血液净化联合常规方法治疗热射病的效果  

Effect of blood purification combined with conventional methods in treating heat stroke

作　　者：王西臻 张珊 张斌[1] WANG Xizhen;ZHANG Shan;ZHANG Bin(Emergency Department,South Branch of the Sixth People′s Hospital Affiliated to Shanghai Jiao Tong University,Shanghai,201400)

机构地区：[1]上海交通大学附属第六人民医院南院急诊科,上海201400

出　　处：《实用临床医药杂志》2024年第3期18-22,共5页Journal of Clinical Medicine in Practice

基　　金：上海市卫生健康委员会卫生行业临床研究专项立项项目(20234Y0283)。

摘　　要：目的 观察连续性血液净化(CBP)联合常规方法治疗热射病(HS)的临床疗效。方法 回顾性分析热射病患者38例的临床资料,其中死亡组6例、观察组16例,对照组16例;对照组给予常规治疗,观察组早期给予CBP联合常规治疗。比较3组患者入院时及治疗后的血压、呼吸、心率、体温等生命体征变化以及0、24、48、72 h的炎症、生化等指标变化。结果 与入院时相比较,治疗后观察组与对照组的呼吸、心率、体温下降,差异均有统计学意义(P<0.05)。入院初期观察组炎症、生化指标高于对照组,差异有统计学意义(P<0.05);治疗后2组的炎症及生化指标差异无统计学意义(P>0.05)。入院时观察组中窦性心动过速的病例多于对照组,治疗后观察组出现窦性心动过缓的病例少于对照组,差异均有统计学意义(P<0.05)。结论 早期CBP联合常规方法治疗HS可以改善预后,降低病死率。Objective To observe the clinical efficacy of continuous blood purification(CBP) combined with conventional methods for the treatment of heat stroke(HS).Methods Retrospective analysis was performed for clinical data of 38 patients with HS,including 6 cases in death group,16 cases in observation group,and 16 cases in control group.The control group received conventional treatment,while the observation group was given early CBP combined with conventional treatment.Changes in vital signs such as blood pressure,respiration,heart rate,body temperature at admission and after treatment,and changes in inflammatory and biochemical indicators at 0,24,48 and 72 h were compared among the three groups.Results Compared with the indicators at admission,the respiratory rate,heart rate,and body temperature decreased in both the observation and control groups after treatment(P<0.05).The inflammatory and biochemical indicators at initial admission were higher in the observation group than in the control group(P<0.05).However,there was no statistical significance in inflammatory and biochemical indicators between the two groups after treatment(P>0.05).There were more sinus tachycardia cases in the observation group than in the control group at admission,and the number of cases with sinus bradycardia in the observation group was less than that in the control group after treatment(P<0.05).Conclusion Early CBP combined with conventional treatment for HS can improve prognosis and reduce the case fatality rate.

关 键 词：热射病 生命体征变化 炎症指标 生化指标 连续性血液净化 

分 类 号：R459.7[医药卫生—急诊医学] R331[医药卫生—治疗学] R598[医药卫生—临床医学]