首次血液灌流时间对百草枯中毒患者血药浓度及预后的影响

发布时间：2018-05-31 12:06

本文选题：血液灌流 + 百草枯中毒　；参考：《吉林大学》2015年硕士论文

【摘要】：目的通过测定百草枯（paraquat, PQ）清除率探讨首次血液灌流（hemoperfusion,HP）时间对PQ中毒患者血药浓度及预后的影响，为临床治疗提供理论依据。方法收集吉林大学第一医院二部重症医学科从2014年1月1日至2015年3月1日口服PQ中毒患者62例，均为12小时内就诊，将其进行回顾性分析。所有患者均行HP，按照首次HP时间不同，分为A组：HP2小时组，B组：HP4小时组，根据口服PQ剂量不同分为轻、中、重度中毒，记录A、B两组首次HP前、灌流2小时、灌流4小时的血浆PQ浓度，计算两组PQ清除率，，及所有患者死亡及生存结果，比较A、B两组PQ清除率、病死率及死亡患者生存时间有无差别。结果 1.随着HP的进行，血浆PQ浓度逐渐下降，B组第一个2小时较第二个2小时PQ浓度下降速度显著。 2.中、重度中毒患者，B组相比A组清除率高，差异有统计学意义；而对于轻度中毒患者，两组HP清除率相近，差异无统计学意义。重度中毒较轻度中毒的清除率高，差异有统计学意义。 3. A组与B组病死率相近，差异无统计学意义；中、重度中毒患者，B组死亡患者生存时间高于A组，差异有统计学意义。结论 1.首次HP对PQ的清除效果显著。 2.对中、重度PQ中毒患者，延长首次HP时间对病死率无影响，但可以延长患者的生存时间。
[Abstract]:Purpose In order to provide theoretical basis for clinical treatment, the effect of the first time of hemoperfusion of paraquat (PQQ) on the blood drug concentration and prognosis of PQ poisoning patients was studied by measuring the clearance rate of paraquat (PQQ). Method From January 1, 2014 to March 1, 2015, 62 patients with oral PQ poisoning were collected and analyzed retrospectively. All patients were treated with HP. according to the time of the first HP, they were divided into two groups: group A: HP2, group B, group B: HP4. According to the different doses of oral PQ, they were divided into mild, moderate and severe poisoning. The plasma PQ concentration was perfused for 4 hours. The PQ clearance rate of the two groups and the death and survival results of all the patients were calculated. The PQ clearance rate, mortality and survival time of the two groups were compared. Result 1. With the development of HP, the plasma PQ concentration gradually decreased in group B at the first 2 hour and the second 2 hour, and the decrease rate of PQ concentration in group B was significantly higher than that in the second hour. 2. The clearance rate of HP in group B was higher than that in group A, but there was no significant difference in the clearance rate of HP between the two groups. The clearance rate of severe poisoning was higher than that of mild poisoning, and the difference was statistically significant. 3. The mortality of group A was similar to that of group B. there was no significant difference between group A and group B. the survival time of group B was higher than that of group A, and the difference was statistically significant. Conclusion 1. The effect of HP on PQ removal was significant for the first time. 2. In patients with moderate or severe PQ poisoning, prolonging the first HP time had no effect on the mortality, but could prolong the survival time of the patients.
【学位授予单位】：吉林大学
【学位级别】：硕士
【学位授予年份】：2015
【分类号】：R595.4

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