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目的:总结急性重症中毒并急性肾功能衰竭(ARF)的临床特点并探讨多种血液净化(BP)模式抢救急性重症中毒的临床疗效。方法:回顾性分析我院30例急性中毒并ARF患者,其中9例行血液透析(HD)治疗,11例行HD串联血液灌流(HD+HP)治疗,10例采用连续性静脉-静脉血液透析滤过(CVVHDF)治疗,各组均给予综合性治疗,比较单纯HD组、HD+HP组、CVVHDF组之间治疗效果。结果:CVVHDF组治愈率高,肾功能恢复优于其他血液净化组(P(0.05),昏迷者的清醒时间快,住院时间缩短(P(0.05),无明显毒副作用。结论:CVVHDF、HD+HP血液净化治疗抢救各种急性中毒并ARF患者成功率高,对急性重症中毒伴多器官功能障碍者,提倡早期行CV-VHDF治疗,同时重视洗胃、营养支持、水电解质酸碱平衡、抗感染等综合治疗,以利于急危重症中毒患者的救治。
Objective: To summarize the clinical features of acute severe acute renal failure (ARF) and explore the clinical efficacy of various blood purification (BP) modalities to rescue acute severe poisoning. Methods: Thirty patients with acute poisoning and ARF were retrospectively analyzed. Among them, 9 were treated with hemodialysis (HD), 11 with HD + HP, and 10 were treated with continuous veno-venous hemodialysis (CVVHDF) treatment, each group were given a comprehensive treatment, compared HD group, HD + HP group, CVVHDF group between the treatment effect. Results: The cure rate of CVVHDF group was higher than that of other blood purification group (P (0.05)), the awake time of coma was fast and the hospitalization time was shortened (P (0.05)), no obvious side effects.Conclusion: CVVHDF, HD + HP blood purification treatment of various acute poisoning and ARF patients with high success rate, for acute severe poisoning with multiple organ dysfunction, promote early CV-VHDF treatment, with emphasis on gastric lavage, nutritional support, water and electrolyte acid-base balance, resistance Infection and other comprehensive treatment, in order to facilitate the treatment of critically ill patients with poisoning.