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目的观察序贯性血液净化救治急性百草枯(paraquat,PQ)中毒的临床疗效。方法选择73例急性PQ中毒患者随机分为对照组和治疗组,对照组给予常规方法治疗,治疗组在对照组基础上给予序贯性血液净化治疗。结果两组治疗7、14 d后除WBC外其他实验室指标比较差异均有统计学意义(均P<0.05),两组治疗后肺部CT表现比较差异均有统计学意义(均P<0.05)。对照组治疗后发生多器官功能衰竭、死亡、存活患者住院时间分别为63.6%、66.7%、(41.5±5.5)d,治疗组分别为27.5%、27.5%、(25.9±4.8)d,两组比较差异均有统计学意义(均P<0.05)。对照组无并发症发生。治疗组在序贯性血液净化过程中出现血压下降4例,经快速补液很快纠正;出现肉眼血尿3例,未行任何特殊处理,序贯性血液净化结束后自然恢复。结论尽早实施序贯性血液净化救治急性PQ中毒能减轻各脏器的损伤,减少肺纤维化的形成,降低死亡率,明显改善患者预后,值得临床推广应用。
Objective To observe the clinical efficacy of sequential blood purification in the treatment of acute paraquat (PQ) poisoning. Methods Seventy-three patients with acute PQ poisoning were randomly divided into control group and treatment group. The control group was given routine treatment. The treatment group was given sequential blood purification treatment based on the control group. Results After 7 and 14 days of treatment, there were significant differences in other laboratory indexes except WBC (all P <0.05), and there was significant difference in CT findings between the two groups after treatment (both P <0.05 ). In the control group, multiple organ failure occurred after treatment, and the hospital stay was 63.6%, 66.7% and 41.5 ± 5.5 days, respectively, in the treatment group were 27.5%, 27.5% and 25.9 ± 4.8 days, respectively The differences were statistically significant (all P <0.05). No complications occurred in the control group. In the treatment group, there were 4 cases of blood pressure drop during the process of sequential blood purification, which was quickly corrected by rapid rehydration. There were 3 cases of gross hematuria without any special treatment and natural recovery after sequential blood purification. Conclusion Early implementation of sequential blood purification to treat acute PQ poisoning can reduce the damage of various organs, reduce the formation of pulmonary fibrosis, reduce the mortality, and obviously improve the prognosis of patients. It is worthy of clinical application.