| 摘要: |
| 目的:观察蟾蜍毒素致儿童肾损伤的临床表现以及血液灌流(HP)对肾损伤的保护作用。方法:采用回顾性分析方法,观察记录我院收治的4例蟾蜍中毒患儿0 h、24 h、48 h 和72 h生命体征和小儿危重病评分(PICS)、心电图( ECG)、血清肌酐
(Cr)水平、视黄醇结合蛋白(RBP)水平、血清半胱氨酸酶抑制剂C(Cys-C)水平、HP治疗时间、住院时间、临床转归并进行分析。结果: 4例患儿均出现过缓型心律失常,0 h RBP 和Cys-C水平升高,均值分别为142.5 mg/L和1.51 mg/L,经2 ~6 h 的HP治疗后,存活患儿24 h RBP 和Cys-C降至正常水平,均值分别为90.5 mg/L和0郾86 mg/L,48~72 h观察值继续下降。1例患儿年龄幼小、服食蟾蜍量多和病情危重,出现严重心律失常而死亡,其余3例痊愈出院。结论:蟾蜍中毒可引起多脏器严重损害,尽早实施HP 对中毒导致的肾损伤有保护作用。 |
| 关键词: 血液灌流 蟾蜍 中毒 肾损伤 儿童 |
| DOI：doi:10.13407/j.cnki.jpp.1672-108X.2016.08.005 |
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| 基金项目: |
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| Protective Mechanism of Hemoperfusion on Renal Injury Induced by Toad Poison in Children |
| Ji Xunqi, Feng Xiaowei, Chen Yuwen, Sun Song, Chen Zefu |
| (The People's Hospital of Hainan Province, Hainan Haikou 570311, China) |
| Abstract: |
| Objective: To observe clinical symptoms of toad poison causing kidney injury and the protective effect of hemoperfusion (HP) on renal damage. Methods: Four cases were retrospectively studied, 0 h, 24 h, 48 h and 72 h vital signs, pediatric critical care score (PICS), electrocardiogram (ECG), serum creatinine (Cr), retinol binding protein ( RBP), serum homocysteine enzyme inhibitors C (Cys-C), HP treatment time, length of hospital stay and clinical outcome were analyzed. Results: Four children suffered from slow arrhythmia and 0 h RBP, Cys-C increasing (the mean were 142.5 mg/L and 1.51 mg/L). After 2 to 6 hours’HP treatment, the survivals 24 h RBP and Cys-C fell to normal level, with average value of 90.5 mg/L and 0.86 mg/L, there had continuous declining after 48 h and 72 h. One young children taken much toad died of severe arrhythmia in critical condition, the rest 3 cases cured. Conclusion: Toad poison can cause severe multiple organ damage, early HP has a protective effect on kidney injury caused by poisoning. |
| Key words: hemoperfusion toad poisoning kidney damage children |
