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体外治疗:我们应该使用血浆而非血液吗?

Extracorporeal therapies: should we use plasma instead of blood?

作者信息

Ronco C

机构信息

Department of Nephrology, St. Bortolo Hospital, Vicenza, Italy.

出版信息

Int J Artif Organs. 1999 May;22(5):342-6.

Abstract

The evolution of extracorporeal therapies has required the parallel evolution of devices designed to extract the blood from the patient and to move it in the extracorporeal circuit. Blood is a peculiar fluid in which viscosity may be strongly affected by the contingent operational conditions of the extracorporeal circuit. Because hematocrit is an important component of blood viscosity, and viscosity may definitely affect the performance of blood purification devices, major problems arise when high hematocrits are present in the patient. All these problems might be avoided if plasma could be used instead of whole blood. Plasma treatment is already performed in various therapies, but the treated plasma is obtained by separation from whole blood in the extracorporeal environment. In this paper we propose a new approach to perform different plasma treatments. Plasma is extracted directly from the patient thanks to a special catheter or plasma extraction device. Utilizing plasmafiltration technology to create a membrane that is placed on the tip of an intravascular catheter, plasma extraction may become easy to perform. The extracted plasma is then available for any type of treatment before being restituted to the patient via a second lumen in the same catheter.

摘要

体外治疗的发展需要并行发展用于从患者体内抽取血液并使其在体外循环中流动的设备。血液是一种特殊的流体,其粘度可能会受到体外循环的偶然运行条件的强烈影响。由于血细胞比容是血液粘度的重要组成部分,并且粘度肯定会影响血液净化设备的性能,因此当患者血细胞比容较高时会出现重大问题。如果可以使用血浆代替全血,所有这些问题都可以避免。血浆治疗已经在各种疗法中进行,但所处理的血浆是通过在体外环境中从全血中分离获得的。在本文中,我们提出了一种进行不同血浆治疗的新方法。借助特殊的导管或血浆提取装置,直接从患者体内提取血浆。利用血浆过滤技术创建放置在血管内导管尖端的膜,血浆提取可能会变得易于执行。然后,提取的血浆可用于任何类型的治疗,之后通过同一导管中的第二个内腔归还给患者。

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