摘要
目的:探讨早期碱化血液在急性百草枯(PQ)中毒救治中的意义及其对预后的影响。方法:对2011-01-2015-06遵义医学院附属医院收治的129例PQ中毒患者的临床资料进行回顾性分析,依据其就诊时间分为对照组(n=62)和治疗组(n=67)。对照组进行洗胃、血液灌流、利尿、导泻等基础治疗,治疗组在基础治疗上加碳酸氢钠碱化血液治疗。结果:治疗组病死率低于对照组(P<0.05),丙氨酸氨基转移酶(ALT)、天门冬氨酸氨基转移酶(AST)、总胆红素(TBIL)、肌酐(Cr)、肌酸激酶同工酶(CK-MB)峰值水平均显著低于对照组(P<0.05),动脉血氧分压(PaO2)和乳酸(Lac)水平较对照组有明显改善。结论:PQ中毒后早期进行常规碱化血液治疗,能促进患者血液中残余PQ的分解,同时中毒后易引发代谢性酸中毒,酸中毒能加重心、肺等重要脏器损伤,及早应用碱化血液治疗不仅能改善脏器功能,降低Lac水平,还能显著改善中毒患者的预后,降低病死率。
Objective：To assess the effect of early alkalinizing blood in patients with acute paraquat poisoning（PQ）.Method：In this retrospective study,the clinical characteristics of 129 PQ patients were obtained between January 2011 and June 2015 from the Affiliated Hospital of Zunyi Medical College.Individuals were divided into two groups according to the time they arrived at the hospital.The control group obtained a basic therapeutic regimen including gastric lavage,haemoperfusion,diuretic,cathartic and so on.The case group obtained extro alkalinizing blood with sodium bicarbonate besides the basic therapeutic regimen.Result：The mortality of the case group was significantly lower than the control group（P〈0.05）,and the level of alanine aminotransferase（ALT）,aspartate aminotransferase（AST）,total bilirubin（TBIL）,creatinine（Cr）and creatine kinase-MB（CK-MB）showed the same difference（P〈0.05）.The arterial partial pressure of oxygen（PaO2）and lactate（Lac）got significantly better than the control group.Conclusion：Alkalinizing blood in patients with PQ could promote the left paraquat to be resolved in blood.PQ could result in metabolic acidosis which could injury heart and lung.Alkalinizing blood in early time could improve the function of organs,reduce the level of lactate,improve the success rate of the raping and decrease the mortality.
出处
《临床急诊杂志》
CAS
2016年第5期343-346,共4页
Journal of Clinical Emergency
关键词
百草枯
中毒
碱化血液
碳酸氢钠
paraquat
poisoning
alkalinizing blood
sodium bicarbonate
