本文關鍵詞： 兒童危重癥 血漿置換 小兒危重病例評分 療效　出處：《山東醫(yī)藥》2017年36期 　論文類型：期刊論文

【摘要】：目的探討血漿置換輔助治療兒童危重癥的療效及安全性。方法采用血漿置換輔助常規(guī)療法治療危重癥患兒60例。其中,膿毒癥合并多臟器功能不全(MODS)12例、急性肝衰竭(ALF)6例、巨噬細胞活化綜合征(MAS)12例,經免疫抑制劑治療未見好轉;溶血尿毒綜合征(HUS)18例、狼瘡性腎炎合并MODS 6例、格林巴利綜合征(GBS)6例。治療前小兒危重病例評分為(72.4±3.2)分。患兒均在常規(guī)治療的基礎上行血漿置換,每例1~4次。觀察血漿置換前后小兒危重病例評分、治療結局,血漿置換前后平均動脈壓、血氧飽和度和心率以及治療期間不良反應情況。結果 60例患兒共進行168例次血漿置換,血漿置換前后危重病例評分分別為(72.4±3.2)、(90.3±5.3)分,二者比較P0.05。60例患兒中,死亡12例,其余48例治療后平均動脈壓、血氧飽和度和心率較治療前明顯改善,治療期間均未發(fā)生低血壓性休克、低鈣驚厥和多臟器出血等嚴重不良反應,達到臨床治愈并出院。結論血漿置換輔助治療兒童危重癥療效確切且較為安全。
[Abstract]:Objective to investigate the efficacy and safety of plasma exchange adjunctive therapy for critical children. Methods 60 critically ill children were treated with plasma exchange adjunctive routine therapy. There were 12 cases of sepsis complicated with multiple organ dysfunction, 6 cases of acute liver failure and 6 cases of ALF, 12 cases of macrophage activation syndrome. There were 18 cases of hemolytic uremic syndrome and 6 cases of lupus nephritis with MODS. There were 6 cases of Guillain-Barre syndrome (GBS). The score of critical children before treatment was 72.4 鹵3.2. Plasma exchange was performed on the basis of routine treatment. The scores, therapeutic outcome and mean arterial pressure before and after plasma exchange were observed. Results 168 times of plasma exchange were performed in 60 children. The scores of critical cases before and after plasma exchange were 72.4 鹵3.2). The mean arterial pressure, blood oxygen saturation and heart rate were significantly improved after treatment in 48 cases of P0.05.60 cases (P 0.05.60). There were no severe adverse reactions such as hypotensive shock, hypocalcemia convulsion and multiple organ hemorrhage during the treatment. Conclusion Plasma exchange is effective and safe in the treatment of critical children.
【作者單位】： 廣州市婦女兒童醫(yī)療中心;
【基金】：廣東省自然科學基金資助項目(2015A030313682)
【分類號】：R720.597

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