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目的探讨大剂量甲基强的松龙联合血液灌流治疗重症百草枯中毒的临床疗效。方法将2006年7月—2010年9月收治的重度百草枯中毒患者72例随机分为常规组和强化组各36例,常规组给予常规治疗,强化治疗组在常规治疗基础上加用大剂量甲基强的松龙静脉滴注及血液灌注治疗,比较两组患者的治疗有效率及ARDS、MOF发生率。结果治疗组有效率69.4%,对照组16.7%;治疗组患者ARDS发生率27.8%,MOF发生率22.2%,明显低于对照组;组间比较差异有显著性(P<0.05)。结论血液灌流联合大剂量甲基强的松龙治疗百草枯中毒可快速清除患者体内毒素,显著降低肺组织的损害,延缓肺间质纤维化,降低死亡率,改善患者预后。
Objective To investigate the clinical effect of high-dose methylprednisolone combined with hemoperfusion on severe paraquat poisoning. Methods Seventy-two patients with severe paraquat poisoning who were admitted from July 2006 to September 2010 were randomly divided into routine treatment group and intensive treatment group (n = 36). Conventional treatment was given in the conventional treatment group. On the basis of conventional treatment, intensive treatment group Methylprednisolone infusion and blood perfusion treatment, the treatment of patients in both groups and ARDS, MOF incidence rates were compared. Results The effective rate was 69.4% in the treatment group and 16.7% in the control group. The ARDS incidence rate was 27.8% and the MOF incidence rate was 22.2% in the treatment group, which was significantly lower than that in the control group. There was significant difference between the two groups (P <0.05). Conclusion Hemoperfusion combined with high-dose methylprednisolone treatment of paraquat poisoning can rapidly remove toxins from patients, significantly reduce the damage of lung tissue, delay the interstitial fibrosis, reduce the mortality and improve the prognosis of patients.