血浆置换术抢救25例蜂毒致急性重度溶血性贫血临床观察

摘要

目的:观察血浆置换术(TPE)治疗蜂毒致急性重度溶血性贫血的疗效.方法:对25例已被确诊为蜂毒致急性重度溶血性贫血患者,在应用糖皮质激素的基础上进行TPE治疗,并观察其治疗效果.结果:25例患者中,22例患者经1～2次TPE治疗后,中毒症状很快缓解,血氧饱和度上升到90%～99%,溶血基本控制,血红蛋白尿、高胆红素血症消失,降低了多脏器功能衰竭的发生率,有效率为88%,平均住院12.5 d.结论:TPE能快速有效地清除蜂毒及红细胞溶解产物,可阻断因溶血及蜂毒导致的脏器功能衰竭,是抢救蜂毒危重者的有效方法.%Objective:To observe the effect of the rapeutic plasma exchange in acute severe hemolysis which was caused by bee venom.Methods:25 patients were made a definite diagnosis to acute severe hemolysis which was caused by bee venom.Corticosteroid and plasma exchange were given to them.Results:Among 25 patients,22 patients who have undergone 1 to 2 times TPE.During the operation and end of TPE, the symptom of toxicosis remitted at once.The SaO2 rised to 90%- 99%.Hospitalization time was 12.5 days,hemolysis were controlled,hemoglobinnria and hyperbilirubinemia disappeared, the incidence of organ function failure decreased,effective rate was 88%.Conclusion:Plasma exchange can quickly remove the apitoxin and product of crythrolysis,TPE can bolck the organ function failure caused by hemolysis and apitoxin and is an effective method for rescue severe patients by bee venom.