序贯性血液净化治疗重症毒鼠强中毒

目的观察血液净化治疗重症毒鼠强中毒患者的临床疗效和对预后的影响。方法11例重症毒鼠强中毒的患者人院后．除给予镇静、抗惊厥、冼胃、利尿、导泻、营养神经、支持等常规治疗外,并给予序贯性血液净化治疗。观察患者的临床症状、血压、脉搏、血清酶学变化。结果11例患者进行血液净化治疗,死亡1例,1例临床症状好转后自动出院．其余9例患者痊愈。结论及时有效的血液净化治疗可明显改善毒鼠强中毒患者的预后。     

血液净化治疗百草枯中毒的疗效和价值

目的:分析、探讨血液净化疗法(血液灌注和血液透析)抢救百草枯中毒的疗和价值.方法:50例百革枯中毒患者,其中20例应用洗胃、口服漂白土及导泻剂等抢救,余30例在上述治疗基础上,加用血液灌流和透析抢救,比较二者治愈率的不同.结果:50例中共治愈20例,死亡30例.其中血液净化组治愈18例,死亡12例,治愈率60％;非血液净化组治愈4例,死亡16例,治愈率20％.另比较开始血液净化时间的迟早,发现中毒6h内净化者治愈21例,死亡9例,治愈率70％;中毒6h后净化者治愈9例,死亡21例,治愈率30％.结论:在洗胃、口服漂白土及导泻剂的基础上,尽早应用血液净化技术是抢救百草枯中毒的有效疗法.     

Depmas 双重血液净化治疗急性百草枯中毒的效果

目的：探讨Depmas双重血液净化治疗急性百草枯中毒的临床疗效。方法回顾性研究我科2011年3月至2013年11月收治的急性百草枯中毒患者,将其分为4组：常规治疗组未行血液净化治疗,只采用药物治疗;血液灌流组除采用药物治疗外,还行HA230/330血液灌流治疗;血液灌流联合血浆置换组除采用药物治疗,还行HA230/330血液灌流及血浆置换联合治疗;Depmas组除采用药物治疗外,通过血浆分离器,对分离的血浆串联HA230/330及BS 330血液灌流治疗。观察4组患者的存活率、平均存活时间、血液中百草枯浓度、胆红素及炎性介质变化。结果血液灌流组、血液灌流联合血浆置换组及Depmas组较常规治疗组存活率提高,平均存活时间延长,周围血液中百草枯、胆红素及炎症介质浓度明显降低,差异具有统计学意义（P＜0．01）。血液灌流联合血浆置换组及Depmas组较血液灌流组存活率提高,平均存活时间延长,周围血液中百草枯、胆红素及炎症介质浓度降低,差异具有统计学意义（ P＜0．05）。血液灌流联合血浆置换组与Depmas组存活率、平均存活时间、周围血液中百草枯、胆红素及炎症介质浓度未见明显异常,差异无统计学意义（ P＞0．05）。结论 Depmas双重血液净化治疗急性百草枯中毒有显著疗效。     

血液净化治疗急性氟硅酸钠中毒

氟硅酸钠是一种剧毒的无机氟化物 ,一般用于金属防腐剂。 2 0 0 1年 3月 2 3日下午 5时左右 ,乡村某户主误将氟硅酸钠粉末混同米粉炒黄当成炒粉 ,厚涂于糯米圆外层 ,因混和不均 ,每只糯米圆约含有氟硅酸钠 2～ 3ｇ左右 ,导致11例食物中毒的重大事件。发病 10ｈ后死亡 1例 ,其余     

中毒患者血液净化治疗情况调查

随着血液净化技术不断发展,血液净化使用范围越来越广,其中在中毒治疗方面已经成为一个不可替代的重要方法。为了解血液净化在中毒方面的使用情况,在中华医学会浙江省肾脏病分会倡议和领导下,对浙江省42家医院中毒患者的血液净化治疗情况进行调查,现报告如下。     

