血浆置换及大剂量甲泼尼龙治疗蜂螫伤致溶血性贫血的疗效分析

Clinical Observation of Plasma Exchange and Large Dose of Methylprednisolone in Rescuing Hemolysis by Wasp Sting

目的比较血浆置换（PE）与大剂量甲泼尼龙治疗蜂螫伤致溶血性贫血的疗效。方法蜂螫伤导致溶血性贫血患者35例,入院后除常规的对症处理外,拒绝行PE治疗的患者分为大剂量甲泼尼龙治疗组（n=13）,其余的22位患者采用PE方法治疗,比较两组的溶血控制时间、并发症发生率、死亡率、平均住院天数。结果与大剂量甲泼尼龙治疗组相比,PE治疗组溶血控制的时间相当,差异没有统计学意义,但该组患者的并发症发生率、死亡率、平均住院天数均低于前者,差异有统计学意义（P〈0.05）。结论 PE治疗能够有效治疗蜂螫伤所致溶血性贫血,且降低并发症的发生率,从而减低死亡率,缩短病程,减少平均住院天数,是早期治疗蜂螫伤中毒的有效手段。

Aim To observe the therapeutic effect of plasma exchange and large dose of methylprednisolone on hemolytic anemia by wasp sting. Method 35 patients of hemolytic anemia caused by wasp sting were divided into two groups. 13 patients were treated with large dose of methylprednisolone who refused being treated with plasma exchange,while the other 22 patients were treated with plasma exchange. Result After treatment, compared to the group treated with large-dose methylprednisolone ,PE treatment group has the same control time for hemolysis,but the incidence of comphcations, mortality, average length of hospital stay were significantly lower than the former. Conclusion Plasma exchange can quickly remove the toxin and lysis produce of red cells, reduce the incidence of complications, mortality, average length of hospital stay .It is effective and safe to treat acute hemolysis bywasp sting.