不同血液净化方式对重症砷中毒患者疗效分析

目的：探讨持续床旁血滤治疗与持续床旁血滤联合血浆置换治疗对存在多器官功能不全的砷中毒患者的疗效。方法回顾性分析2010年1月至2012年2月我科收治的8例重症砷中毒患者治疗，将其随机分两组。其中治疗组4例行持续床旁血滤治疗，对照组4例行床旁血滤联合血浆置换治疗。比较观察患者临床症状改善情况，血红蛋白，肝肾功能，尿量， ICU住院时间等指标。结果两组患者经持续床旁血液净化治疗后恶心、呕吐、腰痛、腹痛等临床症状均能明显缓解。治疗组及对照组经治疗后第7d血肌酐、胆红素、心肌酶较治疗前有明显好转。但两组患者尿量恢复时间、ICU住院时间及总住院时间无明显差异。结论重症砷中毒患者存在多器官功能不全时，早期给予持续床旁血滤治疗或持续床旁血滤联合血浆置换治疗能明显改善患者预后，且两种治疗方式对患者预后无明显差异。

Curative effect analysis of different blood purification way for severe arsenic poisoning patients

Objective To explore the curative effect of continuous bedside blood filter treatment and continuous bedside blood filter combined with the plasma exchange on the patients with multiple organ dysfunction caused by arsenic poisoning. Metheds To analyze 8 cases of severe arsenic poisoning patients retrospectively which were acceptted in hospital from January 2010 to February 2012,they were divided randomly into two groups,4 cases of the treatment group were treated with continuous bedside blood filter treatment,the others with continuous bedside blood filter combined with the plasma exchange. Through the change of clinical symptoms,hemoglobin,liver and kidney function,urine volume,and the time of in hospital of ICU,we compared and ob-served the patient＇s condition. Results Such as ausea,vomiting,waist pain,abdominal pain and so on clinical symptoms were all can obviously relieve after continuous bedside blood purification treatment on the two groups of patients. After the seventh day , serum creatinine,bilirubin,myocardial enzyme have improved significantly compare with before treatment. But there were no obvi-ous difference between the two groups in the time of the urine recovery time,ICU length of hospital stay and total length of hospital stay. Conclusion Early be treated with continuous bedside blood filter treatment or continuous bedside blood filter combined with plasma exchange,the prognosis of the severe arsenic poisoning patients with multiple organ function can obviously be improved. And there was no obvious difference between the two kinds of treatment methods on the prognosis.