早期连续静脉-静脉血液滤过联合血液灌流治疗群蜂蜇伤致急性多器官功能衰竭的临床疗效  

The clinical effect of the early continuous hemodialysis therapy(CVVH model)and hemoperfusion therapy combined with conventional therapy following multiple wasp stings induced acute multiple organ dysfunction

作　　者：陈庆永[1] 郑海[1] 

机构地区：[1]华中科技大学同济医学院附属协和医院急诊外科,武汉430022

出　　处：《临床急诊杂志》2016年第10期795-797,共3页Journal of Clinical Emergency

基　　金：湖北省自然科学基金(No:2014CKB517)

摘　　要：目的:探讨早期行连续静脉-静脉血液滤过(CVVH模式)配合血液灌流配合常规疗法治疗群蜂蜇伤致急性多器官功能衰竭(MODS)患者的临床疗效。方法:前瞻性选择我院2012-07-2015-10收治的严重群蜂蜇伤致急性MODS患者60例,随机分成治疗组(n=30)及对照组(n=30),治疗组早期行连续静脉-静脉血液滤过(CVVH模式)配合血液灌流治疗配合常规疗法清除血液中的毒素和肌红蛋白,血液灌流共治疗3d,1次/d;对照组仅采用常规疗法加血液透析治疗,观察2组的病死率及平均住院时间等各项指标。所有患者均签署知情同意书,符合医学伦理学规定。结果:治疗组的平均住院时间较对照组明显缩短,治疗组的病死率较对照组的病死率明显下降,2组间的差异均有统计学意义(P<0.05)。结论:早期行连续静脉-静脉血液滤过(CVVH模式)配合血液灌流配合常规疗法治疗可有效降低蜂蜇伤患者病死率并缩短住院时间。Objective：To explore the effect of the early continuous hemodialysis therapy（CVVH model）and hemoperfusion therapy combined with conventional therapy following multiple wasp stings induced acute multiple organ dysfunction.Method：A prospective study was performed on 60 patients following multiple wasp stings induced acute multiple organ dysfunction from July 2012 to October 2015 in our hospital.The subjects were assigned to experimental groups（n=30）and control groups（n=30）,the experimental groups was performed early continuous hemodialysis therapy（CVVH model）and hemoperfusion therapy combined with conventional therapy to remove toxins in the blood and myoglobin,hemoperfusion therapy for 3days,1times a day;the control groups was only performed hemodialysis combined with conventional therapy.Data regarding patients＇ average length hospital stay,mortality rate in both groups were analyzed and compared.The informed consents of all patients were obtained and local ethical committee approval had been received.Result：There were significant differences in patients＇ average length hospital stay and mortality rate between experimental groups and control groups（13.4±3.3vs19.4±4.3;3.3% vs 20%;all P〈0.05）.Conclusion：Multiple wasp stings can cause severe disease,so doctors should pay more attention.Correct and timely diagnosis and early continuous hemodialysis therapy（CVVH model）and hemoperfusion therapy combined with conventional therapy are the principal determinant of decreasing mortality in cases of multiple wasp stings.

关 键 词：蜂蜇伤 蜂毒 急性多器官功能损害 血液透析 血液灌流 

分 类 号：R197.3[医药卫生—卫生事业管理]