儿童治疗性血浆置换——来自三级医疗中心的经验
Therapeutic Plasma Exchange in Children - Experience From a Tertiary Care Center.
作者信息
Mazahir Rufaida, Anand Kanav, Pruthi P K
机构信息
Division of Pediatric Nephrology, Department of Pediatrics, Institute of Child Health, Sir Ganga Ram Hospital, New Delhi. Correspondence to: Dr Rufaida Mazahir, Division of Pediatric Nephrology, Department of Pediatrics, Institute of Child Health, Sir Ganga Ram Hospital, Old Rajender Nagar, New Delhi 110 060.
Division of Pediatric Nephrology, Department of Pediatrics, Institute of Child Health, Sir Ganga Ram Hospital, New Delhi.
出版信息
Indian Pediatr. 2021 Dec 15;58(12):1151-1154. Epub 2021 Jun 28.
OBJECTIVE
To assess the safety, efficacy and outcomes of therapeutic plasma exchange (TPE) in children.
METHODS
Data were retrieved from hospital records for all children £18 years who underwent TPE between August, 2011 and July, 2018.
RESULTS
46 children [median (range) age 96 (8-204) months] underwent 293 sessions of TPE by membrane plasma separation technique. Renal disease was the commonest indication (24, 52.2%) followed by neurological illnesses (17; 36.9%). 36 (78.2%) patients belonged to American Society for Apheresis category I. Overall, the most common indication was atypical hemolytic uremic syndrome (aHUS) (16; 34.8%). Fresh frozen plasma plus albumin was used as replacement fluid in aHUS, while albumin was used in others. 40 (86.9%) patients had complete/partial recovery while six did not show any sign of recovery. Complications were seen in 21 (7.1%) sessions; majority of which were minor in the form of blood pressure fluctuations.
CONCLUSION
TPE can be performed safely and effectively for renal and non-renal indications, even in small children.
目的
评估治疗性血浆置换（TPE）在儿童中的安全性、有效性及治疗结果。
方法
检索2011年8月至2018年7月期间接受TPE治疗的所有18岁以下儿童的医院记录数据。
结果
46名儿童[年龄中位数（范围）为96（8 - 204）个月]通过膜血浆分离技术接受了293次TPE治疗。肾脏疾病是最常见的适应症（24例，52.2%），其次是神经系统疾病（17例；36.9%）。36名（78.2%）患者属于美国血液分离协会I类。总体而言，最常见的适应症是非典型溶血尿毒综合征（aHUS）（16例；34.8%）。aHUS中使用新鲜冷冻血浆加白蛋白作为置换液，其他情况使用白蛋白。40名（86.9%）患者实现了完全/部分康复，而6名患者未显示任何康复迹象。21次（7.1%）治疗出现并发症；其中大多数为血压波动等轻微并发症。
结论
即使对于小儿患者，TPE用于肾脏及非肾脏适应症时均可安全有效地进行。
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