血液灌流联合血液透析治疗急性百草枯中毒荟萃分析

An additional hemoperfusion-hemodialysis treatment for acute paraquat poisoning：a meta-analysis

目的 分析血液灌流（HP）联合血液透析（HD）治疗急性百草枯中毒及其对预后的改善.方法 以＂百草枯＂及＂HP＂为关键词检索Pubmed、万方数据库、中国期刊全文数据库（CNKI）、维普数据库相关文献,文献以常规内科治疗为对照组,并以HD＋HP＋常规内科治疗为治疗组,对检索文献进行评价并对符合拟定条件的数据进行独立录入.结果 共检索到807篇相关文献,其中14篇文献纳入研究,14项研究中无明显异质性I2=0.00（P=0.976,χ2=4.96）,应用固定效应模型进行荟萃分析,纳入14项研究总病例数为648例,其中HD＋HP＋常规内科治疗死亡率为36.5%（375例中137例死亡）,而单纯常规内科治疗死亡率为75.3%（264例中199例死亡）（P=0.000,OR=5.4,95%CI 3.698～7.885）.结论 HD＋HP＋常规内科治疗较单纯常规内科治疗可以明显改善早期轻度中毒患者预后,提高百草枯中毒的生存率.

Objective To investigate the effect of an additional hemoperfusion （HP） hemodialysis （HD） treatment on the prognosis of acute paraquat poisoning. Methods Related articles were searched in Pubmed, CNKI, Wangfang and VIP database with paraquat and hemoperfusion as the key words. The relevant articles were reviewed and the qualified data were collected by two authors independently. Results 14 studies involving 648 subjects, 375 in group of HP ＋ HD ＋ conventional medical treatment and 264 in group of conventional medical treatment were included into the meta - analysis. No heterogeneity in ld enrolled studies （12 = 0.00） was found in meta -analysis （P = 0. 976, X2 = 4.96）. A fixed effect meta - analyse was used to analyse the difference in prognosis. The mortality in HP ＋ HD ＋ conventional medical treatment group was reduced into 36.5% （ 137 deaths among 375）, as compared with 75.3% （ 199 deaths among 264） in conventional medical treatment group （P = 0.00, 0R=5.4, 95%CI 3.698 -7.885）. Conclusion The combination of hemoperfusion, hemodialysis, and conventional medical treatment in early stage significantly improves the prognosis of the mild paraquat poisonin~ patients.