小儿危重型溶血尿毒综合征的抢救治疗

EXPERIENCES OF RESCUE OF CHILDREN SUFFERING FROM SEVERE HEMOLYTIC UREMIC SYNDROME

为进一步提高小儿危重型溶血尿毒综合征 (HUS)的诊治水平 ,总结了 3例病人在 6次住院中抢救成功的经验。对于反复出现溶血、肾衰的病人 ,认真监测胃肠道症状、系列血化验结果、肾功能、尿量、血压、中枢神经系统表现可在某种程度上预测溶血、肾衰的发生。积极控制恶性高血压和中枢神经系统症状可有效地改善肾功能。当HUS病情重、尿少发展快、肌酐及尿素氮浓度呈上升趋势或合并严重感染时 ,主张早期进行血液透析治疗 。

In order to improve the diagnosis and treatment of severe hemolytic uremic syndrome (SHUS),we summarized the rescuing experiences in 3 children with SHUS.Therefore,close observation of gastro intestinal symptoms,collaborated with repeated examinations of the blood,renal function,urinary output,blood pressure,and manifestations of the central nervous system could help predict to certain extent the occurrence of further hemolysis and renal failure in these patients.Energetic treatment of malignant hypertension and relieving the symptoms of center nervous system could successfully improve renal functions.If urinary output decreased quickly,creatinine (Cr) and blood urea nitrogen (BUN) increased,or severe infection occurred in SHUS patients,hemodialysis should be undertaken as early as possible to prevent caute renal failure and multiple organ failure syndrome (MOFS).Therefore,the treatment of SHUS in children has its peculiarity and complexity.