持续血液灌流联合大黄为主组方序贯治疗百草枯中毒的临床疗效

发布时间：2018-09-17 15:01

【摘要】：目的探讨持续血液灌流联合大黄为主组方序贯治疗急性百草枯中毒(APP)的临床疗效。方法选择本院中度APP患者116例,按随机数字法将患者分为A组(血液灌流组)31例、B组(血液灌流联合大黄为主组方组)40例及C组(持续血液灌流联合大黄为主组方组)45例。分别于治疗前及治疗后5、7 d,检测C-反应蛋白(CRP)、丙氨酸氨基转移酶(ALT)、肌酸激酶(CK-MB)、肌酐(Cr)、肿瘤坏死因子-α(TNF-α)、白细胞介素-6(IL-6)及白细胞介素-10(IL-10)水平。于治疗前及治疗后8、12、24 h检测血百草枯含量。结果治疗后,C组总有效率(68.89%)显著高于A组(35.48%)、B组(52.5%),组间比较差异有统计学意义(χ2=8.335,P=0.015);治疗后5 d,ALT、CK-MB、Cr、CRP、TNF-α、IL-6、IL-10水平均升高,A组升高最明显;治疗后7 d,C组降低最显著,各组间比较差异均有统计学意义(P0.05)。治疗后8 h,B、C组百草枯含量低于A组;治疗后12 h,C组百草枯含量最低,组间比较差异有统计学意义(P0.05)。治疗后24 h,各组百草枯含量均明显降低,组间比较差异无统计学意义(P0.05)。结论早期给予持续血液灌流联合大黄为主组方序贯治疗APP,能有效降低患者病死率,改善预后。
[Abstract]:Objective to investigate the clinical effect of continuous hemoperfusion combined with rhubarb as main prescription in the treatment of acute paraquat poisoning (APP). Methods 116 patients with moderate APP in our hospital were randomly divided into group A (hemoperfusion group) and group B (hemoperfusion plus rhubarb group) (40 cases) and group C (continuous hemoperfusion combined with rhubarb as main prescription group) (45 cases). The levels of C-reactive protein (CRP), alanine aminotransferase (ALT), creatine kinase (CK-MB), creatinine (Cr), tumor necrosis factor- 伪 (TNF- 伪), interleukin-6 (IL-6) and interleukin-10 (IL-10) were measured before and 5 days after treatment. Blood paraquat content was measured before and after treatment at 812 hours. Results the total effective rate of group C (68.89%) was significantly higher than that of group A (35.48%) (52.5%), the difference between the two groups was statistically significant (蠂 ~ 2 = 8.335), the level of IL-6 IL-10 in group A was significantly higher than that in group A at 5 d after treatment, and the level of IL-6 IL-10 in group A was significantly lower than that in group A at 7 days after treatment, and the total effective rate of group C (68.89%) was significantly higher than that of group A (35.48%) (P < 0.05), and the level of IL-6 IL-10 in group A was significantly higher than that in group A (P < 0.05). The differences between the groups were statistically significant (P0.05). The paraquat content in group C was lower than that in group A at 8 hours after treatment, and the content of paraquat in group C was the lowest at 12 hours after treatment (P0.05). 24 hours after treatment, the content of paraquat decreased significantly in each group, there was no significant difference between the groups (P0.05). Conclusion early continuous hemoperfusion combined with rhubarb for sequential treatment of APP, can effectively reduce the mortality and improve the prognosis.
【作者单位】：河北医科大学哈励逊国际和平医院急救医学部;河北医科大学哈励逊国际和平医院EICU;河北医科大学哈励逊国际和平医院急诊综合病房;
【基金】：河北省省级科技计划项目(编号:162777109D)
【分类号】：R595.4

【相似文献】