中国输血杂志2024，Vol.37Issue(7)：728-733,6.DOI:10.13303/j.cjbt.issn.1004-549x.2024.07.002
血浆置换介入时机与肝损伤分期对劳力性热射病患者预后的影响研究
Impact of therapeutic plasma exchange intervention timing and liver injury periodization on the prognosis of pa-tients with exertional heat stroke
何宗忠 1权香 2江颖 2周谋 3康红军 4于洋 2王敏 4庄远 2林洁 2张雷英 2邹立洋 2李玲玲 2马春娅 2刘晓敏2
作者信息
- 1. 解放军总医院第一医学中心 输血医学科,北京 100853||南部战区总医院 输血医学科
- 2. 解放军总医院第一医学中心 输血医学科,北京 100853
- 3. 南部战区总医院 输血医学科
- 4. 解放军总医院第一医学中心 重症医学科
- 折叠
摘要
Abstract
Objective To explore the prognostic impact and clinical application value of therapeutic plasma exchange(TPE)intervention timing and liver injury periodization in patients with exertional heat stroke(EHS).Methods Data of 127 EHS patients from the First Medical Center of the General Hospital of the People′s Liberation Army from January 2011 to December 2023 were collected,then divided into the death group and the survival group based on therapeutic outcomes and into 5 stages according to the dynamic changes of ALT,AST,TBIL and DBIL.According to propensity score matching analysis,11 patients in the survival group and 12 patients in the death group were included in the statistical analysis,and 20 of them were treated with TPE.The changes in indicators and clinical outcomes before and after TPE were observed,in order to evaluate the impact of intervention timing on prognosis.Results Among the 23 patients,14 had no liver injury or could progress to the repair phase,resulting in 3 deaths(with the mortality rate of 21.43%),while 9 patients failed to pro-gress to the repair phase,resulting in 9 deaths(with the mortality rate of 100%),with significant differences(P＜0.05).The mortality rate of the first TPE intervention before the third stage of liver injury was 23.08%(3/13),while that of interven-tion after reaching or exceeding the third stage was 85.71%(6/7),and the difference was statistically significant(P＜0.05).Conclusion TPE should be executed actively in EHS patients combined with liver injury before the third phase to lock its pathological and physiological processes,thereby improving prognosis and reducing mortality.关键词
劳力性热射病/肝损伤/血浆置换Key words
exertional heat stroke(EHS)/liver injury/therapeutic plasma exchange分类
医药卫生引用本文复制引用
何宗忠,权香,江颖,周谋,康红军,于洋,王敏,庄远,林洁,张雷英,邹立洋,李玲玲,马春娅,刘晓敏..血浆置换介入时机与肝损伤分期对劳力性热射病患者预后的影响研究[J].中国输血杂志,2024,37(7):728-733,6.
