血液灌流与持续静脉-静脉血液滤过在治疗百草枯中毒中疗效观察

目的：总结血液灌流（HP）与持续静脉-静脉血液滤过（CVVH）对百草枯（PQ）中毒患者的疗效，以便探讨更加有效的治疗模式。方法：回顾性分析了54例PQ中毒患者，分成对照（常规治疗）组（14例）及试验组（40例），两组均给予常规治疗，试验组加予血液灌流（HP）或CVVH或血液灌流＋持续血液滤过（HP＋CVVH），比较生存率、死亡生存天数、MODS发生率、肺纤维化发生率的情况。结果：试验组较对照组死亡生存天数明显增加，以HP＋CWH组增加最为显著；4h内行HP治疗组的生存率高于4h组，而MODS的发生率降低。结论：CVVH能明显延长PQ中毒患者的生存时间，有效降低早期死亡率，并有望降低整体死亡率；早期、足够的HP治疗能够改善PQ中毒患者的预后，提高生存率；合理的HP及CVVH联合使用有望提高PQ中毒患者的整体救治成功率。

Investigation of effect of hemoperfusion,continuous venous-venous hemofiltration on treatment of paraquat poisoning

Objectlve：To investigate the effect of hemopeffusion （HP） and continuous venous-venous hemofidtration （CVVH） on treatment of paraquat poisoning for finding a more effective way of treatment. Methods：To conduct the retrospective analysis of 54 patients admitted with the diagnosis of paraquat poisoning. All patients were given conventional therapy. The control group （n=14） received conventional therapy,the experimental group （n=40） added HP or CVVH or HP＋CVVH therapy. Survival rate, living days,MODS rate and pulmonary fibrosis rate between the two groups were analyzed. Results：The living days of the experimental group was more than those of the control group,especially the subset with HP＋CVVH had most significant difference.The survival rate was higher in the subset with HP that been given in 4 h than in the subset （HP 〉4h）, MODS rate was lower in the former. Conclusion：CVVH can prolong the live time and reduce the mortality rate of earlier period,it would be a hope of reducing total mortality rate.Early and adequate HP is able to improve the prognosis and survival rate. Reasonable use of HP and CVVH would be a way to promote the entire remedy success.