Franz H R, Hohl-Taheri M, Kraatz B, Kühnl P, Neppert J
Abtlg. f. Transfusionsmedizin u. Transplantationsimmunologie, Universität Hamburg.
Beitr Infusionsther. 1990;26:147-9.
From 1979 to 1989 fifty patients, representing 18 different diagnoses/indications, were treated with 385 non-selective therapeutic plasma exchanges (TPE). In the first five years of the survey, the neurological diseases predominated; since 1984, these cases were treated by the Dept. of Neurology. Five % human albumin solution, fresh-frozen-plasma and saline solution were used as replacement fluids. In the beginning, the exchange volume was 1.5-2 times that of the patient's plasma volume, now it is less and varies with the disorder. ACD-A was used as anticoagulant. 11% of the TPE treatments side effects, and in another 3% technical or operator mistakes were noticed. As a supportive therapy, the plasma exchange was effective in the hyperviscosity syndrome, myasthenia gravis, thrombotic thrombocytopenic syndrome, myasthenia gravis, thrombotic thrombocytopenic purpura (TTP), hypercholesterolaemia, Guillain-Barré Syndrome, haemolytic crisis of a homozygous sickle-cell anaemia. There was, however, no definite convincing success in acute liver failure.
1979年至1989年期间,对50例患者进行了385次非选择性治疗性血浆置换(TPE),这些患者代表了18种不同的诊断/适应症。在调查的前五年中,神经系统疾病占主导;自1984年起,这些病例由神经内科治疗。使用5%人白蛋白溶液、新鲜冷冻血浆和生理盐水作为置换液。起初,置换量为患者血浆量的1.5至2倍,现在则减少且因疾病而异。使用ACD - A作为抗凝剂。发现11%的TPE治疗有副作用,另有3%存在技术或操作失误。作为一种支持性治疗,血浆置换在高黏滞综合征、重症肌无力、血栓性血小板减少综合征、重症肌无力、血栓性血小板减少性紫癜(TTP)、高胆固醇血症、吉兰 - 巴雷综合征、纯合子镰状细胞贫血的溶血危象中有效。然而,在急性肝衰竭方面未取得明确的令人信服的成功。