血液灌流治疗药物中毒的临床疗效研究

The Study of Clinical Effects of Therapy on Drugs Poisoning by Hemoperfusion

目的:探讨血液灌流(HP)对急性药物中毒患者血中毒物的清除作用及临床疗效。方法:收集我院2002年7月～2006年12月住院的鼠药(主要为毒鼠强、四亚甲基二砜四胺)和部分药物中毒患者69例,其中34例按常规给予洗胃、解毒、排毒、保肝、利尿或呼吸支持等综合治疗(非HP组),35例在综合治疗基础上同时给予HP。通过观察灌流前后的临床疗效。结果:HP组35例中死亡3例,生存率91.4%,非HP组34例中死亡5例,生存率85.3%(P>0.05)。HP组病程明显缩短(P<0.05)。HP后患者意识清醒及抽摔停止时间较非HP组显著提前。通过对清除率的计算发现:不同药物的清除效果有差异,其中氮卓类清除效果好,清除率为(91.6±12.5)%。结论:HP能不同程度清除体内毒物,可明显缩短病程、减少并发症,对于急性重度中毒可望提高生存率。

Objective：To investigate the ability of hemoperfusion to remoce some drugs or toxin from the vody and its clinical efficacy.Methods：Sixty-nine cases of poisoning due to tetramine or Other drugs poisoning in our hospital between July 2002 and December 2006 were studied.Thirty-four patients among them received conventional treatment（including early gastric lavage,detoxify.elimination of toxicant.hepatoprotection,diuresis or respiratory support）,and the remaining were given conventional treatment and hemoperfusion.Clinical symptoms before and after hemoperfusiom.Survival rate,time from come onset to regaining consciousness and convulsion termination and duration of clinial course were compared,Results：In the hemoperfusion group,three patients died,the survival rate was 91.4%,whereas in the non-hemoperfusion group,the survival rate was 85.3%（P〉0.05）.Meanwhile the clinical course was markedly shortened in the hemoperfusion group（P〈0.05）.The time from coma onset to regaining consciousness and convulsion termination in the hemoperfusion group was significantly shorter han that in the non-hemoperfusion group.The clearance rate was different for different poisons,among them the benzodiazepines had an excellentclearance.Conclusion：Hemoperfusion could absorb from blood a different amount of poisons.There is obvious efficacy in shortening clinical course and reducing complicaions.It could possibly raise survival rate in serious poisoning.