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目的:探讨血液透析(hemodilalysis,HD)治疗急性百草枯中毒的临床疗效,为临床应用HD治疗急性百草枯中毒提供依据。方法:选择我院2003年3月~2012年7月收治的百草枯中毒患者40例,根据患者使用是否行透析治疗分为透析组(A组17例)和非透析组(B组23例),比较分析两组患者治疗后的肝功能、肾功能、肺功能及心肌酶学指标的变化,治疗效果及存活情况。结果:两组患者入院后前3天ALT、AST、BUN、CR、CK、CK-MB水平均呈上升趋势,且非透析组患者以上指标的水平高于透析组患者,但差异无统计学意义(P>0.05),入院后第7天,两组以上指标的比较亦无统计学差异(P>0.05);两组患者之间入院时和入院后72小时内最低的SPO2%、血气分析中PaO2和PaCO2水平比较无统计学意义(P>0.05);透析组和非透析组患者的病死率分别为70.6%和69.6%,差异无统计学意义(P>0.05)。结论:百草枯溶液中毒的患者预后差、病死率高,血液透析治疗并不能显著提高急性百草枯中毒患者的生存率。
Objective: To investigate the clinical efficacy of hemodilalysis (HD) in the treatment of acute paraquat poisoning and provide evidence for the clinical application of HD in the treatment of acute paraquat poisoning. Methods: Forty patients with paraquat poisoning who were treated in our hospital from March 2003 to July 2012 were divided into dialysis group (group A, n = 17) and non-dialysis group (group B, n = 23) according to whether patients underwent dialysis. , Comparative analysis of two groups of patients after treatment of liver function, renal function, lung function and myocardial enzyme changes, the treatment effect and survival. Results: The levels of ALT, AST, BUN, CR, CK and CK-MB both showed an upward trend in the first 3 days after admission, and the levels of the above indexes in non-dialysis group were higher than those in dialysis group, but the difference was not statistically significant (P> 0.05). On the 7th day after admission, there was no significant difference between the two groups (P> 0.05). The lowest SPO2% at admission and within 72 hours after admission was The PaO2 and PaCO2 levels were not statistically significant (P> 0.05). The mortality of patients in dialysis group and non-dialysis group were 70.6% and 69.6%, respectively, with no significant difference (P> 0.05). Conclusion: Patients with paraquat poisoning have poor prognosis and high mortality. Hemodialysis does not significantly improve the survival rate of patients with acute paraquat poisoning.