血液净化治疗儿童急性中毒53例临床分析
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南京医科大学附属儿童医院 重症医学科 210008

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南京市医学科技发展项目(YKK16181)北京儿童医院集团2015年度科研课题


Clinical Analysis of 53 cases with Blood Purification in Children with acute poisoning
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    摘要:

    目的 探讨血液净化(Continuous Blood Purification,CBP)技术在儿童急性中毒中的应用价值及不良事件。方法 回顾南京医科大学附属儿童医院2015年至2017年所有进行CBP治疗的中毒病例,进行汇总,分析其疾病谱、治疗模式、耗时、不良事件、疗效及费用等特点。结果 本研究一共纳入53个样本,共计158人次,平均每人2.98次。最小体重11公斤,治疗时间最长24小时,平均时间4.64小时。本研究中好转50例,占94.34%,死亡3例,占5.66%。治疗过程不良事件共8次,发生率占15.09%,主要有低血压、过敏性皮疹、置管及管路凝血及滤器凝血。结论 血液净化技术是抢救儿童急性中毒的重要手段。常用的模式主要有连续性静-静脉血液透析滤过(continuous venovenous hemodiafiltration CVVHDF)、血浆置换(Therapeuti plasma exchange TPE)、血液灌流(Hemoperfusion HP)。血液净化可以清除患儿血液毒物,维持因毒物对机体造成的内环境紊乱,可有效降低因中毒致死及致残。

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    Objective The application and adverse events of the continous blood purification (CBP) technology in the children"s acute poisoning. Methods All the cases applying CBP in acute poisoning in Children’s hospital of Nanjing Medical University from 2015 to 2017 are reviewed. We summarized and analyzed the characteristics of spectrum, treatment mode, the consumption of disease, adverse events, efficacy and cost. Results A total of 53 samples were included in this study, with a total of 158 CBP treatments, with an average of 2.98 times per person. The minimum weight was 11 kg, the longest duration of treatment was 24 hours, and the average duration was 4.64 hours. In this study, 50 cases were improved, accounting for 94.34%, and 4 cases of death, accounting for 5.66%. There were 8 adverse events in the treatment process, and the incidence was 15.09%.There are mainly allergic rash, catheterization and pipeline coagulation, filter coagulation. Conclusions Blood purification is an important means to rescue acute poisoning in children. The commonly used modes include CVVHD、TPE and HP. Blood purification can remove the poison and maintain the internal environment disorder caused by poison to the body, which can effectively reduce death and disability caused by poisoning.

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  • 收稿日期:2018-06-08
  • 最后修改日期:2018-12-27
  • 录用日期:2019-03-04
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