摘要
目的探析蜂蜇伤所致多器官功能障碍综合征应用糖皮质激素及血液净化的疗效。方法选取2020年4月-2021年11月广西玉林市第二人民医院收治的120例蜂蜇伤所致多器官功能障碍综合征患者,通过随机分组的方式分为对照组和观察组,各60例。对照组采用常规治疗+血液净化治疗,观察组采用常规治疗+血液净化技术+糖皮质激素。比较两组凝血功能指标、炎症介质、肝肾功能、病死率。结果治疗前,两组凝血功能差异无统计学意义(P>0.05);治疗后凝血功能指标显著下降,且观察组PT(10.71±1.10)s、APTT(37.98±5.10)s、TT(15.76±2.15)s、FIB(3.12±0.81)g/L均比对照组低,差异有统计学意义(P<0.05)。治疗前两组炎症介质水平差异无统计学意义(P>0.05);治疗后炎症介质水平显著下降,且观察组IL-1(27.38±6.22)nmol/L、IL-6(18.37±9.11)nmol/L、TNF-α(13.12±4.41)nmol/L均低于对照组,差异有统计学意义(P<0.05)。治疗后,观察组RI、PI及血肌酐水平明显低于对照组,差异有统计学意义(P<0.05)。治疗后,观察组病死率较对照组低,差异有统计学意义(P<0.05)。结论应用糖皮质激素联合血液净化对蜂蜇伤所致多器官功能障碍综合征患者进行治疗,对患者凝血功能及肾功能改善有积极影响,可缓解炎症反应,降低病死率。
Objective To explore the efficacy of glucocorticoid and blood purification for multiple organ dysfunction syndrome caused by bee stings.Methods 120 patients with multiple organ dysfunction syndrome caused by bee sting treated in the Second People's Hospital of Yulin from April 2020 to November 2021 were randomly divided into con⁃trol group and observation group,with 60 cases in each group.The control group was treated with routine treatment+blood purification treatment,and the observation group was treated with routine treatment+blood purification tech⁃nology+glucocorticoid.The indexes of coagulation function,inflammatory mediators,liver and kidney function and mortality were compared between the two groups.Results Before treatment,there was no statistically significant dif⁃ference in coagulation function between the two groups(P>0.05).The indexes of coagulation function decreased sig⁃nificantly after treatment,and PT(10.71±1.10)s,APTT(37.98±5.10)s,TT(15.76±2.15)s and FIB(3.12±0.81)g/L in the observation group were significantly lower than those in the control group,the difference was statistically sig⁃nificant(P<0.05).There was no statistically significant difference in the level of inflammatory mediators between the two groups before treatment(P>0.05).After treatment,the levels of inflammatory mediators decreased significantly,and the observation group IL-1(27.38±6.22)nmol/L,IL-6(18.37±9.11)nmol/L,TNF-α(13.12±4.41)nmol/L were all lower than the control group,the difference was statistically significant(P<0.05).The levels of RI,PI and serum creatinine in the observation group after treatment were significantly lower than those in the control group,and the difference was statistically significant(P<0.05).The mortality rate after treatment in the observation group was lower than that in the control group,and the difference was statistically significant(P<0.05).Conclusion The application of glucocorticoid combined with blood purification in the treatment of patients with multiple organ dysfunction syn⁃drome caused by bee stings has a positive effect on the improvement of coagulation function and renal function,and can relieve inflammation and reduce mortality.
作者
黎贵才
王冰
宁妮
庞俊华
黄福林
LI Guicai;WANG Bing;NING Ni;PANG Junhua;HUANG Fulin(Department of Critical Care Medicine,the Second People's Hospital of Yulin(People's Hospital of Yuzhou District),Yulin,Guangxi Zhuang Autonomous Region,537000 China)
出处
《系统医学》
2022年第12期5-9,共5页
Systems Medicine
基金
玉林市科学研究与技术开发计划项目合同(玉市科20202905)。
关键词
蜂蜇伤
多器官功能障碍综合征
糖皮质激素
血液净化
炎症因子
Bee stings
Multiple organ dysfunction syndrome
Glucocorticoids
Blood purification
Inflammatory factors
