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目的：比较思密达、大黄与漂白土、甘露醇在治疗急性百草枯中毒中的疗效。方法将确诊的77例口服急性百草枯中毒患者按数字表法随机分为治疗组（39例）和对照组（38例），进行前瞻性研究，两组均行洗胃、血液灌流及常规治疗，治疗组应用思密达吸附、大黄导泻，对照组应用漂白土吸附、甘露醇导泻。观察两组胃肠道毒物清除时间、胃肠功能恢复时间和胃肠功能不全发生率及严重程度评分，以及肺、肾、肝、心肌损伤的发生率、呼吸衰竭的发生率和病死率。结果治疗组胃肠道毒物清除时间（h）、胃肠功能恢复时间（h）均较对照组明显缩短（毒物清除时间：5.87±2.47比7.21±3.31，P<0.01，胃肠功能恢复时间：20.37±6.21比24.56±7.53，P<0.01），胃肠功能不全严重程度评分2分的患者例数较对照组明显减少（4比13，P<0.05），治疗组各器官损伤发生率均较对照组明显降低（肺：48.7%比78.9%，肾：23.1%比40.0%，肝：43.5%比60.0%，心肌：20.5%比47.3%，均P<0.05），呼吸衰竭的发生率、病死率明显降低（呼吸衰竭发生率：15.4%比36.8%；病死率：20.5%比42.0%，P<0.05）。结论思密达、大黄较漂白土、甘露醇有明显清除百草枯中毒胃肠道毒物的作用，且对器官损伤有一定防治作用。“,”Objective To compare of the result effort among simida, rhubarb, bleaching clay, and mannitol for acute paraguat poisoning. Methods A total of 77 patients of acute paraquat poisoning were randomly divided into treatment group (n=39) and control group (n=37). Both two groups underwent gastric lavage, hemoperfusion and conventional treatment. On top of those, the treatment group was given Smecta for adsorption and rhubarb for catharsis, and the control group was given bleaching clay and mannitol. Observation took place on gastrointestinal decontamination time, recovery of gastrointestinal functions, damage severity score, lung, liver, kidney and myocardial damage incidence, as well as the incidence of respiratory failure and severity score. Results The treatment group of gastrointestinal decontamination time, hospital stays was obviously shortened (poison removal time:5.87 ± 2.47 to 7.21 ± 3.31, P<0.01, recovery time:20.37 ± 6.21 to 24.56 ± 7.53, P<0.01,hospital stays:11.87 ± 4.25 to 14.36 ± 5.87, P<0.05). The severity score of gastrointestinal function was lower than that of the control group (4 to 13, P<0.05). Organ injury incidence, the incidence of respiratory failure and mortality significantly was lower (lung: 48.7% to 78.9%, kidney: 23.1% to 40.0%, liver:43.5%to 60.0%, myocardial:20.5%to 47.3%, respiratory failure:15.4%to 36.8%, mortality:20.5%to 42% average P< 0.05). Conclusion Smecta and rhubarb are considered being effective in cleaning acute paraquat poisoning gastrointestinal toxic effects and protection of organ injury.