血液净化辅助治疗急性重度乌头碱中毒55例临床研究

Clinical Study of 55 cases on blood Purification in the Treatment of Acute Severe Aconitine Poisoning

目的探究急性重度乌头碱中毒患者应用血液净化辅助治疗的临床疗效。方法由2016年2月—2017年10月在该院接受急性重度乌头碱中毒治疗的患者中随机选取55例作为研究对象,根据患者所应用治疗方案的差异将患者分为常规治疗组(n=26)和血液净化组(n=29),全部患者均接受常规治疗,血液净化组患者联合应用急诊血液净化治疗,比较2组研究对象临床症状缓解时间、平均住院时间和不良反应出现情况。结果常规治疗组患者心悸缓解时间为(205.34±20.33)min,血液净化组缓解时间为(43.79±6.02)min,2组差异有统计学意义(t=40.878 9,P=0.042 9)、2组呕吐缓解时间差异有统计学意义(t=25.421 0,P=0.035 1)、2组血压异常缓解时间差异有统计学意义(t=9.077 8,P=0.028 9)、2组肢体麻木缓解时间差异有统计学意义(t=29.247 5,P=0.003 5),2组平均住院时间差异有统计学意义(t=2.588 0,P=0.012 4)。常规治疗组出现不良反应患者为10例,总发生率为38.46%,血液净化组出现不良反应患者为4例,总发生率为13.79%,2组差异有统计学意义(χ~2=4.396 5,P=0.036 0)。结论急性重度乌头碱中毒患者应用血液净化辅助治疗能够缩短患者各项临床症状缓解时间并可降低不良反应发生率,临床疗效以及治疗安全性均较高。

Objective To investigate the clinical efficacy of blood purification adjuvant therapy in patients with acute severe aconitine poisoning. Methods From February 2016 to October 2017, 55 patients were randomized to receive acute aconitine poisoning in the hospital. The patients were divided into routine treatment groups according to the differences in the treatment options applied by patients（n=26） and blood purification group（n=29）, all patients received conventional treatment, and patients in the blood purification group were combined with emergency blood purification treatment, to compare the clinical symptom remission time, average length of stay, and adverse reactions in the two groups. Results The time of palpitation relief was （205.34±20.33）min in the conventional treatment group, and （43.79±6.02）min in the blood purification group. The difference between the two groups was statistically significant（t=40.878 9, P=0.042 9）, and the emesis relief time of the two groups had statistically significant difference （t=25.421 0, P=0.035 1）. There was a statistically significant difference in the time of blood pressure abnormal remission between the two groups（t=9.077 8, P=0.028 9）. There was a statistically significant difference in the remission time between the two groups of limb numbness（t=29.247 5, P=0.003 5）, the difference between the average length of stay in the two groups was statistically significant（t=2.588 0, P=0.012 4）. There were 10 patients with adverse reactions in the conventional treatment group with a total incidence of 38.46%. There were 4 patients with adverse reactions in the blood purification group, and the overall incidence was 13.79%. The difference between the two groups was statistically significant （χ2=4.396 5, P=0.036 0）. Conclusion The application of blood purification auxiliary therapy to patients with acute severe aconitine poisoning can shorten the clinical symptom remission time and reduce the incidence of adverse reactions. The clinical efficacy and treatment safety are high.