群蜂螫伤致急性肾功能衰竭并多器官功能障碍综合征治疗分析

Analysis of acute renal failure complicated with multiple organ dysfunction syndrome caused by bee stings

目的探讨群蜂螫伤致急性肾功能衰竭（ARF）合并多器官功能障碍综合征（MODS）的临床表现及治疗效果。方法对肾内科收治的群蜂螫伤致ARF合并MODS病人25例，使用连续性肾脏替代治疗（CRRT）联合间断血液透析（IHD）治疗。分析其肾脏及肾外表现，治疗及预后资料。结果本组患者分别发生肝脏，心脏，胃肠道，凝血，代谢或呼吸功能障碍。所有病人均接受规律血液透析，其中有13例患者接受从20～170小时不等的CRRT治疗。7～28天所有病人进入多尿期。1例死于上消化道大出血，3例死于MODS，余病人均好转出院。结论群蜂螫伤致ARF并MODS患者预后严重，CRRT联合IHD治疗效果较好。

Objective To investigate the clinical manifestation of acute renal failure （ARF） complicated with multiple organ dysfunction syndrome （MODS） caused by bee stings. Methods 25 patients with ARF combined with MODS caused by bee stings were collected, which were treated by continuous renal replacement therapy （CRRT） combined with intermittent hemodialysis （IHD）. Their renal and extrarenal manifestations, treatment process and prognosis were analyzed. Results The patients respectively suffered from liver, heart, gastrointestinal tract, blood clotting, metabolism or respiratory dysfunction. All patients received regular hemodialysis and 13 patients received CRRT treatment between 20-170 hours. All of the patients entered into diuresis stage in 7-28 days. 1 case died of massive hemorrhage of gastrointestinal tract, 3 cases died of MODS, the other patients upturned and discharged. Conclusion ARF complicated with MODS caused by bee stings has a serious prognosis. CRRT combined with IHD have a good curative effect.