百草枯中毒血液灌流_血液灌流联合血液透析治疗急性百草枯中毒的临床研究

　　【摘要】 目的 评估血液灌流联合血液透析治疗急性百草枯中毒的临床疗效并进行系统研究。 方法 将本院自2008年1月至2012年12月确诊为急性百草枯中毒40例患者随机分为两组，其中观察组23例，对照组17例，对照组采用常规治疗措施如积极洗胃、导泻、抑酸、保肝、补液及利尿等对症及支持疗法；观察组在对照组的常规治疗措施的基础上再配合血液灌流联合血液透析治疗，观察两组疗效并系统比较。 结果 观察组23例中显效10例、有效8例、无效6例、总有效率74%、病死率26%；对照组17例中显效1例、有效3例、无效13例、总有效率23.6%、病死率76.4%，两组总有效率和病死率比较有显著性差异( P <0.01)。其中观察组在血液灌流和血液透析后出现血小板数量的减少，未进行治疗，2 d后自行恢复，所有病例均未见其他脏器的活动性出血及血滤管阻塞。 结论 根据两组之间治疗急性百草枯中毒的总有效率的比较，不难得出血液灌流联合血液透析治疗较常规治疗不但能提高有效率，还能早期改善症状及其预后，降低肺间质纤维化及其他并发症的发生率，疗效肯定，副作用又小，能被患者接受，值得在临床上推广应用。
　　【关键词】
　　百草枯； 中毒；血液灌流；血液透析；疗效
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　　Hemoperfusion combined with hemodialysis in the treatment of acute paraquat poisoning
　　
　　YANG Fei-yun. Henan First Affiliated Hospital of Xinxiang Medical College, Weihui 453100，China
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　　【Abstract】 Objective To
　　assessment of blood perfusion combined with hemodialysis in the treatment of acute paraquat poisoning: clinical efficacy and conducts the system research. Methods The hospital from January 2008 to december 2012 and diagnosed with acute paraquat poisoning in 40 patients were randomly divided into two groups, the observation group of 23 cases,17 cases of the control group, the control group using conventional therapeutic measures such as positive gastric lavage, catharsis, acid suppression, liver, rehydration and diuretic in symptomatic and supportive therapy.Observation group in the conventional treatment measures based on combined with hemoperfusion combined with hemodialysis treatment, observation and comparison of efficacy of the two groups of the system. Results The observation group 23 cases in 10 cases, effective in 8 cases, ineffective in 6 cases, the total effective rate was 74%, the mortality rate was 26%;17 cases in the control group1 cases, effective in 3 cases, ineffective in 13 cases, the total effective rate was 23.6%, the mortality rate was 76.4%, the two group total effective rate and case fatality rate comparison significant differences ( P < 0.01). The observation group in hemoperfusion and hemodialysis after the decrease in the number of platelets, untreated,2 days later to resume, all cases showed no other organ of active bleeding and blood filter tube obstruction. Conclusion According to between the two groups in treatment of acute paraquat poisoning in the total efficiency comparison, not difficult hemodialysis combined with hemoperfusion in the treatment of more conventional treatment can not only improve the efficiency, but also improve the symptoms and prognosis of early, reduced pulmonary interstitial fibrosis and other complications, definite curative effect, side effects and small, can be accepted by patients, worthy of clinical application.