血液灌流联合血液滤过治疗急性重症白毒伞蕈中毒临床分析

Clinical Analysis of Hemopevfusion Combined with Hemofiltration in Treating Acute Severe Poisoning with White Umbrella Mushroom

目的:探讨血液灌流联合血液滤过治疗白毒伞蕈中毒的临床价值。方法:对我院2004年6月至8月集中收治的进行血液灌流联合血液滤过治疗的13例急性重症白毒伞蕈中毒患者进行回顾性分析。对13例患者治疗前后肝、肾功能、心肌酶及临床症状进行对比观察。结果:13例患者在应用血液灌流联合血液滤过治疗后,血液中血尿素氮(BUN)、血肌酐(SCr)、肌酸激酶同工酶(CK-MB)、丙氨酸氨基转移酶(ALT)、天门冬酸氨基转移酶(AST)、乳酸脱氢酶(LDH)明显下降,其中BUN、SCr、CK-MB具有统计学意义(P<0.05)。临床症状明显改善,除2例患者由于经济原因未坚持治疗自动出院、1例因多器官功能衰竭死亡外,其余10例全部治愈出院。结论:对于急性重症白毒伞蕈中毒的救治,早期及时行血液灌流联合血液滤过治疗,可有效地清除和吸附血液中BUN、SCr、CK-MB、ALT、AST、LDH毒性物质,是避免白毒伞蕈中毒发生致死性肝损害的有效措施之一。

Objective： To sum up the clinical value of blood perfusion of blood filtration in treating white umbrella mushroom poisoning. Method： 13 cases of severe acute poisoning with white umbrella poisoning patients on joint hemoperfusion blood filtration treatment were analyzed from June to August in 2004. Their liver and kidney function, myocardial enzymes and clinical symptoms were observed and compared. Results： With the application of the joint hemoperfusion blood filtration treatment, the patients＇ blood urea nitrogen （BUN）, serum creatinine （SCr）, creatine kinase （CK-MB）, Shift enzyme （ALT）, aspartic acid aminotransferase （AST）, and lactate dehydrogenase （LDH） decreased significantly, BUN, SCr, CK-MB was significant （P〈0.05）. Clinical symptoms improved significantly. Conclusion： In treating severe acute poisoning with white umbrella, early time line hemoperfusion joint hemofihration treatment can be effective in removal and absorption LDH toxic substances of BUN, SCr, CK-MB, ALT, AST in the blood. It was effective to avoid liver injury in white umbrella mushroom poisoning.