血液灌流联合持续性血液滤过对敌草快中毒的疗效观察  

Effect of hemoperfusion combined with continuous veno-venous hemofiltration on diphtheria poisoning

作　　者：张晓凡[1] 朱志强[1] 裴辉[1] 谷玉雷[1] 谢佳丰 毛宇径 訾亚楠 黄亚辉[1] 刘景荣 ZHANG Xiaofan;ZHU Zhiqiang;PEI Hui;GU Yulei;XIE Jiafeng;MAO Yujing;ZI Yanan;HUANG Yahui;LIU Jingrong(Department of Emergency Medicine,The First Affiliated Hospital of Zhengzhou University,Zhengzhou,Henan 450000,China)

机构地区：[1]郑州大学第一附属医院急诊医学部,450000

出　　处：《现代医药卫生》2023年第11期1849-1852,1856,共5页Journal of Modern Medicine & Health

摘　　要：目的探讨血液灌流联合持续性血液滤过在敌草快中毒中的临床应用效果。方法选取2020年1月至2021年12月郑州大学第一附属医院急诊医学部收治的84例敌草快中毒患者作为研究对象,根据治疗方式分为对照组和试验组。对照组接受血液灌流治疗,试验组给予血液灌流联合持续性血液滤过治疗,对比两组患者的肝肾功能、炎性细胞因子等,比较两组患者脏器功能障碍发生率、病死率及毒物清除时间的差异。结果试验组患者第7天谷丙转氨酶(ALT)、谷草转氨酶(AST)、血肌酐(Cr)、白细胞介素-6(IL-6)、肿瘤坏死因子-α(TNF-α)水平较对照组患者均明显降低,差异均有统计学意义(P<0.05);而氧分压(PaO_(2))较对照组明显上升,差异有统计学意义(P<0.05)。两组患者血尿中毒物清除的时间比较,差异有统计学意义(P<0.05)。预后分析比较,试验组多脏器功能障碍综合征(MODS)的发生率(42.2%)与对照组(69.2%)比较,差异有统计学意义(P<0.05);两组病死率比较[22(48.9%)vs.24(61.5%)],差异无统计学意义(P>0.05)。结论早期血液灌流联合持续性血液滤过在一定程度上改善了患者的临床症状,降低了多脏器功能损伤发生率,在临床上值得应用。Objective To explore the clinical application effect of hemoperfusion(HP)combined with continuous veno-venous hemofiltration(CVVH)on diphtheria poisoning(DQ).Methods A retrospective analysis was performed on 84 patients with DQ admitted to the Department of Emergency Medicine of the First Affiliated Hospital of Zhengzhou University from January 2020 to December 2021.The patients were divided into the experimental group and the control group.The control group received HP,and the experimental group received HP combined with CVVH.The differences of liver and kidney function,inflammatory factors,incidence of multiple organ function injury,mortality and toxin clearance time between the two groups were compared.Results On day 7,the level of alanine aminotransferase(ALT),aspartate aminotransferase(AST),serum creatinine(Cr),interleukin-6(IL-6),tumor necrosis factor-α(TNF-α)in the experimental group were significantly decreased compared with the control group(P<0.05),and PaO_(2) was significantly increased compared with the control group(P<0.05).There were significant differences in the clearance time of poisons in blood and urine between the two groups(P<0.05).Prognostic analysis showed that the incidence of MODS between the experimental group(42.2%)and the control group(69.2%)was significantly different(P<0.05).The mortality between the two groups was[22(48.9%)vs.24(61.5%)]was not statistically significant different(P>0.05).Conclusion Early HP combined with CVVH can improve the clinical symptoms of patients and reduce the occurrence of multiple organ function injury,which is worthy of clinical application.

关 键 词：血液灌流 静脉-静脉血液滤过 敌草快 临床疗效 

分 类 号：R459.7[医药卫生—急诊医学]