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目的观察血液灌流联合疗法治疗危重症毒物或药物中毒患者的临床疗效和预后的评价。方法对危重症毒物或药物中毒患者59例,男16例,女43例,平均年龄35±18.5岁,镇静安眠药中毒15例,有机磷农药中毒25例,杀鼠剂11例,除草剂3例,其他5例。所有患者均在院外或院内进行治疗,病情无改善。立即予血液灌流联合疗法,血液透析(HD)2例,血液灌流单泵术(HP)2例,血液透析串联血液灌流(HD+HP)52例,膜式血浆置换(PE)及HD+HP3例。二次HD+HP26例,三次HD+HP2例。结果镇静安眠药中毒经HD、HP或HD+HP治疗1次后全部治愈,疗效显著;有机磷农药、杀鼠剂中毒经HD+HP经1～3次治疗后治愈率分别96%、81.8%,但昏迷至清醒时间及住院时间明显比镇静安眠药中毒组延长;除草剂中毒2例行简易PE及HD+HP治疗治愈。结论血液灌流联合疗法可明显改善危重度毒物中毒预后,但应根据病情,慎重治疗方法,并尽早进行。对除草剂中毒适宜PE后行HD+HP治疗。
Objective To observe the clinical efficacy and prognosis of hemoperfusion combined therapy in patients with critically ill poison or drug poisoning. Methods 59 cases of critically ill poison or drug poisoned patients, 16 males and 43 females, with an average age of 35 ± 18.5 years old, sedative sleeping pills poisoning in 15 cases, organophosphorus pesticide poisoning in 25 cases, rodenticide in 11 cases, herbicide in 3 cases , The other 5 cases. All patients were treated outside the hospital or hospital, the condition did not improve. Immediate combination therapy of hemoperfusion, 2 cases of hemodialysis (HD), 2 cases of hemoperfusion (HP), 52 cases of hemodialysis hemodialysis (HD + HP), membrane plasma exchange (PE) and HD + HP3 example. Secondary HD + HP26 cases, three HD + HP2 cases. Results The sedative sleeping pills poisoning was completely cured by HD, HP or HD + HP treatment for 1 time, and the curative effect was remarkable. The cure rates of organophosphorus pesticides and rodenticide poisoning by HD + HP were 96%, 81.8% However, the coma to waking time and hospitalization time were significantly longer than the sedative hypnotizing drug poisoning group. Herbicide poisoning 2 patients were treated with simple PE and HD + HP. Conclusion Hemoperfusion combined therapy can significantly improve the prognosis of critically toxic poisoning, but should be based on the disease, careful treatment, and as soon as possible. Suitable for herbicide poisoning after PE HD + HP treatment.