治疗性血交换在严重的狂犬病:一个病例对照研究
Sukhmani Boparai1, Rachaita Lakra1, Lovekirat Dhaliwal1
1Internal Medicine, Louisiana State University (LSU) Health Shreveport, Shreveport, USA.
Cureus
|July 3, 2023
概括
治疗性血交换 (TPE) 没有显著改善严重病情的狂肌痛患者的死亡率或重症监护室 (ICU) 停留. 需要进一步的研究来了解TPE对脏结果的长期影响.
科学领域:
- 腎臟病學 (nephrology) 是一種醫學.
- 关键护理医学 关键护理医学
- 血液学 血液学 血液学
背景情况:
- 轮骨髓溶解是一种严重的疾病,有可能导致急性损伤 (AKI),隔间综合征和致命的代谢障碍.
- 治疗性血交换 (TPE) 是一种潜在的治疗方法来清除肌球蛋白,但支持其在狂犬病溶解中使用的证据有限.
研究的目的:
- 调查TPE作为诊断为狂犬病症的重症患者的辅助疗法的疗效.
- 评估TPE对该患者群体的死亡率和ICU停留时间的影响.
主要方法:
- 对2012年至2021年期间被诊断患有体胆固醇症的成年ICU患者的回顾性图表审查.
- 患者被分为两组:接受标准护理加TPE的患者和仅接受标准护理的患者.
- 使用带有 TPE2000 过器的 PRISMA 机器和 5% 的白蛋白或新鲜冷血进行 TPE.
主要成果:
- 在研究的患者中,28.78%接受了TPE. 总体死亡率为31.9%.
- 在TPE和非TPE组之间没有观察到统计学上显著的死亡率差异 (36.84%与36.17%,p=0.959).
- 老年和休克被确定为死亡率的预测因素. 长期的结结果被评估在一个小的子集,只有两个非TPE患者发展慢性病/末期病.
结论:
- 给TPE没有显著改善死亡率或减少重症监护室住院时间的好处.
- 需要进一步的研究,以澄清TPE在狂犬病溶解中的特定指示及其对功能的长期影响.
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