血液净化疗法在儿童急性中毒中的应用

Application of blood purification in children acute poisoning

急性中毒通常为急症,儿童急性中毒表现更为突出,其死亡威胁较成人更大,急性中毒的常规治疗方法如催吐、洗胃、导泻、利尿等至关重要,但对于重症急性中毒患儿,单纯运用常规治疗方法往往难以支持患儿度过危险期。近年来,血液净化疗法的应用挽救了越来越多的危重急性中毒患儿的生命,由于毒物种类繁杂,毒物毒理学机制复杂,临床表现各异,对于急性中毒患儿是否行血液净化、选择何种血液净化模式效果好,急诊儿科医生主要根据毒物的种类及临床经验而决定,几乎没有相关的指南可以参考。因此,探讨血液净化疗法的时机、合理的模式选择显得尤为重要。

Acute poisoning is usually an emergency,the acute poisoning of children is more prominent,Its death threat is greater than that of adults.Although the conventional treatment of acute poisoning is crucial,such as vomiting,gastric lavage,catharsis and diuresis,but for children with severe acute poisoning,simply using conventional treatment methods are often difficult to support the children through the dangerous period .In recent years,the application of blood purification therapy has saved more and more children with critically acute poisoning.Because of the variety of poisons,the complexity of toxicological mechanisms and the different clinical manifestations,emergency pediatricians mainly depend on the types of poisons and clinical experience to determine whether blood purification should be carried out in children with acute poisoning and what kind of blood purification mode should be chosen.There are almost no relevant guidelines for reference.Timing of blood purification therapy and reasonable mode selection are particularly important.