CO2激光治疗宫颈糜烂179例的临床观察

目的 探讨血液透析串联血液灌流(HD HP)治疗急性重度有机磷农药中毒的临床疗效.方法 将48例重度有机磷中毒患者随机分为HD HP组(治疗组)和对照组.对照组给予综合治疗,治疗组在综合治疗的基础上,同时予以HD HP治疗.通过观察阿托品用量、恢复清醒时间、胆碱酯酶(CHE)恢复时间、平均住院时间、病死率等5项指标来判断HD HP的疗效.结果 治疗组的阿托品用量、恢复清醒时间均低于对照组(P＜0.01).CHE恢复时间、平均住院时间均明显低于对照组(P＜0.05).治疗组病死率8.33%,明显低于对照组29.17%(P＜0.01).结论 HDP能有效清除体内有机磷,HD HP治疗急性重度有机磷农药中毒疗效显著.     

血液透析串联血液灌流抢救急性重度有机磷中毒疗效分析

目的 探讨血液透析串联血液灌流(HD+HP)治疗急性重度有机磷农药中毒的临床疗效.方法 将48例重度有机磷中毒患者随机分为HD+HP组(治疗组)和对照组.对照组给予综合治疗,治疗组在综合治疗的基础上,同时予以HD+HP治疗.通过观察阿托品用量、恢复清醒时间、胆碱酯酶(CHE)恢复时间、平均住院时间、病死率等5项指标来判断HD+HP的疗效.结果 治疗组的阿托品用量、恢复清醒时间均低于对照组(P＜0.01).CHE恢复时间、平均住院时间均明显低于对照组(P＜0.05).治疗组病死率8.33%,明显低于对照组29.17%(P＜0.01).结论 HDP能有效清除体内有机磷,HD+HP治疗急性重度有机磷农药中毒疗效显著.     

血液灌流联合血液透析在重度急性有机磷中毒中的综合效果护理观察

目的：分析血液灌流（HD）联合血液透析（HP）在重度急性有机磷中毒中的治疗效果及护理方法。方法选取本院在2012年4月~2014年1月收治重度急性有机磷中毒患者78例,随机分为对照组与观察组各39例,两组均展开常规内科治疗,在此基础上对照组采用HD治疗,观察组采用HD联合HP治疗,对比两组患者治疗效果。结果观察组治愈率显著高于对照组,昏迷到清醒时间、ChE恢复时间及住院时间显著短于对照组,阿托品用量显著少于对照组。结论对于重度急性有机磷中毒患者采取HD联合HP治疗具有显著疗效,在治疗中给予精心护理干预可促使治疗效果进一步提升,促使治愈率提高,值得在临床中推广。     

血液灌流联合血液透析救治重度有机磷农药中毒的护理

目的:探讨血液灌流(HP)联合血液透析(HD)治疗重度有机磷中毒的效果及护理措施.方法:19例重度有机磷中毒患者在内科综合治疗基础上,采用HP联合HD治疗与护理.结果:患者救治成功,治愈出院,无任何后遗症.结论:加强HP联合HD治疗的护理,是顺利进行HP联合HD治疗重度有机磷中毒的关键.     

血液灌流与血液透析抢救重度有机磷农药中毒的护理

目的探讨血液灌流（HP）与血液透析（HD）抢救重度有机磷农药中毒（ASOPP）的护理措施。方法回顾性分析19例重度有机磷农药中毒患者在常规治疗的同时行HP＋HD的临床资料。结果19例患者治愈18例,死亡1例,抢救成功率95％。结论常规治疗加血液灌流与透析是抢救重度ASOPP的有效方法,而护理措施得当,配合到位,观察及时是提高疗效的保证。     

血液灌流联合血液透析在重度急性中毒中的救治体会

目的 探讨血液灌流(HP)联合血液透析(HD)治疗重度急性有机磷农药中毒的临床疗效.方法 随机分为观察组(29例)和对照组(24例).对照组入院后立即给予彻底洗胃、导泻、补液、利尿、尽快达阿托品化等处理及对症治疗,观察组在对照组治疗的基础上进行HP联合HD治疗.分别记录两组的阿托品用量以及治疗后患者清醒时间、胆碱酯酶(CHE)活力恢复时间、平均住院天数和病死率.结果 观察组阿托品用量、恢复清醒时间、胆碱酯酶活性恢复时间、平均住院时间及病死率分别与对照组比较,差异均有统计学意义(P<0.05).结论 HP联合HD治疗重度急性有机磷农药中毒疗效显著.     