序贯性血液净化技术抢救急性中毒致多器官功能障碍综合征30例临床观察

目的:观察序贯性血液净化技术抢救急性中毒致多器官功能障碍综合征(M0Ds)的治疗效果.方法:对30例急性中毒致多器官功能障碍综合征患者,应用序贯性血液净化技术,即先血液灌流(HP)3-5h,随后立即给予连续性血液净化(CBP)治疗(CVVH或CVVHDF)24 h-72h治疗.并监测治疗前后血白细胞计数(wBC)、凝血功能(PT、APTT)、心肌酶学(CK、CK-MB)、肝功能酶学(ALT、TBi)、肾功能(BUN、Cr)、超敏C反应蛋白(hs-CRP)、肿瘤坏死因子(TNF-α)及白介素6(IL-6)等指标,并随访记录患者的最终预后.结果:序贯性血液净化治疗后,30例患者血WBC、PT、APTT、TBi、ALT、CK、CK-MB、BUN、Cr hs-CRP、TNF-α、IL-6均较治疗前明显下降,P＜0.01,最终预后为:治愈24例,好转2例,死亡3例,自动放弃治疗1例,抢救成功率90％.结论:序贯性血液净化技术是抢救急性中毒致多器官功能障碍综合征的重要措施,抢救成功率高,值得临床推广.     

血液净化抢救氟硅酸钠中毒

氟硅酸钠是一种剧毒的无机氟化物,我院收住氟硅酸钠集体食物中毒10例,以内科常规治疗联合血液净化疗法,取得较满意疗效,现报告如下。 临床资料 1.一般资料:本组10例均为同期同批误食氟硅酸钠中毒而住院患者(为某乡村户主误将氟硅酸钠粉末混同米粉当成炒粉,厚涂于糯米园外层而导致我市集体中毒重大事件)。临床表现为恶心、呕吐、腹痛、乏力、肢体麻木、头昏、头痛     

八例烧伤合并中毒性肠麻痹的血液净化治疗

临床资料:本组患者中男6例、女2例,年龄12-55岁[(31±7)岁]。烧伤总面积15％-75％,其中深Ⅱ、Ⅲ度面积15％-40％TBSA。致伤原因为热液烫伤、火焰烧伤。患者严重腹胀、肠鸣音消失;腹部X线片和B超检查提示存在扩张积气和少许液体,排除肠梗阻;呕吐咖啡样物,均发热(体温>38．5℃);胃肠减压、肛管排气等对症处理及应用新斯的明等药物均无明显效果。低钾血症7例次(血钾离子浓度2．8-3．4 mmol／L),低钠血症4例次(血钠离子浓度120- 128 mmol／L),酸中毒4例次。白细胞计数(WBC)12．1×     

神经系统疾病的血液净化治疗进展

近年来,血液净化疗法在临床得到广泛应用,其可通过非肾途径将体内的代谢废物、毒素、抗体、免疫复合物、药物以及其他有害和致病物质从血液中排出体外,从而达到治疗疾病的目的。目前,血液净化疗法在神经系统疾病的治疗亦越来越被关注,如对神经系统疾病相关炎性因子、抗体及致病物质的清除,可显著缓解患者神经精神症状,为神经系统疾病开辟了新的治疗途径。     

危重患者急性肾功能衰竭血液净化治疗的进展

在重症监护病房危重患者中,急性肾衰竭（ARF）是常见的严重并发症,发生率约5%,病死率高达50%～70%。近年来,危重ARF的血液净化治疗,尤其是在连续性肾脏替代治疗（CRRT）剂量、时机的研究取得了重要的进展,并出现了持续低效每日透析（sustained low-efficiency daily dialysis,SLEDD）等一些新的替代治疗模式。     

连续性血液净化技术治疗脓毒症的研究进展

脓毒症以及相关的感染性休克和多器官功能障碍综合征(MODS)是当前加强治疗病房(ICU)内重症患者死亡的主要因为,也是当代重症医学面临的主要焦点及难点.目前虽然抗感染治疗措施和器官支持手段取得长足进步,但脓毒症及其相关的感染性休克和MODS病死率依然很高~([1]).由于机体炎性反应失控是脓毒症发生发展的根本机制,因而控制炎性反应就显得至关重要.连续性肾脏替代治疗(CRRT)是一种将患者血液引出体外并通过净化装置,除去其中某些致病物质,净化血液,达到治疗疾病的技术.     

