重型蝮蛇咬伤患者在ICU早期血液净化治疗分析  

Research on early blood purification treatment for serious viper bite in ICU

作　　者：李波[1] 万娅莉[1] 唐忠志[1] 

机构地区：[1]广州军区武汉总医院急诊科,武汉430070

出　　处：《临床急诊杂志》2013年第11期549-551,共3页Journal of Clinical Emergency

摘　　要：目的:探讨重型蝮蛇咬伤患者在ICU早期血液净化治疗效果。方法:选择我院ICU收治的重型蝮蛇咬伤患者28例,分为对照组和血液净化组,两组患者早期急救措施及治疗原则相同,血液净化组在咬伤后24h内行血液灌流(HP)+连续静脉-静脉血液透析滤过(CVVHDF)治疗。检测两组患者入院治疗前和治疗3d后的白细胞计数、C反应蛋白(CRP)、肝功能(ALT与AST)、肾功能(BUN与Cr)、肌酸激酶同工酶(CK-MB)、血清肌红蛋白(MB)水平,并统计两组患者的多器官功能衰竭发生率。将所得数据做统计学分析。结果:血液净化组患者治疗3d后,血白细胞计数、CRP、心、肝、肾功能等指标与对照组比较明显好转,且多器官衰竭发生率也低于对照组,相关数据差异有统计学意义。结论:重型蝮蛇咬伤患者早期行血液净化治疗,可有效地保护器官功能、减轻全身炎症反应,防止多器官功能衰竭的发生,提高救治的成功率。Objective：To investigate the therapeutic effects of early blood purification therapy in the treatment of serious viper bite.Method：28 patients were randomly divided into two groups,control group and blood purification group.Patients in both groups were treated with conventional therapy.Blood purification group were treated with blood purification therapy in 24 hours.The biochemical indicators（white blood cell count,C-reactive protein, liver function,renal function,CK-MB,and MB）in both groups and incidence of multiple organ failure were compared.Result：There was no significant differences for all above indexes before treatment between these two groups,but the difference of these indexes at 3 days after treatment was significant between these two groups.Conclusion：Blood purification can effectively regulate the inflammatory response and has beneficial protection on heart, liver and renal functions in patients.Blood purification can reduce incidence of multiple organ failure.

关 键 词：蛇咬伤 ICU 血液净化 多器官功能衰竭 

分 类 号：R646[医药卫生—外科学]