血液灌流联合连续性静脉-静脉血液透析治疗马蜂蜇伤并发MODS患者的效果

Effect of Hemoperfusion Combined with Continuous Veno-venous Hemodialysis in the Treatment of Wasp Sting Complicated with MODS

目的:探讨血液灌流(HP)联合连续性静脉-静脉血液透析(CVVHD)治疗马蜂蜇伤并发多器官功能障碍综合征(MODS)患者的效果。方法:回顾性分析2017年2月—2021年12月遂宁市中心医院收治的107例马蜂蜇伤并发MODS患者的资料,根据治疗方式不同分为A组和B组。B组53例给予血液灌流联合间歇性血液透析治疗(IHD)治疗,A组54例给予HP联合CVVHD治疗。比较两组临床疗效、住院一般情况、肾肝功能、炎症因子水平。结果:治疗结束后,A组总有效率(94.44%)高于B组(81.13%)(P<0.05)。A组住院时间、机械通气时间、血液净化治疗时间及住ICU时间均短于B组(P<0.05)。治疗结束后,两组肝肾功能、炎症因子各指标较治疗前均降低,A组谷草转氨酶(AST)、谷丙转氨酶(ALT)、血尿素氮(BUN)、血肌酐(Scr)、中性粒细胞/淋巴细胞比(NLR)、C反应蛋白(CRP)及血清降钙素原(PCT)水平均低于B组(P<0.05)。结论:HP联合CVVHD治疗马蜂蜇伤并发MODS患者,可加快肝肾功能恢复,降低炎症因子水平,改善住院一般情况,进而提高临床疗效。

Objective:To explore the effect of hemoperfusion(HP)combined with continuous veno-venous hemodialysis(CVVHD)in the treatment of wasp sting complicated with multiple organ dysfunction syndrome(MODS).Method:The data of 107 patients with wasp sting complicated with MODS who admitted to Suining Central Hospital from February 2017 to December 2021 were retrospectively analyzed,they were divided into group A and group B according to different treatment methods,53 cases in group B were treated with HP combined with intermittent hemodialysis(IHD),and 54 cases in group A were treated with HP combined with CVVHD.Clinical curative effect, general hospitalization conditions, renal liver function and inflammatory factors of two groups were observed. Result: After treatment, the total effective rate of group A (94.44%) was higher than that of group B (81.13%) (P<0.05). The hospitalization, mechanical ventilation, blood purification and ICU stay time in group A were shorter than those in group B (P<0.05). After treatment, the indexes of liver and kidney function and inflammatory factors in two groups decreased compared with those before treatment, the levels of aspartate aminotransferase (AST), alanine aminotransferase (ALT), blood urea nitrogen (BUN), serum creatinine (Scr), neutrophil/lymphocyte ratio (NLR), C-reactive protein (CRP) and serum procalcitonin (PCT) in group A were lower than those in group B (P<0.05). Conclusion: HP combined with CVVHD in the treatment of wasp sting complicated with MODS can accelerate the recovery of liver and kidney function, reduce the levels of inflammatory factors, improve the general situation of hospitalization, and thus improve the clinical efficacy.