连续性静-静血液滤过联合血浆吸附救治百草枯中毒患者89例分析

Plasma adsorption with continuous veno-venous hemofiltration in treatment of paraquat poisoning： analysis of 189 eases

目的探讨对百草枯中毒患者行连续性血液净化治疗的治疗、护理经验。方法对189例百草枯中毒患者进行连续性血浆吸附（PAP）治疗，待患者体内毒药清零后再行），PAP治疗中用枸橼酸钠抗凝。总结分析治疗、护理的经验。结果共行连续性CVVH319次，PAP238次，救治成功135例，抢救成功率71．43％。护理中强调左侧卧位，监测凝血功能及预防低血压。结论连续性PAP，枸橼酸钠抗凝，体内毒药清零后再行连续性CVVH，左侧卧位等，可以有效的提高百草枯患者的抢救成功率。

Objective To summarize the experience in treatment and nursing of patients with paraquatpoisoning. Methods The clinical data of 189 patients with paraquat poisoning who underwent eontinuous plasma adsorption（PAP） when sodium citrate was used as anticoagulant and continuous veno-venous hemofiltration （CVVH） after the poison in the body was cleared were analyzed. Results PAP and CVVH were eonducted 238 and 319 times respectively. 135 cases had been rescued suceessfully with a success rate of 71.43%. During the nursing left lateral deeubitus position was adopted. Coagulation function was monitored. Prevention of hypotension was emphasized. Conclusion Continuous PAP, anticoagulation with sodium citrate, continuous CVVH after the elearance of poison in the body, and left lateral deeubitus position all help raise the successful rescue rate of paraquat poisoning.