Cov ntshav hauv peb lub cev yog ib yam zoo kawg nkaus, puas yog? Nws muaj cov qe ntshav liab, cov qe ntshav dawb, thiab ntau yam ntxiv. Ntawm cov no, cov kua ntawm cov ntshav hu ua 'plasma'. Qee zaum, vim muaj kab mob hauv peb lub cev, cov plasma no tuaj yeem ua rau muaj teeb meem. Thaum lub sijhawm zoo li no, peb yuav tham txog txoj kev kho mob tshwj xeeb uas tshem tawm cov plasma uas muaj teeb meem thiab ntxuav cov ntshav.
Cia peb xub saib, cov plasma no yog dab tsi?
Hais yooj yim xwb, plasma yog cov kua daj daj ntawm peb cov ntshav. Ntau tshaj ib nrab ntawm peb cov ntshav yog ua los ntawm plasma. Txawm hais tias feem ntau yog dej, nws kuj muaj ntau yam tseem ceeb uas peb lub cev xav tau. Tshwj xeeb, cov protein thiab electrolytes , uas yog cov ntsev yaj.
Xav txog tias peb lub cev zoo li ib lub teb chaws. Ces qee cov protein hauv cov ntshav no zoo li cov tub rog hauv lub teb chaws ntawd. Lawv tiv thaiv peb ntawm cov yeeb ncuab xws li cov kab mob thiab cov kab mob uas los ntawm sab nraud. Peb kuj hu cov tshuaj no ua cov tshuaj tiv thaiv . Lwm hom protein pab tiv thaiv kom tsis txhob los ntshav thaum muaj qhov txhab. Yog li koj tuaj yeem pom tias cov ntshav tseem ceeb npaum li cas, puas yog?
Yog li plasmapheresis thiab plasma exchange yog dab tsi?
Ob lub npe no zoo sib xws me ntsis, yog li nws yuav ua rau me ntsis tsis meej pem. Cia peb ua kom yooj yim.
- Kev Siv Plasmapheresis: Qhov no tsuas yog cais cov plasma tawm ntawm cov ntshav xwb. Txoj kev no feem ntau siv los coj cov plasma los ntawm ib tus neeg noj qab nyob zoo (cov plasma uas tus neeg pub dawb) thiab kho lwm tus neeg mob.
- Kev Sib Pauv Plasma: Qhov no yog txoj kev kho mob uas siv ntau tshaj plaws. Qhov tshwm sim ntawm no yog tias cov plasma uas muaj teeb meem, ua rau muaj kab mob hauv koj lub cev raug tshem tawm thiab hloov nrog cov plasma zoo lossis cov kua zoo sib xws. Nws zoo li tshem tawm qee cov dej qias neeg thiab ntxiv dej huv. Hauv tsab xov xwm no, peb yuav tham txog kev kho mob Plasma Exchange no.
Cov kab mob twg kho tau los ntawm kev kho mob no?
Kev pauv ntshav hauv cov ntshav yog ib txoj kev kho mob uas siv los kho ntau yam mob. Tshwj xeeb, nws tuaj yeem kho tau cov kab mob autoimmune, cov kab mob ntshav, thiab qee hom mob qog noj ntshav.
