序贯性血液净化联合纳洛酮对急性中毒患者血气分析、血液流变学和炎症因子的影响  

Effect of sequential blood purification combined with naloxone on blood gas parameters,hemorheology,and inflammatory factors in patients with acute poisoning

作　　者：徐飞[1] 江亚 刘超[1] 吴瑶[2] 李冰[3] Xu Fei;Jiang Ya;Liu Chao;Wu Yao;Li Bing(Department of Emergency Medicine,3201 Affiliated Hospital of Xi'an Jiaotong University,Hanzhong 723000,China;Department of Emergency Medicine;Daytime Operation Center,the Second Affiliated Hospital of Xi'an Jiaotong University,Xi'an 710004,China)

机构地区：[1]西安交通大学附属三二〇一医院急诊科,陕西汉中723000 [2]西安交通大学第二附属医院急诊科,西安710004 [3]西安交通大学第二附属医院日间手术中心,西安710003

出　　处：《中华临床医师杂志（电子版）》2022年第3期236-240,共5页Chinese Journal of Clinicians(Electronic Edition)

摘　　要：目的探讨序贯性血液净化联合纳洛酮对急性中毒患者血气分析、血液流变学和炎症因子的影响。方法选择2019年6月至2020年6月西安交通大学附属三二〇一医院收治的急性中毒患者102例,按照治疗方法分为观察组与对照组,各51例。2组患者入院均采取常规治疗。对照组给予纳洛酮治疗,观察组在纳洛酮基础上结合序贯性血液净化治疗。比较2组患者治疗效果、苏醒时间、住院时间,以及治疗前后血气分析、血液流变学和炎症因子变化情况。结果观察组急性中毒患者治疗总有效率高于对照组(94.12%vs 80.39%,P<0.05)。观察组急性中毒患者苏醒时间和住院时间短于对照组[(2.46±0.71)h vs(4.72±1.29)h;(7.85±2.12)d vs(10.94±2.53)d,P<0.05)。2组急性中毒患者治疗后氧分压(PaO2)高于治疗前,而二氧化碳分压(PaCO_(2))和乳酸水平低于治疗前(P<0.05);观察组患者治疗后PaO2高于对照组,PaCO_(2)和乳酸水平低于对照组(P<0.05)。2组急性中毒患者治疗后血浆黏度、全血高切黏度、全血低切黏度和血细胞比容均低于治疗前(P<0.05),观察组患者治疗后上述各指标均低于对照组(P<0.05)。2组急性中毒患者治疗后肿瘤坏死因子-α(TNF-α)、白细胞介素-18(IL-18)和白细胞介素-6(IL-6)水平均低于治疗前(P<0.05),观察组患者治疗后上述各指标均低于对照组(P<0.05)。结论序贯性血液净化联合纳洛酮对急性中毒患者疗效良好,可改善患者的血气分析和血液流变学指标,减轻炎症反应。Objective To investigate the effect of sequential blood purification combined with naloxone on blood gas parameters,hemorheology,and inflammatory factors in patients with acute poisoning.Methods A total of 102 patients with acute poisoning admitted to 3201 Hospital of Xi'an Jiaotong University from June 2019 to June 2020 were selected and divided into an observation group and a control group according to the treatment method used,with 51 cases in each group.Patients in both groups received conventional treatment.The control group was additionally given naloxone treatment,and the observation group was additionally treated with naloxone combined with sequential blood purification.The therapeutic effects,awakening time,and hospitalization time were compared between the two groups.Blood gas parameters,hemorheology,and inflammatory factors before and after treatment were also compared Results The total effective rate in the observation group was higher than that of the control group(94.12%vs 80.39%,P<0.05).The awakening time and hospitalization time in the observation group were shorter than those of the control group[(2.46±0.71)h vs(4.72±1.29)h,(7.85±2.12)d vs(10.94±2.53)d,P<0.05].After treatment,PaO2 in both groups was higher than that before treatment,while PaCO_(2) and lactic acid levels were lower than those before treatment(P<0.05);after treatment,PaO2 in the observation group was higher than that that of the control group,while PaCO_(2) and lactic acid levels were lower than those of the control group(P<0.05).Plasma viscosity,whole blood high shear viscosity,whole blood low shear viscosity,and hematocrit after treatment were lower than those before treatment in both groups(P<0.05);these indexes in the observation group were lower than those of the control group after treatment(P<0.05).The levels of tumor necrosis factor-α(TNF-α),interleukin(IL)-18,and IL-6 after treatment were lower than those before treatment in both groups(P<0.05);these indexes in the observation group were lower than those of the contr

关 键 词：序贯性血液净化 纳洛酮 急性中毒 血气分析 血液流变学 炎症因子 

分 类 号：R595.4[医药卫生—内科学]