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目的探讨单独血液灌流与血液灌流联合血液透析对急性百草枯中毒患者的疗效及血清PDGF、MMP-9的影响。方法共纳入52例急性百草枯中毒患者,平均分为两组,A组给予5%NaHCO3液体洗胃、导泻、补液等常规内科治疗措施,并行血液灌流血液净化;B组在A组基础上同时给予血液透析治疗。结果 B组(血液灌流联合血液透析组)明显优于A组(单独血液灌流组),总有效率分别为69.2%及46.2%,差异有统计学意义(P﹤0.05);两组间血清PDGF、MMP-9比较,血液灌流联合血液透析组PDGF及MMP-9水平均明显低于单独血液灌流组,差异有统计学意义(P﹤0.05)。结论急性百草枯中毒患者中肺纤维化的比例最高。与单独血液灌流相比,血液灌流联合血液透析对急性中毒患者治疗效果更明显,且可以更显著的降低血清PDGF、MMP-9,延缓患者肺纤维化的发生发展,对该类人群能有效提高抢救成功率,降低患者病死率,改善长期预后,值得临床推广应用。
Objective To investigate the effects of hemoperfusion and hemoperfusion combined with hemodialysis on the efficacy of acute paraquat poisoning and serum levels of PDGF and MMP-9. Methods A total of 52 acute paraquat poisoning patients were enrolled in this study. The patients were divided equally into two groups. Group A received 5% sodium bicarbonate gastric lavage, catharsis, rehydration, and other conventional medical treatment. Blood was purified by hemoperfusion. In group B, At the same time give hemodialysis treatment. Results The total effective rate of group B (hemoperfusion combined with hemodialysis group) was significantly higher than that of group A (hemoperfusion alone group), the total effective rates were 69.2% and 46.2%, respectively, with significant difference (P <0.05) , MMP-9 in hemoperfusion group and hemodialysis group were significantly lower than those in hemoperfusion group (P <0.05). Conclusions Patients with acute paraquat poisoning have the highest proportion of pulmonary fibrosis. Compared with hemoperfusion, hemoperfusion combined with hemodialysis treatment of patients with acute poisoning effect is more obvious, and can significantly reduce serum PDGF, MMP-9, delay the occurrence of pulmonary fibrosis in patients with this group can effectively improve Rescue success rate, reduce patient mortality, improve long-term prognosis, it is worth clinical application.