序贯应用血浆置换联合血液滤过救治重症毒蕈中毒的疗效分析  

Curative effect analysis of sequential using of plasma exchange and hemofiltration (HF) for severe mushroom poisoning

作　　者：张明玺[1] 胡健[1] 程冲[1] 段延鹏[1] 

机构地区：[1]湖北省丹江口市第一医院重症医学科,442700

出　　处：《齐齐哈尔医学院学报》2013年第10期1456-1457,共2页Journal of Qiqihar Medical University

摘　　要：目的观察血浆置换联合血液滤过救治伴有肝肾等多器官系统损害的重症毒蕈中毒患者的疗效。方法本院ICU血液净化组用血透专用深静脉导管、血滤动静脉管建立体外循环,使用BaxterBM25 CRRT机,用GAMBRO PF 2000 N血浆分离器行血浆置换(PE),接着用旭化成APS-650滤器进行CVVH治疗24 h,PE+CVVH可重复做,基础内科治疗不变。结果 16例重症患者13例完全康复,1例死亡。2例出院时仍合并肾功能不全。结论对于急性肝肾功能损害及凝血障碍毒蕈中毒患者PE+CVVH能有效的清除毒物和炎症介质,稳定内环境,改善患者的预后。Objective To observe the curative effect of sequential using of plasma exchange and hemofiltration （HF） for severe mushroom poisoning complicated by MODS. Methods Patients in bloodpurification in my ICU. The extracorporeal, circulation was built by Arrow indwelling catheter special for hemodialysis and Sucquet＇s canal special for blood hemofihration. PE was proceeded in Baxter BM25 CRRT machine and GAMBRO PF 2000 N plasma separator, and then CVVH was proceeded in APS-650 filter made by Asahi Chemical Industry for 24h. PE ＋ CVVH can be repeated, if necessary. Results Among the 16 patients, 13 fully recovered, 1 died and 2 left hospital with renal inadequacy. Conclusions PE ＋ CVVH for severe mushroom poisoning complicated by MODS can get rid of pest and mediators of inflammation efficaciously, stabilize internal environment and improve prognosis.

关 键 词：PE CVVH 毒蕈中毒 MODS 

分 类 号：R595.7[医药卫生—内科学]