CAJ | 학술논문

目的：探讨连续性静脉-静脉血液净化（CVVH）对口服百草枯急性中毒患者的疗效。方法采用前瞻性单中心随机对照研究，对119例口服百草枯急性中毒患者随机数字法随机分成CVVH治疗组（n=48）和常规治疗组（n=71），观察两组患者的30 d病死率、死亡患者存活时间、脏器损伤情况。结果CVVH治疗组患者死亡23人，病死率47.9%，常规治疗组死亡43人，病死率60.6%，差异有统计学意义，P=0.05；两组中死亡患者生存时间相比具体有统计学差异（8 dVs3 d）；CVVH治疗组患者中肾损伤发生率、低氧血症发生率、MODS发生率低于常规治疗组（66.7%Vs80.3%、47.9%Vs62%、41.7%Vs56.3%），差异有统计学意义，均P=0.04；而两组患者肝损伤发生率无差异，P=0.15；常规治疗组患者死于MODS明显高于CVVH治疗组，差异有统计学意义，P=0.03，而两组患者死于低氧血症无差异，P=0.15；CVVH组患者中行CVVH次数与时间长短与患者预后无线性关系。结论连续性静脉-静脉血液滤过可降低口服百草枯急性中毒患者病死率，延长死亡患者的生存时间，可能是治疗口服百草枯急性中毒的新方向。
목적：탐토련속성정맥-정맥혈액정화（CVVH）대구복백초고급성중독환자적료효。방법채용전첨성단중심수궤대조연구，대119례구복백초고급성중독환자수궤수자법수궤분성CVVH치료조（n=48）화상규치료조（n=71），관찰량조환자적30 d병사솔、사망환자존활시간、장기손상정황。결과CVVH치료조환자사망23인，병사솔47.9%，상규치료조사망43인，병사솔60.6%，차이유통계학의의，P=0.05；량조중사망환자생존시간상비구체유통계학차이（8 dVs3 d）；CVVH치료조환자중신손상발생솔、저양혈증발생솔、MODS발생솔저우상규치료조（66.7%Vs80.3%、47.9%Vs62%、41.7%Vs56.3%），차이유통계학의의，균P=0.04；이량조환자간손상발생솔무차이，P=0.15；상규치료조환자사우MODS명현고우CVVH치료조，차이유통계학의의，P=0.03，이량조환자사우저양혈증무차이，P=0.15；CVVH조환자중행CVVH차수여시간장단여환자예후무선성관계。결론련속성정맥-정맥혈액려과가강저구복백초고급성중독환자병사솔，연장사망환자적생존시간，가능시치료구복백초고급성중독적신방향。
Objective To evaluate the efficacy of continuous veno-venous hemofiltration (CVVH) for patients with acute paraquat (PQ) poisoning in a prospective, single-center, randomized controlled study. Methods A total of 119 patients with acute paraquat poisoning were randomly assigned to 2 group:control group (n=71) and CVVH treatment group (n=48). The mortality within 30days and survival time of the deaths were measured. Results There were no significant differences in mean age, sex ratio, mean volume of PQ ingested, initial renal function, or initial liver function between these 2groups. The mortality was significantly lower in the CVVH group (47.9%vs. 60.6%;P<0.05) and the survival time of the deaths significantly prolonged (8 days vs. 3 days;P<0.05). Moreover, incidences of renal injury, hypoxia, and multi-organ system dysfunction (MODS) were all lower in the CVVH group (renal injury:66.7%vs. 80.3%;hypoxia:47.9%vs.62%;MODS:41.7%vs.56.3%;all P<0.05), while there was no difference in the incidence of liver injury (P=0.15) or death due to hypoxia (P=0.15). The incidence of death due to MODS was higher in the control group,(P=0.03). There was no significant linear relationship between the CVVH duration and prognosis in the CVVH group. Conclusion continuous veno-venous hemofiltration can reduce the mortality and prolong the survival time of patients with PQ poisoning.