Cov pa roj carbon ua kom muaj zog tsis tsuas yog muaj kev tshaj tawm adsorption zoo thiab tuaj yeem tswj lub pob pore qauv nyob hauv qee qhov; nws kuj muaj biocompatibility zoo thiab tsis muaj kev phiv tshuaj lom. Sij hawm dhau los, feem ntau nws tau siv rau hauv kev kho mob lub qhov ncauj kom tiv thaiv kev mob plab thiab tiv thaiv kev nqus ntawm cov tshuaj lom. Nrog hemoperfusion adsorbents, cov khoom hauv nruab nrog cev Kev tsim kho adsorption npaj tshwj xeeb adsorb nruab nrab cov tshuaj molecular los kho ntau yam kab mob, uas yog, siv cov pa roj carbon ua cov cab kuj mus rau adsorb qee qhov muaj zog ua ntej, dhau ib nrab-lub neej, muaj kev puas tsuaj loj rau cov leeg ib txwm, thiab kev quav yeeb yooj yim (xws li kev tiv thaiv kabmob kheesxaws, kev siv tshuaj kho mob, pleev tshuaj loog) kom ua tiav lub hom phiaj ntawm kev tso tshuaj qeeb qeeb thiab kev txhim kho ntawm cov tshuaj kho kom zoo dua qub.
1. Kev tshem tawm tshuaj lom ntawm qhov ncauj
Hauv Suav teb, kev mob plab zom zaub mov tau dav siv ua txoj hauv kev los daws kev phom sij. Lub Koom Haum Asmeskas ntawm Chaw Kuaj Mob Toxicology thiab European Toxicology Center thiab Lub Koom Haum ntawm Chaw Kuaj Mob Toxicology tau taw qhia tias kev mob plab zom zaub mov tau siv rau hauv cov neeg mob lom yav dhau los, tab sis kev mob plab yuav tsum tsis txhob siv tas li. Cov kev tshawb nrhiav kev sim rau cov neeg mob lom tau pom tias cov paib tau tshem tawm los ntawm lub plab zom zaub mov txawv ntau thiab ploj mus raws sijhawm. Kev tshawb fawb ntawm cov txiaj ntsig ntawm kev kho mob kev saib xyuas ntawm cov neeg mob noj ntau dhau kuj qhia meej tias tsis muaj txiaj ntsig zoo. Txoj kev pheej hmoo ntawm cov teeb meem loj muaj xws li nqaij hypoxia, arrhythmia, caj pas stenosis, perforation ntawm lub plab zom mov thiab pharynx, dej thiab electrolyte tsis txaus, thiab kev mob ntsws. Feem ntau, qhov neeg tuag ntawm tus mob huam sai yog tsawg dua 1%, thiab cov neeg mob yuav tsum tsis txhob muaj kev phom sij txaus ntshai vim tias muaj teeb meem lub plab zom mov.
Nrog rau cov ntawv tshaj tawm tsis zoo thiab cov pov thawj tshawb fawb txog kev pheej hmoo ntawm lub plab zom zaub mov thiab ntuav, lub qhov ncauj ua kom hluav ncaig tau ua txoj hauv kev zoo rau cov neeg mob kom txo qis. Tsuav muaj cov kev taw qhia, ua kom hluav ncaig hluav taws xob yuav tsum tau siv sai li sai tau tom qab noj tshuaj lom, thiab tsis tas yuav ntxias mob ntuav lossis pais plab lav nrog emeticine ua ntej. Lub tshuab hluav ncaig ua kom zoo tuaj yeem khi mus rau 45% ~ 60% ntawm cov co toxins 30 ~ 60min tom qab noj tshuaj lom. 10g tshuab txais carbon yuav tsum siv los nqus tshuaj 1g ntawm cov tshuaj lom rau ib tus neeg, thiab qhov koob tshuaj 50-100g feem ntau txaus. Kev siv cov roj carbon ib zaug qhib kev kho mob feem ntau tsis muaj kev phiv tshuaj. Tsis tas li ntawd, muaj ntau txoj kev siv hluav ncaig hluav taws xob ntau, uas yog, rov ua dua qhov ncauj ntawm kev siv lub tshuab hluav taws xob (tsawg kawg 2 zaug) txhawm rau ua kom qhov kev tshem tawm ntawm cov tshuaj nqus hauv lub cev. Kev haus yeeb tshuaj nrog tsawg ntim kev faib tawm, tsis muaj protein txuas, ib nrab ntawm lub neej ntev, thiab cov yam ntxwv ntawm hepatoenteric ncig yog qhov qhia tau zoo rau daim ntawv thov ntawm ntau cov tshuaj ntawm cov pa roj carbon activated.
