中毒剂量及血液净化方式与急性百草枯中毒疗效的关系  

Relationship between Intoxicating Dose,Blood Purification Method and Clinical Efficacy in Treatment of Acute Paraquat Poisoning

作　　者：黄杨[1] 尹文[1] 瞿丽娟[1] 崔锐红[1] 余厚友[1] 王玉同[1] 郝璐[1] 

机构地区：[1]第四军医大学西京医院急诊科,西安710032

出　　处：《临床误诊误治》2013年第10期6-8,共3页Clinical Misdiagnosis & Mistherapy

基　　金：国家青年科学基金资助项目(81101413);陕西省自然科学基金资助项目(2010JM4051)

摘　　要：目的 探讨血液净化对急性百草枯中毒的治疗效果.方法 将108例急性百草枯中毒根据服毒剂量分为A组（＜5 ml）、B组（5～20 ml）、C组（20～50 ml）和D组（＞50 ml）.每组根据血液净化方式再分为常规组和强化组.比较各组患者病死率及其治疗第1天和第7天的动脉血氧分压（PaO2）、血清肌酐（Cr）、天冬氨酸转移酶（AST）的变化.结果 D组患者病死率显著高于其他各组（P＜0.01）.B组和C组中,强化组病死率显著低于常规组（P＜0.01）.在治疗第7天,与同组的常规组相比,B组和C组中的强化组PaO2明显提高、Cr和AST指标降低（P＜0.01）,在A组和D组中两种治疗方法各项指标的改善差异并不显著.结论 中毒剂量与血液净化方式的选择和百草枯中毒的疗效关系密切.Objective To explore the clinical efficacy of blood purification in treatment of acute paraquat poisoning. Meth- ods A total of 108 patients with acute paraquat poisoning were divided into four groups by different oral doses： group A （ 〈5 ml）, group B （5-20 ml）, group C （20-50 ml） and group D （20-50 ml）. Each group was then divided into conventional group and intensive group according to different methods of blood purification. Fatality rates and changes of levels of arterial po2 （ PaO2 ）, serous creatinine （Cr）, aspartic transaminase （AST） on 1 D and 7 D after treatment were compared. Results Fatality rate of group D was significantly higher than those of other groups （P 〈 0. O1 ）. In the same group, fatality rate of intensive group was significantly lower than that of conventional group in group B and C （ P 〈 0. 01 ）. In the same group, the PaO2 level was significantly higher, and indexes of Cr and AST were significantly lower in intensive group on 7 D after treatment compared with those in conventional group in group B and C （P 〈0. O! ） ; while there were no significant differences in index changes in group A and D by the two therapy methods. Conclusion There was a close relationship between intoxicating dose, blood purification method and clinical efficacy in treatment of acute paraquat poisoning＋

关 键 词：中毒 百草枯 血液净化 

分 类 号：R595.4[医药卫生—内科学]