急诊科早期应用血液净化治疗急性重度中毒的临床研究  

Application emergency hemopurification therapies in patients with acute toxicants poisoning at the early stage

作　　者：吕菁君[1] 魏捷[1] 王蕊[1] 李文强[1] 李玲莉[1] 杨卫泽[1] 李涛[1] 万曦[1] 杨河欣[1] 周燕[1] 祁必富[1] 

机构地区：[1]武汉大学人民医院急诊科,武汉430060

出　　处：《临床急诊杂志》2011年第4期238-241,共4页Journal of Clinical Emergency

摘　　要：目的:探讨血液净化治疗在急性药物或毒物中毒中的应用时机和方法。方法:2008年至2010年符合急性重度药物或毒物中毒诊断标准的患者65例。根据病情选择血液灌流、血液透析、血液灌流联合血液透析、或床旁连续性肾脏替代治疗。评估Glasgow评分,机械通气使用率,住院天数,治愈率,死亡率,以及血液净化治疗的不良反应。结果:首诊时Glasgow评分为5.4±2.2。血液净化治疗开始的时间为首诊后2.3±0.8h。平均血液净化治疗的次数为2.7±0.5次。患者痊愈出院50例(76.9%),自动出院7例(10.7%),死亡8例(12.3%)。平均住院天数5.6±2.2d。结论:在常规内科对症对因治疗的同时,尽早、综合、大胆应用血液净化治疗,显著提高急性重度中毒患者的救治成功率,减少住院天数。Objective：To explore the timing and technique of emergency hemopurification therapies in patients with acute toxicants poisoning. Method：On the basis of routine medical therapy,sixty-five patients with acute toxicants poisoning in the emergency department were treated with hemoperfusion,or/and hemodialysis,or/and continuous renal replacement therapy（CRRT） in according to clinical manifestation and toxicants properties. The timing of hemopurification therapy,Glasgow coma score and the rate of mechanical ventilation were measured. Result：The first time for hemopurification therapy was 2.3±0.8 hour after arrive in ER and Glasgow coma score was 5.4±1.2. On the average,each patient with acute toxicants poisoning got 2.7±0.5 hemopurification therapy. 76.9% patients were healed and dischargedfrom hospital,10.7 % patients left hospital with illness and 12.3% patients passed away. Mean hospital stays was 5.6±2.2 days. Conclusion：Base on routine medical therapy,hemopurification therapy at the early stage can improve recovery rate and reduce hospital stays.

关 键 词：中毒 血液净化 早期 治疗 

分 类 号：R595.4[医药卫生—内科学]