应用SOFA评分评估血液灌流治疗百草枯中毒的临床疗效

Evaluation of the therapeutic effect of hemoperfusion in paraquat poisoning by sepsis-related organ failure assessment score

目的:应用序贯器官功能衰竭评估系统(sequential organ failure assessment,SOFA)评估多次血液灌流治疗百草枯中毒的临床疗效。方法:将2007-01-2012-02重庆市急救医疗中心收治的27例百草枯中毒患者分为两组,在常规治疗的基础上,仅接受1次血液灌流治疗的患者为单次血灌组(15例),接受2次及以上血液灌流治疗的患者为多次血灌组(12例),比较两组患者入院时SOFA评分及最大SOFA评分(住院期间SOFA评分最高值)的差异,以评估多次血液灌流治疗百草枯中毒的临床疗效。结果:两组患者入院时SOFA评分差异无统计学意义(2.52±1.57)分比(2.35±1.12)分,P>0.05,单次血灌组最大SOFA评分较多次血液灌流组显著增高,差异有统计学意义(9.32±2.41)分比(7.13±1.78)分,P<0.05;经积极治疗后,单次血灌组死亡9例,多次血灌组死亡6例,与两组SOFA评分具有较好的相关性。结论:在常规治疗的基础上,多次血液灌流比单次血液灌流能更好改善百草枯中毒患者的临床疗效;SOFA评分在百草枯中毒临床疗效的循证医学系统评估中有应用价值。

Objective：To study the therapeutic effect of hemoperfusion in treating paraquat poisoning according to sepsis related organ failure assessment（SOFA） score.Method：Twenty-seven patients with paraquat intoxication treated in Chongqing Emergency Medical Centre from January 2007to February 2012 were divided into two groups：single and repeated hemoperfusion group.The single hemoperfusion group（15cases） was treated with one hemoperfusion besides conventional therapy,and the repeated hemoperfusion group（12cases） was treated with more than one hemoperfusion.The SOFA score at admission and the maximum score during hospitalization were registered.Their differences were compared between the two groups to evaluate the therapeutic effect of hemoperfusion on paraquat intoxication.Result：There was no significant difference of the SOFA score between the two groups at admission（（2.52±1.57） vs（2.35±1.12）,P0.05）.The maximum SOFA score of the single hemoperfusion group was higher than that of the repeated hemoperfusion group（（9.32±2.41） vs（7.13±1.78）,P 0.05）.After active treatments,nine patients died in single hemoperfusion group and six patients died in repeated hemoperfusion group.There was a good correlation with SOFA score.Conclusion：Repeated hemoperfusion has clinical value in treating paraquat intoxication.SOFA score is useful for assessment of the therapeutic effect of hemoperfusion on paraquat intoxication in evidence based medicine.