血液灌流联合血液透析治疗急性农药或药物中毒

目的探讨血液灌流联合血液透析(HP+HD)治疗农药或药物中毒的治疗效果,以及影响患者预后的相关因素。方法对13例农药或药物中毒患者应用HP+HD,治疗前后观察血气分析、肝肾功能及凝血功能变化,并对患者进行APACHEⅢ评分。结果HP+HD治疗48h后,血pH值、PaO2、PaCO2、SatO2、 ALT、AST、Cr均明显改善(P<0．05);血PLT较治疗前下降,PT和APTT较前延长(P<0．05),但未见出血现象;APACHEⅢ评分较治疗前降低(P<0．05)。13例患者中死亡4例,死亡率为30．77％(4／13)。其中4例百草枯中毒者3例死亡,死亡率75％(3／4)。结论除内科综合治疗外,尽早加用血液灌流对急性农药或药物中毒抢救成功有明显的效果。

Therapeutical effects of hemoperfusion plus hemodialysis therapy on patients with acute poisoning of agricultural chemicals or drugs

Objective To investigate the efficacy of hemoperfusion plus hemodialysis (HP+HD) therapy on patients of acute poisoning of agricultural chemicals or drugs and evaluate the influence factors. Methods 13 patients were treated in the form of HP+HD. The concentration of ALT, AST, Cr, PLT, PT, APTT in blood as well as the blood gases analysis, the acute physiology and chronic health evaluation Ⅲ (APACHEⅢ) were evaluated, and both results of before HP+HD and 48h later were compared .Results After HP+HD, the concentration of ALT,AST,Cr and blood gases analysis got much better(P<0.05),APACHEⅢ score and PLT were decrea-sed significantly (P<0.05), and PT, APTT were prolong significantly. But the bleeding wasn't happen during HP+HD;4 of all cases were dead,the mortality was 30.77%(4/13).And 3 of 4 cases with paraquat poisoning were dead,the mortality was 75% (3/4).Conclusion HP+HD is an effiective and safe method for acute poisoning of agricultural chemicals or drugs; and it is practiced as early as possible, it would have distinct efficacy.