同步换血治疗新生儿败血症合并多器官功能障碍综合征的疗效评价

目的探讨换血疗法对新生儿败血症合并多器官功能障碍综合征(MODS)的疗效。方法新生儿败血症合并MODS76例,随机分为换血治疗组36例,非换血治疗组40例。比较换血组非换血组之间的病死率,脏器功能受损的程度与病死率间的关系;比较换血组患儿治疗前后血气值及心、肾、血液系统生化指标的变化。结果换血治疗组病死率明显低于非换血组(P<0·05)。换血后酸中毒得到纠正,PaO2升高,PaCO2下降;心肌酶谱、BUN、Cr明显下降(P均<0·01);血小板数升高、凝血酶原时间、凝血酶时间、部分活化凝血酶时间均恢复至正常(P<0·01)。结论同步换血疗法对新生儿败血症合并MODS有较好的疗效。

Exchange transfusion in septic neonate with multiple organ dysfunction syndrome

Objective To explore the efficacy of exchange transfusion in septic neonate with multiple organ dysfunction syndrome (MODS).Methods Seventy-six cases of septic neonate with MODS were randomly divided into two groups,36 cases for exchange transfusion group and 40 cases for non-exchange transfusion group.The mortality rate of exchange transfusion group and non-exchange transfusion group was compared.The relationship between the mortality and the quantity of dysfunctional organs was studied in exchange transfusion group.Arterial blood gas,cardiac function,renal function and blood clotting function were compared.Results The mortality of exchange transfusion group was lower than that of non-exchange transfusion group(P<0.05).Exchange transfusion facilitated acidosis correction and respiratory function improvement (PaO_2 was increased and PaCO_2 was decreased).Additionally,myocardial zymogram,blood urea nitrogen and creatinine were significantly decreased (P<0.01);platelet count was increased;and blood clotting function (PT,TT and APTT) returned to normal after exchange transfusion.Conclusion The exchange transfusion as a simple blood purification method is effective on neonate septicemia with MODS.