血液灌流联合连续性静脉-静脉血液滤过救治重度急性中毒的疗效观察

目的探讨血液灌流（HP）联合连续性静脉-静脉血液滤过（CVVH）救治重度急性中毒的临床效果。方法在彻底洗胃、导泻、利尿、保肝等综合治疗的基础上，治疗组采用HP联合CVVH治疗，对照组采用单纯HP治疗。结果治疗组患者的昏迷时问（9．12±2．21）h]、平均住院时间（11．46±3．50）d]明显短于对照组（18．85±4．28）h、（22．27±2．90）d]（P〈0．05），死亡率明显低于对照组（10．63％US36．13％，P〈0．05），治愈率明显高于对照组（89．37％vs63．87％，P〈0．05）。两组患者治疗前后格拉斯哥昏迷量表评分比较，治疗组明显提高，差异有统计学意义（P〈0．05）；急性生理学与慢性健康状况Ⅱ（APACHEⅡ）评分比较，治疗组明显降低，差异有统计学意义（P〈0．05）。结论HP联合CVVH是治疗重度急性毒物中毒更有效的方法之一。

Effect observation on treating severe acute poisoning with hemoperfusion and continuous veno-venous hemofiltration

Objective To investigate the clinical effect of continuous veno-venous hemofiltration （CVVH） and hemodialysis （HD） on clinical outcomes in the treatment of severe acute poisoning. Methods On the basis of thoroughly gastric lavage,catharsis,diuresis,proteet liver, etc. comprehensive treatment,the treatment group was given HP with CVVH therapy,control group was given HP treatment alone. Results The coma time （9.12±2.21） bours],the average length of hospitalization （11.46±3.50） days] in the treatment group was shorter than that of the control group respec- tively （18.85±4.28） hours,（22.27±2.90） days] （P〈0.05）.Yhe mottality rate was significantly lower （10.63% vs 36.13%, P〈0.05）,while the cure rate obviously higher than that of the control group （89.37% vs 63.87%,P〈0.05）.The patients with a Glasgow coma scale score （GCS） compared in two groups before and after treatment,the treatment group in- creased significantly,the difference was statistically significant （P〈0.05）,aeute physiology and chronic health evaluation Ⅱ （APACHE Ⅱ ） was compared between the two groups, significantly lower in treatment group,the difference was sta- tistically significant （P〈0.05）. Conclusion Hemoperfusion combined with continuous venovenous hemofiltration in treat- ment of severe acute poisoning is a more effective methods.