated with double filtration plasmapheresis (DFPP). Patients' clinical statas and biochemistry parameters were detected before and after treatment. Results The patients clinical status and biochemistry parapneters were improved after the treatment of TPE. Conclusion TPE is a kind of widespread clinial treatment which can be used in nervous system disease, renal disease, immune disease and other acute severe diseases.