摘要
百草枯中毒后会直接损害各重要脏器,尤其是肺功能受损显著,有极高的病死率。急性百草枯中毒后的高病死率主要受救治效果的影响,临床上多推荐早期使用活性炭灌流的方法降低患者血浆内百草枯的浓度,以抑制或减少肺组织对毒性物质的摄取和吸收。根据全血灌流后患者血浆内百草枯水平的反弹性,若延长患者的灌流救治时间可能对改善预后有一定价值,故提出了持续灌流治疗的概念。但多数患者常合并出血,持续灌流实施的难度较大,此时可考虑先进行血浆置换,再实施持续血浆吸附治疗,以降低患者血浆中百草枯的浓度。
Paraquat poisoning directly damages important organs,especially pulmonary function,and has a very high mortality.The high mortality after acute paraquat poisoning is mainly affected by the therapeutic effect.Clinically,the early use of activated carbon perfusion is recommended to reduce the concentration of paraquat in patient′s plasma in order to inhibit or reduce the uptake and absorption of toxic substances in lung tissues.It is considered that according to the rebound of paraquat concentration in plasma after whole blood perfusion,prolonging the perfusion time may be valuable to improve the prognosis,so the concept of continuous perfusion therapy is put forward.However,most patients are often complicated with bleeding,and continuous perfusion is more difficult to implement.At this time,continuous plasma adsorption therapy after plasma exchange can be considered to reduce the concentration of paraquat in the plasma of the patients.
作者
董倩怡
王秋
DONG Qianyi;WANG Qiu(Department of Emergency Internal Medicine,the First Affiliated Hospital of Harbin Medical University,Harbin 150001,China)
出处
《医学综述》
2020年第15期3007-3011,共5页
Medical Recapitulate
