血液灌流联合疗法在危重症毒物或药物中毒应用的临床观察  

Hemoperfusion, Hp United Therapeutics Applied in Serious Poison or Medicine Poisoning and Assessment for Post-Treatment

作　　者：阮建平[1] 陈华基[1] 付康才[1] 张卫[1] 王晓鸣[1] 

机构地区：[1]广东省农垦中心医院血液净化中心,广东湛江524002

出　　处：《海南医学》2006年第6期6-7,36,共3页Hainan Medical Journal

摘　　要：目的观察血液灌流联合疗法治疗危重症毒物或药物中毒患者的临床疗效和预后的评价。方法对危重症毒物或药物中毒患者59例,男16例,女43例,平均年龄35±18.5岁,镇静安眠药中毒15例,有机磷农药中毒25例,杀鼠剂11例,除草剂3例,其他5例。所有患者均在院外或院内进行治疗,病情无改善。立即予血液灌流联合疗法,血液透析(HD)2例,血液灌流单泵术(HP)2例,血液透析串联血液灌流(HD+HP)52例,膜式血浆置换(PE)及HD+HP3例。二次HD+HP26例,三次HD+HP2例。结果镇静安眠药中毒经HD、HP或HD+HP治疗1次后全部治愈,疗效显著;有机磷农药、杀鼠剂中毒经HD+HP经1～3次治疗后治愈率分别96%、81.8%,但昏迷至清醒时间及住院时间明显比镇静安眠药中毒组延长;除草剂中毒2例行简易PE及HD+HP治疗治愈。结论血液灌流联合疗法可明显改善危重度毒物中毒预后,但应根据病情,慎重治疗方法,并尽早进行。对除草剂中毒适宜PE后行HD+HP治疗。Objective To explore the hemoperfusion, Hp united therapeutics applied in serious poison and medicine poisoning and assessment for post-treatment; Methods To analyze 58 cases of patients suffering from serious poison and medicine poisoning, 16 cases of males, 42 cases of females, average age of 35＋18.3 years old, 15 cases of sedative hypnolic poisoning, 24 cases of pesticide poisoning. 11 cases of mouse killer poisoning, 3 cases of herbicide poisoning, 5 cases of other medicine. All patients are treated in or out of hospital without improvement so as to be treated by hemoperfusion, Hp united therapeutics intermediately; 2 cases of HD, 2 cases of HP, 49 cases of HD＋HP, 3 cases of PE and HD＋HP; 26 cases of HD＋HP for two times and 2 cases of HD＋HP for three times, Results The patients suffered from sedative hypnolic poisoning are treated to be totally cured by HD, HP or HD＋HP with remarkable curative effect for one time. The patient suffered from organic phosphorus pesticide, mouse killer, herbicide poisoning is treated by HD＋HP with cured rate of 95.8%, 81.8% and 66.7% separately for one to three times. However, its coma to sober time compared with inpatients＇ time is longer than the sedative hypnolic poisoning group; The curative effect for PE and HD＋HP of simple herbicide and mouse killer is better;, Conclusions The hemoperfusion, Hp united therapeutics can improve serious poisoning, but it should depend on therapeutics and poisoning situation carefully for the treatment suited to PE and HD＋HP to herbicide poisoning as soon as possible .

关 键 词：血液灌流 膜式血浆置换 毒物 药物 中毒 

分 类 号：R595[医药卫生—内科学]