摘要
目的探讨大剂量环磷酰胺、甲强龙联合无创正压通气治疗百草枯中毒的疗效。方法选择2009年10月至2010年11月百草枯中毒患者21例试验,其中男性8例,女性13例,平均年龄(39.6±15.6)岁。对照组:采用回顾性匹配的方法,选择2009年1月至2009年9月的21例百草枯中毒患者。其中男11例,女10例,平均年龄(34.1±15.4)岁。对照组常规治疗加地塞米松,治疗组常规治疗加大剂量环磷酰胺和甲强龙,并据需要联合应用无创正压通气。比较两组患者低氧血症、急性肾损伤、中毒性肝炎的发生率、生存时间和病死率。结果对照组肾功损害、肝损害发生率分别为76.2%和66.7%,而治疗组分别为47.6%和47.6%,无统计学差异。对照组低氧血症发生率为95.2%较治疗组57.1%明显升高,差异有统计学意义。治疗组生存时间较对照组延长(19.1±4.9 VS 8.6±3.5,t=-4.451,P=0.000),差异有统计学意义(P<0.05)。治疗组病死率10/21(47.6%),较对照组病死率18/21(85.7%)降低(χ2=5.081,P=0.024),差异有统计学意义(P<0.05)。结论大剂量环磷酰胺与甲强龙联合无创正压通气治疗百草枯中毒,能够延长患者生存时间、降低病死率。
Objective To study curative effect of the pulse large dose of cyclophosphamide and methylprednisolone combined with non-invasion mechanic ventilation for paraquat poisoning .Methods 21 cases with paraquat poisoning from Jan. 2009 to Sept. 2009 served as control group and 21 cases from Oct. 2009 to Dec. 2010 served as trial group .Conventional therapy plus dexamethasonwas performed in the control group （21 cases）, and the pulse large dose of cyelophosphamide and methylprednisolone combined with non-invasion mechanic ventilation were used in the trial group （21 cases）.The rate of hypoxemia, kidney and liver injury were compared between two groups. Survival time and mortality of two groups were also compared .Results The prevalence of acute renal failure, hepatitis were 76.2% and 66.7% in control group respectively, and 47.6%, 47.6% in the trail group respectively. There were no significant differences of prevalence rate of those symptoms between the two groups. But the prevalence of hypoxemia in control group were higher than the treatment group .However, survival time in the trail group（19.1±4.9d） were longer than those in the control group（8.6±3.5d, P〈0.05）, and mortality in trail group（47. 6%, 10/21） was lower than that of control group（85.7%, 18/21, P〈0.05）. Conclusion Pulse large dose of cyclophosphamide and methylprednisolone combined with non-invasion mechanic ventilation can reduce mortality and prolong survival time.
出处
《中国医药指南》
2013年第18期410-412,共3页
Guide of China Medicine
关键词
百草枯
环磷酰胺
中毒
甲强龙
无创正压通气
Paraquat
Cyclophosphamide
Poisoning
Methylprednisolone
Non-invasion mechanic ventilation
