血浆置换联合血液灌流治疗蛇毒中毒伴呼吸肌麻痹的临床分析

Plasma Exchange Unite Hemoperfusion in the Treatment of Ophiotoxemia Followed by Respiratory Muscles Paralysis

目的探讨血浆置换联合血液灌流治疗严重蛇毒中毒在伴有呼吸肌麻痹的患者中的应用及疗效。方法对我院急诊收治的5例毒蛇咬伤致呼吸肌麻痹的严重中毒的患者在常规治疗的基础上,加用血浆置换及血液灌流治疗,观察病情变化及患者恢复情况,评价疗效。结果 5例患者在毒蛇咬伤后,及时在常规治疗基础上进行血浆置换联合血液灌流治疗,4例患者临床治愈出院,1例患者并发急性肾功能衰竭,出院后维持每周3次的血液透析治疗2个月后,肾功能恢复。结论尽早应用血浆置换联合血液灌流治疗严重蛇毒中毒伴呼吸肌麻痹的患者,可提高抢救成功率,其疗效优于单纯常规治疗者。

Objective To explore the unite treatment of Hemoperfusion plasma exchange and Hemoperfusion in the application of the serious respiratory muscles paralysis caused by ophiotoxemia. Methods 5 cases of emergency snake bites with respiratory muscles paralysis, on the basis of routine treatment, were added with plasma exchange and Hemoperfusion treatment. To observe the condition changes and the patients＇ recovery, evaluate its efficacy. Results 4 patients cured, 1 patient with acute renal failure, and three times a week to maintain blood dialysis, renal function recovered after 2 months post -discharge. Conclusion The early application of the unite treatment of I-Iemopeffusion plasma exchange and Hemoperfusion can improve the success rate of rescue in the serious respiratory muscles paralysis caused by ophiotoxemia, its curative effect is better than pure conventional treatment.