血液净化救治急性重症中毒并急性肾功能衰竭30例的临床分析

目的：总结急性重症中毒并急性肾功能衰竭（ARF）的临床特点并探讨多种血液净化（BP）模式抢救急性重症中毒的临床疗效。方法：回顾性分析我院30例急性中毒并ARF患者，其中9例行血液透析（HD）治疗，11例行HD串联血液灌流（HD＋HP）治疗，10例采用连续性静脉-静脉血液透析滤过（CVVHDF）治疗，各组均给予综合性治疗，比较单纯HD组、HD＋HP组、CVVHDF组之间治疗效果。结果：CVVHDF组治愈率高，肾功能恢复优于其他血液净化组（P〈0．05），昏迷者的清醒时间快，住院时间缩短（P〈0．05），无明显毒副作用。结论：CVVHDF、HD＋HP血液净化治疗抢救各种急性中毒并ARF患者成功率高，对急性重症中毒伴多器官功能障碍者，提倡早期行CV—VHDF治疗，同时重视洗胃、营养支持、水电解质酸碱平衡、抗感染等综合治疗，以利于急危重症中毒患者的救治。

Clinical Analysis of A Variety Blood Purification Therapy Acute Severe Poisoning with Acute Renal Failure of 30 Caces

Objective： To review the clinical characteristics of acute severe poisoning with acute renal failure（ARF） and to explore a variety of blood purification （BP） to rescue acute severe poisoning with ARF. Methods： Nine patients of 30 cases with a routine hemodialysis （HD） treatment, 11 with routine HD series hemoperfusion （HP） treatment, 10 with Continuous venovenous hemodiafihration（CVVHDF） treatment, all groups were given a comprehensive treatment, relatively simple HD group, HD tandem HP, CVVHDF between the treatment groups. Results： CVVHDF team had the high cure rate and renal function was superior to other blood purification groups （P 〈0.05）, the clear time of unconscious was quickly, the time of staying in hospital was shortened （P〈0. 05）, with no significant side effects. Conclusion： CVVHDF, HD with HP has a high success rate of acute severe poisoning with ARF. It＇s necessary to promote the early line CVVHDF treatment for acute severe poisoning with muhiple organ dysfunction, at the same time great importance to gastric lavage, nutrition support, water, electrolyte acid-base balance, anti-infection.