重症砷中毒患者的多种血液净化方式治疗效果对比

Comparison of therapeutic effects of various blood purification methods in patients with severe arsenism

目的比较不同血液净化方式治疗重症砷中毒的效果。方法病例纳入时间范围为2018年6月至2019年6月,均为因重症砷中毒到本院接受治疗患者,共计60例,血液透析(HD)联合血液灌流(HP)治疗(对照组)、血液滤过(CVVH)联合HP治疗(观察组)均为30例,对比两组ICU住院时间、尿量相关指标以及治疗前后肾功能、胆红素等水平变化情况,随访治疗效果。结果观察组患者ICU住院时间、总住院时间及尿量≥800 ml/d时间均较对照组短,差异有统计学意义(P<0.05);两组间TBIL、Scr、IBIL等指标对比,治疗前无差异,治疗后观察组明显改善,与对照组比较P<0.05,差异有统计学意义;观察组与对照组总有效率分别为96.7%、70.0%,差异显著(P<0.05),有统计学意义。结论静脉血液滤过联合血液灌流治疗重症砷中毒,能够减轻肾脏损伤,促进患者术后恢复,增强预后,疗效确切,值得临床借鉴。

Objective To compare the effect of different blood purification methods in the treatment of severe arsenic poisoning.Methods From June 2018 to June 2019,all the patients were admitted to our hospital for treatment due to severe arsenic poisoning,a total of 60 cases,hemodialysis(hd)combined with hemoperfusion(HP)treatment(control group),hemofiltration(CVVH)combined with HP treatment(observation group)were 30 cases,and the length of stay in ICU,urine volume related indicators,renal function,bile red before and after treatment were compared between the two groups The change of hormone level and the effect of follow-up treatment.Results The length of stay in ICU,total length of stay and urine volume≥800ml/D in the observation group were shorter than those in the control group,with statistical significance(P<0.05);There was no difference in TBIL,SCR,ibil and other indicators between the two groups before treatment,but after treatment,the observation group improved significantly,with statistical significance compared with the control group(P<0.05);The total effective rates of the observation group and the control group were 96.7%and 70.0%,respectively The difference was statistically significant(P<0.05).Conclusion Veno hemofiltration combined with hemoperfusion in the treatment of severe arsenism can reduce renal injury,promote postoperative recovery,enhance prognosis,and have definite curative effect,which is worthy of clinical reference.