摘要
目的观察杂合式肾脏替代治疗急性重症蜂蛰伤患者的临床效果。方法回顾性选取2008年10月~2013年10月本院就诊的急性蜂中毒并肝肾功能损害、血液系统损害的多器官功能障碍患者,治疗组患者（n=20）在内科综合治疗的基础上及时给予血浆置换、每日连续性低效血液透析滤过、连续性血液滤过、血液灌流等肾脏替代方式;对照组患者（n=20）仅予以内科综合治疗：保护肝肾功能、输血浆、输血小板及行普通血液透析。比较两组治疗前后肝功能（ALT、AST）、肾功能（BUN、Cr）、血小板的变化。结果治疗组治疗前后肝肾功能有明显改善（P〈0.05）、血小板明显上升（P〈0.05）;对照组治疗前后肝功能、肾功能未见明显改善（P〉0.05）,血小板无明显上升（P〉0.05）,且患者大多死亡。治疗后治疗组肝肾功能较对照组显著改善（P〈0.05）;治疗组血小板较对照组显著上升（P〈0.05）。结论在综合治疗的基础上,行杂合式肾脏替代治疗急性重症蜂蛰伤患者在改其肝肾功能及血液系统损害方面较行单纯血液透析治疗组的疗效显著。
Objective To observe the clinical effect of hybrid renal replacement therapy on acute critical patients with severe bee sting. Methods Forty bee stings patients with multiple organ dysfunction syndrome,including liver and kidney functional lesion,hematological system damage were retrospectively selected in our hospital from October 2008 to October 2013,the treatment group（n=20） was given additional hybrid renal replacement therapy（plasma exchange,daily continuity inefficient hemodialysis filtration,continuous veno-venous hemofiltration,hemoperfusion） on the base of medical comprehensive treatment,and the control group（n=20） was only given regular hemodialysis and comprehensive treatment,including liver and kidney function protection,plasma and platelet transfusion.The changes of liver function（ALT, AST）,renal function（BUN,Cr）and blood platelet between the two groups were compared. Results The functions of liver and kidney in treatment group after treatment were improved significantly（P0.05）,and the platelet rised significantly（P0.05）,the liver function,renal function,did not see improved significantly（P0.05）,the platelet had no significant increase in control group before and after the treatment（P0.05）, and most of patients in control group died.After treatment,the function of liver and kidney in treatment group were improved significantly than those in control group（P0.05）, and the count of platelet in treatment group was higher than that in control group（P0.05）.Conclusion Additional hybrid renal replacement therapy in patients with acute severe bee sting has superior curative effect in improving liver and kidney function and alleviating blood system damage compare to comprehensive treatment and regular hemodialysis.
出处
《中国当代医药》
2014年第6期17-18,21,共3页
China Modern Medicine
基金
贵州省省长资金临床应用课题专项研究项目(黔省专合字[2012]128号)
关键词
杂合式肾脏替代治疗
重症蜂蛰伤
临床疗效
Hybrid renal replacement therapy
Severe bee sting
Clinical effect
