大剂量甲基强的松龙冲击疗法对急性百枯草中毒患者血清同工酶及炎症因子水平的影响

目的研究大剂量甲基强的松龙冲击疗法对急性百枯草中毒患者血清同工酶及炎症因子水平的影响。方法选取2014年6月-2015年10月浙江省宁波市医疗中心李惠利医院急诊内科收治46例急性百枯草中毒患者,随机分成2组,各23例。在常规治疗基础上,对照组予血液灌流治疗,观察组在对照组基础上再予大剂量甲基强的松龙冲击疗法,观察比较治疗前后血清有关酶及炎症因子水平,观察临床症状、治疗效果及不良反应。结果与治疗前比较,2组IL-1、IL-10、TNF-α以及CRP水平降低（P〈0.05）,CK、CK-MB、TGF-β1及HIF-1α水平降低（P〈0.05）;与对照组比较,观察组IL-1、IL-10、TNF-α及CRP水平较低（P〈0.05）,CK、CK-MB、TGF-β1以及HIF-1α水平较低（P〈0.05）,治疗后距最后一次排绿色便的时间、血浆PQ清除时间以及住院时间较短（P〈0.05）,治疗总有效率较高（P〈0.05）。结论大剂量甲基强的松龙冲击疗法对急性百枯草中毒患者疗效确切,能够降低患者血清CK、CK-MB、TGF-β1、HIF-1α以及炎症因子水平,安全性较高。

1例百草枯中毒患儿的急救与护理

百草枯,又名克芜踪、对草快,含20%百草枯原液,为我国农业上常用的除草剂之一.成人口服20 mg/kg（甚至更少）即可中毒,致死剂量为30~40 mg/kg[1],且目前百草枯无特效解毒剂[2].由于百草枯在农业上的广泛推广,小儿误服百草枯的例数也越来越多,而患儿大多会逐渐出现不可逆转的肺纤维化等重要器官损害,病死率高达85%~95%[3].我科2012年9月9日~10月6日,成功救治了1例百草枯中毒患儿,现将救治过程中的护理情况报告如下.

血液灌流治疗百草枯中毒的护理

目的对血液灌流治疗百草枯中毒的护理进行探讨。方法选取我院2009年4月-2011年4月收治的6例百枯草口服中毒患者行血液灌流治疗并对相关护理进行深入研究。结果 6例患者中1例痊愈,3例好转,2例死亡。结论认真细致的做好血液灌流护理能明显减少并发症,是提高抢救成功率的关键。

成功救治百草枯中毒后偶合急性腮腺炎1例

百草枯（paraquat,PQ）,又名克无踪,化学名1,1-二甲基-4,4-联吡啶二氢化物,由吡啶、金属钠、硫酸二甲酯反应而成,PQ口服后吸收率为5%~15%,进入机体后迅速分布至重要组织器官,在肺部停留时间最长且浓度最高,其次是肌肉组织,2 d后PQ大部分都以原形经肾脏排出[1],由于中毒机制不明确,目前缺乏特效的解毒剂及有效的治疗措施,中毒后病死率居高不下,

Therapeutic potential of intravenous Xuebijing on transforming growth factor β_1 and procollagen type III peptide in patients with acute paraquat poisoning

OBJECTIVE： Paraquat （PQ） poisoning-induced pul- monary fibrosis causes asphyxiation and death. The therapeutic potential of intravenous Xuebijing ther- apy in PQ poisoning patients and its underlying im- munomodulatory effects on transforming growth factor （TGF）-131 and procollagen type III peptide （PIIIP） were investigated. METHODS： Thirty-six acute PQ poisoning patients were randomly assigned to conventional therapy （Group A） and intravenous Xuebijing administra- tion plus conventional therapy （Group 13）. Twenty volunteers served as controls （Group C）. Blood sam- ples were collected upon admission （day O） and at post-treatment days 5, 10, and 14. TGF-β1 and PIIIP concentrations were determined by ELISA and ana- lyzed for intra- and inter-group differences over time. One-month follow-up was conducted for de- termining the mortality rate. RESULTS： TGF-β1 and PIIIP levels were significantly higher in PQ poisoning patients and increased over time （Groups A and B vs C, P〈0.01）. However, the TGF-β1 and PIIIP levels were consistently significant- ly lower in Group B compared with those of Group A （P〈0.01）. The 1-month mortality rate was also lower in Group B compared with that of Group A （P〈0.05）. PQ poisoning patients showed remark- ably high levels of TGF-β1 and PIIIP, which increased as PQ-induced pulmonary fibrosis progressed. CONCLUSION： Treatment with intravenous Xuebi- jing plus conventional therapy significantly low- ered TGF-β1 and PIIIP levels, which indicates thera- peutic efficacy in the treatment of PQ poisoning pa- tients.