| Pawg kab mob | Lub npe ntawm tus kab mob | Kev kho mob no pab tau li cas? |
|---|---|---|
| Kev Mob Hlwb | Kab mob Multiple Sclerosis (MS) | Nws tshem tawm cov protein phem tawm ntawm cov ntshav uas tawm tsam lub cev nws tus kheej, tswj cov tsos mob sai sai thiab hnyav. |
| Myasthenia Gravis | Nws tshem tawm cov tshuaj tiv thaiv tsis raug uas tawm tsam cov nqaij noj qab haus huv, txo cov leeg nqaij tsis muaj zog. | |
| Guillain-Barré Syndrome | Cov tshuaj tua kab mob uas tawm tsam cov hlab ntsha raug tshem tawm ntawm cov ntshav, ua kom cov txheej txheem kho sai dua. | |
| Kev Mob Ntshav | Cryoglobulinemia | Nws tshem tawm cov protein tsis zoo (cryoglobulins) uas thaiv cov hlab ntsha, thiab rov qab ua kom cov ntshav ntws tau zoo. |
| Kab mob ntshav txhaws (TTP) | Tshem tawm cov plasma uas muaj teeb meem uas ua rau cov ntshav txhaws hauv cov hlab ntsha me. | |
| Mob qog noj ntshav | Waldenström Macroglobulinemia | Ib hom tshuaj tiv thaiv kab mob (immunoglobulin M) uas tsim tawm ntau dhau raug lim tawm ntawm cov ntshav. |
| Ntau yam mob myeloma | Tshem tawm cov tshuaj phem uas tsim los ntawm cov hlwb plasma tsis zoo uas tau dhau los ua mob qog noj ntshav. |
Ua ntej thiab thaum lub sijhawm kho mob muaj dab tsi tshwm sim?
Kev npaj ua ntej kev kho mob
Yog koj tus kws kho mob sau ntawv kom koj kho qhov teeb meem no, nws yuav qhia koj tej yam zoo li no kom koj npaj tau.
- Haus dej ntau ntau uas tsis muaj roj carbonated (dej, dej txiv hmab txiv ntoo) li peb hnub ua ntej kev kho mob.
- Noj ib pluag mov me me li ib teev ua ntej kev kho mob, yam tsis txhob tshaib plab.
- Tuaj nrog cov khaub ncaws xis nyob thiab xoob. Vim tias kev kho mob yuav siv sijhawm ntau teev, nws yog ib lub tswv yim zoo kom nqa ib yam dab tsi los nyeem, xws li ib phau ntawv lossis ib lub xov tooj los mloog nkauj.
- Tom qab kho mob tas, tej zaum koj yuav nkees me ntsis, yog li ntawd nws yuav nyuaj rau tsav tsheb. Yog li ntawd, nws yog ib qho tseem ceeb uas yuav tsum coj ib tus neeg tuaj coj koj mus tsev.
Thaum lub sijhawm kho mob
Cov kauj ruam koom nrog kev kho mob Plasma Exchange yog yooj yim heev.
1. Ua ntej, tus kws kho mob lossis tus nais maum yuav muab ib txoj kab IV tso rau hauv ib txoj hlab ntsha hauv koj txhais caj npab. Lawv kuj tseem yuav muab ib txoj catheter tso rau hauv ib txoj hlab ntsha loj hauv koj lub caj dab lossis qhov chaw mos.
2. Tom qab ntawd, ib qho ntshav me me maj mam raug rho tawm ntawm koj lub cev los ntawm nws.
3. Cov ntshav raug xa mus rau lub tshuab tshwj xeeb, qhov chaw uas tsuas yog cov plasma raug cais tawm.
4. Cov ntshav uas muaj teeb meem uas ua rau koj mob raug tshem tawm lawm .
5. Tom qab ntawd, cov kua tshwj xeeb xws li cov plasma tshiab lossis albumin raug ntxiv rau cov qe ntshav liab thiab cov qe ntshav dawb uas tseem tshuav.
6. Thaum kawg, cov ntshav uas tau ntxuav lawm no raug muab rov qab rau hauv koj lub cev los ntawm tib lub cannula ntawd.
Tag nrho cov txheej txheem no tuaj yeem siv sijhawm ob peb teev, tab sis txhua yam koj yuav tsum ua thaum lub sijhawm no yog pw hauv txaj thiab so kom txaus.
Qhov no puas mob? Puas muaj tej yam txaus ntshai?
Ib lo lus nug uas ntau tus neeg muaj yog seb qhov no puas yuav mob. Tsis yog, qhov no tsis yog kev kho mob uas mob heev. Txawm li cas los xij, koj yuav hnov qhov mob me ntsis thaum lub cannula raug ntxig rau hauv koj txhais caj npab. Ib txhia neeg yuav muaj cov hauv qab no thaum lub sijhawm kho mob:
- Zoo li koj txhais tes thiab ko taw tingling
- Xav tias xeev siab
- Ib qho kev xav tu siab
- Kev xav txias
Yog koj xav li no, koj yuav tsum qhia rau tus kws kho mob lossis tus nais maum tam sim ntawd. Lawv paub tej yam yooj yim uas koj ua tau.
