摘要
目的 探讨血液灌流（hemoperfusion,HP）结合连续性静脉-静脉血液滤过（continuous venovenous hemofiltration,CVVH）对于急性百草枯中毒患者的疗效.方法 急性百草枯中毒患者91例随机分成HP组（49例）和HP后给予CVVH治疗组（HP-CVVH组,42例）,比较两组患者的病死率、存活时间和死亡原因.结果 HP组病死率为59.2%（29/49）,HP-CVVH组为61.9%（26/42）,两组比较,差异无统计学意义（χ2=0.070,P=0.791）.HP-CVVH组患者中毒至死亡时间为（4.9±3.1）d,明显长于HP组[（3.5±2.0）d],差异有统计学意义（t=2.026,P=0.049）.HP组和HP-CVVH组中毒后4 d内死亡构成比分别为62.1%（18/29）和30.8%（8/26）,HP组和HP-CVVH组中毒至死亡＞4 d的构成比分别为37.9%（11/29）和69.2%（18/26）,差异有统计学意义（χ2=5.388,P=0.020）.HP-CVVH组患者出现中毒至低氧血症时间为（4.3±2.5）d,明显长于HP组[（3.2±1.9）d],差异有统计学意义（t=2.033,P=0.047）.HP组呼吸衰竭导致死亡的发生率为20.4%（10/49）,明显低于HP-CVVH组（40.5%,17/42）,差异有统计学意义（χ2=4.365,P=0.037）;HP组患者急性肾衰竭的发生率为63.3%（31/49）,明显高于HP-CVVH组（40.5%,17/42）,差异有统计学意义（χ2=4.712,P=0.030）.结论 HP结合CVVH可减少急性百草枯中毒的早期死亡,延长病死患者的存活时间,降低急性肾衰竭的发生率,但无法降低总体病死率.
Objective To explore the therapic effects of hemoperfusion （HP） with continuous venovenous hemofiltration （CVVH） on the patients with acute paraquat poisoning. Methods Nighty-one patients with acute paraquat poisoning were randomly divided into HP group （49 cases） and HP-CVVH group（42 cases）. The mortality, survival duration and the death causes between the two groups were compared and analyzed. Results There were no significant differences in mortality （59.2% versus 61.9%） between the two groups. The mean time between poisoning and death in HP-CVVH group was （4.9±3.1） days, which was significantly longer than that （3.5 ±2.0） days in HP group （P＜0.05）.The death proportion on 4th day after poisoning in HP group was 62.1%（18/29）, which was significantly higher than that （30.8%, 8/26） in HPCVVH group （P＜0.05）. The hypoxia appeared in 4.3±2.5 days after poisoning in HP-CVVH group, which was significantly longer than that （3.2±1.9） days in HP group （P＜0.05）. The mortality due to respiratory failure in HP group was 20.4%（10/49）,which was significantly lower than that （40.5%, 17/42） in HP-CVVH group （P＜0.05）. The incidence of acute renal failure in HP group was 63.3%（31/49）, which was significantly higher than that （40.5%,17/42） in HP-CVYH group （P＜0.05）. Conclusion The combined therapy of HP and CVVH can prevent the patients with acute paraquat poisoning from early death and prolong the survival duration, but can not reduce mortality for the patients with acute paraquat poisoning.
出处
《中华劳动卫生职业病杂志》
CAS
CSCD
北大核心
2011年第4期266-269,共4页
Chinese Journal of Industrial Hygiene and Occupational Diseases
基金
科技部科技基础性工作专项项目（2006FY230300）
解放军总医院科技创新基金（200800684）
关键词
灌流
血液透析过滤
百草枯
中毒
治疗效果
Perfusion
Hemodiafltration
Paraquat
Poisoning
Treatment outcome
