血浆置换治疗在儿科危重患者抢救中的经验

Experiences of plasmapheresis in the treatment of severe and critical diseases in children

目的探讨血浆置换治疗在儿科危重症患者的应用价值和治疗方案。方法应用GAMBRO-PRISMA床旁血滤机和TPE2000膜式血浆分离器对15例危重症患儿(1岁10月～15岁,平均6.8岁)进行39次血浆置换治疗;以新鲜冰冻血浆作置换液,置换量为40～70ml/(kg·次),血泵速度为50～120ml/min,治疗时间2～3h/次;结果39次血浆置换治疗均顺利成功实施,无明显并发症出现;14例在治疗后临床症状及生化指标好转,5例痊愈。结论血浆置换可以应用于多种危重症儿科疾病,治疗方案需根据病情制定。

Objective To explore clinical therapeutic effect and program of plasmapheresis in the treat-ment of critical diseases in children. Methods We retrospectively studied the effectiveness of plasmapheresis in 15 patients （22 months to 15 years old, mean 6.8 years） with severe and critical diseases. Plasmapheresis was per- formed by the PRISMA machine and the TPE2000 membrane plasma separator using freshly frozen plasma as the exchanger. The average total exchange volume was 40-70ml/kg, achieved a blood flow rate of 50-120ml/min over the duration of 2-3 hours. Results We successfully carried out 39 times of plasmapheresis for 15 severe and critical children without any apparent complications. After plasmapheresis, clinical status and biochemistry parameters improved in 14 children, and full recovery gained in 5 cases. Conclusion Plasmapheresis appears to be safe and effective for the treatment of severe and critical diseases in children.