摘要
目的探讨血液灌流联合血液透析治疗急性百草枯中毒的临床效果。方法回顾性分析2010年1月至2015年1月四川省乐山市人民医院肾病内科收治的169例急性百草枯中毒患者的临床资料,按治疗方法的不同,分为2组,分别为常规治疗组(对照组,96例),此组予以洗胃、催吐、导泻、保持呼吸道通畅、大量补液利尿、激素抗肺纤维化、大剂量维生素C和E抗氧自由基、还原型谷胱甘肽保肝、奥美拉唑制酸护胃、抗菌药物预防感染、营养支持及纠正水、电解质和酸碱失衡等综合性治疗,研究组为血液灌流联合血液透析(73例),该组在以上常规治疗的基础上,加以血液灌流联合血液透析。结果采用血液透析联合血液灌流进行治疗的患者治愈率(50.68%)、好转率(21.92%)、有效率(72.60%)均明显高于采用常规治疗的患者(7.29%、2.08%、9.38%),差异均有统计学意义(均P<0.05)。常规治疗组病死率(90.63%)明显高于血液灌流联合血液透析组(27.40%),差异有统计学意义(P<0.05)。经联合治疗而死亡的患者存活时间明显长于采用常规治疗的患者,差异具有统计学意义(P<0.05)。结论对急性百草枯中毒患者在常规治疗基础上在予以血液灌流联合血液透析可延迟各器官衰竭的进程,可为进一步采取相应的治疗措施赢得治疗时间。及时采取血液灌注联合血液透析治疗可以有效提高治疗效果。
Objective To investigate the clinical effects of hemoperfusionin combined with hemodialys in treatment of patients with acute paraquat poisoning. Methods Retrospectively, the clinical data of 169 patients with acute paraquat poisoning admitted to the Department of Nephrology in Les- han People＇s Hospital were analyzed by being divided into two groups, according to different treating methods. A part of the patients were assigned to the control group （96 cases） with conventional comprehensive therapy, such as gastric lavage, emetic methods, catharsis, keeping the fluency of respiratory tract, diereses by large fluid replacement, preventing pulmonary fibrosis by using hormone, quenching oxygen radicals by administrating large dose of vitamin C and vitamin E, protecting the liver by using reduced glutathione, protecting the stomach by using Omeprazole to inhibit gastric acid, preventing infection by using antibacterial drugs, nutrition support and balancing the water, electrolytes and acid-base, etc. The rest patients were assigned to the experimental group （73 cases） with conventional treatment and hemoperfusion combined with hemodialys according to treatment plans. Results The cure rate of hemedialysis combined hemoperfusion treatment （50. 68%）, the improvement rate （21.92%） and the efficiency （72. 60%） were significantly higher than those （7. 29%, 2. 08%, and 9. 38% respectively） of conventional treatment （P〈0. 05 for all）. The mortality rate （90. 63%） （i. e. , the inefficiency rate） of the patients with conventional therapy was significantly higher than that （27.40%） of the patients with combination therapy, and the difference was statistically significant （P 〈0. 05）. The survival time of patients with the combination therapy who eventually died was signifi-cantly longer than that of those with conventional therapy, and the difference was statistically significant （P〈0.05）. Conclusions Hemoperfusionin combined with hemodialys treatment, based on the conventi
出处
《临床肾脏病杂志》
2016年第11期669-672,共4页
Journal Of Clinical Nephrology
