【摘要】 目的 评估重度毒鼠强中毒患者应用序贯性血液灌流(HP)及连续性静静脉血液滤过(CVVH)治疗的临床疗效，及对毒鼠强的清除作用。 方法 给予11例重度毒鼠强中毒患者常规治疗外，同时进行序贯性血液灌流(HP)2.5～5h，及连续性静静脉血液滤过(CVVH)治疗20～24h。观察总结11例中毒患者的生存率、肝肾功能、电解质，测定血液净化治疗前后的血浆毒素浓度变化。 结果 11例患者存活10例，死亡1例。经治疗后电解质恢复正常，APACHEⅡ评分明显降低，Glasgow昏迷评分明显好转。HP治疗后血浆毒素浓度明显下降，CVVH治疗后血浆毒素浓度低水平保持平稳。 结论 血液灌流可迅速降低血浆毒鼠强浓度，随后的连续性静静脉血液滤过可持续清除毒素，从而避免血浆毒鼠强浓度的反跳。

    关键词 血液灌流 血液净化 中毒 毒鼠强

    Sequential hemoperfusion and continuous venovenous hemofiltration

    in treatment of severe tetramine poisoning

    Wu Lixiang，Zhou Yun，Guo Yuling，et al.

    The First Hospital of Shanxi Madical University，Taiyuan030001.

    【Abstract】 Objective To investigate the therapeutic effects of sequential hemoperfusion(HP)and continuous venovenous hemofiltration(CVVH)in patients with severe tetramine poisoning，and to evaluate the removal of plasma tetramine by these modalities in these patients.Methods Eleven patients with severe tetramine poisoningwere treated with HP using activated charcoal for2.5～5hours and consecutive CVVH for20～24hours.APACHEⅡand Glas-gow scores were evaluated daily.Blood routine and serum biochemical parameters were also tested and evaluated.Plasma tetramine concentration was determined before and after blood purification procedures.Results In the11pa-tients ......