本文選題：血液灌流 + 百草枯中毒��； 參考：《吉林大學》2015年碩士論文

【摘要】：目的 通過測定百草枯（paraquat, PQ）清除率探討首次血液灌流（hemoperfusion,HP）時間對PQ中毒患者血藥濃度及預后的影響，為臨床治療提供理論依據(jù)。 方法 收集吉林大學第一醫(yī)院二部重癥醫(yī)學科從2014年1月1日至2015年3月1日口服PQ中毒患者62例，均為12小時內(nèi)就診，將其進行回顧性分析。所有患者均行HP，按照首次HP時間不同，分為A組：HP2小時組，B組：HP4小時組，根據(jù)口服PQ劑量不同分為輕、中、重度中毒，記錄A、B兩組首次HP前、灌流2小時、灌流4小時的血漿PQ濃度，計算兩組PQ清除率，，及所有患者死亡及生存結(jié)果，比較A、B兩組PQ清除率、病死率及死亡患者生存時間有無差別。 結(jié)果 1.隨著HP的進行，血漿PQ濃度逐漸下降，B組第一個2小時較第二個2小時PQ濃度下降速度顯著。 2.中、重度中毒患者，B組相比A組清除率高，差異有統(tǒng)計學意義；而對于輕度中毒患者，兩組HP清除率相近，差異無統(tǒng)計學意義。重度中毒較輕度中毒的清除率高，差異有統(tǒng)計學意義。 3. A組與B組病死率相近，差異無統(tǒng)計學意義；中、重度中毒患者，B組死亡患者生存時間高于A組，差異有統(tǒng)計學意義。 結(jié)論 1.首次HP對PQ的清除效果顯著。 2.對中、重度PQ中毒患者，延長首次HP時間對病死率無影響，但可以延長患者的生存時間。
[Abstract]:Purpose In order to provide theoretical basis for clinical treatment, the effect of the first time of hemoperfusion of paraquat (PQQ) on the blood drug concentration and prognosis of PQ poisoning patients was studied by measuring the clearance rate of paraquat (PQQ). Method From January 1, 2014 to March 1, 2015, 62 patients with oral PQ poisoning were collected and analyzed retrospectively. All patients were treated with HP. according to the time of the first HP, they were divided into two groups: group A: HP2, group B, group B: HP4. According to the different doses of oral PQ, they were divided into mild, moderate and severe poisoning. The plasma PQ concentration was perfused for 4 hours. The PQ clearance rate of the two groups and the death and survival results of all the patients were calculated. The PQ clearance rate, mortality and survival time of the two groups were compared. Result 1. With the development of HP, the plasma PQ concentration gradually decreased in group B at the first 2 hour and the second 2 hour, and the decrease rate of PQ concentration in group B was significantly higher than that in the second hour. 2. The clearance rate of HP in group B was higher than that in group A, but there was no significant difference in the clearance rate of HP between the two groups. The clearance rate of severe poisoning was higher than that of mild poisoning, and the difference was statistically significant. 3. The mortality of group A was similar to that of group B. there was no significant difference between group A and group B. the survival time of group B was higher than that of group A, and the difference was statistically significant. Conclusion 1. The effect of HP on PQ removal was significant for the first time. 2. In patients with moderate or severe PQ poisoning, prolonging the first HP time had no effect on the mortality, but could prolong the survival time of the patients.
【學位授予單位】：吉林大學
【學位級別】：碩士
【學位授予年份】：2015
【分類號】：R595.4

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