急性鱼胆中毒三种治疗方法的比较

The Comparative Study of Three Therapeutic Regimens for Acute Fish's Gallblader Poisoning

目的:了解血液透析治疗对急性鱼胆中毒患者预后的影响。方法:将我院近十年收治的78例急性鱼胆中毒患者分为非透析治疗A组29例、血液透析治疗B组44例和提早行血液透析治疗C组5例(服用鱼胆到就诊时间≤12小时),A组患者单纯给予洗胃等常规治疗,B组在常规治疗基础上行血液透析治疗,C组则无论肾功如何,在就诊时立即给予血液透析治疗,分别比较三组患者少尿期时间、平均住院日及预后差异。结果:A、B、C三组患者少尿期时间分别为9·03±3·16、8·69±2·94及0天,平均住院日分别为17·8±8·42、17·33±7·86及7·12±1·66天,其中A、B两组少尿期时间和平均住院日无显著差异(P>0·05),C组与A、B两组比较则两项指标均显著降低(P<0·05);三组治愈率分别为62·1%、90·9%和100%,B组与A组相比、C组与B组相比,治愈率均显著提高。结论:对鱼胆中毒患者早期行血液透析治疗,尤其是在服用鱼胆后12小时内,尚未出现肾功损害时提早进行,是防治急性肾功能衰竭、改善预后的有效措施之一。

Objective： To investigate the effects of hemodialysis on the prognosis of patients with acute fish＇s gallblader poisoning. Methods： 78 patients with acute fish＇s gallblader induced intoxication who went to our hospital in the past ten years have been divided into three groups： 29 patients in the non- hemodialysis group （group A）, 44 patients in the hemodialysis group （group B）, and 5 patients in the advanced hemodialysis group （group C）, the time between they intaked fish＇s gallblader and visited hospital are no more than 12 hours）. Patients in group A were only given routine therapy, included gastric lavage et al, patients in group B were added hemodialysis to routine therapy; and patients in group C were given hemodialysis as soon as they went to hospital, regardless of their kidney function. The duration of oliguria, average hospitalization days and prognosis of the three groups were compared with each other. Results： The duration of olignria of the three groups were 9.03 ± 3.16, 8.69 ± 2.94 and 0 days, and average hospitalization days were 17.8 ± 8.42, 17.33 ± 7.86, 7.12 ± 1.66 days, respectively. There were no significant defference between group A and group B （ P 〉 0.05）, but significant decress between group C and group A or group B （ P 〈 0. 05 ）. The cure rate of the three groups were 62.1%, 90.9% and 100%, respectively. There were significante increse between group B and group A, or between group C and group B. Conclusions： The early hemodialysis on patients with acute fish＇s gallblader induced intoxication, especially less than 12 hours after intake, may prevent or cure associated acute renal failure, and improve the prognosis.