Isbister J P, Biggs J C, Penny R
Aust N Z J Med. 1978 Apr;8(2):154-64. doi: 10.1111/j.1445-5994.1978.tb04503.x.
Clinical experience with large volume plasmapheresis in a wide range of malignant and immune disorders is described. An average of 4 litres of plasma was exchanged for various colloid and electrolyte solutions. Patient tolerance was good but close medical and nursing supervision in monitoring fluid balance and adverse reactions to replacement fluids is necessary. Plasmapheresis has been established to be of benefit in immunoproliferative diseases when complicated by hyperviscosity, and may also have a place in other cases with haemostatic or renal impairment. Autoantibodies, alloantibodies and immune complexes can be removed by plasmapheresis, but the effect is usually transient and the procedure should be combined with immunosuppressive therapy in most cases. The removal of blocking factors in disseminated malignant melanoma is an experimental procedure at present, but initial results have been encouraging.
本文描述了大量血浆置换在多种恶性疾病和免疫性疾病中的临床经验。平均4升血浆被置换为各种胶体和电解质溶液。患者耐受性良好，但在监测液体平衡和对置换液的不良反应时，密切的医疗和护理监督是必要的。血浆置换已被证实对并发高粘滞血症的免疫增殖性疾病有益，在其他有止血或肾脏损害的病例中也可能有作用。血浆置换可去除自身抗体、同种抗体和免疫复合物，但效果通常是短暂的，在大多数情况下该操作应与免疫抑制治疗相结合。目前，去除播散性恶性黑色素瘤中的阻断因子是一个实验性操作，但初步结果令人鼓舞。
