血浆置换、血液灌流联合连续性肾脏替代治疗蜂蛰伤致多器官功能损伤的研究

Randomized control clinical trial in multi -organ dysfunction by bee sting

目的观察对比血液灌流联合连续性肾脏替代治疗（CRRT）与血浆置换、血液灌流联合CRRT对胡蜂蛰伤致多器官功能损伤的临床疗效。方法将2008年8月～2013年10月来本院就诊的胡蜂蛰伤致多器官功能损伤者72例，根据患者经济情况及意愿分为两组（两组患者一般资料具有均衡性），对照组（35例）行血液灌流联合CRRT，实验组（37例）行血浆置换、血液灌流联合CRRT，观察记录两组患者治疗前后生化指标、并发症和病死率、治愈率以及平均住院天数的情况。结果实验组患者各项生化指标明显改善，并优于对照组（P〈O．05），具有更少的临床并发症、较低的病死率以及更高的治愈率，缩短了住院时间（P〈0．05）。结论血浆置换、血液灌流联合CRRT能更有效治疗蜂蛰伤致多器官功能损伤，值得临床推广应用。

Objectives To analyze and compare the effect of hemoperfusion conrbined with continuous renal replace menttherapy（CRRT） and plasmapheresis,hemoperfusion combined with CRRT to treat multi - organ dys- function by bee sting. Methods Seventy - two patients with bee sting - caused multi - organ dysfunction were studied. The 35 patients who refused plasmapheresis, hemoperfusion combined with CRRT were put hemoperfusion combined with CRRT group （ control group）, and the other 37 patients were put to plasmapheresis, hemoperfusion combined with CRRT group （experimental group）. The biochemical index were detected before and after treatment, meanwhile the complication,the recovery rate, the average hospital days and fatality rate were compared too. Resuits The experimental group is obviously improved the biochemical indexes, and is superior to the control group （ P 〈 0.05 ）, with fewer clinical complications, lower mortality and a higher cure rate, and shortening the length of hospital stay. Conclusions Plasmapheresis, hemoperfusion combined with CRRT is the more effective intreating multi - organ dysfunction by bee sting compared with the effect of hemoperfusion combined with CRRT, which is worthy of clinical promotion.