床边血液灌流联合血浆置换治疗重度蘑菇中毒效果.docVIP

床边血液灌流联合血浆置换治疗重度蘑菇中毒效果 　　[摘要] 目的 研究床边血液净化联合治疗重症蘑菇中毒患者的效果。 方法 我院2006年7月～2014年9月收治的重度蘑菇中毒患者根据其治疗方案分为3组，其中灌流组32例采用血液灌流治疗，联合组 32例采用血液灌流及血浆置换联合治疗，置换组32例采用血浆置换治疗，观察三组患者临床疗效、并发症发生率。 结果 联合组患者有效25例，其中我院2例重症蘑菇中毒合并多脏器功能衰竭并横纹肌溶解综合征经过床边血液灌流联合血浆置换治疗及呼吸机等综合治疗后，痊愈出院，高于灌流组的13例以及置换组的20例，联合组患者住院时间、昏迷时间等均短于置换组及灌流组（P0.05），联合组各项指标以及成功率均好于其他两组（P=0.00200.05），各种并发症发生率低于其他两组（P0.05）。 结论 联合组对治疗蘑菇中毒具有很好疗效，可有效降低患者死亡率。 　　[关键词] 重度蘑菇中毒；床边；血液灌流；血浆置换 　　[中图分类号] R595.4 [文献标识码] B [文章编号] 1673-9701（2015）30-0058-03 　　Treatment effect of bedside hemoperfusion combined with plasma exchange on severe mushroom poisoning 　　YANG Wu CHEN Junhua WEN Longqing SHU Wensong 　　Department of Emergency， Jian Central Peoples Hospital in Jiangxi Province， Jian 343000， China 　　[Abstract] Objective To study the effect of bedside hemopurification combined treatment on severe mushroom poisoning. Methods The patients with severe mushroom poisoning treated in our hospital from July 2006 to September 2014 were divided into three groups according to the treatment program， of which 32 patients of the perfusion group received hemoperfusion treatment， 32 patients of the combination group received hemoperfusion combined with plasma exchange treatment， and 32 patients of the exchange group received plasma exchange treatment. The clinical efficacy and incidences of complications of the three groups were observed. Results In the combination group， 25 patients were effective， of which 2 patients with severe mushroom poisoning complicated by multiple organ failure and rhabdomyolysis recovered and discharged after comprehensive treatment such as hemoperfusion combined with plasma exchange treatment and ventilator treatment. The number was higher than the 13 patients of the perfusion group and the 20 patients of the exchange group. The combination group was shorter than the exchange group and the perfusion group in the hospital stay and coma duration（P0.05）， in each indicator and the success rate was better than the other two groups（