血浆置换联合CVVH治疗蜂蜇伤合并MODS疗效观察

发布时间：2018-05-31 07:53

本文选题：蜂蜇伤 + MODS　；参考：《实用医学杂志》2016年16期

【摘要】：目的:探讨早期应用血浆置换(PE)联合连续静脉-静脉血液滤过(CVVH)治疗群蜂蜇伤合并多器官功能障碍综合征(MODS)患者的疗效。方法:对2009年7月至2014年10月确诊蜂蜇伤并MODS的61例患者进行回顾性研究,一组患者予CVVH治疗(对照组),另一组患者予PE联合CVVH治疗(治疗组)。两组患者均予内科治疗,病情稳定后仍存在肾衰者予血液透析。记录两组患者临床表现,监测血常规、血乳酸、血生化指标,观察病死率及ICU住院时间。结果:治疗组病死率8.3%,对照组病死率32.0%(P0.05)。两组患者治疗1周后WBC、TBIL、ALT、AST、CK、CKMB、Lac与治疗前比较显著下降(P0.001),而BUN、SCr治疗前后无明显变化(P0.05)。治疗1周后,治疗组ALT、AST、CK、CKMB、Lac、TBIL治疗前后差值与对照组治疗前后差值比较,差异有统计学意义(TBIL P0.05,其余指标P0.001)。治疗组WBC治疗前后差值与对照组治疗前后差值比较,差异无统计学意义(P0.05)。两组存活患者的平均ICU住院时间比较,治疗组低于对照组(P0.001)。结论:蜂蜇伤合并MODS的患者早期给予PE联合CVVH治疗,可降低病死率,缩短ICU住院时间。
[Abstract]:Objective: to evaluate the efficacy of plasma exchange (PEP) combined with continuous veno-venous hemofiltration (CVVH) in the treatment of bee sting complicated with multiple organ dysfunction syndrome (MODS). Methods: from July 2009 to October 2014, 61 patients with MODS were studied retrospectively. One group was treated with CVVH (control group), the other group was treated with PE combined with CVVH (treatment group). Patients in both groups were treated with internal medicine and hemodialysis was given to patients with renal failure after stable condition. The clinical manifestations, blood routine examination, blood lactic acid, blood biochemical indexes, mortality and hospitalization time of ICU were recorded. Results: the mortality of treatment group and control group were 8.3 and 32.0 respectively (P 0.05). After one week of treatment, the levels of WBC TBILT, TBILT, CKMBM, Lac, and pre-treatment were significantly decreased (P 0. 001), but there was no significant difference between the two groups before and after treatment (P 0. 05). After one week of treatment, the difference between the treatment group and the control group before and after treatment was statistically significant (P 0.001). The difference of WBC before and after treatment in the treatment group was not statistically significant compared with that in the control group (P 0.05). The average ICU hospitalization time of the two groups was lower than that of the control group (P 0.001). Conclusion: the early treatment of PE combined with CVVH in the patients with bee sting combined with MODS can reduce the mortality and shorten the hospitalization time of ICU.
【作者单位】：河南科技大学第一附属医院;
【分类号】：R646;R459.7

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