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Chinese Journal of Blood Purification ›› 2006, Vol. 5 ›› Issue (2) : 61-64.

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Abstract

Objective To observe clinical effect of plasmapheresis（PP）for Guillain-Barre syndrome and compare different methods, provid theory and practice experience for application of PP. Methods Thirty-eight patients with Guillain-Barre syndrome hospitalized during 1998～2004 were retrospectively reviened. There were 23 cases (18 male and 5 female)in PP group, age ranged from 15 to 16 years, mean age was (39.95±16.66) years.Other 15 cases (11 male and 4 female) were in non-PP group, age ranged form 20 to 70 years, mean age was (44.07±14.70)years.Baseline characteristics of the patients in two group were well-matched. Patients were evaluated. According to Hughes classification, every treatment exchanged 1～2 the patient's estimated plasma volume. Clinical symptoms and muscle tensility prior-and post-treatment were evaluated. Results The average days to improve 1 grade of hughes classification in PP group was statistically different with that in non-PP group [(10.83±9.38) vs (32.13±11.30), P＜0.01)]. The period of ventilatory support was 7 days in PP group and 18 days in non-PP group.One patient died in PP group and no case died in non-PP. Group of 23 cases in PP group，16 cases were performed by the plasma exchange (PE), 4 cases by the double filtration plasmapheresis(DFPP),and 3 cases by the plasma adsorption(PA), and the average days to improve 1 grade were 11.44 days, 7.25 days and 12.33 days respectively. Total 84 procedures in PP group，in 13 procedures occurred adverse effect(15.5%). Of the 57 procedures in PE patients, in 9 procedures occurred adverse effect, include a mouth and limbs anesthesia, urticaria, chill,fever and hypotension;4 procedures of 16 procedures in DFPP patients occurred hypotension; no complication occurred in PA(11 procedures).Conclusions PP treatment could relief clinical symptoms of GBS patient rapidly, significantly, shorten the course of disease and the period of ventilatory support, and improve the prognosis of GBS patient. Compared with PE, DFPP and PA, the incidence of complications of PE was the highest. An effective method, low-cost and minimal complication procedure should be selected.