连续性静脉-静脉血液滤过对中重度百草枯中毒患者脏器的疗效评价  

Evaluation of the Efficacy of Continuous Venous-venous Hemofiltration in the Organs of Patients with Moderate to Severe Paraquat Poisoning

作　　者：许铎 韦国华[2] 刘海燕[3] XU Duo;WEI Guo-hua;LIU Hai-yan(Department of Critical Care Medicine,Suzhou Science and Technology City Hospital,Suzhou,Jiangsu Province,215153 China;Department of Emergency,Jianyang People's Hospital,Jianyang,Sichuan Province,641400 China;Department of Toxicology,Qilu Hospital,Shandong University,Jinan,Shandong Province,250000 China)

机构地区：[1]苏州科技城医院重症医学科,江苏苏州215153 [2]四川省简阳市人民医院急诊科,四川简阳641400 [3]山东大学齐鲁医院中毒科,山东济南250000

出　　处：《中外医疗》2019年第29期53-55,72,共3页China & Foreign Medical Treatment

摘　　要：目的 讨论连续性静脉-静脉血液滤过对中重度百草枯中毒患者脏器的疗效。方法 方便选择2017年1月-2018年12月该院ICU及山东大学齐鲁医院中毒科接收诊治的中重度百草枯中毒患者92例,按照治疗方式分成两组,每组46例;对照组采用甲强龙联合环孢素治疗,观察组则在对照组治疗基础上加用连续性静脉-静脉血液滤过治疗;比较两组治疗30 d的病死率、病死患者的平均存活时间以及患者脏器损伤情况。结果 治疗30 d,观察组病死率明显低于对照组(39.13%vs 60.87%)(χ^2=4.348),死亡患者存活时间明显长于对照组[(9.8±1.1)d vs (6.6±0.9)d (t=15.270)],观察组肾损伤发生率明显低于对照组,患者肾损伤发生时间、肝损伤发生时间、低氧血症发生时间均晚于对照组,呼吸衰竭发生率高于对照组,上述均差异有统计学意义(P<0.05)。结论 连续性静脉-静脉血液滤过治疗能更有效地降低中重度百草枯中毒患者病死率,延长患者存活时间,并延迟患者各脏器功能损伤时间,在临床上的应用价值高。Objective To investigate the effect of continuous venous-venous hemofiltration on the organs of patients with moderate to severe paraquat poisoning.Methods From January 2017 to December 2018,92 patients with moderate to severe paraquat poisoning received from the ICU of the hospital and the Qilu Hospital of Shandong University were convenient selected and divided into two groups according to the treatment method,46 cases in each group.The control group was combined with cyclosporine treatment,the observation group was treated with continuous venous-venous hemofiltration on the basis of the control group;the mortality rate of the 30 days of treatment,the average survival time of the patients with death and the organ damage were compared.Results After treatment for 30 days,the mortality rate of the observation group was significantly lower than that of the control group(39.13%vs 60.87%)(χ^2=4.348).The survival time of the death patients was significantly longer than that of the control group[(9.8±1.1)d vs(6.6±0.9)d(t=15.270)],the incidence of renal injury in the observation group was significantly lower than that in the control group.The time of renal injury,the time of liver injury and the time of hypoxemia were later than the control group,and the incidence of respiratory failure was higher than that of the control group.The differences were statistically significant(P<0.05).Conclusion Continuous venous-venous hemofiltration can reduce the mortality rate of patients with moderate to severe paraquat poisoning,prolong the survival time of patients,and delay the time of functional damage of various organs.It has high clinical value.

关 键 词：连续性静脉-静脉血液滤过 百草枯中毒 脏器损伤 病死率 存活时间 

分 类 号：R595[医药卫生—内科学]