血液净化治疗重度有机磷农药中毒26例临床应用

有机磷农药中毒是临床上常见的中毒疾病,重度中毒患者死亡率高.我们对26例重度有机磷农药中毒的患者进行了血液灌流(HP)联合血液透析(HD)治疗,取得了良好的效果,现报告如下.     

血液灌流联合血液透析治疗急性重度有机磷农药中毒32例临床分析

血液灌流加血液透析已成为临床抢救急性重度有机磷农药中毒的首选措施。血液灌流对分子量大、脂溶性高、在体内易与蛋白结合的药物和毒物清除效果好,血液透析适用于清除水溶性,不适用于蛋白或血浆其他成分结合的毒物或药物。我院于2008年12月至2010年1月,对32例急性重度农药中毒患者进行血液灌流（HP）加血液透析（HD）联合抢救治疗取得显著疗效。现报告如下。     

血液灌流救治急性重度中毒的临床研究

目的评价血液灌流(HP)治疗急性重度中毒的疗效。方法选择2005-2009年在我院住院的急性重度中毒患者80例,经血液灌流治疗40例,未经血液灌流治疗40例,对照分析两组患者临床效果。结果与非血液灌流组比较,HP组24hBUN、Cr、CK、GOT、GPT较非HP组降低(P<0.05),血CHE水平显著回升(P<0.05)。阿托品总用量、呼吸机使用时间、住院时间均显著下降(P<0.05),治愈率显著提高(P<0.05)。结论对急性重度中毒患者在综合治疗基础上加用血液灌流,治疗效果显著,值得在急诊科进一步推广应用。     

血液灌流串联血液透析在抢救急性安眠药中毒的应用

传统血液净化法在抢救急性安眠药中毒多采用血液透析(HD),近年来血液灌流(HP)在急性安眠药中毒救治中列为首选措施。HP加HD串联应用,取长补短,发挥各自的优点,提高疗效。我院自1993—1997年应用HP加HD抢救急性安眠药中毒8例,取得了较满意的效果。报告如下。1 资料与方法1.1 临床资料 本组8例病人中,男5例,女3例;年龄在18～43岁,平均34.3岁。其中安定中毒5例,安眠酮中毒2例,苯巴比妥中毒1例。8例患者中     

血液灌流联合血液透析救治急性重度有机磷农药中毒的临床护理

目的：探讨血液灌流联合血液透析抢救急性重度有机磷农药中毒患者的临床护理。方法：对51例急性重度有机磷农药中毒患者进行血液灌流联合血液透析治疗,同时加强观察和临床护理。结果：经过积极救治,有48例治愈出院,另有3例因出现多器官功能障碍死亡,抢救成功率为94．12％。结论：血液灌流联合血液透析是抢救急性重度有机磷农药中毒的有效方法,高质优质的临床护理是抢救成功的重要保证。     

急性乌头碱中毒63例的心电图表现和临床分析

目的探讨乌头碱急性中毒患者的心电图特点及临床救治。方法2006年5月-2011年5月本院先后成功抢救乌头碱急性中毒患者63例,总结其临床资料,分析心电图的特点及抢救治疗后的变化。结果63例患者均发生心律失常,室性期前收缩为主。频发多源室性期前收缩、室性心动过速、心室颤动均出现在临床重度中毒患者中．其中6例重度患者行急诊床旁血液灌注联合血液透析治疗,心律失常迅速减少,心电图转为正常。所有患者治愈出院。结论乌头碱急性中毒患者的心电图表现多样化,以室性心律失常最常见,其心律失常严重性直接反映临床急性中毒的严重程度,早期进行床旁血液灌注联合血液透析治疗可迅速纠正心律失常,使心电图恢复正常。     

