Bläker F, Altrogge H, Hellwege H H, Menke B, Thimm K
Dtsch Med Wochenschr. 1978 Aug 4;103(31):1229-32. doi: 10.1055/s-0028-1129236.
Since 1973 haemodialysis was performed on 30 children with severe haemolytic-uraemic syndrome. Serial measurements were made of blood pressure, blood picture, renal function, complement values, excretion of fibrinogen split-products and beta2-microglobulin in urine. Of 22 children in the acute severe stage two died, in one case treatment having been started too late, in the other as a result of fulminating pneumococcal pneumonia. Twenty children survived without residual symptoms and with normal renal function. Of six children with severe progressive haemolytic-uraemic syndrome two developed terminal renal failure. In one child a renal transplantation has since been performed. One child requires chronic dialysis after nephrectomy. Three children died as a result of arterial hypertension, one of yeast septicaemia. Of two children with recurrent haemolytic-uraemic syndrome one developed terminal renal failure which was successfully treated by renal transplantation. One child died in a hypertensive crisis. The overall death rate of the group was 23%, in the group with the acute severe haemolytic-uraemic syndrome it was 9%. The results suggest that haemodialysis significantly improves the prognosis of severe haemolytic-uraemic syndrome.
自1973年以来,对30例患有严重溶血尿毒综合征的儿童进行了血液透析。对血压、血常规、肾功能、补体值、纤维蛋白原裂解产物排泄及尿中β2-微球蛋白进行了系列测定。在急性重症期的22例儿童中,2例死亡,1例因治疗开始过晚,另1例死于暴发性肺炎球菌肺炎。20例儿童存活,无残留症状且肾功能正常。在6例患有严重进行性溶血尿毒综合征的儿童中,2例发展为终末期肾衰竭。其中1例儿童此后接受了肾移植。1例儿童肾切除术后需要长期透析。3例儿童死于动脉高血压,1例死于酵母菌败血症。在2例复发性溶血尿毒综合征儿童中,1例发展为终末期肾衰竭,通过肾移植成功治疗。1例儿童死于高血压危象。该组总体死亡率为23%,急性重症溶血尿毒综合征组为9%。结果表明,血液透析显著改善了严重溶血尿毒综合征的预后。