Nws tau tshaj tawm tias qhov ncauj ua kom cov pa roj carbon muaj qhov sib cuam tshuam zoo hauv kev kho tshuaj ethanol thiab methanol lom. Ib qho kev tshawb fawb txog kev kho mob rwj hauv cov neeg mob lom hauv Finland pom tias 66.5% ntawm 226 tus neeg mob uas raug tshuaj lom feem ntau yog haus cawv lom (150 tus neeg mob), thiab ib qho me me yog tshwm sim los ntawm kev siv tshuaj ntau dhau. 60% ntawm cov neeg mob no xaiv cov pa tshuaj tso qhov ncauj, thiab cov nyhuv tshuaj kho kom pom tseeb. Qee cov kws tshawb fawb tau siv qhov ncauj tshaj tawm hauv carbon los txo cov tsiaj uas raug lom los ntawm methanol.
Hauv Hong Kong, kev siv hluav ncaig hluav taws xob nws tus kheej yog qhov kev kho mob xwm txheej ceev rau cov neeg mob lom. Nws raug nquahu tias cov pa roj carbon activated yuav tsum tau siv li ntawm 1 teev ua kev haus dej haus tshuaj ntawm qhov muaj feem ua rau qaug tshuaj lom. Txawm hais tias tsis muaj cov ntaub ntawv los txhawb lossis siv nws tom qab 1 kab, yog tias tsis muaj contraindication, thawj ob peb teev yuav ua haujlwm, tshwj xeeb tshaj yog rau cov tshuaj nrog hepatoenteric ncig xws li digoxin thiab theophylline. Nws tuaj yeem siv rau ntawm ncauj lossis los ntawm kev tso cov nyuv. Yog tias tus neeg mob noj cov tshuaj tuag, xav siv ntau cov koob tshuaj carbon. Cov tshuaj loog xws li sorbitol lossis magnesium sulfate ua ke nrog cov roj carbon activated yog tseem muaj tam sim no pom tias muaj qee cov txiaj ntsig lossis qhov ua tsis tau zoo.
2. Kev siv lub plab zom mov pab txoj kev tso pa tawm
Nws tau tshaj tawm tias kev mob plab hnyuv taum nrog lub qhov hluav taws xob ua kom zoo yuav tsum tau siv, siv hluav ncaig hluav taws xob yuav tsum tau muab ntawm 1: 1, thiab tom qab ntawd 20% mannitol 250mL rau catharsis. Lub tshuab ntawm qhib lub tshuab hluav ncaig rau lub plab zom zaub mov thiab hemoperfusion cia siab rau adsorption ntawm kev ua kom hluav ncaig txhawm rau tshem tawm cov co toxins, tsis muaj kev puas tsuaj rau daim siab, raum kev ua haujlwm thiab hematopoietic muaj nuj nqi, tshwj xeeb tshaj yog rau cov plab hnyuv rov qab ntawm cov tshuaj tsaug zog tshuaj lom. Cov tshuaj Hepato-enteric ncig ua dua yog muab cov ncau rau cov plob zom mov rau lub plab zom mov, uas ua lub luag haujlwm ntawm lub plab hnyuv plab. Muab piv nrog cov kua zaub kev ua lav, nws tshem tawm cov tshuaj lom kom huv ntxiv thiab tiv thaiv kev nqus ntawm cov tshuaj lom, thiaj li txo cov nyhuv tshuaj lom rau hauv lub cev. Kev puas tsuaj rau cov kabmob ua rau tiv thaiv kom tsis txhob muaj teeb meem. Qhov sib txawv ntawm cov khoom siv feem ntau quav hnyuv quav hauv lub teb chaws txawv teb chaws, tom kawg yuav tsum txhaj tshuaj ntau ntau ntawm cov tshuaj polyethylene glycol sai sai los ntawm lub qhov ncauj kom txog thaum cov quav tawm mus ua kom pom tseeb. Cov hnyuv ntxig tas li yog qhov tshwj xeeb rau cov tshuaj lom uas tsis nqus los ntawm cov roj carbon (lithium, hlau), cov tshuaj uas nyob hauv cov hnyuv ntev ntev, xws li qee cov tshuaj siv ntev-tso cov ntsiav tshuaj (xws li calcium antagonists), thiab cov nqa khoom uas nqos tau ntau ntawm cov tshuaj. Polyethylene glycol tsis yog nqus thiab yuav tsis ua rau tus neeg mob' s dej thiab ntsha tsis zoo.
