儿科治疗性血交换:膜和离心技术的比较评估
Ebru Guney Sahin1, Kubra Boydag Guvenc1, Idris Abdullah Yilmaz1
1Health Science University, Sancaktepe Sehit Prof. Dr. IlhanVarank Training and Research Hospital, Department of Pediatric Intensive Care, Istanbul, Turkey.
概括
离心式 (cTPE) 和膜式 (mTPE) 治疗性血交换 (TPE) 在儿童中有效. cTPE提供更快的处理和更好的乳酸减少,而mTPE需要更高的血液流动,为个性化的儿科TPE策略提供信息.
科学领域:
- 儿科脏病学 儿科脏病学
- 身体以外的治疗方法
- 关键护理医学 关键护理医学
背景情况:
- 治疗性血交换 (TPE) 对于在各种疾病中去除致病物质至关重要.
- 膜 (mTPE) 和离心 (cTPE) TPE都有效,但儿科的比较数据很少.
研究的目的:
- 在儿科患者中,比较离心TPE (cTPE) 与膜TPE (mTPE) 的疗效和安全性.
- 在儿科群体中确定cTPE和mTPE之间的程序差异和并发症概况.
主要方法:
- 在儿童患者中对94个TPE手术进行了回顾性分析.
- 程序包括离心TPE (cTPE) 和膜TPE (mTPE).
- 新鲜冷血是主要的替代液体.
主要成果:
- cTPE与显著缩短的手术持续时间和更大的乳酸减少有关 (p<0.001,p=0.003).
- mTPE需要更高的血液流速;在血液学或凝血参数中没有发现显著差异.
- 在56.4%的病例中出现并发症,在cTPE中出现低血压,在mTPE中出现电路凝血.
结论:
- 在实验室参数中,cTPE和mTPE都表现出类似的疗效.
- cTPE在处理时间和乳酸减少方面表现出优势.
- 基于患者特征的TPE方法的个性化选择和进一步的多中心研究是优化儿科TPE的建议.
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