论文部分内容阅读
目的:探讨早期碱化血液在急性百草枯(PQ)中毒救治中的意义及其对预后的影响。方法:对2011-01-2015-06遵义医学院附属医院收治的129例PQ中毒患者的临床资料进行回顾性分析,依据其就诊时间分为对照组(n=62)和治疗组(n=67)。对照组进行洗胃、血液灌流、利尿、导泻等基础治疗,治疗组在基础治疗上加碳酸氢钠碱化血液治疗。结果:治疗组病死率低于对照组(P<0.05),丙氨酸氨基转移酶(ALT)、天门冬氨酸氨基转移酶(AST)、总胆红素(TBIL)、肌酐(Cr)、肌酸激酶同工酶(CK-MB)峰值水平均显著低于对照组(P<0.05),动脉血氧分压(PaO2)和乳酸(Lac)水平较对照组有明显改善。结论:PQ中毒后早期进行常规碱化血液治疗,能促进患者血液中残余PQ的分解,同时中毒后易引发代谢性酸中毒,酸中毒能加重心、肺等重要脏器损伤,及早应用碱化血液治疗不仅能改善脏器功能,降低Lac水平,还能显著改善中毒患者的预后,降低病死率。
Objective: To investigate the significance of early alkalized blood in the treatment of acute paraquat (PQ) poisoning and its effect on prognosis. Methods: The clinical data of 129 PQ poisoning patients admitted to the Affiliated Hospital of Zunyi Medical College from January 2011 to June 2015 were retrospectively analyzed. According to their time of treatment, they were divided into control group (n = 62) and treatment group (n = 67) ). The control group was given gastric lavage, hemoperfusion, diuretic, catharsis and other basic treatment, the treatment group in the basic treatment with sodium bicarbonate alkalosis blood treatment. Results: The mortality of the treatment group was lower than that of the control group (P <0.05). The ALT, AST, TBIL, Cr, The peak levels of creatine kinase (CK-MB) were significantly lower than those of the control group (P <0.05). PaO2 and Lac levels were significantly improved compared with the control group. Conclusions: The treatment of routine alkalosis blood treatment in the early stage of PQ poisoning can promote the decomposition of residual PQ in the blood of the patients, and lead to metabolic acidosis after the poisoning. Acidosis can aggravate the injury of important organs such as heart and lung, Blood treatment can not only improve organ function, reduce Lac levels, but also significantly improve the prognosis of poisoning patients and reduce mortality.