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目的:研究早期运用血必净联合血液灌流治疗百草枯农药中毒肺纤维化患者的临床效果。方法:选择来安徽医科大学第二附属医院进行抢救治疗的百草枯农药中毒患者102例,按其入院日期随机分成观察组和对照组,各51例。两组均进行百草枯中毒的常规急救处理,入院后均给予血液灌流措施;观察组则在上述措施基础上联合运用血必净治疗。观察两组治疗后存活率、肺纤维化的发生率及纤维化程度。结果:观察组和对照组患者在第4周时的存活率分别为64.70%和45.10%,差异有统计学意义(P<0.05)。观察组第3天肺纤维化率为56.52%,第4周为51.51%;对照组第3天肺纤维化率为68.18%,第4周为78.26%,第4周观察组纤维化率显著低于对照组(P<0.05)。观察组仅第3天到第1周时,纤维化程度有显著加重(P<0.05),对照组各时间点肺纤维化程度与前一时间点比较均显著加重(P<0.05);观察组第2、4周肺纤维化程度显著低于对照组(P<0.05)。结论:血必净联合血液灌流早期治疗百草枯农药中毒患者,存活率高,肺纤维化发生率和程度均得到比较有效的控制,值得临床推广。
Objective: To study the clinical effect of early application of Xuebijing combined with hemoperfusion on patients with paraquat pesticide poisoning pulmonary fibrosis. Methods: A total of 102 patients with paraquat pesticide poisoning who were chosen to come to the Second Affiliated Hospital of Anhui Medical University for emergency treatment were randomly divided into observation group and control group according to the date of their admission, and each group had 51 cases. Both groups were given paraquat poisoning routine emergency treatment, after admission were given hemoperfusion measures; the observation group is based on the above measures combined with Xuebijing treatment. After treatment, the survival rate, the incidence of pulmonary fibrosis and the degree of fibrosis were observed. Results: The survival rates of the observation group and the control group were 64.70% and 45.10% respectively at the 4th week, the difference was statistically significant (P <0.05). The lung fibrosis rate was 56.52% on the third day in the observation group and 51.51% on the fourth week. On the third day, the lung fibrosis rate was 68.18% in the control group, 78.26% in the fourth week, and the fibrosis rate in the fourth week was significantly lower In the control group (P <0.05). The degree of fibrosis was significantly increased in the observation group from the third day to the first week (P <0.05), and the degree of pulmonary fibrosis in the control group at each time point was significantly increased compared with the previous time point (P <0.05) Lung fibrosis in the 2nd and 4th week was significantly lower than that in the control group (P <0.05). Conclusion: Xuebijing combined with hemoperfusion in the early treatment of paraquat pesticide poisoning patients with high survival rate, the incidence and extent of pulmonary fibrosis have been more effective control, worthy of clinical promotion.