不同血液净化方法对鱼胆中毒的疗效比较

Effect of different methods of blood purification on fish's gall intoxication

目的研究不同血液净化方法对鱼胆中毒的治疗价值。方法回顾分析65例鱼胆中毒的临床资料。在常规治疗的基础之上,采用血液透析(hemodialysis,HD)治疗28例,透析时间3～6h;血液灌流(hemoperfusion,HP)-HD序贯性血液净化治疗20例,先HP灌流2h,随后立即进行HD透析4～6h;HP治疗17例,灌流时间2h。结果HP-HD组、HD组、HP组的有效率分别为90.0%、60.7%、47.1%,病死率分别为5.0%、32.1%、41.1%,净化次数分别为5.0±1.0次、8.6±2.1次、9.0±2.5次,少尿持续时间分别为6.0±1.7d、8.8±2.1d、9.4±2.8d,肝功能恢复正常时间分别为13.5±3.1d、18.9±4.0d、19.3±4.7d(HP-HD组与HD、HP组比较P<0.05,HD组与HP组比较P>0.05),肾功能恢复正常时间分别为16.2±3.4d、20.6±4.3d、25.8±5.6d(HP-HD组与HD、HP组各组间比较P<0.05)。结论HP-HD序贯性血液净化是治疗鱼胆中毒的最有效方法之一。

Objective To investigate the clinical value of different methods of blood purification in fish＇ s gall intoxication. Methods The clinical data of 65 cases in fish＇s gall intoxication were reviewed. Based on the conventional medical therapies, 28 cases were treated with hemodialysis for 3-6hours,20 cases with hemoperfusion for 2 hours and sequential hemodialysis 4-6 hours, 17 cases with hemopeffusion for 2 hours. Results The effective rate of HP-HD group, HD group and HP group was 90.0%,60.7%,47.1% respectively, the death rate was 5.0%,32.1%,41.1%, the times of blood purification were 5.0±1.0,8.6±2.1,9.0±2.5 times, the time of oliguria was 6.0±1.7,8.8±2.1,9.4±2.8 days.The recovering time of liver function was 13.5±3.1,18.9±4.0,19.3±4.7 days （HP-HD group was compared with HD group or HPgroup P〈0.05, HD and HP P〉0.05）, The recovering time of renal function was 16.2±3.4,20.6±4.3,25.8±5.6 days（HP-HD group was compared with HD group or HP group P〈0.05, HD and HP P〈0.05）.Conclusions The sequential hemopeffusion and hemodialysis are one of the best effective methods for acute fish＇s gall intoxication.