Txawm hais tias kev pauv plasma yog ib txoj kev kho mob uas muaj kev nyab xeeb heev, tab sis muaj qee qhov kev phiv uas tshwm sim tsawg heev.
- Hypocalcemia: Qhov no tshwm sim vim tias calcium tuaj yeem poob thaum lub sijhawm kho mob. Nws raug kho nrog calcium hauv cov hlab ntsha.
- Hypothermia: Lub cev yuav txias vim yog cov kua dej rov qab los rau nws. Qhov no tuaj yeem tswj tau los ntawm kev muab dej sov lossis qhwv lub cev hauv ib daim pam.
- Ntshav siab qis (Hypotension):Yog tias tsim nyog, yuav muab cov kua ntsev lossis lwm yam kua rau qhov no.
Puas yog kev ntxuav ntshav thiab kev kho mob plasma no zoo ib yam?
Muaj ib txhia neeg tsis meej pem vim ob txoj kev no yog kev ntxuav ntshav. Txawm li cas los xij, ob txoj kev no muaj ob lub hom phiaj.
- Kev ntxuav ntshav: Qhov no yog ua rau cov neeg uas lub raum tsis ua haujlwm zoo. Kev ntxuav ntshav suav nrog kev lim cov khoom pov tseg ntawm cov ntshav uas lub raum tsis tuaj yeem tshem tawm.
- Kev Sib Plasma: Qhov no tsis tshem tawm cov khoom pov tseg ntawm lub cev. Nws tshem tawm cov protein lossis cov tshuaj tua kab mob uas ua rau muaj kab mob uas muaj nyob hauv cov ntshav plasma .
Hais yooj yim xwb, kev ntxuav ntshav yog txoj kev tshem tawm 'cov khib nyiab' ntawm cov ntshav. Kev pauv cov ntshav hauv cov ntshav yog txoj kev ntes thiab tshem tawm cov 'neeg phem' (cov protein uas ua rau muaj kev phom sij) ntawm cov ntshav.
Koj yuav xav tias koj lub siab tus ntev npaum li cas tom qab kho mob nyob ntawm koj tus mob. Piv txwv li, ib tug neeg uas muaj Myasthenia Gravis tej zaum yuav tsis muaj tsos mob li ntau lub hlis tom qab ob peb lub lis piam ntawm kev kho mob.
Cov Lus Qhia Txog Kev Coj Mus Tsev
- Kev Hloov Plasma yog ib txoj kev kho mob tshwj xeeb uas ntxuav cov ntshav los ntawm kev tshem tawm cov plasma uas muaj teeb meem ntawm cov ntshav thiab hloov nws nrog cov kua dej zoo.
- Nws yog siv los kho ntau yam kab mob ntsig txog lub cev tiv thaiv kab mob, xws li cov kab mob neurological, cov kab mob ntshav, thiab qee hom mob qog noj ntshav.
- Kev kho mob tsis mob, tab sis nws siv sijhawm ob peb teev. Tej zaum koj yuav xav tias nkees tom qab kev kho mob, yog li nws yog ib qho tseem ceeb uas yuav tsum tau so.
- Kev kho mob no feem ntau pab tswj cov tsos mob thiab txhim kho lub neej zoo, es tsis yog kho tus kab mob kom zoo tag nrho.
- Tsuas yog koj tus kws kho mob thiaj paub zoo tshaj plaws seb qhov kev kho mob no puas yog rau koj thiab yuav muaj txiaj ntsig zoo li cas. Yog li ntawd, nrog koj tus kws kho mob tham kom paub ntau ntxiv.
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Tsis muaj lus teb tau muab tso tawm. Ntxiv koj cov lus tawm ntawm no thawj zaug.
Ntxiv koj cov lus