Lukomskiĭ G I, Alekseeva M E, Ivanova N A, Kabanova G M, Tatsievskiĭ V A, Saulko A M
Khirurgiia (Mosk). 1991 Apr(4):102-5.
The authors studied the efficacy of plasmapheresis in preoperative management of patients with thyrotoxicosis in intolerance of and resistance to thyrostatic agents. Seventy-three patients were examined. Preoperative management was accomplished by gravitation plasmapheresis (PP) with a PP-0.5 apparatus according to the continuous flow principle. The course consisted of 1-5 sessions during which a total volume of 800-5,000 ml of plasma was removed. Heparin was administered in a dose of 150-200 U/kg before PP. It was proved that the most rational technique was replacement of the lost plasma by reopolyglucin with albumin--300% of the total volume of the plasma substitute. Dynamic study of the level of the T3, T4, and TSH hormones proved that the use of such substituting medium leads to stable euthyroidism and that PP is the optimal method of preoperative management of patients with thyrotoxicosis in intolerance of and resistance to thyrostatic agents.
作者研究了血浆置换术在对甲状腺抑制剂不耐受和耐药的甲状腺毒症患者术前管理中的疗效。共检查了73例患者。术前管理通过使用PP - 0.5设备根据连续流动原理进行重力血浆置换（PP）来完成。疗程包括1 - 5次治疗，在此期间共去除800 - 5000毫升血浆。在血浆置换前，以150 - 200 U/kg的剂量给予肝素。结果证明，最合理的技术是以含有白蛋白的低分子右旋糖酐替代丢失的血浆，替代量为血浆代用品总体积的300%。对T3、T4和TSH激素水平的动态研究证明，使用这种替代介质可导致稳定的甲状腺功能正常状态，并且血浆置换是对甲状腺抑制剂不耐受和耐药的甲状腺毒症患者术前管理的最佳方法。
