【摘要】：目的探討持續(xù)血液灌流聯(lián)合大黃為主組方序貫治療急性百草枯中毒(APP)的臨床療效。方法選擇本院中度APP患者116例,按隨機數(shù)字法將患者分為A組(血液灌流組)31例、B組(血液灌流聯(lián)合大黃為主組方組)40例及C組(持續(xù)血液灌流聯(lián)合大黃為主組方組)45例。分別于治療前及治療后5、7 d,檢測C-反應蛋白(CRP)、丙氨酸氨基轉移酶(ALT)、肌酸激酶(CK-MB)、肌酐(Cr)、腫瘤壞死因子-α(TNF-α)、白細胞介素-6(IL-6)及白細胞介素-10(IL-10)水平。于治療前及治療后8、12、24 h檢測血百草枯含量。結果治療后,C組總有效率(68.89%)顯著高于A組(35.48%)、B組(52.5%),組間比較差異有統(tǒng)計學意義(χ2=8.335,P=0.015);治療后5 d,ALT、CK-MB、Cr、CRP、TNF-α、IL-6、IL-10水平均升高,A組升高最明顯;治療后7 d,C組降低最顯著,各組間比較差異均有統(tǒng)計學意義(P0.05)。治療后8 h,B、C組百草枯含量低于A組;治療后12 h,C組百草枯含量最低,組間比較差異有統(tǒng)計學意義(P0.05)。治療后24 h,各組百草枯含量均明顯降低,組間比較差異無統(tǒng)計學意義(P0.05)。結論早期給予持續(xù)血液灌流聯(lián)合大黃為主組方序貫治療APP,能有效降低患者病死率,改善預后。
[Abstract]:Objective to investigate the clinical effect of continuous hemoperfusion combined with rhubarb as main prescription in the treatment of acute paraquat poisoning (APP). Methods 116 patients with moderate APP in our hospital were randomly divided into group A (hemoperfusion group) and group B (hemoperfusion plus rhubarb group) (40 cases) and group C (continuous hemoperfusion combined with rhubarb as main prescription group) (45 cases). The levels of C-reactive protein (CRP), alanine aminotransferase (ALT), creatine kinase (CK-MB), creatinine (Cr), tumor necrosis factor- 偽 (TNF- 偽), interleukin-6 (IL-6) and interleukin-10 (IL-10) were measured before and 5 days after treatment. Blood paraquat content was measured before and after treatment at 812 hours. Results the total effective rate of group C (68.89%) was significantly higher than that of group A (35.48%) (52.5%), the difference between the two groups was statistically significant (蠂 ~ 2 = 8.335), the level of IL-6 IL-10 in group A was significantly higher than that in group A at 5 d after treatment, and the level of IL-6 IL-10 in group A was significantly lower than that in group A at 7 days after treatment, and the total effective rate of group C (68.89%) was significantly higher than that of group A (35.48%) (P < 0.05), and the level of IL-6 IL-10 in group A was significantly higher than that in group A (P < 0.05). The differences between the groups were statistically significant (P0.05). The paraquat content in group C was lower than that in group A at 8 hours after treatment, and the content of paraquat in group C was the lowest at 12 hours after treatment (P0.05). 24 hours after treatment, the content of paraquat decreased significantly in each group, there was no significant difference between the groups (P0.05). Conclusion early continuous hemoperfusion combined with rhubarb for sequential treatment of APP, can effectively reduce the mortality and improve the prognosis.
【作者單位】： 河北醫(yī)科大學哈勵遜國際和平醫(yī)院急救醫(yī)學部;河北醫(yī)科大學哈勵遜國際和平醫(yī)院EICU;河北醫(yī)科大學哈勵遜國際和平醫(yī)院急診綜合病房;
【基金】：河北省省級科技計劃項目(編號:162777109D)
【分類號】：R595.4

【相似文獻】

相關期刊論文 前2條

1 張立辰;東輝英;張書彥;盧立娟;李志忠;賈若敏;;持續(xù)血液灌流搶救阿普唑侖中毒成功1例[J];臨床薈萃;2009年03期

2 張立辰;東輝英;張書彥;趙建波;李志忠;;持續(xù)血液灌流聯(lián)合血液透析治療急性百草枯中毒153例[J];臨床薈萃;2008年22期

，

本文編號：2246281