中华劳动卫生职业病杂志
中華勞動衛生職業病雜誌
중화노동위생직업병잡지
CHINESE JOURNAL OF INDUSTRIAL HYGIENE AND OCCUPATIONAL DISEASES
2014年
11期
862-864
,共3页
周亚东%史继学%杨琳%汤庆宾%程岳雷%张宪静
週亞東%史繼學%楊琳%湯慶賓%程嶽雷%張憲靜
주아동%사계학%양림%탕경빈%정악뢰%장헌정
百草枯%中毒%血液%灌流
百草枯%中毒%血液%灌流
백초고%중독%혈액%관류
Paraquat%Poisoning%Blood%Perfusion
目的 研究血液灌流(HP)、血液灌流联合血液透析(HP+HD)、血液灌流联合持续静脉-静脉血液滤过(HP+CVVH)对百草枯中毒患者毒物清除作用.方法 选取本院收治的72例百草枯中毒患者,在给予常规药物治疗的同时分别给予HP、HP+HD、HP+CVVH 3种血液净化方式,对比观察血液净化前后血百草枯浓度下降率、肝肾功能损害和患者死亡率.结果 HP+HD、HP+CVVH组百草枯浓度下降率明显大于HP组,差异有统计学意义(P＜0.05),HP+HD、HP+CVVH组百草枯浓度下降率的差异无统计学意义(P＞0.05).HP+HD组和HP+CVVH组天冬氨酸转氨酶(AST)、丙氨酸转氨酶(ALT)升高率均明显低于HP组,差异有统计学意义(P＜0.05),HP+HD组和HP+CVVH组AST、ALT升高率的差异无统计学意义(P＞0.05).HP+HD组Cr升高率(223％±19.9％)均明显低于HP组(445％±37.6％)和HP+CVVH组(289％±20.7％),差异有统计学意义(P＜0.05),HP+CVVH组和HP组Cr升高率差异有统计学意义(P＜0.05).HP组、HP+HD组、HP+CVVH组BUN升高率分别为323％±25.7％、192％±15.6％、223％±19.7％,其中HP+HD组及HP+CVVH组BUN升高率均明显低于HP组,差异有统计学意义(P＜0.05),HP+HD组与HP+CVVH组的差异无统计学意义(P＞0.05).HP+HD、HP+CVVH组存活时间均较HP组延长,差异有统计学意义(P＜0.05).3组患者死亡率无明显差异.结论 3种血液净化方式均可有效清除吸收入血的毒物,HP+HD或HP+CVVH可有效降低肝肾功能损害程度,延长存活时间,但不能明显提高患者存活率.
目的 研究血液灌流(HP)、血液灌流聯閤血液透析(HP+HD)、血液灌流聯閤持續靜脈-靜脈血液濾過(HP+CVVH)對百草枯中毒患者毒物清除作用.方法 選取本院收治的72例百草枯中毒患者,在給予常規藥物治療的同時分彆給予HP、HP+HD、HP+CVVH 3種血液淨化方式,對比觀察血液淨化前後血百草枯濃度下降率、肝腎功能損害和患者死亡率.結果 HP+HD、HP+CVVH組百草枯濃度下降率明顯大于HP組,差異有統計學意義(P＜0.05),HP+HD、HP+CVVH組百草枯濃度下降率的差異無統計學意義(P＞0.05).HP+HD組和HP+CVVH組天鼕氨痠轉氨酶(AST)、丙氨痠轉氨酶(ALT)升高率均明顯低于HP組,差異有統計學意義(P＜0.05),HP+HD組和HP+CVVH組AST、ALT升高率的差異無統計學意義(P＞0.05).HP+HD組Cr升高率(223％±19.9％)均明顯低于HP組(445％±37.6％)和HP+CVVH組(289％±20.7％),差異有統計學意義(P＜0.05),HP+CVVH組和HP組Cr升高率差異有統計學意義(P＜0.05).HP組、HP+HD組、HP+CVVH組BUN升高率分彆為323％±25.7％、192％±15.6％、223％±19.7％,其中HP+HD組及HP+CVVH組BUN升高率均明顯低于HP組,差異有統計學意義(P＜0.05),HP+HD組與HP+CVVH組的差異無統計學意義(P＞0.05).HP+HD、HP+CVVH組存活時間均較HP組延長,差異有統計學意義(P＜0.05).3組患者死亡率無明顯差異.結論 3種血液淨化方式均可有效清除吸收入血的毒物,HP+HD或HP+CVVH可有效降低肝腎功能損害程度,延長存活時間,但不能明顯提高患者存活率.
