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目的:探讨早期床旁血液灌流(HP)治疗急性重度中毒的疗效。方法:回顾性分析2007年1月-2015年6月我院急诊收治的在确诊后1.5 h内应用HP联合常规内科治疗的急性重度中毒患者65例的临床资料,比较治疗前和治疗后24 h血常规、血气分析、肝肾心功能及凝血功能及急性生理和慢性健康状况评分(APACHEⅡ)。结果:治疗前后患者的血pH、血小板(PLT)、血红蛋白(HB)和钾(K+)值均明显改善(P<0.05),APACHEⅡ评分明显降低(P<0.05),二氧化碳分压(PaCO_2)、谷丙转氨酶(ALT)、谷草转氨酶(AST)、白蛋白(ALB)、肌酐(Cr)、肌酸激酶同工酶(CK-MB)、钠(Na~+)、凝血酶原时间(PT)和活化部分凝血活酶时间(APTT)等数值的变化与HP治疗密切相关(P<0.05)。本组治愈率为93.8%。结论:尽早采用床旁HP治疗可提高急性重度中毒抢救的成功率。
Objective: To investigate the efficacy of early bedside hemoperfusion (HP) in the treatment of acute severe poisoning. Methods: A retrospective analysis of clinical data of 65 patients with acute severe poisoning who were treated with HP combined with routine medical treatment within 1.5 hours after diagnosis in our hospital from January 2007 to June 2015 was retrospectively analyzed. Blood routine, blood gas analysis, heart and liver function, coagulation function and acute physiology and chronic health status score (APACHE II). Results: The blood pH, platelet (PLT), hemoglobin (HB) and potassium (K +) of patients before and after treatment were significantly improved (P <0.05), APACHE Ⅱ score was significantly lower (P < ALT, ALB, creatinine (CK), creatine kinase (CK), sodium (Na ~ +) and prothrombin time (PT) And activated partial thromboplastin time (APTT) and other numerical changes are closely related with HP treatment (P <0.05). The cure rate was 93.8%. Conclusion: As soon as possible, bedside HP treatment can improve the success rate of acute severe poisoning and rescue.