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目的研究三黄汤联合乌司他丁治疗百草枯中毒的临床疗效。方法将100例确诊为百草枯中毒的患者随机分成对照组和观察组。观察组在常规治疗基础上加用三黄汤口服及乌司他丁静脉推注。观察两组患者口服百草枯毒剂量、首次口服农药时间、首次灌流时间、首次排便时间、末次停止排绿便时间、动脉血气、血乳酸(LAC)、肝肾功能、胸部CT及病死率。结果与对照组相比,首次排便时间、末次停止排绿便时间明显缩短,病死率降低,差异有统计学意义(P<0.05)。入院第5天、第7天、第14天,观察组Cr、BUN、ALT、LAC各指标测得值低于对照组,PO2高于对照组,差异有统计学意义(P<0.05)。结论早期联合应用三黄汤及乌司他丁治疗急性百草枯中毒可减少百草枯吸收,减轻中毒后所导致的多脏器损伤,改善患者预后。
Objective To study the clinical efficacy of Sanhuang Decoction combined with ulinastatin in the treatment of paraquat poisoning. Methods 100 patients diagnosed with paraquat poisoning were randomly divided into control group and observation group. Observation group on the basis of conventional treatment plus San Huang Tang oral and ulinastatin intravenous injection. Oral paraquat poisoning dose, the first oral pesticide time, the first perfusion time, the first defecation time, the last time to stop the row of green tea, arterial blood gas, blood lactic acid (LAC), liver and kidney function, chest CT and mortality were observed. Results Compared with the control group, the time of the first defecation, the time of the last stop of the row of green cells was significantly shortened and the case fatality rate was decreased, the difference was statistically significant (P <0.05). On the 5th, 7th and 14th day after admission, the measured values of Cr, BUN, ALT and LAC in the observation group were lower than those in the control group, and PO2 was higher than that in the control group (P <0.05). Conclusions Early combination of Sanhuang Decoction and ulinastatin in the treatment of acute paraquat poisoning can reduce the absorption of paraquat, reduce the multiple organ injury after poisoning and improve the prognosis of patients.