血液透析治疗儿童蜂蜇伤致急性肾损伤60例临床观察

Clinical observation on hemodialysis in treating 60 cases of acute kidney injury caused by bee sting

目的总结蜂蜇伤致急性肾损伤患儿的临床特征及血液透析治疗的效果。方法回顾性分析60例蜂蜇伤致急性肾损伤患儿的临床特征及实验室资料。结果急性肾损伤患儿透析后胱抑素C、血肌酐、尿素氮显著下降,同时降钙素原、超敏C反应蛋白、酸中毒和电解质紊乱等得到纠正或改善。60例患儿经过透析后45例临床治愈,13例明显好转出院,2例死亡。结论蜂蜇伤最容易致患儿急性肾损伤,血液透析是急性肾损伤有效的治疗措施,能积极的改善肾脏的功能,无明显的酸碱平衡及电解质紊乱等并发症。但患儿预后与急性肾损伤发病年龄,损伤程度,是否合并多脏器衰竭、诊治时机等密切相关。

Objective To summarize the clinical features of bee sting caused aute kidney injury in children and the effect of he-modialysis therapy .Methods 60 children cases of bee sting caused acute renal injury were performed the retrospective analysis on the clinical features and laboratory data .Results Cystatin C ,serum creatinine ,blood urea nitrogen in children patients with acute kidney injury after hemodialysis were significantly decreased ,while procalcitonin ,high-sensitivity C-reactive protein ,acidosis and e-lectrolyte imbalance also were corrected or improved .After hemodialysis in 60 children cases ,45 cases were clinically cured ,13 cases were significantly improved and discharged and 2 cases died .Conclusion Bee sting is most likely to result in children acute renal in-jury .Hemodialysis is safe and effective treatment measures for acute kidney injury ,can actively improve the renal function without significant complications of acid-base balance and electrolyte imbalance .But the prognosis is closely related with the onset age of the aute kidney injury ,injury severity ,where or not accompanied by MOF ,opportunity of diagnose and treatment ,etc .