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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。
Objective To observe the efficacy of high-dose methylprednisolone combined with continuous blood purification (CBP) in the treatment of bee venom-induced multiple organ dysfunction syndrome (MODS). Methods Twenty-three patients with severe bee stings were treated with CBP every day after admission. One patient was treated with plasma exchange (PE). In addition, all patients intravenous methylprednisolone 1 g / d, once every 3 to 7 d. Results Twenty patients were treated for 2 ~ 5 days and hemolysis was controlled. The function of organ was gradually improved. Abdominal pain disappeared in 1 patient with peritonitis. Bleeding stopped in 8 patients with gastrointestinal hemorrhage. Three patients died and the case fatality rate was 13%. Conclusion Intravenous injection of high-dose methylprednisolone combined with CBP is an effective measure to rescue MODS caused by bee venom and is also effective and safe for the complication of gastrointestinal bleeding and peritonitis.