血液净化联合血塞通注射液治疗蜂蜇伤并多器官功能障碍综合征的临床研究  

The Clinical Study of the Blood Purification Combined with Xuesaitong Injection on Multiple Organ Dysfunction Syndrome Caused by Bee Sting

作　　者：曹平 刘琼[2] 

机构地区：[1]重庆市璧山县人民医院,重庆402760 [2]重庆医科大学附属第一医院,重庆400016

出　　处：《中国中医急症》2013年第3期358-360,共3页Journal of Emergency in Traditional Chinese Medicine

基　　金：重庆市卫生局重点课题基金(2012-1-023)

摘　　要：目的观察连续性静静脉血液滤过(CVVH)+血浆置换(PE)联合血塞通注射液治疗蜂蜇伤并多器官功能障碍患者的治疗效果。方法将患者分为治疗组(在传统治疗基础+CVVH+PE联合血塞通注射液治疗)和对照组(按传统方法治疗),ELISA检测并比较两组患者治疗前后血清TNF-α、IL-1、IL-6水平和肝肾功能、电解质、凝血功能、心肌酶谱及预后转归的结果。结果治疗组患者治疗后血清炎症因子水平显著下降,而对照组改变不明显,组间差异有统计学意义;治疗组治疗后肝肾功能、电解质、凝血功能及心肌酶谱较对照组明显改善,总体治愈率也明显高于对照组。结论蜂蜇伤并多器官功能障碍患者及时行CVVH治疗对清除炎症因子、纠正水/电解质和酸碱平衡紊乱、改善肝肾功能效果明显,特别是对重度肝功能损害及凝血功能异常患者及时行PE治疗效果良好,联合血塞通注射液治疗,能进一步改善重要器官微循环,提高蜂蜇伤并多器官功能障碍患者抢救成功率。Objective： To investigate the effect of continuous renal replacement therapy （CRRT） and plasma exchange （PE） combined with Xuesaitong Injection on patients with multiple organ dysfunction syndrome （MODS） caused by bee sting. Methods： 42 cases were divided into two group randomly. Patients in treatment group were treated with CRRT and PE combined with xuesaitong,while patients with in control group were treated with tradi- tional method. Plasma levels of TNF-α,IL-1 and IL-6 were detected by enzyme-linked immunosorbent assay （ELISA） before and after CRRT and PE combined with xuesaitong treatment,and the outcomes of liver function, renal function,level of electrolytes,coagulation function and myocardial zymogram were also detected. Results： Plasma levels were significantly decreased in treatment group after treatment,while there was no significant change in control group. All the observed indices were significantly improved in treatment group compared with control group after treatment. Conclusion： Blood purification combined with Xuesaitong Injection has significant role in clearing inflammatory cytokines, correction of electrolyte and acid-base balance disturbance,improving the outcomes of liver function,renal function,level of electrolytes, coagulation function and making a prognostic im- prove merit for the bee sting patients with MODS by bee sting.

关 键 词：连续性静静脉血液滤过 血浆置换 血塞通注射液 蜂蜇伤 多器官功能障碍 

分 类 号：R646[医药卫生—外科学]