血浆置换抢救12例蜂螫伤致急性重度溶血性贫血临床观察

The Clinical Abservation of PE Rescue Acute Sever Hemolysis Cauised by Bee Sting

目的 :观察血浆置换 (PE)抢救蜂螫伤致急性重度溶血性贫血的疗效。方法 :对 12例确诊为蜂螫伤致急性重度溶血性贫血患者 ,在糖皮质激素应用的基础上进行PE ,并观察其治疗反应。结果 :12例病人中 ,10例病人经 1～ 2次PE ,在运行过程中及结束时中毒症状很快缓解 ,血氧饱和度上升到 90 %～ 95 % ,住院 10 5天 ,溶血基本控制 ,血红蛋白尿、高胆红素血症消失 ,减少了脏器功能衰竭的发生率 ,有效率 83%。结论 :PE能快速有效地清除蜂毒素及红细胞溶解产物 ,可阻断因溶血及蜂毒素导致的脏器功能衰竭 ,是抢救蜂螫伤危重者的有效方法。

Objective:To observe the treatment of plasma exchange in acute severe hemolysis which was caused by bees sting.Methods:To apply of plasma exchange based on using corti costeroid and observe the reaction of treatment.Result:In 12 patients,10 patients who have undergone 1～2 PE.During the operation and end of PE,the symptom of toxicosis remitted at once.The SaO 2 rised to 90%～95%.at 10 5 days of in hospital,hemolysis were controlled approximatly hemoglobinuria and hyperbilirubinemia had been disappeared,the occurrence rate of organ function failure decreased,effective rate 83%.Conclusion:Plasma exchange can quickly remove the apitoxin and lysis produce of red cells,PE can block the organ function failure caused by hemolysis and apitoxin and is an effective method for rescue severe patients by bee sting.