CVVHDF联合HP治疗蜂蜇伤患者临床生化指标的变化研究

Analysis of the Changes of Clinical and Biochemical Indexes in Treatment of Continuous Venovenous Hemodiafiltration Combined with Hemoperfusion in Patients with Bee Stings

目的 探讨连续性静脉血液透析滤过（CVVHDF）联合血液灌流（HP）治疗蜂蜇伤患者中临床血清磷酸肌酸激酶同工酶（CK-MB）、总胆红素（TBil）、丙氨酸氨基转移酶（ALT）、天门冬氨酸氨基转移酶（AST）、肌红蛋白（Mb）、尿素氮（BUN）和肌酐（Scr）生化指标的变化研究及CVVHDF联合HP在蜂蜇伤中的临床应用价值.方法 选取陕西省人民医院25例蜂蜇伤患者,分为常规组（局部处理、抗感染、抗过敏、抑制炎症反应、营养心肌、保肝保肾、营养支持等综合治疗）10例和CVVHDF联合HP治疗组（上述常规综合治疗＋CVVHDF联合HP）15例,比较两组治疗前和治疗后24,48 h的血清CK-MB,TBil,ALT,AST,Mb,BUN和Scr.结果 常规组经48 h治疗后上述生化指标与治疗前比较变化不明显（P＞0.05）,CVVHDF联合HP治疗组经24,48 h治疗后上述生化指标与治疗前比较有所降低,差异有统计学意义（P＜0.05）.结论 CVVHDF联合HP治疗蜂蜇伤患者早期血清CK-MB,TBil,ALT,AST,Mb,BUN和Scr生化指标水平明显降低,能尽早恢复患者各脏器功能,是临床治疗蜂蜇伤患者的有效手段,具有重要临床应用价值.

Objeetive To analyze the changes of serum creatine kinase isoenzyme （CK-MB）, total bilirubin （TBil）, alanine aminotransferase （ALT）, aspartate amino transferase （AST） ,myoglobin （Mb）, usea nitrogen （BUN） and creatinine （Scr） in treatment of continuous venovenous hemodiafiltration （CVVHDF） combined with hemoperfusion （HP） in patients with bee stings. Methods The 25 cases of bee stings were collected,they were divided into conventional treatment group included 10 cases and the group of CVVHDF combined HP treatment included 15 cases. Conventional therapy included partial treat- ment,anti-infection,antianaphylaxis,inhibiting the inflammatory reaction, nourishing cardiac muscle, protecting of liver and kidney,nutritional support and so on,the therapy of CVVHDF combined with HP group included conventional therapy and continuous CVVHDF combined with HP treatment. Compared with the level of CK-MB, TBil, ALT, AST, Mb, BUN and Scr in before and after the first day, the second day treatment of two groups. Results The above clinical and biochemical indexes were no obvious changes after 48h treatment in conventional treatment group compared with before treatment （P〉0.05）, while were reduced after treatment in the group of CVVHDF combined with HP treatment compared with before treatment （P〈0.05）. Conclusion CVVHDF combined with HP in patients with bee stings was an effective means. Not only could re- duce clinical and biochemical indexes but also recovery of multiple organ function in the early phase, that has important value in clinical application.