3. Hemoperfusion kho mob ntawm kev lom hnyav heev
Hemoperfusion yog kom tshem tawm cov tshuaj lom nyob rau hauv cov ntshav los ntawm cov adsorption ntawm cov adsorbent hauv lub ntim tshuaj tsw qab. Nws yog ib txoj kev lees paub los kho ntau yam tshuaj phiv ntau ntau kom txuag tau cov neeg mob' lub neej. Cov adsorbents uas nquag siv hauv tsev kho mob yog tsuas yog ua kom cov pa roj carbon thiab cob. Ob qho muaj qhov sib txawv adsorption zoo rau cov tshuaj sib txawv. Cov pa roj carbon ua kom muaj adsorption muaj zog rau cov tsis muaj-polar thiab hydrophobic lwg me me, thaum cov khoom hnyav muaj cov adsorption muaj peev xwm rau ntau yam lipophilic thiab hydrophobic tshuaj xws li bilirubin thiab ruaj khov. Cov.
Saib lub ntsej muag daim ntawv thov ntawm hemoperfusion mus rau kev lom: cov roj molecular yog qhov loj, cov roj solubility muaj ntau, thiab cov tshuaj thiab cov tshuaj lom uas yooj yim ua ke nrog cov protein hauv lub cev muaj cov txiaj ntsig tshem tawm zoo. Cov tshuaj thiab tshuaj lom uas tuaj yeem nqus tau los ntawm hemoperfusion suav nrog barbiturates, tsis-barbiturates, hypnotic sedatives, antipsychotics, antipyretic analgesics, tshuaj plawv ntshav, tshuaj tua kab, tshuaj tua kab, thiab lwm yam. ; ETxoj kev soj ntsuam cov tsos mob, xws li hypotension, hypothermia, hypoxemia, plawv nres, ua pa tsis ua hauj lwm, thiab lwm yam.; ③Txoj kev mob ntawm lub hlwb tsis txaus lossis ua rau cov neeg mob tsis nco qab; EMuaj qhov teeb meem tom qab lom, xws li mob ntsws thiab mob raum tsis zoo; Txawm tias nws tsis muaj cov tsos mob hnyav tom qab lom, nws kwv yees tias qhov tshuaj lom yuav nqus ntxiv, thiab lub neej muaj mob yuav tshwm sim tom qab, xws li paraquat, methanol thiab lwm yam tshuaj lom; ⑥ Cov neeg mob uas muaj lub siab ua mob rau daim siab ua ntej los yog mob raum raug kwv yees tias muaj detoxification tsis ua haujlwm; ConcentrationTxoj kev ntshav ntawm cov tshuaj lossis cov tshuaj lom tsis tau mus txog rau lub sijhawm ua kom tuag lossis muaj pes tsawg leeg tsis paub, txawm hais tias lwm yam kev ntsuas tau mob siab, tus mob tseem loj zuj zus ntxiv.
