血液灌流在急性中毒一体化治疗中的临床应用

目的研究血液灌流在急性中毒一体化治疗中的意义。方法将急诊收治的280例各类中毒患者随机分为两组：灌流组（150例,于中毒后24 h内进行血液灌流）和非灌流组（对照组,130例,仅予以常规洗胃、导泻等一般性治疗）。观察两组在意识障碍恢复时间、肺水肿纠正时间、解毒剂应用剂量及死亡例数等方面的差异。结果灌流组意识障碍纠正时间为（3.0±0.5）h,肺水肿平均纠正时间为（2.5±0.4）h,有机磷中毒阿托品用量为（26.0±2.5）mg,死亡5例,均显著低于对照组的（6.5±0.8）h、（4.9±0.7）h、（47.0±6.5）mg及12例,差异均有统计学意义（P〈0.05）。结论在急性中毒一体化治疗方法中,血液灌流能明显改善中毒患者的生存质量,提高抢救成功率,值得在急诊临床大力推广应用。

Clinical application of hemoperfusion in integrated treatment of acute poisoning

Objective To study the significance of hemoperfusion（HP） in the integrate treatment of acute poisoning.Methods Two hundred and eighty patients with acute poisoning were randomly divided into two groups： One hundred and fifty patients in HP group were treated by HP within 24 hours after the poisoning in addition to the routine treatment,130 patients in control group were given general treatment such as routine gastric lavage,catharsis.The conscious recovery time,pneumonedema rectification time,amount of antidote used and the numbers of deaths were observed and compared between the two groups.Results The conscious recovery time,pneumonedema rectification time of the HP group were（3.0±0.5）h and（2.5±0.4）h,all significantly shorter than those of the control group [（6.5±0.8）h and（4.9±0.7）h,P＆lt;0.05].The prescribed dosage of atropine for organ phosphorous poisoning of the HP group was（26.0±2.5）mg,significantly lower than that of the contorl group[（47.0±6.5）mg,P＆lt;0.05）].In the HP group,5 cases died,which was lower than that in the control group（12 cases,P＆lt;0.05）.Conclusion In the integrated treatment of acute poisoning,hemperfusion can significantly increase the survival rate,and considerably improve patients’ life quality after the survival,worthy of promotion in the clinical emergency.