Thay huyết tương ở bệnh nhân hồi sức bằng phương pháp ly tâm: Báo cáo loạt ca=Centrifugal therapeutic plasma exchange in the intensive care unit: Case series report

0 Người đánh giá. Xếp hạng trung bình 0

Tác giả: Thị Xuân Phan, Mỹ Dung Vương

Ngôn ngữ: vie

Ký hiệu phân loại:

Thông tin xuất bản: Tạp chí Y học Việt Nam (Tổng hội Y học Việt Nam), 2024

Mô tả vật lý: tr.149-155

Bộ sưu tập: Metadata

ID: 243892

Thêm vào giỏ

Đánh giá hiệu quả và tính an toàn của thay huyết tương bằng phương pháp ly tâm. Đối tượng và phương pháp: Nghiên cứu mô tả loạt ca bệnh, gồm tất cả bệnh nhân được tiến hành thay huyết tương bằng phương pháp ly tâm tại khoa Hồi sức tích cực – chống độc, Bệnh viện Đa khoa Tâm Anh TP.HCM từ 01/11/2023 đến 15/03/2024. Kết quả: Tổng cộng có 34 lượt thay huyết tương bằng phương pháp ly tâm được tiến hành trên 13 bệnh nhân trong khoảng thời gian nghiên cứu. Chỉ định thay huyết tương ở các bệnh nhân này thuộc nhiều bệnh lý khác nhau: hội chứng Guillain-Barré (chiếm 30,7%), suy gan cấp (23,1%), sốc nhiễm khuẩn có biến chứng suy đa tạng (23,1%), viêm tụy cấp tăng triglyceride máu (7,7%). Thay huyết tương bằng phương pháp ly tâm được dung nạp tốt và không ghi nhận biến chứng đáng kể. Các bệnh nhân sau thay huyết tương có sự cải thiện về triệu chứng lâm sàng rõ rệt, đặc biệt ở nhóm bệnh nhân bị hội chứng Guillain-Barré. Chất chống đông citrate được sử dụng cho hầu hết các bệnh nhân, ngoại trừ bệnh nhân bị suy gan nặng, do đó cần theo dõi biến chứng hạ canxi máu trong quá trình thay huyết tương. Kết luận: Nghiên cứu loạt ca bệnh này cho thấy thay huyết tương bằng phương pháp ly tâm là phương pháp thay huyết tương hiệu quả và an toàn. Cần có thêm các nghiên cứu tiếp theo để so sánh phương pháp thay huyết tương bằng màng lọc và ly tâm, cũng như để xây dựng phác đồ chuẩn cho việc sử dụng chống đông trong quá trình thay huyết tương.Evaluating the efficacy and safety of cTPE. Method: This descriptive case series study included all patients who underwent cTPE at the Intensive Care Unit, Tam Anh General Hospital in Ho Chi Minh City from November 1st, 2023 to March 15th, 2024. Results: A total of 34 cTPE sessions were performed on 13 patients during the study period. Indications for TPE in these patients included various diseases: Guillain-Barré syndrome (30,7%), acute liver failure (23,1%), septic shock with multi-organ failure (23,1%), and hypertriglyceridemia-induced acute pancreatitis (7,7%). The cTPE was well-tolerated with no significant adverse events. Most patients showed clearly clinical improvement after procedures, especially those with Guillain-Barré syndrome. Citrate anticoagulant was used for most patients, except for those with severe liver failure, hence monitoring for hypocalcemia during cTPE procedures was necessary. Conclusion: Our findings suggest that cTPE is a safe and effective modality for TPE. Further studies are warranted to compare mTPE with cTPE and to establish standardized protocols for anticoagulation in TPE procedures.

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