血浆置换辅助治疗儿童危重症的疗效及安全性

发布时间：2018-02-05 20:29

本文关键词： 儿童危重症血浆置换小儿危重病例评分疗效　出处：《山东医药》2017年36期 　论文类型：期刊论文

【摘要】：目的探讨血浆置换辅助治疗儿童危重症的疗效及安全性。方法采用血浆置换辅助常规疗法治疗危重症患儿60例。其中,脓毒症合并多脏器功能不全(MODS)12例、急性肝衰竭(ALF)6例、巨噬细胞活化综合征(MAS)12例,经免疫抑制剂治疗未见好转;溶血尿毒综合征(HUS)18例、狼疮性肾炎合并MODS 6例、格林巴利综合征(GBS)6例。治疗前小儿危重病例评分为(72.4±3.2)分。患儿均在常规治疗的基础上行血浆置换,每例1~4次。观察血浆置换前后小儿危重病例评分、治疗结局,血浆置换前后平均动脉压、血氧饱和度和心率以及治疗期间不良反应情况。结果 60例患儿共进行168例次血浆置换,血浆置换前后危重病例评分分别为(72.4±3.2)、(90.3±5.3)分,二者比较P0.05。60例患儿中,死亡12例,其余48例治疗后平均动脉压、血氧饱和度和心率较治疗前明显改善,治疗期间均未发生低血压性休克、低钙惊厥和多脏器出血等严重不良反应,达到临床治愈并出院。结论血浆置换辅助治疗儿童危重症疗效确切且较为安全。
[Abstract]:Objective to investigate the efficacy and safety of plasma exchange adjunctive therapy for critical children. Methods 60 critically ill children were treated with plasma exchange adjunctive routine therapy. There were 12 cases of sepsis complicated with multiple organ dysfunction, 6 cases of acute liver failure and 6 cases of ALF, 12 cases of macrophage activation syndrome. There were 18 cases of hemolytic uremic syndrome and 6 cases of lupus nephritis with MODS. There were 6 cases of Guillain-Barre syndrome (GBS). The score of critical children before treatment was 72.4 卤3.2. Plasma exchange was performed on the basis of routine treatment. The scores, therapeutic outcome and mean arterial pressure before and after plasma exchange were observed. Results 168 times of plasma exchange were performed in 60 children. The scores of critical cases before and after plasma exchange were 72.4 卤3.2). The mean arterial pressure, blood oxygen saturation and heart rate were significantly improved after treatment in 48 cases of P0.05.60 cases (P 0.05.60). There were no severe adverse reactions such as hypotensive shock, hypocalcemia convulsion and multiple organ hemorrhage during the treatment. Conclusion Plasma exchange is effective and safe in the treatment of critical children.
【作者单位】：广州市妇女儿童医疗中心;
【基金】：广东省自然科学基金资助项目(2015A030313682)
【分类号】：R720.597

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