中国小儿急救医学
中國小兒急救醫學
중국소인급구의학
CHINESE PEDIATRIC EMERGENCY MEDICINE
2012年
4期
390-392
,共3页
血浆置换%溶血尿毒综合征%儿童
血漿置換%溶血尿毒綜閤徵%兒童
혈장치환%용혈뇨독종합정%인동
Plasma exchange%Hemolytic uremic syndrome%Children
目的 探讨血浆置换在治疗溶血尿毒综合征(hemolytic uremic syndrome,HUS)中的意义.方法 对本院2008年1月至2010年12月收治的16例HUS患儿进行血浆置换治疗;以新鲜冰冻血浆作置换液,治疗时间每次2～3h.结果 16例患儿经血浆置换治疗均存活,无明显并发症出现.全部患儿首次治疗后病情明显缓解;12 -72 h,黄疸消失,血肌酐[(385.0±189.4)μmol/L vs( 100.0±19.3)μmol/L]、乳酸脱氧酶明显下降[(799.3±289.8)U/L vs (300.0±100.4) U/L],血小板计数[(45.0±18.8)×109/L vs( 120.0±20.0)×109/L]、血红蛋白回升[(59.3±15.3) g/L vs (120.0±18.3) g/L],差异均有统计学意义(P＜0.05).出院时15例患儿症状消失,14例实验室检查正常.住院时间为15 ～57 d.结论 血浆置换可以有效缓解病情,清除血浆致病物质,及时阻断HUS的病理过程,补充血浆中有效成分.推荐血浆置换作为治疗HUS的首选治疗方案.
目的 探討血漿置換在治療溶血尿毒綜閤徵(hemolytic uremic syndrome,HUS)中的意義.方法 對本院2008年1月至2010年12月收治的16例HUS患兒進行血漿置換治療;以新鮮冰凍血漿作置換液,治療時間每次2～3h.結果 16例患兒經血漿置換治療均存活,無明顯併髮癥齣現.全部患兒首次治療後病情明顯緩解;12 -72 h,黃疸消失,血肌酐[(385.0±189.4)μmol/L vs( 100.0±19.3)μmol/L]、乳痠脫氧酶明顯下降[(799.3±289.8)U/L vs (300.0±100.4) U/L],血小闆計數[(45.0±18.8)×109/L vs( 120.0±20.0)×109/L]、血紅蛋白迴升[(59.3±15.3) g/L vs (120.0±18.3) g/L],差異均有統計學意義(P＜0.05).齣院時15例患兒癥狀消失,14例實驗室檢查正常.住院時間為15 ～57 d.結論 血漿置換可以有效緩解病情,清除血漿緻病物質,及時阻斷HUS的病理過程,補充血漿中有效成分.推薦血漿置換作為治療HUS的首選治療方案.
목적 탐토혈장치환재치료용혈뇨독종합정(hemolytic uremic syndrome,HUS)중적의의.방법 대본원2008년1월지2010년12월수치적16례HUS환인진행혈장치환치료;이신선빙동혈장작치환액,치료시간매차2～3h.결과 16례환인경혈장치환치료균존활,무명현병발증출현.전부환인수차치료후병정명현완해;12 -72 h,황달소실,혈기항[(385.0±189.4)μmol/L vs( 100.0±19.3)μmol/L]、유산탈양매명현하강[(799.3±289.8)U/L vs (300.0±100.4) U/L],혈소판계수[(45.0±18.8)×109/L vs( 120.0±20.0)×109/L]、혈홍단백회승[(59.3±15.3) g/L vs (120.0±18.3) g/L],차이균유통계학의의(P＜0.05).출원시15례환인증상소실,14례실험실검사정상.주원시간위15 ～57 d.결론 혈장치환가이유효완해병정,청제혈장치병물질,급시조단HUS적병리과정,보충혈장중유효성분.추천혈장치환작위치료HUS적수선치료방안.
Objective To investigate the significance of plasma exchange (PE) treatment on children with hemolytic uremic syndrome (HUS).Methods From Jan 2008 to Dec 2010,16 patients diagnosed with HUS were included in this study,and PE was carried out on them.Frozen plasma was taken as replacement fluid,and the treatment time was 2 to 3 hours per time.Results All the 16 patients after PE treatment were survived without any apparent complications.The condition obviously alleviated after initial treatment.In 12 to 72hours,the icterus disappeared,serum creatinine [ ( 385.0 ± 189.4 ) μmol/L vs ( 100.0 ± 19.3 ) μmol/L ] and lactate dehydrogenase [ (799.3 ± 289.8 ) U/L vs (300.0 ± 100.4) U/L ] declined obviously ( P ＜ 0.05 ) and platelet count [ (45.0 ± 18.8 ) × 109/L vs ( 120.0 ± 20.0 ) × 109/L ],hemoglobin [ ( 59.3 ± 15.3 ) g/L vs ( 120.0 ± 18.3) g/L] rised( P ＜ 0.05 ).In the end,symptoms disappeared in 15 patients,laboratory examination returned to normal in 14 cases.Hospitalization time was 15 to 57 days.Conclusion PE can effectively relieve the illness and remove plasma pathogenic substances,block the pathological process of HUS and supply useful ingredients.Recommend PE as the fhst option in the treatment of HUS.
