间断和持续血液灌流治疗急性百草枯中毒疗效观察.docVIP

间断和持续血液灌流治疗急性百草枯中毒疗效观察 　　【摘要】 目的：观察间断和“持续”血液灌流对急性百草枯中毒患者的临床疗效。方法：回顾性研究本院急性百草枯中毒患者59例，所有患者均采用内科常规综合治疗，分为A组26例采用间断血液灌流，B组33例采用“持续”血液灌流，根据患者预后又分为死亡组和存活组。结果：A、B两组患者性别、年龄、服药剂量、服药后至入院治疗时间比较差异无统计学意义（P0.05）；A、B两组患者治疗疗效比较差异无统计学意义（P0.05），B组死亡患者存活时间长于A组（P0.05）；与存活组相比，死亡组服药剂量明显增高。结论：间断和“持续”血液灌流对于百草枯中毒患者疗效相同，“持续”血液灌流能明显延长中毒死亡患者的存活时间，中毒患者死亡因素主要与患者服用百草枯剂量有关。 　　【关键词】 血液灌流； 百草枯； 病死率 　　【Abstract】 Objective：To assess the clinical effects of intermittent and continuous hemoperfusion on acute paraquat poisoning. Method：59 patients with acute paraquat poisoning were randomly divided into two groups，A group composed of 26 patients were treated with intermittent hemoperfusion and continuous hemoperfusion was administered in B group composed of 33 patients. All patients were treated with conventional medication. then， According to the prognosis of the patients was divided into death group and survival group. Result：There were no significant difference in Gender， age， the toxic dose， and after the poisoning to hospitalization time between the two groups （P0.05）. Therapeutic effect of the A and B group had no difference（P0.05）. The survival time of death patients in the B group was longer than that of death patients in the A group （P0.05）. Compared with the survival group， the toxic dose was higher significantly in death group. Conclusion：There is no difference in the clinical efficacy between intermittent and continuous hemoperfusion on acute paraquat poisoning，continuous hemoperfusion can prolong the survival time of death obviously，the main causes of death is related to the toxic dose. 　　【Key words】 Paraquat poisoning； Hemoperfusion； Mortality 　　百草枯是目前被广泛使用的吡啶类速效高毒性触灭型农业除草剂，分子量为257.16，中毒死亡率为25%～76%，有报道可高达80%。人口服致死量为30～40 mg/kg，20%百草枯水剂儿童约4.5 mL，成人约10～20 mL，中毒后对多脏器具有毒性作用且无特异性解毒药。血液灌流是利用具有广谱解毒效应的碳性肾清除中毒病人体内有害毒物或外源性毒物的方法，临床主要用于药物及化学毒物的毒素清除，也是目前清除百草枯中毒的有效治疗手段。目前针对百草枯中毒后常规治疗方案及血液灌流治疗策略仍存在不确定性因素[1-2]，临床中逐渐发现血液灌流策略的不同对患者预后可产生明显影响，因此本研究通过对本院2011年前后59例采用不同血液灌流方案治疗百草枯中毒患者的回顾性临床分析，探讨不同血液灌流策略对百草