摘要
Objective:To investigate the therapeutic effects of hybrid renal replacement therapy (HRRT) in patients with severe snake bite. Methods: 15 patients treated with HRRT from July in 2005 to August in 2009 were involved in the study, all patients were established ascular access by central venous catheter, polysulfone membrane connected absorption hemoperfusion cartridge, the blood flow rate was 200 ml/min, the dialysate flow rate was 300 ml/min, heparin or low molecular heparin was used as anticoagulant, treatment time was 6 to 12 hours. Observe the biochemical indicators and APACHE II score before and after HRRT and clinical outcomes of the patients. Results: The level of serum creatinine, glutamic-oxalacetic transaminease, glutamic-pyruvic transaminease, creatine kinase isozyme MB, and creatine kinase were significantly lower than the level before HRRT(P<0.05); the level of cholinesterase was significantly higher than the level before HRRT (P<0.01); the APACHE II score before HRRT was 14.1±3.8, but decreased significantly to 7.9±1.4, 6.2±1.1 and 4.2±0.8 at the first, second and seventh day after HRRT, respectively (P<0.01). There are 3 patients died at the first, third, and fourth HRRT, respectively, the rest 12 patients were cured or improved when discharged, the survival rate was 80%, and the mortality was 20%. Conclusion: HRRT may be an effective treatment method for severe snake bite patients, which can reduce the mortality rate and increase the survival rate.
Objective： To investigate the therapeutic effects of hybrid renal replacement therapy （HRRT） in patients with severe snake bite. Methods： 15 patients treated with HRRT from July in 2005 to August in 2009 were involved in the study, all patients were established ascular access by central venous catheter, polysulfone membrane connected absorption hemoperfusion cartridge, the blood flow rate was 200 ml/min, the dialysate flow rate was 300 ml/min, heparin or low molecular heparin was used as anticoagulant, treatment time was 6 to 12 hours. Observe the biochemical indicators and APACHE II score before and after HRRT and clinical outcomes of the patients. Results： The level of serum creatinine, glutamic-oxalacetic transaminease, glutamic-pyruvic transaminease, creatine kinase isozyme MB, and creatine kinase were significantly lower than the level before HRRT （P〈0.05）; the level of cholinesterase was significantly higher than the level before HRRT （P〈0.01）; the APACHE II score before HRRT was 14.1 ± 3.8, but decreased significantly to 7.9 ± 1.4, 6.2 ± 1.1 and 4.2 ±0.8 at the first, second and seventh day after HRRT, respectively （P〈0.01）. There are 3 patients died at the first, third, and fourth HRRT, respectively, the rest 12 patients were cured or improved when discharged, the survival rate was 80%, and the mortality was 20%. Conclusion： HRRT may be an effective treatment method for severe snake bite patients, which can reduce the mortality rate and increase the survival rate.
