脂肪乳剂治疗儿童卡马西平中毒的疗效观察

Efficacy Observation of Children with Carbamazepine Poisoning Treated with Lipid Emulsion

目的探讨脂肪乳剂在儿童卡马西平中毒治疗中临床效果。方法选取我院收治的48例卡马西平中毒患儿进行回顾性研究,收集时间2010年3月至2016年5月,其中A组26例、B组22例,两组患儿均采用基础治疗、血液灌流,A组患儿治疗过程中加用了脂肪乳剂,对比两组的治疗效果差异。结果入院时,A组和B组患儿的卡马西平血药浓度水平差异无统计学意义(P>0. 05);治疗24h、治疗48h、治疗72h后,A组患儿的卡马西平血药浓度水平均显著的低于B组,差异有统计学意义(P<0. 05);在治疗24h、治疗48h、治疗72h后,两组患儿的卡马西平血药浓度水平较入院时均显著降低,差异有统计学意义(P<0. 05);治疗前,A组和B组患儿的血清ALT、AST、BUN、Scr水平差异无统计学意义(P>0. 05);治疗后,A组患儿的血清ALT、AST、BUN、Scr水平均低于B组,差异有统计学意义(P<0. 05);在治疗后,两组患儿的血清ALT、AST、BUN、Scr水平较入院时均显著降低,差异有统计学意义(P<0. 05); A组的救治成功率为100. 00%,B组的救治成功率95. 45%,两组患儿的救治成功率比较差异无统计学意义(P>0. 05)。结论脂肪乳剂在儿童卡马西平中毒治疗中有助于尽快降低卡马西平血药浓度水平,减轻对患儿肝肾功能的损害。

Objective To explore the clinical efficacy ofcarbamazepine poisoning treated with lipid emulsionin children.Methods 48 cases of children with carbamazepine poisoning treated in our hospital were selected for retrospective study from March 2010 to May 2016.Group A with 26 cases,group B with 22 cases,and two groups of children were given foundation treatment and hemoperfusion.Group A were added with the lipid emulsion in the process of treatment and then efficacy difference was compared between two groups.Results At the time of admission,there was no statistically significant difference in the blood concentration of carbamazepine between group A and group B（ P〉0.05）. After 24 h treatment,48 h treatment and 72 h treatment,the blood concentration of carbamazepine of group A was significantly lower than that in group B and the difference was statistically significant（ P〈0.05）.After 24 h treatment,48 h treatment and 72 h treatment,the blood concentration of carbamazepine was significantly lower in both groups than that at the time of admission,and the difference was statistically significant（ P〈0.05）.Before treatment,serum ALT,AST,BUN and Scr levels of children in group A and group B showed no statistical significance（ P〉0.05）.After treatment,serum ALT,AST,BUN and Scr levels of children in group A were lower than those in group B and the differences were statistically significant（ P〈0.05）.After treatment,serum ALT,AST,BUN and Scr levels of the two groups of children were significantly lower than those at the time of admission,and the differences were statistically significant（ P〈0.05）.The success rate of treatment in group A was 100. 00%,and that in group B was 95. 45%.The difference in the success rate of treatment between the two groups was no statistically significance（ P〉0.05）. Conclusion Lipid emulsion in the treatment of carbamazepine poisoning in children can help to reduce the blood concentration of carbamazepine as soon as possible and reduce the damage to liver and kidney function.