连续性血液净化在乳酸性酸中毒治疗中的应用

目的 观察连续性血液净化在乳酸性酸中毒治疗中的应用效果。方法 选择11例确诊为乳酸性酸中毒患者,在常规治疗效果不显著时予连续性血液滤过,治疗过程中行血气分析,检测血乳酸、血糖、血肌酐水平。结果 治疗后血pH、HCO3^-接近正常,乳酸、肌酐显著下降（P〈0．01）。结论 连续性血液净化在乳酸性酸中毒的治疗中发挥重要的作用,特别是对内科保守治疗效果差或合并肾功能不全的患者。     

Roundup intoxication and a rationale for treatment

A 51-year-old man with no history ofrenal disease was admitted to our hospital after an intentional ingestion of Roundup, a glyphosate-based herbicide. His course was significant for the development of acute renal failure with oliguria and severe hypoxia. Although efficacy data are sparse and controversial, we proceeded with hemodialysis in an effort to correct his worsening volume status and to potentially clear toxins that are normally excreted by the kidney. His condition improved immediately and his renal function returned to normal over the course of several weeks. We argue that hemodialysis in the setting of such herbicide ingestions may facilitate significant intoxicant clearance, especially in the setting of impaired glomerular filtration. We also make recommendations regarding possible toxin-related sequelae that may warrant initiation of hemodialysis therapy.     

Establishment of blood purification system for rats

Objective To establish blood purification system for rats and provide a safe and reliable experimental platform for further research of blood purification. Methods The right carotid artery and the contralateral jugular vein of adult male Sprague-Dawley rats were cannulated to creat vascular access for blood purification, by which continuous arteriovenous hemofiltration blood purification system was established. Blood flow, substitution fluid flow and ultrafiltration rate were regulated by rotary mini-pumps. Blood purification therapy continued for 4 hours on the basis of maintained anesthesia and effective anticoagulation. The safety of continuous arteriovenous hemofiltration blood purification systems was evaluated by comparing the arterial blood gas, electrolyte indexes and blood glucose during the blood purification therapy. Closely monitoring the vital signs of rats, such as blood pressure and heart rate, and observing whether there were any side effects, such as massive haemorrhage, thrombogenesis and gas embolism in the therapeutic process. Results There were no obvious changes of arterial blood gas, electrolyte indexes and blood glucose during the blood purification therapy (P＞0.05). The vital signs did not fluctuate acutely before and after the blood purification therapy (P＞0.05). The incidence rate of side effects was very low. Conclusions Continuous arteriovenous hemofiltration blood purification system had no obvious adverse effects on healthy rats. Our blood purification system for rats appears to be safe and reliable.     

Protein adsorption-resistant hollow fibers for blood purification

Nonfouling polysulfone (PSf) hollow fiber membranes resistant to protein adsorption and deposition were newly developed by the addition of 2-methacryloyloxyethyl phosphorylcholine (MPC) polymer. To improve hydrophilicity, permeability, and nonfouling characteristics of the PSf hollow fiber in a hemodialyzer, we synthesized a MPC polymer which can be blended with PSf for preparing the polymer alloy (PSf/MPC polymer). The composition of the MPC polymer blended in the PSf was in the range between 7.0 and 15 wt%. From the PSf/MPC polymer solution, flat membranes and hollow fibers could be prepared. These membranes took an asymmetric structure, and its mechanical strength was good. The surface characterization of the PSf/MPC polymer hollow fiber membrane by X-ray photoelectron spectroscopy revealed that the MPC units were concentrated at the surface. The permeability for solutes through the PSf/MPC polymer membrane was higher, and the amount of protein adsorbed on the PSf/MPC polymer membrane was lower than those of the PSf membrane. Moreover, platelet adhesion was also effectively inhibited on the PSf/MPC polymer membrane.     

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目的 探讨连续性血液净化(CBP)治疗普通外科严重感染综合征的临床价值.方法 回顾性分析中山大学附属第一医院SICU在2006-01-01-2007-12-31期间52例接受CBP治疗的严重感染综合征(severe sepsis)病人资料.结果 CBP治疗时间(13.5±29.4)d,在CBP治疗期间分别采用低分子质量肝素抗凝11例(21.2%)、体外肝素抗凝13例(25.0%)、无抗凝19例(36.5%),未发生严重出血并发症.52例病人好转16例(30.8%),自动放弃治疗19例(36.5%),ICU内死亡17例(32.7%).抗凝方式、手术类型、感染部位等对CBP疗效影响差异无统计学意义.结论 CBP是外科严重感染综合征病人重要治疗措施之一,治疗过程中应采取个体化抗凝方案.