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目的:探讨采用血液灌流(HP)治疗急性百草枯(PQ)中毒患者的对血清PQ清除率及临床效果的影响。方法:选取我院2011~2015年收治的87例PQ中毒患者进行回顾性分析,根据HP治疗方法分为常规组47例(洗胃+1次HP治疗+常规治疗)和强化组40例[洗胃+3次HP治疗(间隔时间6h)+常规治疗],分别检测HP治疗前、HP后即刻、8h、16h、24h两组患者血清PQ水平,并比较两组患者不同时间点的血清丙二醛(MDA)、超氧化物歧化酶(SOD)、白细胞介素-10(IL-10)、肿瘤坏死因子-α(TNF-α)的差异,并比较2组患者的救治成功率。结果:强化组治疗后8h、16h、24h的血清PQ水平均显著的低于常规组患者(P<0.05);强化组和常规组第1次PQ清除率差异无统计学意义,第2次、第3次HP治疗强化组的PQ清除率分别为(35.9±6.11)%和(28.85±4.70)%;强化组治疗后24h、72h的血清MDA、IL-10、TNF-α、PaCO_2、BUN、Cr水平均显著的低于常规组患者(P<0.05),SOD、PaO_2水平在治疗后24h、72h显著的高于常规组患者(P<0.05);强化组的救治成功率50.00%显著的高于常规组的27.66%(P<0.05)。结论:急性PQ中毒患者及时多次应用HP治疗有利于提高患者的救治成功率。
Objective: To investigate the effect of hemoperfusion (HP) on serum PQ clearance and clinical effect in patients with acute paraquat poisoning (PQ). Methods: A total of 87 patients with PQ poisoning admitted to our hospital from 2011 to 2015 were retrospectively analyzed. According to the HP treatment, 47 patients (conventional gastric lavage plus 1 HP treatment plus conventional therapy) and 40 patients with intensive treatment group Stomach +3 times HP treatment (interval 6h) + conventional treatment], respectively, before and after treatment of HP, P value of 8h, 16h, 24h after the two groups were detected, and compared two groups of patients at different time points (MDA), superoxide dismutase (SOD), interleukin-10 (IL-10) and tumor necrosis factor-α (TNF-α) were measured. The success rate of treatment was compared between the two groups. Results: The levels of serum PQ in the intensive group were significantly lower than those in the conventional group at 8h, 16h and 24h (P <0.05). There was no significant difference in the first PQ clearance between the intensive group and the conventional group. The second, The PQ clearance rates in the third intensive treatment group were (35.9 ± 6.11)% and (28.85 ± 4.70)%, respectively. The levels of MDA, IL-10, TNF- (P <0.05). The levels of SOD and PaO_2 were significantly higher at 24 h and 72 h after treatment than those in the conventional group (P <0.05). The successful treatment rate of the intensive group was significantly higher at 50.00% 27.66% of the control group (P <0.05). Conclusion: Acute PQ poisoning in patients with timely and multiple HP treatment is conducive to improving the success rate of treatment of patients.