血液灌流、血液透析串联治疗急性百草枯中毒对患者靶器官损伤的影响

Effects of hemoperfusion combined with hemodialysis on target organ damage in patients with acute paraquat poisoning

目的:探讨血液灌流、血液透析串联治疗急性百草枯中毒对患者靶器官损伤的影响。方法:选取本院收治并进行治疗的急性百草枯中毒患者42例作为研究对象,回顾治疗方案并将其分为接受单纯血液灌流治疗的对照组20例、接受血液灌流、血液透析串联治疗的串联治疗组22例。对比两组入院即刻、治疗1d后、治疗3d后外周血中肝肾功能指标及动脉血中肺功能指标水平的差异。结果:入院即刻,两组外周血中肝肾功能指标及动脉血中肺功能指标水平的差异无统计学意义。治疗1d后、治疗3d后,串联治疗组外周血中肾功能指标Scr、BUN、β2-MG的水平分别低于对照组相应时间点;外周血中肝功能指标ALT、AST、TB、ALP的水平分别低于对照组相应时间点;动脉血中肺功能指标PaO_2、BE、PCO_3~﹣的水平分别高于对照组相应时间点,PaCO_2的水平低于对照组相应时间点。结论:急性百草枯中毒患者接受血液灌流、血液透析串联治疗,较单纯血液灌流在保护肝肾肺等靶器官功能方面更具优势。

Objective： To investigate the effects of hemoperfusion combined with hemodialysis on target organ damage in patients with acute paraquat poisoning. Methods： A total of 42 patients with acute paraquat poisoning who wcrc admitted and treated in our hospital between December 2013 and October 2017 were selected as the research subjects, and their therapies were reviewed and used to divide them into the control group （n= 20） who received hemoperfusion alone and the combined treatment group （n= 22） who received hemoperfusion combined with hemodialysis. The differences in the levels of liver and kidney function indexes in peripheral blood as well as lung function indexes in arterial blood were compared between the two groups of patients immediately after admission, after 1 d of treatment and after 3 d of treatment. Results： Immediately after ad mission, the differences in the levels of liver and kidney function indexes in peripheral blood as well as lung function indexes in arterial blood were not statistically significant between the two groups（P〉0.05）. After 1 d of treatment and after 3 d of treat ment, kidney function indexes Scr, BUN and β2-MG levels in peripheral blood of combined treatment group were lower than those of control group at corresponding time points respectively（P〈0.05）; liver function indexes ALT, AST, TB and ALP levels in peripheral blood were lower than those of control group at corresponding time points respectively（P〈0.05）; lung func poin 0.05 n indexes PaO2, BE and PCO3^- levels in arterial blood were higher than those of control group at corresponding time respectively whereas PaCO2 levels were lower than those of control group at corresponding time points respectively（P Conclusion： Compared with hemoperfusion alone, hemoperfusion combined with hemodialysis is more advantageous in protecting the functions of liver, kidney, lungs and other target organs of patients with acute paraquat poisoning.