SU1175491A1 - Method of setting extracorporal hemosorbtion - Google Patents

Abstract

METHOD FOR CARRYING OUT EXTRACORPORAL HEMOSORPTION by perfusing blood through a column with a sorbent followed by reinfusing it to a patient, characterized in that, in order to increase the sorption capacity of the column for bilirubin, complamine is administered intravenously at a dose of 1-2 mg every 60 min perfusion.

Description

C71

with

The invention relates to medicine, in particular to methods of detoxifying the body.

The aim of the invention is to increase the bilirubin column sorption capacity.

The method is carried out as follows.

During the procedure of hemosorption, every 60-90 minutes, depending on weight, hemodynamic parameters and central venous pressure, 75 to 150 mg of complamine are administered to patients. The introduction of complamine after 20–40 min increases the concentration of bilirubin bound to albumin by 20% in the blood and by 33% in the lymph. When hemosorbing using complamine, there is a significant increase in bilirubin and its fractions compared with the baseline data, which is not due to an increase in the synthesis, but from the introduction of tissue into the bloodstream. On the second day, the concentrations of these metabolites are reliably reduced, since the substances removed from the tissues do not have a toxic effect on the cell metabolites, thereby stimulating their elimination from the body.

Thus, when using the proposed method, it is possible to increase the detoxification effect of extracorporeal hemosorption, speed up the excretion of metabolites from the body, and reduce the number of procedures and treatment periods for patients.

Example 1. Patient C 25. l enrolled in the Hepatology Department of the 9th Minsk City Clinical Hospital, 109.81 g. Clinical diagnosis: exacerbation of chronic cholestatic hepatitis. The patient is worried about weakness, lack

appetite, painful itching, flat. -) n, aching pain in the epigastric region, bitter taste in the mouth. Sick since 1971, such phenomena have been repeated many times. Last exacerbation from 15.07. 1981 On examination, the skin and sclera are jaundiced, there are multiple scratches on the body, the liver is not palpable, feces are discolored.

Total bilirubin 115.0 mmol / l, direct 90.3 mmol / l, direct 24.7 mmol / l, alkaline phosphatase 1.12 µm.

Conservative treatment, including hepatotropic drugs, detoxification therapy for 15 days, did not produce any effect.

In order to remove cholemic intoxication, it was decided to include sorption detoxification methods in the complex treatment of chronic cholestatic hepatitis. September 15, 16.09 and September 17, the patient underwent extracorporeal hemosorption sessions. Sorbent SKN-2M. The perfusion times are 80, 140 and 60 minutes, respectively. The total volume of perfusion 25200 ml. In the process of the second and third sorption, 300 and 150 mg of complamine were administered to the patient. After the treatment, the general condition of the patient improved significantly: itching, jaundice disappeared, sleep and appetite improved. 1.10. 13 days after hemosorption, the patient was discharged home in a satisfactory condition. Biochemical indicators 1,10. 1981: total bilirubin 48 mmOl / l, direct 27 mmol / l, indirect 21 mmol / l alkaline phosphatase 0.56 µm.

In tab. Figure 1 shows the concentration of bilirubin bound to albumin during the treatment, mmol / L.

Table 1

89.04

50.4 94.9

Example 2. Ill L., 30 years old, entered the Hepatology Department of the 9th Minsk City Clinical Hospital, 30.09.81 g, diagnosed with chronic cholestatic hepatitis. Complaints at admission to pain in the right hypochondrium, weakness, lack of appetite, poor sleep, pruritus, A history of 1961 suffered Botkin's disease. There is jaundice for 4 months. On examination: the skin and sclera are intric, scratching, the liver protrudes 4 cm from the edge of the costal arch, the edge is sharp, painful, the feces are discolored.

91.28 75.04 112.0 84.0

28.0

The diagnosis is confirmed by laboratory and instrumental methods of research.

Liver PEF from 10/06/81. Pronounced disorders of liver PEF. The amplitude of the hepatogram is reduced. Excretory segment is not received.

It was decided to include in the complex treatment of chronic cholestatic hepatitis

sorption detoxification methods. 10/14/15. 10 October 16 20.10 and October 21, extracorporeal hemosorption sessions were conducted. Sorbent SKN-2M.

31175491д

The total volume of perfusion 42500 ml. In the pro-table. Figure 2 shows the concentration of the patient's hemosorption by the bi-sessor of the patient injected with polirubin and its fractions in the course of treatment. 150 kg of complamination, mmol. Total bilirubin 225.6 213.4 197.0 200.0 155.8 misses 125.0 160.0 131.3 140.0 94.4 my 100.6 53.4 665.7 60.0 61.4 34.9

As a result of the treatment, the patient's condition improved significantly: the itching, jaundice disappeared, the appetite decreased, sleep improved, and the liver was reduced to normal size.

PEF of the liver from 3.11.81, moderate violation of PEF of the liver. In comparison with the hepatogram from 6.10.81, isotope dynamics is positive in the intestine

table 2

registered for 37 min. 10.11.81 was discharged home of 8 satisfactory condition. After 4 months, she was admitted to the clinic for follow-up examination. The condition is satisfactory, no complaints, started to work, total bilirubin 25.8 mmol / l, direct 18.4 mmol / l, direct 7.4 mmol / l. Hep PE of 03/22/82, a minor violation of the liver PE. The isotope in the intestine is registered for 34 minutes. 131.3 86.2 102.6 77.9 84.1 34.6 96.441.0 51.330.7 49.2 20.6 45.2 51.347.2 34.8 14.0

Claims (1)

METHOD FOR EXTRACORPORAL HEMOSORPTION by perfusion of blood through a column with a sorbent followed by reinfusion to a patient, characterized in that, in order to increase the sorption capacity of the column for bilirubin, a patient is administered intravenously a dose of 1-2 mg every 60 min of perfusion.