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[溶血尿毒综合征。154例病例的经验]

[Hemolytic-uremic syndrome. Experience with 154 cases].

作者信息

Cordero J, Baeza J, Fielbaum O, Saieh C, Varela M, Rodríguez E, Olivos P, Hernández C, González J

机构信息

Unidad de Cuidados Intensivos, Hospital Luis Calvo Mackenna.

出版信息

Rev Chil Pediatr. 1990 Sep-Oct;61(5):235-42.

PMID:2089489
Abstract

One hundred and fifty four patients with hemolytic uremic syndrome (HUS) were admitted from year 1968 throughout 1989 to a public children's hospital (n = 139) and to a private general clinic (n = 15) at Metropolitan Santiago, Chile. Their mean age at admission was 16 months, 64% of them were 6 to 18 month old. One third of patients were admitted at spring season. The prodromal phase lasted between 1 and 19 days. In 92% of cases there was antecedent diarrhea and 31% showed neurological involvement. Anuria was present in 44 patients (21%) lasting an average of 7 days; sixty one affected children (40%) became hypertensive. Sixty patients (39%) underwent peritoneal dialysis, remaining cases were given maintenance treatment for acute renal failure (ARF). No specific treatment was used except heparin in 5 children along the first years of these series. Ten patients (6%) died during the acute phase of their disease, but death occurred in only 2 of the 76 most recent cases, probably because of more accurate diagnosis and greater experience of the professional team in the management of ARF, even though very heterogeneous clinical presentations were observed along the whole observation period. Three patients developed chronic renal failure.

摘要

1968年至1989年期间,154例溶血性尿毒症综合征(HUS)患者被收治于智利首都圣地亚哥的一家公立儿童医院(n = 139)和一家私立综合诊所(n = 15)。他们入院时的平均年龄为16个月,其中64%为6至18个月大。三分之一的患者在春季入院。前驱期持续1至19天。92%的病例有腹泻前驱症状,31%有神经系统受累表现。44例患者(21%)出现无尿,平均持续7天;61例患病儿童(40%)出现高血压。60例患者(39%)接受了腹膜透析,其余病例接受了急性肾衰竭(ARF)的维持治疗。在这些病例系列的最初几年中,除了5名儿童使用了肝素外,未使用其他特殊治疗。10例患者(6%)在疾病急性期死亡,但在最近的76例病例中仅有2例死亡,这可能是由于诊断更加准确以及专业团队在ARF管理方面经验更丰富,尽管在整个观察期内观察到了非常多样化的临床表现。3例患者发展为慢性肾衰竭。

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