International Journal of Clinical Research
International Journal of Clinical Research. 2025; 9: (6) ; 10.12208/j.ijcr.20250280 .
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江西省儿童医院PICU 江西南昌
*通讯作者： 吴卫萍,单位：江西省儿童医院PICU 江西南昌；
目的 本研究通过回顾性分析江西省儿童医院七年间实施血浆置换术（TPE）治疗的临床资料，旨在总结TPE在儿童患者中的应用特点、治疗效果和安全性。方法 回顾性分析2017年7月1日至2024年6月30日期间在江西省儿童医院接受TPE治疗的105例患儿的临床资料并进行死亡病例的统计，Logistic回归分析死亡相关危险因素。结果 105例患儿中53例男性，52例女性；中位年龄78个月，中位体重20公斤，总计进行192次TPE治疗。患者病种主要涉及中毒、消化系统疾病等六大类。对比置换前后HB、PLT和AST这三项指标的变化具有统计学意义（P<0.05），仅有3例发生了并发症。死亡病例共30例，TPE次数的增加、高氨血症及需要机械通气的患儿面临较高的死亡风险。结论 TPE在儿童危重症治疗中有效且安全，但治疗次数、高氨血症和机械通气需求是影响死亡风险的关键因素。
Objective This study aims to summarize the characteristics, therapeutic effects, and safety of therapeutic plasma exchange (TPE) in pediatric patients through a retrospective analysis of clinical data from seven years of TPE treatment at Jiangxi Children's Hospital. Methods A retrospective analysis was conducted on the clinical data of 105 children who received TPE treatment at Jiangxi Children's Hospital between July 1, 2017, and June 30, 2024. Additionally, statistical analysis of mortality cases and logistic regression were used to identify risk factors associated with mortality. Results Among the 105 patients, there were 53 males and 52 females; the median age was 78 months, and the median weight was 20 kg, with a total of 192 TPE treatments performed. The main conditions treated included poisoning, gastrointestinal diseases, and several other categories. The changes in hemoglobin (HB), platelet count (PLT), and aspartate aminotransferase (AST) before and after treatment were statistically significant (P<0.05), with only 3 cases experiencing complications. There were a total of 30 deaths; an increased number of TPE treatments, hyperammonemia, and the need for mechanical ventilation were associated with a higher risk of mortality. Conclusion TPE is effective and safe in the treatment of critically ill children, but the number of treatments, hyperammonemia, and the requirement for mechanical ventilation are key factors influencing the risk of death.
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