中华航海医学与高气压医学杂志
中華航海醫學與高氣壓醫學雜誌
중화항해의학여고기압의학잡지
Chinese Journal of Nautical Medicine and Hyperbaric Medicine
2015年
5期
389-392
,共4页
序贯透析%海蜇蜇伤%重症%疗效
序貫透析%海蜇蜇傷%重癥%療效
서관투석%해철철상%중증%료효
Sequential dialysis%Jellyfish sting%Severe case%Therapeutic effect
目的 观察序贯透析治疗海蜇蜇伤致心衰(HF)或伴多脏器功能衰竭(MOF) 28例患者的疗效.方法 2011-2014年海蜇蜇伤引起HF患者28例,其中,男22例,女6例,年龄6～ 64岁,平均(29.83 ±8.35)岁.16例伴急性肾衰竭(ARF),8例伴休克,20例伴中心静脉压(CVP)增高,于序贯透析治疗前后以心脏多普勒超声作左室舒张末内径(LVEDd)、每搏输出量(SV)、心输出量(CO)测定和肾功能(BUN和SCr)以及CVP、血钾浓度检测,比较其结果.结果 28例治疗前后LVEDd分别是(65.00±5.51)mm和(35.00±1.42) mm,差异有统计学意义(t=7.16,P＜O.05),SV分别是(54.00±2.21)mm和(76.00±6.33)mm,差异有统计学意义(t=4.42,P＜0.05),LVEF分别是(42.80±3.71)％和(64.90±5.42)％,差异有统计学意义(t=5.91,P＜0.05),CO分别是(2.93±0.95) L/min和(5.78±1.83) L/min,差异有统计学意义(t=2.3,P＜0.05);16例伴ARF治疗前后BUN分别是(40.26 ±3.19) mmol/L和(6.15±1.03) mmol/L,差异有统计学意义(t=13.02,P＜0.05),SCr分别是(256.00±11.76) μmol/L和(106.00±6.87) μmol/L,差异有统计学意义(=9.94,P＜0.05),血钾浓度分别是(6.18±0.92) mmol/L和(4.02±0.13) mmol/L(t =3.09,P＜0.05);20例伴CVP增高患者治疗前后CVP分别是(2.66±0.33) kPa和(1.19±0.14) kPa,差异有统计学意义(t=7.56,P＜0.05).28例中5例死亡(17.86％),23例治愈(82.14％).结论 以序贯透析技术治疗海蜇蜇伤致HF或伴MOF可获明显疗效.
目的 觀察序貫透析治療海蜇蜇傷緻心衰(HF)或伴多髒器功能衰竭(MOF) 28例患者的療效.方法 2011-2014年海蜇蜇傷引起HF患者28例,其中,男22例,女6例,年齡6～ 64歲,平均(29.83 ±8.35)歲.16例伴急性腎衰竭(ARF),8例伴休剋,20例伴中心靜脈壓(CVP)增高,于序貫透析治療前後以心髒多普勒超聲作左室舒張末內徑(LVEDd)、每搏輸齣量(SV)、心輸齣量(CO)測定和腎功能(BUN和SCr)以及CVP、血鉀濃度檢測,比較其結果.結果 28例治療前後LVEDd分彆是(65.00±5.51)mm和(35.00±1.42) mm,差異有統計學意義(t=7.16,P＜O.05),SV分彆是(54.00±2.21)mm和(76.00±6.33)mm,差異有統計學意義(t=4.42,P＜0.05),LVEF分彆是(42.80±3.71)％和(64.90±5.42)％,差異有統計學意義(t=5.91,P＜0.05),CO分彆是(2.93±0.95) L/min和(5.78±1.83) L/min,差異有統計學意義(t=2.3,P＜0.05);16例伴ARF治療前後BUN分彆是(40.26 ±3.19) mmol/L和(6.15±1.03) mmol/L,差異有統計學意義(t=13.02,P＜0.05),SCr分彆是(256.00±11.76) μmol/L和(106.00±6.87) μmol/L,差異有統計學意義(=9.94,P＜0.05),血鉀濃度分彆是(6.18±0.92) mmol/L和(4.02±0.13) mmol/L(t =3.09,P＜0.05);20例伴CVP增高患者治療前後CVP分彆是(2.66±0.33) kPa和(1.19±0.14) kPa,差異有統計學意義(t=7.56,P＜0.05).28例中5例死亡(17.86％),23例治愈(82.14％).結論 以序貫透析技術治療海蜇蜇傷緻HF或伴MOF可穫明顯療效.
