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目的探讨序贯性血液净化治疗百草枯中毒(PQP)的临床疗效及对预后的影响。方法回顾性分析122例PQP患者的临床资料,根据治疗方法不同将其分为常规治疗组42例,血液灌流组47例,序贯性血液净化组[HP+连续性肾替代治疗(CRRT)]33例。采用t检验、χ2检验等方法,分析比较不同治疗组间患者脏器损伤程度、生存时间及病死率之间的差异。结果常规治疗组、血液灌流组、序贯性血液净化组PQP患者年龄、性别、APACHEⅡ评分等差异无统计学意义(P>0.05),具有可比性;序贯性血液净化组脏器损伤程度低于血液灌流组及常规治疗组,差异有统计学意义(P<0.05);序贯性血液净化组生存时间较血液灌流组及常规治疗组延长,差异有统计学意义(P<0.05);122例急性PQP患者总体病死率常规治疗组、血液灌流组、序贯性血液净化组之间比较,差异无统计学意义(P>0.05);98例中-重度PQP患者,序贯性血液净化组病死率低于血液灌流组及常规治疗组,差异有统计学意义(P<0.05)。结论序贯性血液净化治疗可以改善PQP患者的脏器功能、延长生存时间,降低中-重度PQP患者的病死率。
Objective To investigate the clinical effect of sequential blood purification on paraquat poisoning (PQP) and its prognosis. Methods The clinical data of 122 PQP patients were retrospectively analyzed. According to the different treatment methods, they were divided into two groups: conventional treatment group (n = 42), hemoperfusion group (n = 47), sequential blood purification group (HP + continuous renal replacement therapy example. T test, χ2 test and other methods were used to analyze the differences of organ damage, survival time and case fatality rate between different treatment groups. Results There was no significant difference in age, sex, APACHEⅡscore between routine treatment group, hemoperfusion group and sequential blood purification group (P> 0.05), and comparability was found between sequential blood purification group and organ damage group There was significant difference between hemoperfusion group and conventional treatment group (P <0.05). The survival time of sequential blood purification group was longer than that of hemoperfusion group and conventional treatment group (P <0.05) .122 The overall mortality of patients with acute PQP in the conventional treatment group, hemoperfusion group, sequential blood purification group, the difference was not statistically significant (P> 0.05); 98 cases of moderate-severe PQP patients, sequential blood purification group The mortality rate was lower than that of hemoperfusion group and conventional treatment group, the difference was statistically significant (P <0.05). Conclusions Sequential blood purification can improve the organ function, extend the survival time and reduce the mortality of patients with PQP.