血浆置换数学模型的建立和应用

Mathematics models for plasma exchange

目的探索应用计算数学和计算机技术解决血浆置换治疗中血浆用量个体化等技术问题。方法选择各种病因的重型肝炎患者42例,胆红素水平10-40 mg/dl。按照统一方法进行血浆置换,每置换400 ml留取血清标本1次,集中检测胆红素。利用计算数学进行模拟,得出公式。另选同类患者10例对公式进行验证。结果通过数学计算,得到胆红素下降预测公式、血浆用量分析公式、成本—效益分析公式、胆红素反弹曲线。初步验证结果显示计算结果与实际结果相近。最后将以上公式制作为《血浆置换计算分析系统软件》。结论应用计算数学有助于解决血浆置换治疗血浆用量的个体化问题,降低血浆消耗,提高治疗效果。

[ Objective] By setting up mathematics models for plasma dosage in plasma exchange to get best cost-benefit. [ Methods] 42 patients with severe liver diseases whose total bilirubin between 10-40 mg/dl were included. Draw serum samples when every 400 ml plasma was used in plasma exchange. The total bilirubin was determined together. Mathematics models were set up based on these results. Other 10 similar patients were selected to validate the efficacy of the models. [ Results ] Three models were set up： bilirubin prediction model, plasma dosage prediction model, cost-benefit analysis model, in addition a bilirubin rebound curve was drawn. The models showed good efficacy in the 10 patients. A plasma exchange software was invented based on the results. [ Conclusion ] Mathematics models can help to determine individual plasma exchange plan, and get best cost-benefit.