Bartolo M
Ric Clin Lab. 1985;15 Suppl 1:439-54.
Blood and plasma viscosity can be influenced by various therapeutic procedures: among these, that of hemodilution stands out. This can be hypovolemic, normovolemic or hypervolemic; it is hypovolemic if blood subtraction is not followed by a liquid reintroduction, it is normovolemic or hypervolemic if there is a liquid reintroduction of the same or higher quantity than the subtracted blood mass. This method has been considered very favorably by surgery in order to save blood for transfusions. Hypervolemic hemodilution can also be carried out without blood subtraction; a report on this method shows good clinical results and positive hematochemical and hemodynamic effects obtained on 93 peripheral vasculopathic patients at stages III and IV of the Fontaine classification. Plasmapheresis, which would be best called plasma-exchange, consists in the removal of that part of the patient's plasma containing abnormal proteins, immune complexes or toxins, and in its substitution by other colloids or crystalloids. Defibrinogenation is not much employed in Italy, as the most effective drugs, such as ancrod and batroxobin are not available in this country. The good results reported were transitory, due to the rapid appearance of antibodies which can inhibit the effects of these drugs. Nevertheless, there also exist minor fibrinogenolytic drugs.
其中，血液稀释最为突出。血液稀释可分为低血容量性、等血容量性或高血容量性；若放血后不补充液体，则为低血容量性；若补充的液体量与放血量相同或更多，则为等血容量性或高血容量性。这种方法在外科手术中备受青睐，目的是为输血节省血液。高血容量性血液稀释也可在不放血的情况下进行；一份关于该方法的报告显示，对93例处于Fontaine分类III期和IV期的周围血管病变患者取得了良好的临床效果以及积极的血液化学和血液动力学效应。血浆置换，最好称为血浆交换，包括去除患者血浆中含有异常蛋白质、免疫复合物或毒素的部分，并以其他胶体或晶体替代。去纤维蛋白原疗法在意大利使用不多，因为该国没有最有效的药物，如安克洛酶和巴曲酶。所报告的良好效果是暂时的，因为抗体很快出现，会抑制这些药物的作用。不过，也有一些作用较弱的纤维蛋白溶解药物。
