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目的探讨分析对百草枯中毒患者实施血液灌流治疗对其血药浓度及预后的影响。方法选取2012年10月至2015年12月收住洛阳市第三人民医院的百草枯中毒患者32例为对照组,入院后均给予洗胃、导泻、吸氧、活性炭吸附,必要时气管插管或气管切开等常规治疗。同期入院患者29例为观察组,在上述治疗措施基础上辅以血液灌流。分别于治疗后2、4 h以高效液相色谱法检测患者血浆百草枯药物浓度,并观察患者预后情况。结果观察组治疗前及治疗2、4 h后血浆药物浓度分别为(10.5±3.2)mg/L、(2.6±1.9)mg/L和(2.4±1.7)mg/L;而对照组则分别为(10.9±4.2)mg/L、(4.8±2.1)mg/L和(3.5±1.8)mg/L。治疗前2组患者血浆药物浓度差异无统计学意义(P>0.05),治疗后2、4 h观察组血浆药物浓度均低于对照组(P<0.05);延长血液灌流时间并不能进一步显著降低血浆药物浓度(P>0.05)。2组患者死亡率差异无统计学意义(P>0.05),但观察组死亡患者生存时间大于对照组(P<0.05),差异有统计学意义。结论血液灌流可快速有效降低百草枯重度患者血液药物浓度,延长患者生存时间,但不能降低总体死亡率。
Objective To investigate the effects of hemoperfusion on paracetamol poisoning in patients with paraquat poisoning on its blood concentration and prognosis. Methods Thirty-two paraquat poisoning patients admitted to the Third People’s Hospital of Luoyang from October 2012 to December 2015 were selected as control group. After admission, gastric lavage, catharsis, oxygen inhalation and activated carbon adsorption were given respectively. Tubes or tracheostomy and other conventional treatment. In the same period, 29 patients were admitted to the observation group, on the basis of the above treatment measures supplemented by blood perfusion. The concentrations of paraquat in plasma were detected by HPLC at 2,4 h after treatment, and the prognosis of the patients was observed. Results Before treatment and 2,4 and 4 h after treatment, the plasma drug concentrations in the observation group were (10.5 ± 3.2) mg / L, (2.6 ± 1.9) mg / L and (2.4 ± 1.7) mg / L, (10.9 ± 4.2) mg / L, (4.8 ± 2.1) mg / L and (3.5 ± 1.8) mg / L, respectively. There was no significant difference in the plasma drug concentrations between the two groups before treatment (P> 0.05), and the plasma drug concentrations in the observation group at 2 and 4 hours after treatment were lower than those in the control group (P <0.05); prolonged hemoperfusion time did not significantly reduce Plasma drug concentration (P> 0.05). There was no significant difference in mortality rate between the two groups (P> 0.05), but the death time in the observation group was longer than that in the control group (P <0.05). The difference was statistically significant. Conclusion Hemoperfusion can quickly and effectively reduce blood drug concentration in patients with severe paraquat, extend the survival time of patients, but can not reduce the overall mortality.