血液灌流联合二巯基丙磺酸钠及大剂量VitB_6救治急性毒鼠强中毒的临床研究

Clinical study of the treatment of acute tetramine intoxication with hemoperfusion,sodium dimercaptosulphonate and large dose vitamin B_6

目的研究血液灌流(HP)联合二巯基丙磺酸钠及大剂量VitB6救治急性毒鼠强中毒的临床疗效。方法59例急性毒鼠强中毒患者分为:A组采用常规治疗;B组常规+二巯基丙磺酸钠+大剂量VitB6治疗;C组常规+二巯基丙磺酸+大剂量VitB6联合HP治疗。结果①C组与A组、B组相比疗效更满意,HP联合治疗后血液毒鼠强浓度、APACHEⅡ评分均有明显降低,Glasgow评分明显升高(P<0.01);C组与其他两组比较,相同时期内血液毒鼠强浓度下降值差异有统计学意义,意识转清醒及抽搐停止时间均显著提前(P<0.01)。B组、C组治愈率明显高于A组(P<0.01),安定及苯巴比妥用量比A组显著减少(P<0.01)。结论常规+二巯基丙磺酸钠+大剂量VitB6联合HP治疗急性毒鼠强中毒疗效优于常规和常规+二巯基丙磺酸钠+大剂量VitB6治疗,可作为治疗急性毒鼠强中毒的一种较为理想的方案。在无条件行HP治疗时,常规+二巯基丙磺酸钠+大剂量VitB6治疗急性毒鼠强中毒可作为一种可行的治疗手段。

Objective To explore the clinical curative effect of acute tetramine intoxication （ ATI ） with hemoperfusion （ HP ） , sodium dimercaptosulphonate （ Na - DMPS I and large dose vitamin B6. Methods 59 ATI patients were divided into three groups ： A group （ n = 181 were treated with routine therapy, B group （ n = 201 were treated with Na - DMPS, large dose vitamin B6 besides routine therapy,C group （n =21 ） were treated with Na -DMPS, large dose vitamin B6 and HP besides routine therapy. Results The curative effect of C group was more satisfactory compared with A group and B group. Blood concentration of tetramine, APACHE Ⅱ score were decreased and Glasgow score was increased significantly in C group （ P 〈 0.01 ）. The blood concentration reduction of tetramine in group C was significantly different from two other groups. The duration of consciousness recovery and convulsion termination were shortened significantly （ P 〈 0.01 ）. The cure rate in B group and C group were higher than A group. The dose of diazepam and phenobarbital were significantly less in B group and C group than in A group. Conclusion The therapy in C group was better, which was perfect plan to treat ATI. The treatment in B group may be as the second choice without HP.