목적 연구혈액관류(HP)、혈액관류연합혈액투석(HP+HD)、혈액관류연합지속정맥-정맥혈액려과(HP+CVVH)대백초고중독환자독물청제작용.방법 선취본원수치적72례백초고중독환자,재급여상규약물치료적동시분별급여HP、HP+HD、HP+CVVH 3충혈액정화방식,대비관찰혈액정화전후혈백초고농도하강솔、간신공능손해화환자사망솔.결과 HP+HD、HP+CVVH조백초고농도하강솔명현대우HP조,차이유통계학의의(P＜0.05),HP+HD、HP+CVVH조백초고농도하강솔적차이무통계학의의(P＞0.05).HP+HD조화HP+CVVH조천동안산전안매(AST)、병안산전안매(ALT)승고솔균명현저우HP조,차이유통계학의의(P＜0.05),HP+HD조화HP+CVVH조AST、ALT승고솔적차이무통계학의의(P＞0.05).HP+HD조Cr승고솔(223％±19.9％)균명현저우HP조(445％±37.6％)화HP+CVVH조(289％±20.7％),차이유통계학의의(P＜0.05),HP+CVVH조화HP조Cr승고솔차이유통계학의의(P＜0.05).HP조、HP+HD조、HP+CVVH조BUN승고솔분별위323％±25.7％、192％±15.6％、223％±19.7％,기중HP+HD조급HP+CVVH조BUN승고솔균명현저우HP조,차이유통계학의의(P＜0.05),HP+HD조여HP+CVVH조적차이무통계학의의(P＞0.05).HP+HD、HP+CVVH조존활시간균교HP조연장,차이유통계학의의(P＜0.05).3조환자사망솔무명현차이.결론 3충혈액정화방식균가유효청제흡수입혈적독물,HP+HD혹HP+CVVH가유효강저간신공능손해정도,연장존활시간,단불능명현제고환자존활솔.
Objective To investigate the different effect of three methods of blood purification for paraquat poisoning patients:hemoperfusion (HP),hemoperfusion combined with hemodialysis (HP + HD),hemoperfusion combined with continuous veno-venous hemofiltration (HP + CVVH).Methods:72 cases of paraquat poisoning patients were divided into three groups after giving conventional therapy HP group,HP + HD group,HP + CVVH group.Compared the rate of decline concentrations of paraquat in blood,the liver and the kidney damage between before and after blood purification and contrast the mortality in three groups after different method of blood purification.Results:The rate of decline concentrations of paraquat in blood of the HP + HD group and HP + CVVH group were both significantly greater than the HP group,but this result of HP + HD group has no significant difference compared with HP + CVVH group; Among the three groups of patients after 72 hours,the degree of dysfunction of liver of the HP + HD group and HP + CVVH group were both significantly lower than the HP group,whilely the degree of dysfunction of kidney of the HP + HD group was significantly lower than the HP group and the HP + CVVH group.The survival time of the HP + HD group and the HP + CVVH group were significant linger than the HP group,but the comparison among the three groups had no significant difference in mortality.Conclusion:Three blood purification methods can effectively remove paraquat absorbed into the blood,and the hemoperfusion combined with hemodialysis or continuous venovenous hemofiltration can effectively reduce the degree of damage of liver and kidney and also can prolong survival time,but did not significantly improve the survival rate of patients.
