重度药物中毒患者持续床旁血液滤过联合血液灌流治疗的效果观察  

Observation on the effect of continuous bedside hemofiltration combined withhemoperfusion in patients with severe drug poisoning

作　　者：王飘 Wang Piao(Department of Critical Care Medicine,Peixian People's Hospital,Xuzhou City,Xuzhou Jiangsu,221600,China)

机构地区：[1]徐州市沛县人民医院重症医学科,江苏徐州221600

出　　处：《中外女性健康研究》2023年第6期13-16,共4页Women＇s Health Research

摘　　要：目的:观察持续床旁血液滤过与血液灌流联合应用对重度药物中毒患者心肌酶谱指标(谷丙转氨酶、谷草转氨酶、磷酸肌酸激酶、磷酸肌酸激酶同工酶、乳酸脱氢酶)、肾功能指标(血肌酐、尿素氮)、死亡率、并发症(脑水肿、肺水肿、心力衰竭)总发生率的影响。方法:选取本院2020年1月至2022年1月收治的60例重度药物中毒患者,依据患者实施的治疗方案进行分组,每组各30例。对照组按照传统救治方案予以治疗,观察组加用持续床旁血液滤过联合血液灌流治疗。72h后采集空腹静脉血并测定心肌酶谱指标以及肾功能指标,治疗结束时统计死亡率,转出本科室前统计并发症总发生率。获得以上数据后比较两组的疗效差异。结果:观察组的死亡率、并发症总发生率低于对照组,治疗后的心肌酶谱指标、肾功能指标优于对照组,差异有统计学意义(P<0.05)。结论:在重度药物中毒患者治疗中持续床旁血液滤过与血液灌流联合应用可以降低死亡率以及并发症总发生率、为心肾功能提供保护,值得临床使用。Objective:To observe the combined application of continuous bedside hemofiltration and hemoperfusion on myocardial enzyme spectrum indexes(alanine aminotransferase,aspartate aminotransferase,phosphocreatine kinase,phosphocreatine kinase isoenzyme,lactate dehydrogenase)in patients with severe drug poisoning),renal function indicators(serum creatinine,blood urea nitrogen),mortality,and the overall incidence of complications(cerebral edema,pulmonary edema,and heart failure).Methods:A total of 60 patients with severe drug poisoning who were admitted to our hospital from January 2020 to January 2022 were selected and divided into groups according to the treatment plan implemented by the patients,with 30 cases in each group.The control group was treated according to the traditional treatment plan,and the observation group was additionally treated with continuous bedside hemofiltration combined with hemoperfusion.After 72 hours,fasting venous blood was collected,and myocardial enzyme spectrum indexes and renal function indexes were measured.At the end of treatment,the mortality rate was counted,and the total incidence of complications was counted before being transferred out of the department.After obtaining the above data,the difference in efficacy between the two groups was compared.Results:The mortality rate and the total incidence of complications in the observation group were lower than those in the control group,and the myocardial enzyme spectrum indexes and renal function indexes after treatment were better than those in the control group,and the difference was statistically significant(P<0.05).Conclusion:The combined application of continuous bedside hemofiltration and hemoperfusion in the treatment of patients with severe drug poisoning can reduce the mortality and the total incidence of complications,and provide protection for the heart and kidney function,which is worthy of promotion.

关 键 词：重度药物中毒 持续床旁血液滤过 血液灌流 心肌酶谱指标 肾功能指标 死亡率 并发症总发生率 

分 类 号：R595.4[医药卫生—内科学]