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目的研究血液灌流在急性中毒一体化治疗中的意义。方法将急诊收治的280例各类中毒患者随机分为两组:灌流组(150例,于中毒后24 h内进行血液灌流)和非灌流组(对照组,130例,仅予以常规洗胃、导泻等一般性治疗)。观察两组在意识障碍恢复时间、肺水肿纠正时间、解毒剂应用剂量及死亡例数等方面的差异。结果灌流组意识障碍纠正时间为(3.0±0.5)h,肺水肿平均纠正时间为(2.5±0.4)h,有机磷中毒阿托品用量为(26.0±2.5)mg,死亡5例,均显著低于对照组的(6.5±0.8)h、(4.9±0.7)h、(47.0±6.5)mg及12例,差异均有统计学意义(P<0.05)。结论在急性中毒一体化治疗方法中,血液灌流能明显改善中毒患者的生存质量,提高抢救成功率,值得在急诊临床大力推广应用。
Objective To study the significance of hemoperfusion in the treatment of acute poisoning. Methods A total of 280 cases of poisoning were randomly divided into two groups: perfusion group (150 cases, hemoperfusion within 24 hours after poisoning) and non-perfusion group (control group, 130 cases, only conventional gastric lavage, Catharsis and other general treatment). The differences between the two groups in the recovery time of consciousness, the correction time of pulmonary edema, the dosage of antidote and the number of death cases were observed. Results The corrected time of consciousness disturbance in perfusion group was (3.0 ± 0.5) h, the average correction time of pulmonary edema was (2.5 ± 0.4) h, the dosage of atropine in organophosphate poisoning group was (26.0 ± 2.5) mg, and death was 5 cases (6.5 ± 0.8) h, (4.9 ± 0.7) h, (47.0 ± 6.5) mg and 12 cases respectively. The difference was statistically significant (P <0.05). Conclusion In the integrated treatment of acute poisoning, hemoperfusion can significantly improve the quality of life of patients with poisoning, improve the success rate of rescue, it is worth to promote the clinical application of emergency.