血浆置换在急诊危重病中的应用

Application of plasma exchange therapy in critically ill patients

目的:评价急诊危重病患者中血浆置换(PE)的应用及对患者的临床疗效。方法:回顾性分析我院急诊重症监护室(EICU)2009年3月至2012年11月收治的13例行血浆置换治疗的病例,观察和比较生化指标和临床疗效。结果:13例患者平均ICU住院时间为(26.9±18.9)d,脓毒症组ICU住院时间短于非脓毒症组(P<0.01),平均病死率为46%,脓毒症组病死率高于非脓毒症组(P>0.05)。PE治疗后,血生化指标和炎症指标得到改善(P<0.05)。结论:PE可以作为急诊不同病种危重病患者尤其是脓毒症的辅助疗法。

Objective To evaluate the clinical application of plasma exchange （PE） in critically ill patients and its efficacy. Methods Data of 13 critically ill patients admitted in EICU from Mar. 2009 to Nov. 2012 who underwent PE were retrospectively analyzed. Then the biochemical markers and clinical efficacy were observed. Results The mean length of EICU stay was （26.9 _＋ 18.9） days, which was significantly shorter in septic patients than that in non-septic cases （P 〈 0.01 ）. The overall mortality was 46%, which was also higher in septic patients （P 〉 0.05）. After the PE treatment, the biochemical and inflammatory markers of patients were improved （P 〈 0.05）. Conclusions PE may be used as an adjuvant therapy to conventional therapies for critically ill patients in the ICU, particularly for septic patients.