野生菌中毒多器官功能衰竭血浆置换效果分析

The analysis of 5 cases of wild fungus poisoning combined with multiple organ failure plasma replacement

目的探讨血浆置换对野生菌中毒合并多器官功能衰竭患者的辅助治疗效果。方法回顾2014年5月1日—2017年8月31日期间实施血浆置换的野生菌中毒合并多器官功能衰竭患者病例,收集患者血浆置换次数、数量,并对患者治疗前后心脏、肝脏、肾脏功能、凝血功能相关指标及临床症状进行对比分析。结果 5例野生菌中毒合并多器官功能衰竭患者,经及时有效的血浆置换治疗,谷丙转氨酶（ALT）、谷草转氨酶（AST）、肌酸激酶（CK）、肌酸激酶同工酶（CK-MB）、α-羟丁酸脱氢酶（α-HBDH）明显下降,心脏、肝脏功能得到有效恢复。其中2例患者肾功能损伤后恢复相对较心、肝缓慢,1例患者病情较为复杂,血尿素氮（BUN）、血肌酐（CREA）血浆置换期间有升高趋势,但经过后续治疗,治愈出院。结论野生菌中毒合并多器官功能衰竭在早期及时有效的进行血浆置换可有效清除患者体内有毒物质,有利于各个器官功能得到及时恢复,改善预后,挽救患者生命。

Objective To explore the adjuvant therapeutic effect of plasma exchange on the patients with multiple organ failure.Methods Review on May 1, 2014--August 31, 2017, during the implementation of the plasma exchange merger of wild fungus poisoning cases of patients with multiple organ failure, collect patients plasma exchange number, quantity, and before and after treatment in patients with heart, liver, kidney function, blood coagulation function related indicators and clinical symptoms were analyzed.Results After the prompt effective plasma exchange treatment, 5 cases of wild fungus poisoning patients with combined multiple organ failure, ALT, AST, CK, CK-MB and α-HBDH decreased obviously, heart, liver function recovered effectively.Including 2 cases of patients with renal function injury recovery is relatively slow the heart, liver, 1 case of patient condition is relatively complex, BUN, CREA during plasma exchange, had a tendency to rise, but after follow-up treatment, cure the hospital.Conclusion Wild fungus poisoning combined multiple organ failure in the early days of the timely and effective for patients with plasma exchange can effectively remove poisonous substances in the body, is advantageous to the various organs function recovered in time, improve the prognosis, save patients＇ lives.