血液灌流联合血液透析治疗重度药物中毒的临床研究(1)
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【摘要】 目的 观察血液灌流联合血液透析(HPD)治疗重度药物中毒的临床疗效。方法 将来我科进行急诊治疗的94例重度药物中毒患者随机分为观察组和对照组,其中对照组47例,采用常规方法治疗;观察组47例,在常规治疗的基础上采用HPD治疗,比较两组的临床疗效。结果 观察组治愈率为97.9%,对照组治愈率为80.9%。观察组的治愈率显著高于对照组,差异有统计学意义(P<0.05);观察组患者意识恢复时间和住院时间分别为(4.5±2.7)h和(8.3±1.5)d,明显比对照组短,差异有统计学意义(P<0.05)。结论 重度药物中毒在常规治疗的基础上加用血液灌流联合血液透析治疗具有很好的临床疗效,能显著减少病死率,缩短意识恢复时间和住院时间,值得推广应用。
【关键词】 重度药物中毒;血液透析;血液灌流;联合治疗
The study of hemoperfusion combined with hemodialysis in treatment of severe drug poisoning
【Abstract】 Objective To observe the clinical efficacy of hemoperfusion combined with hemodialysis(HPD)in treatment of severe drug poisoning.Methods 94 patients with severe drug poisoning in our department were randomly divided into the observation group and control group,47 cases of the control group were treated by conventional therapy; 47 cases of the observation group were treated by HPD therapy at the basis of conventional therapy.The clinical efficacy was compared between the two groups.Results The cure rate was 97.9%in the observation group and the control group was 80.9%.The cure rate was significantly higher than the control group,the difference was statistically significant(P<0.05); the time of patients’ consciousness recovery and hospital stay was(4.5 ± 2.7)h and(8.3 ± 1.5)d,they were significantly shorter compared with the control group,the difference was statistically significant(P<0.05).Conclusion The therapy of HPD at the basis of conventional therapy in treatment of severe drug poisoning has a good clinical efficacy,it can reduce mortality and shorten the time of consciousness recovery and hospital stay significantly,and it is worth to promote.
【Key words】 Severe poisoning;Hemodialysis; hemodialysis;Combination therapy
药物中毒是急诊科比较常见的一种疾病,虽然大部分病例经过常规治疗能够治愈,但是对于重度药物中毒,特别是伴有严重并发症的患者,常规治疗效果较差,死亡率非常高。相关报道发现,镇静剂类药物中毒出现昏迷时病死率可以高达9.3%以上,而急性有机磷农药中毒病死率可达8.5%以上[1]。近年来血液灌流联合血液透析开始应用于治疗重度药物中毒。为了探讨该种方法的效果,我们自2007年2月至2010年6月分别用血液灌流联合血液透析和常规方法对重度药物中毒患者进行了治疗,现将结果报告如下。
1 资料与方法
1.1 临床资料
自2007年2月至2010年6月来我科治疗的94例重度药物中毒患者,全部病例均符合重度药物中毒的诊断标准[2]。其中男38例,女56例,年龄最大的为61岁,最小的为19岁,平均为39.4岁。药物中毒类型:安定34例,氯丙嗪23例,泰尔登+氯丙嗪17例,卡马西平+安定9例,鲁米那+安定11例;患者病程最长为18 h,最短为3 h,平均病程在8 ......
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