强化血液灌流联合甲泼尼龙冲击疗法在百草枯中毒血液净化疗法中的应用

Application of intensive hemoperfusion combined with methylprednisolone pulse therapy in the blood purification therapy of paraquat poisoning

目的:探究强化血液灌流(HP)联合甲泼尼龙冲击疗法在百草枯中毒血液净化疗法中的应用。方法:选取2013年1月至2017年8月于我院急诊科收治的百草枯中毒患者60例作为研究对象,将患者随机分为对照组和观察组,每组30例。对照组患者采用血液灌流治疗,观察组患者在对照组治疗的基础上加用甲泼尼龙治疗;测定两组患者治疗前,治疗后5 min,治疗后8 h,治疗后16 h血液中百草枯的浓度;对两组患者治疗前及治疗后7 d肺纤维化情况进行评分,测定血清中肿瘤坏死因子-α(TNF-α)及白介素-10(IL-10)的含量;记录两组患者的生存率情况。结果:治疗后,观察组患者血清中百草枯含量低于对照组(P<0.05);肺纤维化评分低于对照组(P<0.05);血清中TNF-α及IL-10的含量低于对照组(P<0.05);生存率高于对照组(P<0.05)。结论:HP联合甲泼尼龙冲击疗法治疗百草枯中毒具有良好的临床效果,增加患者的生存率,值得临床推广。

Objective： To probe into the application of intensive hemoperfusion（HP） combined with methylprednisolone pulse therapy in the blood purification therapy of paraquat poisoning. Methods： 60 cases of patients with paraquat poisoning treated in the department of emergency in our hospital from January,2013 to August,2017 were selected as the research objects,and were divided into the control group and the observation group according to the random number table method,30 cases in each group. The control group was treated with hemoperfusion,while the observation group was treated with methylprednisolone treatment on the basis of treatment in the control group. The concentration of paraquat in blood before treatment,5 min,8 h and 16 h after treatment in the two groups were measured; the pulmonary fibrosis before treatment and 7 days after treatment in the two groups were scored; the levels of tumor necrosis factor-α（TNF-α） and interleukin-10（IL-10） in serum were determined;the survival rate in the two groups were recorded. Results： After the treatment,compared with the control group,the serum paraquat content in the observation group was significantly decreased（P〈0.05）; the score of pulmonary fibrosis was significantly decreased（P〈0.05）; the levels of TNF-α and IL-10 in serum were significantly decreased（P〈0.05）; the survival rate was significantly improved（P〈0.05）. Conclusion：HP combined with methylprednisolone pulse therapy in the treatment of paraquat poisoning has good clinical effect,and can increase the survival rate of patients,thus it is worthy of being promoted clinically.