血液灌流联合血液透析早期治疗重症野蜂蜇伤的临床观察

Clinical Observation:Hemoperfusion Combined with Hemodialysis in Early Treatment of Severe Hornet Stings

目的比较不同血液净化方式治疗重症野蜂蜇伤的临床疗效。方法回顾性分析汉中市中心医院肾内科2008年7月至2010年11月收治的59例重症野蜂蜇伤患者资料。按患者接受的治疗模式分组,将同意接受血液灌流加血液透析的36例患者纳入治疗组,将拒绝血液灌流加血液透析治疗,只接受普通血液透析的23例患者纳入对照组。结果治疗组患者的心肌酶谱和肝、肾功能等各项指标恢复情况均较对照组好,两组间治疗后各项指标的比较差异均有统计学意义(P<0.05)。治疗组中25例患者治愈,10例好转,1例死亡,而对照组中仅3例治愈,11例好转,有9例死亡;治疗组病死率为2.78%,对照组病死率为39.13%,两组比较差异有统计学意义(χ2=10.719,P<0.05)。治疗组的治疗效果好于对照组,比较差异有统计学意义(Z=-4.620,P<0.01)。结论对于重症野蜂蜇伤患者早期给予血液灌流联合血液透析治疗,比普通血液透析治疗可更好地降低病死率及改善预后。

Objective To compare the clinical efficacy of different blood purification treatments on patients with severe hornet sting. Methods Clinical data of 59 patients with severe hornet stings treated by Hanzhong Central Hospital of Nephrology, admitted from July 2008 to November 2010 were retrospectively analyzed. The patients were groups by received treatment mode. 36 patients, treated by blood perfusion and dialysis, were included in the treatment group, while 23 patients, treated by ordinary hemodialysis,were inclu ded in the control group. Results The myocardial enzymes and liver, renal function recovery indicators of treatment group were better than those of control group, the differences were statistically significant（P 〈0.05）. In treatment group, 25 patients were cured, 10 cases improved, and 1 patient died; while in the control group only 3 patients were cured, 11 cases improved, 9 died. The mortality of treatment group was 2.78 %, compared with 39.13% of control group, the difference was statistically significant（ χ2 = 10. 719 ,P 〈 0.05 ）. The therapeutic effect of the treatment group was better than the control group, the difference was statistically signi ficant （ Z = - 4. 620,P 〈 0.01 ）. Conclusion Early hemoperfusion combined with hemodialysis treatment is better than ordinary hemodialysis treatment to reduce mortality and improve the prognosis for patients with severe hornet stings.