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目的评估血液灌流联合血液透析治疗急性百草枯中毒的临床疗效并进行系统研究。方法将本院自2008年1月至2012年12月确诊为急性百草枯中毒40例患者随机分为两组,其中观察组23例,对照组17例,对照组采用常规治疗措施如积极洗胃、导泻、抑酸、保肝、补液及利尿等对症及支持疗法;观察组在对照组的常规治疗措施的基础上再配合血液灌流联合血液透析治疗,观察两组疗效并系统比较。结果观察组23例中显效10例、有效8例、无效6例、总有效率74%、病死率26%;对照组17例中显效1例、有效3例、无效13例、总有效率23.6%、病死率76.4%,两组总有效率和病死率比较有显著性差异(P<0.01)。其中观察组在血液灌流和血液透析后出现血小板数量的减少,未进行治疗,2 d后自行恢复,所有病例均未见其他脏器的活动性出血及血滤管阻塞。结论根据两组之间治疗急性百草枯中毒的总有效率的比较,不难得出血液灌流联合血液透析治疗较常规治疗不但能提高有效率,还能早期改善症状及其预后,降低肺间质纤维化及其他并发症的发生率,疗效肯定,副作用又小,能被患者接受,值得在临床上推广应用。
Objective To evaluate the clinical efficacy of hemoperfusion combined with hemodialysis in the treatment of acute paraquat poisoning and to conduct a systematic study. Methods Forty patients with acute paraquat poisoning diagnosed in our hospital from January 2008 to December 2012 were randomly divided into two groups, of which 23 cases in the observation group and 17 cases in the control group were treated with routine treatment such as active gastric lavage , Catharsis, acid suppression, liver protection, rehydration and diuresis and other symptomatic and supportive therapy; observation group in the control group on the basis of conventional treatment measures combined with hemoperfusion hemodialysis treatment, the two groups were observed and compared. Results The observation group of 23 cases markedly effective in 10 cases, effective in 8 cases, 6 cases of ineffective, the total effective rate was 74%, the mortality rate was 26%; control group of 17 cases markedly effective in 1 case, 3 cases were ineffective in 13 cases, the total effective rate was 23.6 %, And the case fatality rate was 76.4%. There was significant difference between the two groups in total effective rate and case fatality rate (P <0.01). In the observation group, the number of platelets decreased after hemoperfusion and hemodialysis. No treatment was performed and the patients recovered on their own after 2 days. All patients had no active hemorrhage and blood clots in other organs. Conclusion According to the comparison of the total effective rate of acute paraquat poisoning between the two groups, it is not difficult to conclude that hemodialysis combined with hemodialysis can not only improve the efficiency, but also improve the symptoms and prognosis early, reduce the interstitial fibrosis The incidence of complications and other complications, efficacy is positive, side effects and small, can be accepted by patients, it is worth to promote the clinical application.