血液灌流治疗儿童急性毒鼠强中毒的疗效观察

Effect of hemoperfusion therapy in children with acute tetramine poisoning

目的分析总结血液灌流治疗急性毒鼠强中毒的经验和价值。方法根据患儿法定监护人的选择，将67例误服毒鼠强的患儿分为血液灌流组（灌流组）和常规治疗组（对照组），灌流组48例，在常规治疗的基础上进行血液灌流治疗，对照组19例，只接受常规治疗，比较不同血清毒鼠强浓度范围时患儿的治疗效果。结果血清毒鼠强浓度〉0．5mg／dl时，灌流组和对照组患儿均很快死亡；血清毒鼠强浓度为0．20-0．49mg／dl时，灌流组患儿血清毒鼠强浓度下降值明显大于对照组[（0．28±0．02）me,／dlvs（0．13±0．03）me,／d1]（P〈0．05）；血清毒鼠强浓度〈0．2mg／dl时，两组浓度下降值差异无统计学意义[（0．12±0．02）mg／dlvs（0．11±0．03）mg／d1]（P〉0．05）。结论应根据患儿血清毒鼠强浓度决定治疗方案，选择最为经济实用的治疗方法。

Objective To analyze the therapeutic experience and value of hemoperfusion in children with acute tetramine poisoning. Methods According to the choice of children＇s legal guardian,67 cases with acute tetramine poisoning were divided into two groups：the perfusion group （48 cases）, and the control group （ 19 cases）. The patients in perfusion group received blood perfusion based on conventional treatment,while the patients in control group received conventional treatment only. Survival outcomes of patients with different ser- um tetramine concentrations in two groups were compared. Results When the serum concentration of tetra- mine was 〉 0. 5 mg/dl,patients in both groups died in a short time. When the serum concentration of tetra- mine was 0. 20 - 0. 49 mg/dl, the drop value of serum concentration of tetramine significantly greater in per- fusion group [ （ 0. 28 ± 0. 02） mg/dl ] than that in control group [ （0. 13 ± 0. 03 ） mg/dl ] （ P 〈 0. 05 ）. When the serum concentration of tetramine was 〈 0. 2 rag/all, the drop value of serum concentration of tetramine in two groups showed no significant difference [ （0. 12 ±0.02） mg/dl vs （0. 11 ±0.03） mg/dl] （P〉0. 05）. Conclusion The treatment method for tetramine poisoning should be selected based on the serum concentration of tetramine.