过敏性紫癜患儿血液灌流并发症及处理

Complications of hemoperfusion for Henoch-Schonlein purpura in children and their countermeasures

目的探讨过敏性紫癜患儿血液灌流过程中的并发症及处理。方法将96例382次血液灌流的过敏性紫癜患儿按年龄分为两组,≤6岁组和>6岁组,观察记录两组过敏性紫癜患儿进行血液灌流治疗过程中出现的不良反应及体征,并给予干预。对不同年龄段、不同时间段出现的并发症进行比较,并对常见并发症及原因进行总结、分析。结果并发症中胃肠道反应、低血压、低体温为最常见,总发生率分别为10.7%、6.8%和5.5%。在0~30min,30~60min,60~120min各时段各种并发症的发生频次不同(x^2=36.18,P<0.001),胃肠道反应及低血压、过敏反应集中发生在前60min,凝血、低体温集中发生在60~120min。6岁以下患儿发生胃肠道症状、低血压、低体温等并发症的比例均明显大于>6岁患儿组(x^2值分别为14.39、12.20、8.61,均P<0.05);当出现各类并发症,给予积极有效的对策后,基本得到有效缓解。结论小儿血液灌流过程虽出现并发症,但及时观察,及时干预,均可缓解,可提高患儿治疗的依从性。

Objective To explore the complications of hemoperfusion for Henoch-Schonlein purpura （ HSP ） in children and countermeasures.Methods Totally 96 children with HSP who received hemoperfusion for 382 times were divided into two groups：≤6 years old group and 〉6 years old group.The complications of the children in two groups were observed, recorded and intervened.The complications occurring in different periods after hemoperfusion and at different age were compared, and the common complications and their causes were summarized and analyzed.Results Gastrointestinal tract reaction, low blood pressure, and low body temperature were the most common complications, and the total rate of them was 10.7%, 6.8%and 5.5%, respectively.In the period of 0-30 minutes, 30-60 minutes and 60-120 minutes the frequency of different complications was different （χ^2 =36.18,P〈0.001）.Gastrointestinal reaction, low blood pressure, and allergic reaction mainly occurred in the first 60 minutes,and blood coagulation and low body temperature occurred in 60-120 minutes.The proportion of gastrointestinal symptoms, low blood pressure and low body temperature was significantly higher in≤6 years old group than in 〉6 years old group （χ^2 value was 14.39, 12.20 and 8.61, respectively, all P〈0.05）.When positive and effective countermeasures were provided, all kinds of complications were relieved fundamentally.Conclusion Although some complications may occur in hemoperfusion, all of them can be alleviated if timely observation and intervention are provided, and the children＇s treatment compliance can be improved.