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目的探讨各种急性中毒经血液灌流(HemoperfusionHP)治疗后血小板(PLT)变化及其原因。方法对27例急性中毒患者的42次HP治疗中,在灌流前30min,灌流后30min、60min、120min、180min分别检查血小板数量,对其变化的有关因素进行分析。结果HP治疗后,血小板15例次减少,其中13例次较治疗前严重减少(P<0.01)。灌流治疗持续时间在1小时者,血小板下降比治疗2小时以上者更严重(P<0.01)。使用高浓度肝素盐水(50mg/500ml)预灌流器比低浓度肝素盐水(15mg/500ml)血小板减少的程度更显著。结论血液灌流可能引起血小板明显减少,与灌流持续时间和使用肝素的量有关,应进行全程检测,预防出血,提高中毒患者的抢救成功率。
Objective To investigate the changes of platelet (PLT) and its causes after acute poisoning by HemoperfusionHP. Methods Totally 42 cases of acute poisoning were treated with HP, 30 minutes before perfusion, 30 minutes after perfusion, 60 minutes, 120 minutes and 180 minutes after perfusion. The number of platelets was examined and the related factors were analyzed. Results After HP treatment, platelets decreased in 15 cases, of which 13 cases were significantly reduced compared with that before treatment (P <0.01). Perfusion treatment for one hour duration, thrombocytopenia was more severe than 2 hours treatment (P <0.01). Thrombocytopenia was more pronounced with high-concentration heparin saline (50 mg / 500 ml) pre-cartridge than low-concentration heparin saline (15 mg / 500 ml). Conclusion Hemoperfusion may cause a significant reduction of platelets, which is related to the duration of perfusion and the amount of heparin. It should be tested in the whole process to prevent bleeding and improve the success rate of rescue in patients with poisoning.