血液灌流治疗百草枯中毒的临床总结

Clinical analysis of blood perfusion treatment for paraquat poisoning

目的 研究血液灌流（HP）治疗对百草枯中毒患者的疗效.方法 回顾性分析2005年1月至2009年12月收治的222例百草枯中毒患者的临床资料,按治疗方案分为对照组（140例）和HP组（82例）.两组均给予常规治疗;HP组加用HP,每日1次,持续4 h.比较两组患者临床指标、实验室指标、序贯器官功能衰竭评分系统（SOFA）评分与预后.结果 HP组患者动脉血氧分压（PaO2）、白细胞计数（WBC）、丙氨酸转氨酶（ALT）、天冬氨酸转氨酶（AST）、尿素氮（BUN）、肌酐（Cr）均较治疗前明显改善,且明显优于对照组（均P〈0.05）.HP组患者SOFA评分显著低于对照组[（2.69±0.36）分比（2.78±0.39）分,P〈0.05].HP组患者28 d生存率明显高于对照组[48.8%（40/82）比43.6%（61/140）,P〈0.053.结论 HP能够减轻百草枯中毒患者的器官损害,并改善预后.

Objective To study the efficacy of hemoperfusion （HP） therapy in treatment of patients with paraquat poisoning. Methods The clinical data of 222 patients with paraquat poisoning admitted from January 2005 to December 2009 were retrospective analyzed. The patients were assigned to control group （n= 140） or HP group （n = 82） according to treatment plan. The conventional therapy was administered in both groups, and HP therapy was added in HP group （once a day, persisting for 4 hours）. The clinical parameters, laboratory results, sequential organ failure assessment （SOFA） score and prognosis of the groups were compared. Results Partial pressure of oxygen in artery （PaO2）, white blood cell （WBC） count, alannine aminotransferase （ALT）, aspartate aminotransferase （AST）, blood urea nitrogen （BUN）, and creatinine （Cr） were all better than those before the treatment in HP group, and surpassed the control group （all P〈0.05）. The SOFA score of HP group was lower than that of control group （2.69 ± 0.36 vs. 2.78±0.39, P〈0.05）. The 28-day survival rate of HP group was higher than that of control group [48.8% （40/82） vs. 43.6% （61/140）, P〈0.05]. Conclusion Hemoperfusion may reduce the severity of organ lesion and improve the prognosis of patients with paraquat poisoning.