4. Tshaj tawm adsorption thiab tshwj xeeb adsorption hauv kev ua kom huv ntshav
Daim ntawv thov ntawm adsorbents hauv kev siv tshuaj kho mob tau tsim rau hauv ceg tseem ceeb ntawm kev tshawb nrhiav biomedical engineering. Nyob rau tib lub sijhawm, nws tseem muab cov txheej txheem kho tshiab rau kev siv tshuaj, qhib lub qhov rooj rau ntau cov kab mob loj thiab nyuaj thiab txawm tias" cov kab mob tsis tuaj yeem" ;. , Tau dhau los ua ib qho ntawm cov cim tseem ceeb ntawm kev tsim kho hauv tsev kho mob. Tam sim no, daim ntawv thov raug ntawm adsorbents hauv tshuaj yog ntshav ntxuav. Kev ntxuav ntshav yog ib txoj kev tseem ceeb kom tshem tawm cov tshuaj lom cov ntshav thiab kab mob. Nws kuj tseem muaj feem xyuam rau kev nyab xeeb ntawm cov ntshav thiab cov ntshav, tshwj xeeb yog kis kab mob tom qab hloov ntshav. Txhawj txhawj xeeb. Kev ua kom muaj pa roj carbon ua ib qho ntawm adsorbents muaj ntau qhov dav, tab sis cov adsorption xaiv qhov tsawg. Txhawm rau txhim kho qhov kev siv tshuaj kho mob ntawm cov roj carbon activated, nyob rau xyoo tsis ntev los no, cov kev tshawb fawb hauv tsev thiab txawv teb chaws tau ua tiav ntawm kev tsim tshuab, siv hom thiab txhim kho cov adsorption kev ua haujlwm ntawm cov roj carbon activated, thiab kev nce qib tau nrawm dua. Ntau cov kua roj hydrophilic tau tshwm sim tom qab ua ke. , Activated carbon coated nrog cov ntaub ntawv polymer, carbon fiber, carbon zaj duab xis, carbon fiber ntaub thiab lwm yam kev kho mob ua kom carbon adsorbents. Txhim kho cov pa roj carbon ua kom zoo nkauj adsorbent tau txhim kho nws cov kev ua tiav rau qib sib txawv.
Txog rau tam sim no, nws tau lees paub tias kev xaiv siab siab thiab tshem tawm tsis tu ncua ntawm cov tshuaj nruab nrab-cov tshuaj molecular hauv cov ntshav ntawm cov neeg mob muaj qhov tseem ceeb tseem ceeb hauv tsev kho mob. Cov tshuaj nruab nrab hauv nruab nrab yog cov tshuaj lom loj uas nthuav tawm hauv cov ntshav ntawm cov neeg mob uas muaj kab mob loj xws li uremia, mob rau daim siab thiab mob ntsws qhuav. Nws kuj tseem muaj ntau cov kab mob uas tau nce qib theem nruab nrab ntawm cov khoom nruab nrab, xws li mob rheumatism, ua xua, ntau yam khoom hauv lub cev tsis ua haujlwm, Aluminium hyperplasia tau dhau los ua thaj chaw kho rau cov ntshav ua kom huv. Hemoperfusion thev naus laus zis tau tsim los ntawm kev tshaj tawm adsorption mus rau qhov tshwj xeeb adsorption thiab immunoadsorption; kev kho mob ntawm cov kab mob kuj tau nthuav dav vim cov khoom siv tshiab, los ntawm kev siv tshuaj lom neeg thiab tshuaj lom cov tshuaj lom mus rau uremic molecular tshem tawm, adsorption ntawm cov ntshav lipids, cov roj (cholesterol), bilirubin ntau, thiab lwm yam; Kev kho mob ntawm cov kab mob tiv thaiv kab mob tiv thaiv kab mob xws li kab mob lupus erythematosus, mob caj dab, mob caj dab, Guillain Barril, myasthenia gravis, ntau yam mob myeloma, nrog rau cov neeg mob hemophilia thiab kab mob siab B nrog rau antigen saum npoo tsis ua tsis zoo; nws tau tshaj tawm, Siv hemoperfusion rau lub qog ua haujlwm tsis txaus, schizophrenia, psoriasis thiab lwm yam kab mob, tshuaj tua kab mob adsorption, detoxification, thiab lwm yam.
