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本研究旨在观察群体性急性可乐定中毒的流行病学特点、临床表现及救治方法,尤其是评价血液灌流(hemoperfusion,HP)治疗急性可乐定中毒的有效性和安全性.通过对北京怀柔4.23急性可乐定中毒事件行流行病学调查,分析所有80例患者的所有流行病学资料,研究病情较重的34例患者的临床表现、治疗方案、预后情况.采用HA230树脂血液灌流器数次HP治疗前后血可乐定、尿可乐定浓度的变化,计算血可乐定浓度下降率,及与常规内科治疗相比HP的排毒效率.观察治疗前患者血压、心率及其他实验室指标如血小板、心肌酶谱、肝酶谱的变化并评价疗效及副作用.研究发现急性可乐定中毒具有隐蔽性强,发病潜伏期短,症状重等特点,HP治疗可显著降低血可乐定水平,短暂升高尿可乐定水平.患者临床症状亦显著改善,血可乐定的下降率为(81±12)%,所有患者经间断HP治疗1～3次后血、尿可乐定水平接近正常.随着患者血可乐定浓度渐趋正常,其临床症状及实验室指标亦能明显改善,短期HP治疗无明显副作用,随访观察半月余,未观察到后遗症.群体性可乐定中毒常常具有危害人群广,症状重风险大,诊治难度大的特点,重者致人死亡,或者造成社会极大恐慌.研究群体性可乐定中毒有浓厚的军事医学意义,HP是治疗可乐定中毒安全有效的治疗手段.
The purpose of this study was to observe the epidemiological characteristics, clinical manifestation and treatment of acute clonidine in group, especially to evaluate the efficacy and safety of hemoperfusion (HP) in the treatment of acute clonidine poisoning.After the study of Beijing Huairou 4.23 Epidemiological investigation of acute clonidine poisoning was conducted to analyze all the epidemiological data of 80 patients and to study the clinical manifestations, treatment regimens and prognosis of 34 patients with severe disease.Using HP230 resin hemoperfusion device, several times HP Blood clonidine before and after treatment, urine concentration changes, calculate the declining blood concentration of clonidine, and compared with conventional medical treatment of HP detoxification efficiency.Observed before treatment in patients with blood pressure, heart rate and other laboratory indicators such as platelets, myocardial enzymes Spectrum, liver enzymes and to evaluate the efficacy and side effects.Studies found that acute clonidine poisoning has the characteristics of a strong concealment, the incubation period is short, symptoms such as heavy, HP treatment can significantly reduce the level of blood clonidine, transient increase in urinary level of clonidine . The clinical symptoms were also significantly improved, the decline rate of blood clonidine was (81 ± 12)%, all patients treated with intermittent HP 1 to 3 times after the blood, urine The level of leding was close to normal.As the concentration of blood clonidine became normal, the clinical symptoms and laboratory parameters also significantly improved, no obvious side effects of short-term HP treatment, follow-up observation of more than a half months, no sequelae were observed. Poisoning often has the characteristics of a wide range of people, the risk of serious symptoms, diagnosis and treatment is difficult, heavy cause death, or cause great panic in society .Studies on group clonidine poisoning has a strong military medical significance, HP is the treatment of clonidine poisoning Safe and effective treatment.