连续性血液净化与常规方法治疗热射病的疗效比较

Efficacy comparison of continuous blood purification and conventional therapy in the treatment of heat stroke

目的 比较连续性血液净化（CBP）与常规方法治疗热射病（HS）的疗效.方法 回顾性分析2000年1月至2013年7月本院收治的22例HS患者的临床资料.根据常规治疗过程中是否联合CBP治疗,分为CBP治疗组（n=14）和常规治疗组（n=8）,比较两组患者的体温下降时间及入院时和出院前的血肌酐（Scr）、尿素氮（BUN）、丙氨酸氨基转移酶（ALT）、天门冬氨酸氨基转移酶（AST）、肌酸激酶（CK）及病死率等.结果 CBP治疗组和常规治疗组患者体温下降时间分别为（11.92±7.44）h和（30.50±11.70）h,CBP治疗组较常规治疗组明显缩短（P＜0.05）.入院时两组患者Scr、BUN、ALT、AST、CK水平差异无统计学意义（均P＞0.05）.与常规治疗组比较,出院前CBP治疗组患者Scr、BUN、ALT、AST、CK的下降值较大（均P＜0.05）.CBP治疗组的病死率显著低于常规治疗组[14.3％（2/14）比62.5％（5/8）,P＜0.05].结论 CBP治疗HS较常规治疗具有显著优势,是早期治疗HS的重要手段.

Objective To compare the efficacy of continuous blood purification （CBP） and conventional therapy in the treatment of heat stroke （HS）.Methods Clinical data of 22 patients with HS in our hospital from January 2000 to July 2013 were retrospectively analyzed.Patients were divided into CBP group （n=14） and conventional therapy group （n=8） according to the treatment of CBP or convention.The hypothermia time and mortality were compared,and the levels of serum creatinine （Scr）,blood urea nitrogen （BUN）,ALT,AST,creatine kinase （CK） were compared between two groups on admission and before hospital discharge.Results The hypothermia time in CBP group decreased significantly than that in conventional therapy group [（11.92±7.44） h vs （30.50± 11.70） h,P＜0.05].There was no significant difference in the levels of Scr,BUN,ALT,AST,CK in two groups on admission （all P＞0.05）.Compared with the conventional therapy group,the decrease values of Scr,BUN,ALT,AST,CK were significant higher in CBP group before hospital discharge （all P＜0.05） . Mortality was lower in CBP group than that in conventional therapy group [14.3％ （2/14） vs 62.5％ （5/8）,P＜0.05].Conclusion CBP shows significant advantages compared with the conventional therapy,and may be an important method for early treatment of HS.