大剂量氨溴索联合血液灌流治疗百草枯中毒肺损伤的疗效

Curative effect of high dose ambroxol combined with hemoperfusion on acute lung injury caused by paraquat poisoning

目的观察大剂量盐酸氨溴索联合血液灌流对急性百草枯中毒肺损伤的临床治疗效果。方法收集急性百草枯中毒患者46例,都给予血液灌流,按照是否采用大剂量氨溴索治疗分为观察组(23例)和对照组(23例),比较两组治疗第1、3、5 d时的动脉血气分析、呼吸参数、胸部CT检查及预后生存结果。结果治疗后两组自主呼吸频率(RR)与潮气量(VT)、呼气末正压(PEEP)、X线胸片改变等均有改善(P<0.05),但观察组改善程度优于对照组,存活率高于对照组,死亡病例平均存活时间延长(P<0.05);而两组发生多脏器功能障碍综合征(MODS)和多器官衰竭(MOF)的情况无明显差异(P>0.05)。结论血液灌流的基础上加用大剂量氨溴索,可明显改善百草枯中毒患者预后,值得临床推广。

Objective To observe the curative effect of high dose ambroxol by intravenous drip combined with hemoperfusion on lung injury caused by paraquate poisoning. Methods 46 cases of paraquate poisoning were divided into 2 groups：observation group and control group,23 cases in each;hemoperfusion was performed in both groups,while intravenous drip of high dose ambroxol was added to cases in observation group;a comparative study was made to arterial blood analysis,respiratory parameters and chest CT of the patients at the time point of 1 day,3 days and 5 days after treatment between the 2 groups as well as the prognosis and survival period of the dead cases. Results After treatment,the respiratory rate（RR）,tidal volume（VT）,positive end-expiratory pressure（PEEP） and X-ray manifestation of the patients in both groups were greatly improved（P ﹤ 0. 05）,while the improvement in observation group was much superior to that in control group;the survival rate in observation group was obviously higher than that in control group and the average survival period of the dead cases was significantly prolonged（P ﹤ 0. 05）;there existed no obvious difference in multiple organ dysfunction syndrome（ MODS）（ ≥3）and multiple organ failure（ MOF）between the 2 groups（ P ﹥ 0. 05）. Conclusions Intravenous drip of high dose ambroxol combined with hemoperfusion can significantly improve the prognosis of the patients of paraquate poisoning and is worthy of wider clinical application.