CAJ | 학술논문

目的：探析血液灌流联合机械通气在氯氮平重度中毒患者临床抢救中的应用效果。方法将我院收治的78例氯氮平重度中毒患者随机分为观察组(40例)和对照组(38例)。对照组采取综合治疗及机械通气进行抢救，观察组在对照组的基础上给予血流灌注，比较两组患者治疗前后血浆药物水平、病死率、机械通气时间、恢复清醒时间以及住院时间。结果治疗后，两组血浆氯氮平浓度及血浆晕原去甲基氯氮平浓度均显著降低，且观察组降低幅度显著大于对照组，差异具有统计学意义(P<0.05)。观察组机械通气时间、恢复清醒时间、住院时间均明显短于对照组，差异具有统计学意义(P<0.05)。观察组病死率和并发症发生率分别为0.0豫和60.0豫，与对照组的5.3豫和57.9豫相比无显著差异(P>0.05)。结论氯氮平重度中毒患者采取血液灌流联合机械通气进行抢救可有效清除体内毒素，缩短机械通气时间及恢复清醒时间，改善患者预后。
목적：탐석혈액관류연합궤계통기재록담평중도중독환자림상창구중적응용효과。방법장아원수치적78례록담평중도중독환자수궤분위관찰조(40례)화대조조(38례)。대조조채취종합치료급궤계통기진행창구，관찰조재대조조적기출상급여혈류관주，비교량조환자치료전후혈장약물수평、병사솔、궤계통기시간、회복청성시간이급주원시간。결과치료후，량조혈장록담평농도급혈장훈원거갑기록담평농도균현저강저，차관찰조강저폭도현저대우대조조，차이구유통계학의의(P<0.05)。관찰조궤계통기시간、회복청성시간、주원시간균명현단우대조조，차이구유통계학의의(P<0.05)。관찰조병사솔화병발증발생솔분별위0.0예화60.0예，여대조조적5.3예화57.9예상비무현저차이(P>0.05)。결론록담평중도중독환자채취혈액관류연합궤계통기진행창구가유효청제체내독소，축단궤계통기시간급회복청성시간，개선환자예후。
Objective To explore the application effect of hemoperfusion combined mechanical ventilation in clinical rescue of patients with severe clozapine poisoning. Methods 78 cases of patients with severe clozapine poisoning treated in our hospital were randomly divided into observation group (40 cases) and control group (38 cases). The control group was given comprehensive treatment and mechanical ventilation for rescuing, the observation group was given hemoperfusion on the basis of control group. The plasma drug level, mortality, mechanical ventilation time, recovery time and hospitalization time of two groups were compared. Results After treatment, the concentrations of clozapine and N-desmethylclozapine in plasma of two groups were significantly decreased, and the reduction of observation group was greater than that of control group, with statistical difference (P<0.05). The mechanical ventilation time, recovery time and hospitalization time of observation group were shorter than those of control group, with statistical difference (P<0.05). The mortality and complications rates of two groups had no statistical difference (0.0%vs 5.3%, 60.0%vs 57.9%,P>0.05). Conclusions For patients with severe clozapine poisoning, hemoperfusion combined mechanical ventilation can effectively eliminate the toxin in the body, reduce mechanical ventilation time and recovery time, and also improve the prognosis of patients.