中国全科医学2011，Vol.14Issue(11)：1205-1207,1210,4.
不同剂量糖皮质激素联合血液净化治疗蜂蜇伤所致多器官功能障碍综合征的疗效研究
Effectiveness of Different Dosages of Glucocorticoid Combined with Blood Purification in Treating Multiple Organ Dysfunction Syndrome Following Bee Sting
刘雷 1李良志 1何先红 1汤跃武 1史继红 1吴泽成 1刘春秋 1佘青1
作者信息
- 1. 404000,重庆市,重庆三峡中心医院肾内科
- 折叠
摘要
Abstract
Objective To investigate the effectiveness of different dosage of glucocorticoid combined with blood purification in treating multiple organ dysfunction syndrome following bee sting. Methods The clinical data of 81 patients with bee sting injury between January 2004 and February 2010 were retrospectively analyzed, among whom 57 patients ( 70. 37％ ) suffered from multiple organs dysfunctional syndrome ( MODS ). These 57 cases were administered with glucocorticoid and blood purification ( HP/HD ), and were divided into two groups based on the dose of methylprednisolone : HMP group : HP/HD + methylprednisolone pulse therapy ( n = 26 ); and HP/HD + conventional high - dose methylprednisolone therapy ( HMC group, n = 31 ).In the HMP group, methylprednisolone ( 0. 5 g or 1. 0 g, given every day for 3 times ) was given, followed hy conventional methylprednisolone ( 40 ～ 80 mg/d ) therapy. In the HMC group, methylprednisolone ( 80 ～ 160 mg/d ) was given. Both two groups were given HP/HD once daily for three days, and then hemodialysis ( HD ) was performed three times per week. Results In the HMP group, 21 patients ( 80. 77％ ) were smoothly discharged after their conditions had been improved, 4 patients ( 5％ ) died in hospital, and 1 patients died after discharge. In the HMC group, 22 patients ( 70. 97％ ) were smoothly discharged after their conditions had been improved, 7 patients died in hospital, and 2 patients died 48 hours after discharge. The survival rate ( 80. 77％ ) of the HMP group was not significantly higher than that of the HMC group ( P ＞ 0. 05 ). The serum creatinine ( SCr ) . bilirubin total ( TBIL ), alanine aminotransferase ( ALT ), lactate dehydrogenase ( LDH ), creatine kinase ( CK ), MB isoenzyme of creatine kinase ( CK - MB ), white blood cell ( WBC ), and hemoglobin ( HB ) were not significantly different between HMP group and HMC group on the first day after admission ( all P ＞0. 05 ) but were showed significant differences on the 7th day after admission ( all P ＜ 0. 05 ). The days required for entering diuresis stage in the HMC group were obviously lower than those in the HMP group ( P ＜ 0. 05 ). Conclusion Compared with conventional high - dose hormone therapy, methylprednisolone pulse therapy may speed up the improvement of impaired organ functions and shorten the hospital stay; however, whether it is helpful to increase the survival rate requires further research.关键词
蜂蜇伤/多器官功能障碍综合征/血液灌流/血液透析/糖皮质激素分类
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刘雷,李良志,何先红,汤跃武,史继红,吴泽成,刘春秋,佘青..不同剂量糖皮质激素联合血液净化治疗蜂蜇伤所致多器官功能障碍综合征的疗效研究[J].中国全科医学,2011,14(11):1205-1207,1210,4.
