Bolandard F, Hommel D, Hulin A
Service de Réanimation Polyvalente, Centre Hospitalier Général, Cayenne.
Cah Anesthesiol. 1995;43(4):371-3.
Severe Falciparum malaria is associated with multiple organ dysfunction and a high rate of fatal outcome. Appropriate antimalarial chemotherapy and symptomatic treatment may be supplemented by early plasma exchange. Two cases are reported in which there were no chemoprophylaxis and a late diagnosis. Initial parasitaemias were 17% and 5%. The two patients had cerebral malaria with in the first case pulmonary oedema and DIC. Plasma exchange was performed and clinical biological symptoms abated quickly. The mechanisms of action and benefits of plasma exchange are discussed.
重症恶性疟与多器官功能障碍及高死亡率相关。适当的抗疟化疗和对症治疗可辅以早期血浆置换。本文报告两例未进行化学预防且诊断较晚的病例。初始疟原虫血症分别为17%和5%。两名患者均患有脑型疟,第一例患者还伴有肺水肿和弥散性血管内凝血。进行了血浆置换,临床和生物学症状迅速缓解。本文讨论了血浆置换的作用机制和益处。