血浆置换在热射病合并多器官功能障碍综合征患者中的应用

Effect of plasma exchange on the patients of heat stroke associated with multiple organ dysfunction syndrome

目的观察血浆置换对热射病伴多器官功能障碍综合征(MODS)患者的治疗效果。方法2004-05～2006-09应用血浆置换治疗劳累型热射病伴多器官功能障碍综合征患者13例。结果10例存活,住院14～60d均痊愈出院,无后遗症；3例发生严重的弥漫性血管内凝血和多脏器功能衰竭而死亡。所有患者在治疗后心率、平均动脉压均有所改善(P＜0．05),肌酸激酶及同工酶、转氨酶、胆红素和血氨均明显下降(P＜0．05),凝血功能改善(P＜0．05),但白细胞、红细胞及血小板计数变化不明显(P＞0．05),治疗中未发现明显的副作用。结论血浆置换后患者多个脏器功能均有所改善,为治疗热射病提供了一个有效手段。

Objective To study the effect of plasma exchange （PE） on the patients of heat stroke （HS） associated with multiple organ dysfunction syndrome （MODS）. Methods Plasma exchange was used in 13 patients of exertional heat stroke （EHS） associated with MODS. Results 10 patients survived and 3 died. There were no sequelae in survival patients. The HR and MAP improved during PE （P 〈0.05）, as well as the function of blcod coagulation （P 〈0.05）. The creatine kinase （CK）, CK isoenzymes of creatine kinase（CKMB）, aspartate aminotransferase （AST） and alanine aminotransferase （ALT） obviously declined （ P 〈0.05）, as well as the bilirubin and blood ammonia （ P 〈0.05）, but the count of leukocytes, erythrocytes and platelets did not （ P 〉0.05 ）. No obvious side - effect related to PE was found. Conclusion The function of organs improved after plasma exchange, which can acts as an effective treatment of heat stroke.