大剂量甲泼尼龙联合连续性血液净化治疗蜂毒所致多脏器功能障碍

目的观察大剂量甲泼尼龙联合连续性血液净化(CBP)治疗蜂毒所致多脏器功能障碍综合征(MODS)的疗效。方法23例重症蜂蜇伤患者入院后每天行CBP治疗,其中1例联用血浆置换(PE)。此外,所有患者静脉滴注甲泼尼龙1 g/d,连用3～7 d。结果20例患者治疗2～5 d后溶血得到控制,脏器功能逐渐好转;1例合并腹膜炎者腹痛消失;8例合并消化道出血者出血停止;3例死亡,病死率13%。结论静脉注射大剂量甲泼尼龙联合CBP是抢救蜂毒所致MODS有效措施,对并发症消化道出血及腹膜炎也是有效和安全的。

Large-dose methylprednisolone with continuous blood purification (CBP) for the treatment of multiple organ dysfunction syndrome(MODS)induced by bee venom

Objective To observe large-dose methylprednisolone combined with continuous blood purification(CBP)for the treatment of multiple organ dysfunction syndrome(MODS)induced by bee venom.Method 23 patients with MODS induced by bee venom accepted CBP every day,including one case with plasma exchange(PE)at the same time.In addition,1 g/d methylprednisolone in glucose solu- tion was injected intravenously in all the patients every day for 3 to 7 days.Result Hemolysis of twenty patients were controlled after 2-day to 5-day treatment,and their organ function recovered gradually; Symptoms of one case with peritonitis and eight cases with gastrointestinal hemorrhage disappeared,three cases died and the mortality was 13%.Conclusion Intravenous infusion of large-dose methylpred- nisolone combined with CBP could effectively treat MODS induced by bee venom.Meanwhile,it is effec- tive and safe for complications such as gastrointestinal hemorrhage and peritonitis.