血液净化方案对急性百草枯中毒患者预后的影响

发布时间：2018-02-27 00:38

本文关键词： 中毒百草枯血液灌流连续性静脉-静脉血液滤过预后　出处：《新疆医科大学》2017年硕士论文　论文类型：学位论文

【摘要】：目的:探讨不同血液净化方案对急性百草枯中毒患者预后的影响。方法:采用回顾性研究的方法,按照接受治疗方案的不同,将89例急性百草枯中毒患者分为常规治疗组,血液灌流(HP)组,血液灌流联合连续性静脉-静脉血液滤过(HP+CVVH)组,收集患者的一般资料以及分别对比入院时与治疗72小时后3组患者间相关检验室检查结果、生存天数以及预后情况,以此评价不同血液净化方式对中毒患者预后的影响。采用多因素logistic回归模型分析血液净化条件下影响中毒患者预后的相关的因素。结果:三组间患者的病死率差异有统计学意义(?2=10.73,P=0.005),HP组病死率明显低于对照组(?2=6.49,P=0.011);HP+CVVH组患者病死率明显低于对照组(?2=10.53,P=0.001);但HP组与HP+CVVH组之间比较差异无统计学意义(?2=0.59,P0.05);三组死亡患者存活时间差异有统计学意义(F=39.79,P0.01),组间两两比较差异有统计学意义(P0.05),HP+CVVH组患者的生存时间要明显高于HP组与对照组(P0.05);多因素logistic回归结果显示,服毒量[OR=1.169,95%CI=1.039~1.315,P0.01],中毒至血液灌流时间[OR=3.635,95%CI=1.535~8.608,P0.01],入院时白细胞计数[OR=1.530,95%CI=1.115~2.100,P0.01],均为影响百草枯中毒患者预后的相关危险因素。结论:HP联合CVVH的血液净化方式虽能有效减轻中毒所至的多脏器功能受损,并延长中毒患者生存天数,但在降低患者远期病死率方面与HP无明显差异;中毒剂量、中毒至血液灌流的时间与白细胞计数水平与中毒患者的预后密切相关。
[Abstract]:Objective: to investigate the effect of different blood purification schemes on the prognosis of patients with acute paraquat poisoning. Methods: 89 patients with acute paraquat poisoning were divided into routine treatment group by retrospective study. Hemoperfusion group, hemoperfusion combined with continuous veno-venous hemofiltration group (CVVH) group, collected the general data of the patients and compared the results of relevant laboratory examination between the three groups at admission and 72 hours after treatment. Survival days and prognosis, The multivariate logistic regression model was used to analyze the factors related to the prognosis of the poisoning patients under the condition of blood purification. Results: the mortality of the three groups was poor. Is there statistical significance? The mortality of HP group was significantly lower than that of control group (P < 0. 005). (2) the fatality rate of patients with HP CVVH was significantly lower than that of the control group (P < 0. 011). The difference between HP group and HP CVVH group was not statistically significant. (2) there was significant difference in survival time among the three groups (P 0.05). The survival time of patients in HP CVVH group was significantly higher than that in HP group and control group (P 0.05), and the multivariate logistic regression analysis showed that the survival time of the patients with HP was significantly higher than that of the control group (P 0.05), and the survival time of the patients with HP was significantly higher than that of the control group (P 0.05), and the difference between the two groups was statistically significant (P < 0.05). The amount of poison taken [ORL 1.16995 CIQ 1.0391.315P0.01], the time from intoxication to hemoperfusion [ORO 3.63595 CIQ 1.535 + 8.608g P0.01], and the leukocyte count on admission [OR1.530c95CII 1.1152.100P0.01] were all related risk factors affecting the prognosis of patients with paraquat poisoning. Conclusion the blood purification mode of CVVH can effectively reduce the damage of multiple organ function caused by poisoning. The survival days of poisoning patients were prolonged, but there was no significant difference between them in reducing the long-term mortality of patients with HP, and the time from poisoning to hemoperfusion was closely related to the level of white blood cell count and the prognosis of poisoning patients.
【学位授予单位】：新疆医科大学
【学位级别】：硕士
【学位授予年份】：2017
【分类号】：R595.4

【相似文献】