목적 관찰서관투석치료해철철상치심쇠(HF)혹반다장기공능쇠갈(MOF) 28례환자적료효.방법 2011-2014년해철철상인기HF환자28례,기중,남22례,녀6례,년령6～ 64세,평균(29.83 ±8.35)세.16례반급성신쇠갈(ARF),8례반휴극,20례반중심정맥압(CVP)증고,우서관투석치료전후이심장다보륵초성작좌실서장말내경(LVEDd)、매박수출량(SV)、심수출량(CO)측정화신공능(BUN화SCr)이급CVP、혈갑농도검측,비교기결과.결과 28례치료전후LVEDd분별시(65.00±5.51)mm화(35.00±1.42) mm,차이유통계학의의(t=7.16,P＜O.05),SV분별시(54.00±2.21)mm화(76.00±6.33)mm,차이유통계학의의(t=4.42,P＜0.05),LVEF분별시(42.80±3.71)％화(64.90±5.42)％,차이유통계학의의(t=5.91,P＜0.05),CO분별시(2.93±0.95) L/min화(5.78±1.83) L/min,차이유통계학의의(t=2.3,P＜0.05);16례반ARF치료전후BUN분별시(40.26 ±3.19) mmol/L화(6.15±1.03) mmol/L,차이유통계학의의(t=13.02,P＜0.05),SCr분별시(256.00±11.76) μmol/L화(106.00±6.87) μmol/L,차이유통계학의의(=9.94,P＜0.05),혈갑농도분별시(6.18±0.92) mmol/L화(4.02±0.13) mmol/L(t =3.09,P＜0.05);20례반CVP증고환자치료전후CVP분별시(2.66±0.33) kPa화(1.19±0.14) kPa,차이유통계학의의(t=7.56,P＜0.05).28례중5례사망(17.86％),23례치유(82.14％).결론 이서관투석기술치료해철철상치HF혹반MOF가획명현료효.
Objective To observe the therapeutic effect of sequential dialysis on heart failure (HF) and or multi-organ failure induced by jellyfish sting.Methods Enrolled in our study were 28 cases of jellyfish sting that occurred between 2011 and 2014.Of the 28 cases, 22 were male cases and 6 were female cases, with an age range of 6 to 64 years (29.83 ± 8.35).Sixteen cases were accompanied with acute renal failure (ARF), 8 cases with shock and 20 cases with increased central venous pressure (CVP).The left ventricular end-diastolic diameter (LVEDd), each stroke volume (SV), cardiac output (CO), blood urea nitrogen (BUN), serum creatinine (Scr), central venous pressure (CVP) and serum potassium level were detected both before and after sequential dialyses, and the obtained results were compared between the patients.Results For the 28 cases before and after sequential dialysis, mean LVEDd were (65.00 ± 5.51) mm and (35.00 ±1.42) mm (t=7.16,P＜0.05), meanSVwere (54.00±2.21) mland (76.00±6.33) ml (t=4.42,P＜ 0.05), mean LVEF were (42.80±3.71)％ and (64.90±5.42) ％ (t=5.91,P＜0.05), and mean CO (L/min) were (2.93 ± 0.95) L/min and (5.78 ± 1.83) L/min (t =2.3, P ＜ 0.05), respectively.In the 16 patients with ARF, mean BUN were (40.26 ±3.19) mmol/L and (6.15 ± 1.03) mmol/L (t =13.02,P ＜0.05), mean SCr were (256.00 ± 11.76) μmol/L and (106.00 ± 6.87) μmol/L (t =9.94, P ＜ 0.05), and mean serum potassium were (6.18 ± 0.92) mmol/L and (4.02 ± 0.13) mmol/L (t =3.09,P ＜ 0.05) respectively, before and after sequential dialysis.In the 20 patients with elevated CVP, mean CVP were (2.66 ± 0.33) kPa and (1.19 ± 0.14) kPa (t =7.56, P ＜ 0.05) respectively, before and after sequential dialysis.There was statistical significance, when comparisons were made between pre-treatment and posttreatment (P＜0.05).Of the 28 cases, 23 were cured (82.14％), with only 5 dead cases(17.86％).Conclusions Sequential dialysis was effective in the treatment of HF and or MOF induced by jellyfish sting.
