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中华老年病研究电子杂志 ›› 2023, Vol. 10 ›› Issue (01) : 48 -51. doi: 10.3877/cma.j.issn.2095-8757.2023.01.009

病例报告

血浆吸附治疗老年重型新型冠状病毒感染1例
王衍慧, 刘丰, 连兴基, 彭晓辉, 谷文龙, 银孟卓, 何婷, 刘丽兰, 黄玉宇()   
  1. 510180 广州市第一人民医院老年病科
  • 收稿日期:2023-02-09 出版日期:2023-02-28
  • 通信作者: 黄玉宇
  • 基金资助:
    广州市校(院)联合资助项目基础与应用基础研究项目(20220102512)

Plasma adsorption therapy for severe novel coronavirus infection in the elderly: A case report

Yanhui Wang, Feng Liu, Xingji Lian   

  • Received:2023-02-09 Published:2023-02-28
引用本文:

王衍慧, 刘丰, 连兴基, 彭晓辉, 谷文龙, 银孟卓, 何婷, 刘丽兰, 黄玉宇. 血浆吸附治疗老年重型新型冠状病毒感染1例[J]. 中华老年病研究电子杂志, 2023, 10(01): 48-51.

Yanhui Wang, Feng Liu, Xingji Lian. Plasma adsorption therapy for severe novel coronavirus infection in the elderly: A case report[J]. Chinese Journal of Geriatrics Research(Electronic Edition), 2023, 10(01): 48-51.

新型冠状病毒感染(coronavirus disease 2019, COVID-19)是一种新发急性感染性疾病,人群普遍易感,以发热、乏力、干咳为主要表现,重症/危重症患者在发病早期即可出现呼吸困难和(或)低氧血症,快速进展为急性呼吸窘迫综合征(acute respiratory distress syndrome, ARDS)、脓毒症休克、难以纠正的代谢性酸中毒和出凝血功能障碍及多器官功能衰竭等。高龄(>60岁)及合并基础疾病是造成重型/危重型新冠病毒感染患者高病死率的重要原因[1]。如何降低重型/危重型患者的病死率,是其救治的重点和难点。我们对1例老年重型COVID-19患者进行血浆吸附治疗,在阻止ARDS进展方面取得良好的效果,现将诊治过程和体会报道如下。

图1 患者临床指标在血浆吸附治疗前后的变化情况。图1A:炎性细胞因子水平的变化情况;图1B:动脉血压分压和氧合指数的变化情况;图1C:D-二聚体水平变化情况;图1D:纤维蛋白原水平变化情况注:IL指白介素;TNF指肿瘤坏死因子;hs-CRP指超敏C反应蛋白
图2 血浆吸附治疗前患者胸部CT影像检查情况。治疗前双侧肺纹理增多、增粗,双肺散在类圆形透亮影,以双肺上叶为著;双肺小叶间隔增厚,双肺散在片状密度增高影,边界模糊,较前稍增多
图3 血浆吸附治疗后患者胸部CT影像检查情况。治疗后患者胸部CT影像,双侧肺纹理增多、增粗,双肺小叶间隔增厚;双肺散在片状密度增高影,较前明显减少
图4 本例新型冠状病毒感染患者治疗时序图
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