糖皮质激素联合HP治疗对改善蜂蜇伤并横纹肌溶解预后分析

Effect of glucocorticoid combined with Hp on improving prognosis of patients with rhabdomyolysis combined with wasps stings

目的探讨糖皮质激素联合HP治疗对改善蜂蜇伤并横纹肌溶解预后分析。方法选取2018年1月至2020年2月于本院就诊收治的78例急性蜂蛰伤所致的RM患者为研究对象,随机数表法分为观察组与对照组(各39例)。对照组患者给予常规治疗+早期序贯HP治疗,观察组在对照组患者的基础上给予糖皮质激素治疗。对比两组患者治疗前、治疗后48h的生化指标、炎性指标水平及预后情况。结果观察组患者的Myo、CK、BUN、SCr指标水平显著低于对照组患者(P<0.05);观察组患者的IL-6、IL-1β、PCT及TNF-ɑ指标水平显著低于对照组(P<0.05);观察组患者AKI3期、MODS的发生率显著低于对照组患者(P<0.05)。结论糖皮质激素联合早期序贯血液灌流治疗蜂蜇伤所致RM患者可有效减轻炎症反应,降低毒性反应,改善患者预后,具有较好的应用价值。

Objective To investigate the prognosis analysis of glucocorticoid combined with HP treatment on improving the prognosis of bee stings and rhabdomyolysis.Methods Seventy-eight patients with RM caused by acute bee sting admitted to our hospital from January 2018 to February 2020 were selected as study objects,and were divided into observation group and control group by random number table method(39 cases each).Patients in the control group were given conventional treatment+early sequential HP treatment,while patients in the observation group were given glucocorticoid therapy on the basis of patients in the control group.The levels of biochemical and inflammatory indicators and prognosis were compared between the two groups 48 h before and after treatment.Result The levels of Myo,CK,BUN and SCr in the observation group were significantly lower than those in the control group(P<0.05).Observation group of patients with IL-6,IL-1 beta,PCT and TNF-ɑ index were significantly lower than the control group(P<0.05);The incidence of AKIphase,MODS lower than those in the control group(P<0.05).Conclusion Glucocorticoid combined with early sequential hemoperfusion in the treatment of RM patients caused by wasp stings can effectively reduce inflammation,reduce toxicity,and improve the prognosis of patients,which has a good application value.