血液透析滤过在鱼胆中毒治疗中的应用体会

The application experience of hemodialysis filtration in the treatment of fish gallbladder poisoning

目的观察血液透析滤过在口服鱼胆中毒患者并发肝肾功能不全的治疗效果。方法对42例鱼胆中毒患者进行积极补液、利尿、保护心肝肾脏等内科综合治疗,同时对所有患者予以血液透析滤过治疗,血管通路为股静脉穿刺插管,血流量为150～250 mL/min,透析液流量为500 mL/min,置换液量为15～20 L。抗凝方法根据患者有无出血倾向用普通肝素或低分子肝素,首次血液透析滤过2 h,后每日3～4 h。结果 42例患者中40例治愈出院,住院天数为9～25 d,平均13.7 d,治愈率为95.2%。结论血液透析滤过治疗鱼胆中毒疗效确切。

Objective To observe the treatment effect of hemodialysis filtration in oral fish gall bladder poisoning patients with liver and kidney dysfunction.Methods 42 cases of patients were given positive rehydration,diuresis,protecting the heart,liver and kidneys comprehensive medical treatment,and all patients were given hemodiafiltration treatment.The vascu lar access was femoral venipuncture intubation,the blood flow was 150-250 mL/min,dialysate flow rate was 500 mL/min,replacement fluid amount was 15-20 L.Anticoagulation method was common heparin or low molecular heparin according to whether patients with haemorrhage tendency,the first time hemodiafiltration was 2 h,then 3-4 h daily.Results 40 cases were cured in 42 patients,inpatient days were 9-25 days,an average of 13.7 days,cure rate was 95.2%.Conclusion The treatment effect of hemodialifiltration on fish gallbladder poisoning is exact.