输血(医学)科基于离心分离技术建立单采/血液净化治疗体系的探索

Strengthening the Application of Centrifugal Technology and Establishing a Combined Apheresis/Blood Purification System in the Department of Transfusion Medicine

非输血血液疗法(Non-transfusional hemotherapy,NTH)的主要承担者应为输血(医学)科,而血细胞离心分离技术是承担此类治疗的技术基础。血浆分离可有两种技术方式实现:离心式和膜滤过式,而两者的技术各有特点。以血细胞离心分离技术为基础的单采治疗/血液净化显示了血浆分离效率高、治疗用时短、血小板损耗低、红细胞不易破坏及使用枸橼酸抗凝利于重症患者非持续性临床治疗的优势。适合输血(医学)科离心技术使用的二级柱可以实现免疫吸附、人工肝支持系统、离心-膜滤过血浆置换及炎性因子吸附等治疗,从而以越来越精细的血浆二级处理技术实现传统血浆置换的有益补充。

Non-transfusional hemotherapy should be mainly carried out by the Transfusion Department,which basis is the apheresis technology by centrifugation.The plasmapheresis can be realized in two ways:centrifugal and membrane filtration,each of which has its own technical characteristics.Apheresis/blood purification based on centrifugation shows the advantages of higher plasma separation efficiency,shorter treatment time,less platelet loss,less destruction of red blood cells,and the use of citrate anticoagulation for non-continuous clinical treatment of critically ill patients.Secondary columns suitable for centrifugal technology can realize immunoadsorption,artificial liver support system,centrifugation-filtration plasmapheresis and inflammatory factor adsorption.Using increasingly sophisticated secondary column technology should be a useful supplement to traditional TPE.