血液灌流联合血液透析治疗重症急性有机磷农药中毒的临床效果

目的观察血液灌流联合血液透析治疗重症急性有机磷农药中毒的临床效果。方法选择60例重症急性有机磷农药中毒患者,随机分为观察组和对照组,各30例,对照组采用常规催吐、导泻、阿托品、胆碱酯酶复能剂等治疗,观察组在对照组基础上,采用血液灌流联合血液透析治疗,比较两组的治愈率、阿托品用量、昏迷至清醒时间、胆碱酯酶活性恢复时间及住院时间。结果对照组治愈率为76.7%,观察组治愈率为96.7%,差异有统计学意义(P<0.05)。观察组的阿托品用量少于对照组,昏迷至清醒时间、胆碱酯酶活性恢复时间及住院时间短于对照组,差异有统计学意义(P<0.05)。结论血液灌流联合血液透析治疗重症急性有机磷农药中毒患者,可有效提高治愈率,减少死亡事件及阿托品用量,缩短胆碱酯酶活性恢复时间及住院时间,临床疗效确切。     

Treatment of severe pediatric ethylene glycol intoxication without hemodialysis

BACKGROUND: There is limited experience treating severe ethylene glycol poisoning in children without hemodialysis. The objective of this study was to describe the clinical course and outcome of severe pediatric ethylene glycol poisoning treated without hemodialysis. METHODS: Patient records were identified retrospectively by hospital discharge diagnosis (ICD-9 code) of ethylene glycol poisoning from 1999 through 2002 at a pediatric medial center. Patients with initial serum ethylene glycol concentrations less than 50 mg/dL or those who received hemodialysis were excluded. RESULTS: Six patients with an age range of 22 months to 14 years were admitted for treatment of ethylene glycol poisoning over a four-year period. Initial serum ethylene glycol concentrations ranged from 62 to 304 mg/dL (mean 174.0 mg/dL). The lowest-measured individual serum bicarbonates ranged from 4 to 17 mEq/L. All patients were initially admitted to intensive care. One patient received ethanol only, two patients received fomepizole only, and three patients received a loading dose of ethanol and then were converted to fomepizole therapy. None of the patients received hemodialysis. Treatment was continued until the serum ethylene glycol was less than 10 mg/dL. Metabolic acidosis resolved with intravenous fluid and supplemental bicarbonate within 24h. All patients had a normal creatinine upon presentation and at discharge. The mean length of stay in intensive care was 21h and on the ward was 33.7h. One episode of hypoglycemia occurred in a 22-month-old. All patients recovered without evidence of renal insufficiency or other major complications at discharge. CONCLUSION: Six pediatric patients with severe ethylene glycol intoxication and normal renal function were successfully treated without hemodialysis.     

血液净化治疗急性中毒30例的护理

目的探讨血液灌流联合血液透析的血液净化方法对急性中毒患者的疗效及护理方法。方法选择2008年5月～2011年7月就诊于笔者所在医院的急性中毒患者30例,所有患者入院后均给予吸氧、彻底洗胃、补液、解毒剂等基础治疗,部分患者给予心肺复苏、呼吸机辅助呼吸、抗脑水肿等治疗,之后立即行血液净化治疗。结果所有30例患者经血液透析联合血液灌流治疗后,2例患者因中毒较为严重,就诊时间长而发生死亡。其他28例患者均恢复意识并痊愈出院,无严重的不良反应发生,疗效较好。结论综合的护理措施在血液净化治疗中起到重要的作用,保证了治疗的安全和高效,有效改善了患者的预后。     

