硫化氢中毒行体外膜肺氧合治疗患者的抗感染方案分析  

Analysis of Anti-infective Therapy for Patients with Hydrogen Sulfide Poisoning Treated by ECMO

作　　者：张莹 张国桃[1] ZHANG Ying;ZHANG Guotao(Department of Pharmacy,the Second People’s Hospital of Huai’an,Huai’an 223001,China)

机构地区：[1]淮安市第二人民医院药学部,淮安223001

出　　处：《药学与临床研究》2024年第4期364-366,共3页Pharmaceutical and Clinical Research

摘　　要：目的:分析坠落下水道致硫化氢气体中毒并接受体外膜肺氧合(ECMO)治疗患者的治疗方案及预后。方法:回顾性分析2021~2022年我院3例因硫化氢中毒接受ECMO治疗的患者临床资料。结果:3例中年男性患者因硫化氢中毒入院,均接受呼吸支持及对症治疗。由于呼吸和循环衰竭,所有患者均接受ECMO联合连续肾脏替代(CRRT)治疗。初始抗感染治疗采用比阿培南联合利奈唑胺,分析ECMO及CRRT对抗菌药物药代动力学的影响,并依据患者具体情况调整药物。病例1和病例2在治疗后病情好转并脱机,转入普通病房继续治疗。病例3病情危重,最终因多器官衰竭死亡。结论:硫化氢中毒重症患者早期应用ECMO联合CRRT可改善预后。由于严重感染、器官功能障碍等影响,需根据患者血药浓度监测情况调整抗菌药物剂量,制定个体化治疗方案。Objective:To analyze the treatment regimens and prognosis of patients with hydrogen sulfide poisoning due to falling into a sewer,who subsequently received ECMO therapy.Methods:A retrospective analysis was conducted on the clinical data of three patients who received ECMO treatment for hydrogen sulfide poisoning at our hospital from 2021 to 2022.Results:Three middle-aged male patients were admitted due to hydrogen sulfide poisoning,all of whom received respiratory support and symptomatic treatment.Due to respiratory and circulatory failure,all patients underwent ECMO combined with CRRT.Initial anti-infective therapy included biapenem combined with linezolid,the effects of ECMO and CRRT on the pharmacokinetics of antibiotics were analyzed,with subsequent adjustments based on specific infections.After treatment,Case 1 and Case 2 showed improvement,were weaned off ECMO,and transferred to the general ward for further treatment.Case 3 remained critically ill and eventually died from multiple organ failure.Conclusion:Early use of ECMO combined with CRRT can improve the prognosis of patients with severe hydrogen sulfide poisoning.Due to complications from severe infections and organ dysfunction,it is necessary to adjust antibiotic dosages according to the monitoring of blood drug concentration and develop individualized treatment plans.

关 键 词：硫化氢 体外膜肺氧合 抗感染治疗 

分 类 号：R595.1[医药卫生—内科学]