5. Kev pabcuam phais mob thiab kev kho mob ntxiv ntawm qog hlav hlav
Cov pa roj carbon tshuab ua kom siv tau rau adsorb sib txawv ntawm cov tshuaj tiv thaiv qog noj ntshav, xws li mitomycin, arubicin, bleomycin, thiab lwm yam tsiaj sim tau lees paub tias nyob hauv tib qho kev ua haujlwm, nws cov tshuaj lom yog tsawg dua li ntawm cov aqueous formulation ntawm cov tshuaj tua kabmob. Cov roj carbon tshuab hluav taws xob muaj cov npluas siab zoo nkauj thiab muaj cov khoom lag luam adsorption, tuaj yeem tawm cov tshuaj tiv thaiv qog noj ntshav, thiab muaj cov yam ntxwv ua kom qeeb-tso tawm. Ntawm ib sab tes, ua kom cov pa roj carbon adsorption tiv thaiv tshuaj tua kabmob kheesxaws tuaj yeem hais kom faib rau cov leeg thiab tswj lub siab ntev rau lub sijhawm ntev; ntawm qhov tod tes, kev ua kom cov pa roj carbon hlau tuaj yeem ua rau cov qog ntshav tawm thaum tsiv mus rau lub qog ua kua, thiaj li ua rau cov qog ntshav tshem tawm phais thiab tshem tawm cov qog ntshav tawm. Vim tias cov pa roj carbon activated muaj cov yam ntxwv ntawm kev ua haujlwm qeeb-tso tawm, lymphatic tropism, kev saib xyuas hauv zos, adsorption rau cov qog thiab lub qog, thiab cov tshuaj lom tsawg thiab phiv, nws cov ntawv thov kev kho mob tau nce ntxiv. Cov kev tshawb nrhiav kab mob tam sim no tsom rau kev ua kom lub cheeb ntawm cov pa roj carbon ntau yam haum rau qhov kev thauj khoom ntawm cov lymphatic system; kev tsim tawm ntawm adsorbed cov tshuaj tiv thaiv kabmob kheesxaws tsim kom muaj cov kabmob sib txawv thiab cov koob tshuaj ntawm cov tshuaj tiv thaiv kabmob kheesxaws, txo kev tshwm sim ntawm kev mob nyhav, thiab ua rau lub hom phiaj tua cov kabmob hlwb tuag lossis tiv cov kabmob lymphatic metastasis ntawm cov qog nqaij hlav cancer, qhib tshiab thaj chaw rau kev kho mob qog hlav.
Cov pa roj carbon tshuab hluav taws xob tso rau hauv cov qog thiab cov nqaij mob ib puag ncig mus txog ib nrab xyoo, maj mam tso cov tshuaj tua kab mob siab rau hauv zos tua cov qog ntshav thiab kho qog noj ntshav. Siv khiav ntawm qhov tsaus nti thiab adsorption stagnation cuam tshuam los ntawm cov pa roj carbon activated, nws tuaj yeem siv rau kev kho mob rau txoj kev mob plab phais los ntawm kev txhaj tshuaj tiv thaiv cov pa roj carbon kom pom kev coj ua cov kab mob lymphatic.
6. Tsim cov chaw thov tshiab
Xyoo tsis ntev los no, cov chaw kho mob tshiab ntawm cov pa roj carbon activated tau hais tawm tas li. Hauv kev phais mob ua kom loog, kev siv cov pa roj carbon monoxide tau siv los lim ib lub voj kaw kom nqus tau cov tshuaj loog roj ntau dhau. Lub sijhawm rov qab los ntawm pawg tau sim tau luv dua li pawg pab pawg tau tswj hwm. Nyiv xaiv siv spherical ua kom cov pa roj carbon monoxide raws li cov khoom siv adsorption AST-120 qhov ncauj ua kom cov pa roj carbon ntau (0.2 ~ 0.3mm inch) rau kev sim cov dev uas muaj lub siab thiab mob raum, uas ua rau lawv lub neej ntev dua. Cov pa roj no ua rau cov pa roj carbon monoxide ua rau cov khoom ua rau cov nyom thiab tshem lawv tawm ntawm lub cev, thiaj li ua kom cov pa tshuaj lom tsawg tsawg hauv lub cev. Cov txiaj ntsig ntawm kev soj ntsuam pom tau hais tias lub sijhawm lim ntshav tau ntxiv ntev txog 9 lub hlis thaum pib ntawm cov neeg mob raum tom qab noj, thiab txawm tias qee kis tsis tas yuav raug lim ntshav tom qab siv nws 2 xyoos. Tib lub sijhawm, los kho cov pore loj thiab faib tawm cov roj carbon activated, nws tuaj yeem adsorb sib txawv cov tshuaj thiab cov kab mob. Yog li ntawd, cov pa roj carbon activated ntawm cov tshuaj tua kab mob hauv cov tshuaj siv tau tuaj yeem siv los ua kom exogenous granulomas, thiab cov metastases ntawm cov qog plab yuav taug qab raws li lawv cov kev hloov sib txawv hauv CT scans.