HA型血液灌流患者外周血细胞成分的变化及意义

目的探讨HA型血液灌流对血细胞成分的影响。方法对急性中毒者、慢性肾功能衰竭皮肤搔痒症状突出者和一般慢性肾功能衰竭者三组病例,分别进行血液灌流、血液透析+血液灌流和血液透析治疗,比较治疗前后血细胞成分的变化。结果血液灌流组治疗前后RBC、WBC、PLT、HGB及HCT无明显变化(P>0.05),而血液透析+血液灌流组、血液透析组治疗后则有明显上升(P<0.05),但后二者升高值无显著差异。结论HA型血液灌流器治疗对患者的外周血红细胞、白细胞、血小板等有形成分无明显影响。     

Changes in the hemodynamic state of patients with acute lethal organophosphate poisoning

The main cause of death due to acute organophosphate poisoning is believed acute respiratory failure caused by peripheral and central cholinergic actions. Today, advances in respiratory management and intensive care make it possible to maintain the respiratory function of patients with organophosphate poisoning, but it is still difficult to maintain their circulation, and some patients with acute organophosphate poisoning die of metabolic acidosis. The present study clarified the hemodynamics of patients with acute lethal organophosphate poisoning. Subjects were patients with severe acute organophosphate poisoning accompanied by hypotension in whom hemodynamics were monitored by pulmonary artery catheterization. In this study, the medical records of these patients were reviewed. Four patients with severe acute organophosphate poisoning accompanied by hypotension and metabolic acidosis died. In 3/4 patients respiration was maintained favorably. In all 4 patients cardiac output was maintained, but systemic vascular resistance index (SVRI) was significantly reduced. Catecholamine administration was ineffective and did not increase SVRI.     

Hydrofluoric acid-induced burns and life-threatening systemic poisoning--favorable outcome after hemodialysis

BACKGROUND: Skin contact with hydrofluoric acid (HF) may cause serious burns and life-threatening systemic poisoning. The use of hemodialysis in fluoride intoxication after severe dermal exposure to HF has been recommended but not reported. CASE REPORT: A 46-year-old previously healthy man had 7% of his body surface exposed to 71% HE Despite prompt management, with subsequent normalization of the serum electrolytes, recurrent ventricular fibrillation occurred. On clinical suspicion of fluoride-induced cardiotoxicity, acute hemodialysis was performed. The circulatory status stabilized and the patient fully recovered. High fluoride levels in the urine and serum were confirmed by the laboratory. DISCUSSION: There is no ultimate proof that the favorable outcome in this case was significantly attributable to the dialysis. However, most reported exposures of this magnitude have resulted in fatal poisoning. As our patient had normal serum electrolytes and no hypoxia or acidosis at the time of his arrhythmias, it was decided that all efforts should be focused on removing fluoride from his blood. The rationale for performing hemodialysis for this purpose is clear, even though such intervention is more obviously indicated in patients with renal failure. CONCLUSION: Hemodialysis may be an effective and potentially lifesaving additional treatment for severe exposure to HF when standard management has proven insufficient.     

急性重度异烟肼中毒9例救治分析

目的探讨重度异烟肼中毒救治的有效方法。方法对9例重度异烟肼中毒病例进行回顾性分析。对于吞服异烟肼剂量明确患者,均给予大剂量维生素B6（与中毒异烟肼比1：1）静脉注射,同时联合地西泮静脉注射,控制抽搐。结果 9例患者中,8例痊愈出院,死亡1例。结论对于重度异烟肼中毒,大剂量维生素B6静脉注射,可有效拮抗异烟肼。     

经气管插管后洗胃抢救重度中毒患者的临床分析

目的探讨采用气管插管洗胃抢救重度中毒患者的疗效。方法采用气管插管后洗胃抢救60例重度中毒患者,并与52例未采用气管插管洗胃的重度中毒患者的抢救效果进行对比。结果 60例采用气管插管抢救的重度中毒患者均成功洗胃,治愈58例;而未采用气管插管洗胃抢救的52例重度中毒患者,治愈43例,两组治愈率比较差异有统计学意义(P<0.05)。结论采用气管插管后洗胃对重度中毒患者的抢救效果较好。