杂合式血液净化在重症中毒中的应用  

Application of Hybrid Blood Purification in Severe Poisoning

作　　者：涂尚贵 廖长发 罗添桂 陈健辉 张炎安 TU Shanggui;LIAO Changfa;LUO Tiangui;CHEN Jianhui;ZHANG Yan'an(Emergency Department,Longyan First Hospital Affiliated to Fujian Medical University,Longyan,Fujian Province,364000 China)

机构地区：[1]福建医科大学附属龙岩第一医院急诊科,福建龙岩364000

出　　处：《中外医疗》2021年第33期9-13,共5页China & Foreign Medical Treatment

基　　金：龙岩市科技计划项目任务书(2019LYF5010)。

摘　　要：目的探讨杂合式血液净化对重症中毒患者的应用效果。方法便利选取2018年1—12月在该院急诊重症监护室治疗的30例急性重症中毒患者为对照组,选取2019年5月—2020年5月在该院急诊重症监护室治疗的30例急性重症中毒患者为观察组。对照组给予血液灌流治疗,观察组给予杂合式血液净化治疗。比较两组患者治疗前、治疗1、3、5、7 d的肝肾功能指标、心肌酶谱、炎症指标、氧合指数以及住院恢复指标和近期预后。结果治疗3~7 d,观察组患者AST、SCr、BUN、CPK均低于对照组,差异有统计学意义(P<0.05)。治疗1~7 d,观察组CRP、IL-6、TNF-α水平低于对照组,氧合指数高于对照组,差异有统计学意义(P<0.05)。观察组患者呼吸机脱机时间、ICU滞留时间、住院时间均短于对照组,差异有统计学意义(t=6.147、3.710、2.914,P<0.05)。两组患者出院30 d内病死率(0.0%vs 3.3%)比较,差异无统计学意义(χ^(2)=1.017,P>0.05)。结论杂合式血液净化对重症中毒患者的应用效果显著,可有效缓解患者肝、肾、心功能损伤,减轻早期炎症反应,促进患者康复。Objective To explore the effect of hybrid blood purification on severely poisoned patients.Methods Conveniently selected 30 patients with acute severe poisoning treated in the hospital's emergency intensive care unit from January to December 2018 as the control group,and selected 30 patients treated in the hospital's emergency intensive care unit from May 2019 to May 2020 patients with acute severe poisoning were the observation group.The control group was given hemoperfusion therapy,and the observation group was given heterozygous blood purification therapy.The liver and kidney function indexes,myocardial enzyme spectrum,inflammation indexes,oxygenation index,hospital recovery indexes and short-term prognosis of the two groups were compared before treatment,1 d treatment,3 d treatment,5 d treatment,7 d treatment.Results After treatment for 3-7 d,AST,SCr,BUN,CPK of the observation group were lower than those of the control group,the difference was statistically significant(P<0.05).After treatment for 1 to 7 d,the levels of CRP,IL-6,and TNF-α in the observation group were lower than those in the control group,and the oxygenation index was higher than that in the control group,the difference was statistically significant(P<0.05).The time of ventilator weaning,ICU retention time,and hospitalization time of the observation group were shorter than those of the control group,and the difference was statistically significant(t=6.147,3.711,2.914,P<0.05).There was no statistically significant difference in the incidence of death(0.0%vs 3.3%)within 30 d of discharge between the two groups(χ^(2)=1.017,P>0.05).Conclusion Hybrid blood purification has a significant effect on severely poisoned patients.It can effectively alleviate the liver,kidney,and heart damage,reduce early inflammation,and promote the recovery of patients.

关 键 词：杂合式血液净化 血液灌流 重症 中毒 肝肾功能 炎症指标 

分 类 号：R5[医药卫生—内科学]