百草枯中毒患者实施血液灌流对血药浓度及其预后的影响研究.docVIP

精品论文 参考文献 百草枯中毒患者实施血液灌流对血药浓度及其预后的影响研究 史玉占１　祝维秋２　杨淑芳１ 聊城市第二人民医院１、急诊科;２、血液透析室　山东　聊城　２５２６０１ 　　【摘要】　目的　探讨实施血液灌流术对百草枯中毒患者血药浓度及其预后的影响.方法　回顾性分析我院２０１３年２月~２０１５年７月收治的３０例百草枯中毒患者的临床资料,所有患者均进行常规治疗,其中１６例进行血液灌流,采用HPLC法测定灌流前和灌流后２、４、６h后百草枯的血药浓度,观察患者病情转归.结果　患者灌流后２h百草枯血药浓度下降显著[由(１２．８４plusmn;３．６５)mg/L降至(２．４３plusmn;０．７９)mg/L,(P＜０．０５)],延长灌流时间对降低百草枯血药浓度无明显效果(P＞０．０５);血液灌流对患者总体死亡率无显著影响(P＞０．０５),但可延长死亡患者生存时间,降低患者???纤维化发生率(P＜０．０５).结论　实施血液灌流可以有效降低患者血浆百草枯浓度和肺纤维化发生率,延长患者生存时间,提高患者预后. 【关键词】　血液灌流;　百草枯;　中毒;　血药浓度;　预后Paraquatpoisoningpatientsembodimentofhemoperfusiononplasmaconcentration　ItsprognosisofstudyShiYu－zhan１ZhuWei－qiu２YangShu－fang１ (TheSecondPeople＇sHospitalofLiaocheng,１,emergencydepartment２,hemodialysisroom LiaochengShandong ２５２６０１)【Abstract】ObjectiveToinvestigatetheimplementationofthepoisonedpatientsbloodconcentrationandbloodperfusiontechniqueprognosticparaquat．MethＧodsAretrospectiveanalysisofclinicaldataofFebruary２０１３－July２０１５weretreated３０casesofparaquatpoisoningpatients,allpatientsunderwentconventionaltreatment,including１６casesofbloodperfusion,perfusionwasdeterminedbyHPLCbeforeandafterperfusion２,４,６hplasmaconcentrationafterparaquatobＧservedinpatientswithdiseaseoutcome．Resultsinpatientsafterreperfusion２hplasmaconcentrationofparaquatsignificantlydecreased[bythe(１２．８４ plusmn; ３．６５)mg/Ldecreasedto(２．４３plusmn;０．７９)mg/L,(P ＜０．０５)],prolongedperfusiontimetoreducetheplasmaconcentrationofparaquatnosignificanteffect(P＞ ０．０５);nosignificanteffectonbloodperfusion(P＞０．０５)forpatientswithoverallmortality,butprolongthesurvivaltimeofdeath,reducetheincidenceofpulmoＧnaryfibrosispatients(P ＜０．０５)．ConclusionTheimplementationofbloodperfusioncanreduceplasmaconcentrationsofparaquatandtheincidenceofpulmonaryfibros【iKseaynwdorpdrsol】ongpatientsurvivaltimes,improvepatientprognosis． bloodperfusion;paraquat;poisoning;bloodconcentration;Prognosis 【中图分类号】R４５ 【文献标识码】B 　　【文章编号】１００８－６３１５(２０１５)１２－１２８１－０２　　 　　百草枯(paraquat,PQ)是一种快速灭生性除草剂,对人毒性极大,可导致系统性中毒,并造成肝、肾等多种器官衰竭,肺部纤维化(不可逆)和呼吸衰竭,口服中毒死亡率可达９０％以上[１].目前百草枯特异性抗体任然处于实验室研究阶段,