血液灌流联合环磷酰胺和氨溴索救治百草枯中毒的临床效果(1)
[摘要]目的 探讨血液灌流联合环磷酰胺和氨溴索救治百草枯中毒的临床效果。方法 选取2017年1月～2019年1月我院收治的92例百草枯中毒患者作为研究对象，按照电脑随机法分为观察组(46例)和对照组(46例)。观察组采用血液灌流联合环磷酰胺和氨溴索救治，对照组采用血液灌流联合环磷酰胺救治。比较两组的实验室指标、急性呼吸窘迫综合征(ARDS)发生情况以及治疗结局。结果 观察组的白细胞、血肌酐、丙氨酸氨基转移酶及血肌酸激酶水平低于对照组，差异均有统计学意义(P<0.05);观察组的ARDS发生率低于对照组，差异有统计学意义(P<0.05);观察组的治疗生存率高于对照组，差异有统计学意义(P<0.05)。结论 血液灌流联合环磷酰胺和氨溴索救治百草枯中毒能调节患者白细胞、血肌酐、丙氨酸氨基转移酶、血肌酸激酶水平等实验室指标，降低患者的ARDS发生率，提高患者的生存率，值得临床推广应用。
[关键词]血液灌流;环磷酰胺;氨溴索;救治;百草枯中毒;临床效果
[中图分类号] R595 [文献标识码] A [文章编号] 1674-4721(2019)9(c)-0064-03
[Abstract] Objective To explore the clinical effect of hemoperfusion combined with Cyclophosphamide and Ambroxol on paraquat poisoning. Methods A total of 92 patients with paraquat poisoning admitted to our hospital from January 2017 to January 2019 were enrolled， they were divided into observation group (46 cases) and the control group (46 cases) according to the computer randomization method. The observation group was treated with hemoperfusion combined with Cyclophosphamide and Ambroxol. The control group was treated with hemoperfusion combined with Cyclophosphamide. Laboratory parameters， incidence of acute respiratory distress syndrome (ARDS)， and treatment outcome were compared between the two groups. Results The levels of white blood cells， serum creatinine， alanine aminotransferase and serum creatine kinase in the observation group were lower than those in the control group， the differences were statistically significant (P<0.05). The incidence of ADRS in the observation group was lower than that in the control group， the difference was statistically significant (P<0.05). The treatment survival rate of the observation group was higher than that of the control group， the difference was statistically significant (P<0.05). Conclusion Hemoperfusion combined with Cyclophosphamide and Ambroxol in the treatment of paraquat poisoning can regulate the level of leukocyte， creatinine， alanine aminotransferase and creatine kinase in patients， reduce the incidence of ARDS and improve the survival rate of patients， which is worthy of clinical application.
[Key words] Hemoperfusion; Cyclophosphamide; Ambroxol; Treatment; Paraquat poisoning; Clinical effect
百草枯為临床常用的强效季铵盐类除草剂，对人畜均具有较强的毒性，易引起多脏器损伤或器官衰竭。由于无特效解毒剂，导致其被多个国家限制使用[1]。因此，对于百草枯中毒应早期寻求安全有效的治疗方式。血液灌流为一种血液净化方法，为临床药物中毒常用的治疗手段，其对于中毒时间短、小剂量、未出现肺损伤的百草枯中毒患者，能取得良好的治疗效果;但对于中毒时间长、出现多器官衰竭、肺纤维化或剂量大者，治疗效果较差[2]。有研究显示，多数百草枯中毒患者，通过应用血液灌流联合环磷酰胺和氨溴索救治后，取得一定的治疗效果，能显著提高患者的存活率，目前该治疗方式已经在国内广泛应用，受到多数患者以及患者家属青睐[3]。本研究旨在探讨血液灌流联合环磷酰胺和氨溴索救治百草枯中毒的临床效果，现报道如下。, 百拇医药(陈群燕 黄舒伟 梁娟清 刘炯)
[关键词]血液灌流;环磷酰胺;氨溴索;救治;百草枯中毒;临床效果
[中图分类号] R595 [文献标识码] A [文章编号] 1674-4721(2019)9(c)-0064-03
[Abstract] Objective To explore the clinical effect of hemoperfusion combined with Cyclophosphamide and Ambroxol on paraquat poisoning. Methods A total of 92 patients with paraquat poisoning admitted to our hospital from January 2017 to January 2019 were enrolled， they were divided into observation group (46 cases) and the control group (46 cases) according to the computer randomization method. The observation group was treated with hemoperfusion combined with Cyclophosphamide and Ambroxol. The control group was treated with hemoperfusion combined with Cyclophosphamide. Laboratory parameters， incidence of acute respiratory distress syndrome (ARDS)， and treatment outcome were compared between the two groups. Results The levels of white blood cells， serum creatinine， alanine aminotransferase and serum creatine kinase in the observation group were lower than those in the control group， the differences were statistically significant (P<0.05). The incidence of ADRS in the observation group was lower than that in the control group， the difference was statistically significant (P<0.05). The treatment survival rate of the observation group was higher than that of the control group， the difference was statistically significant (P<0.05). Conclusion Hemoperfusion combined with Cyclophosphamide and Ambroxol in the treatment of paraquat poisoning can regulate the level of leukocyte， creatinine， alanine aminotransferase and creatine kinase in patients， reduce the incidence of ARDS and improve the survival rate of patients， which is worthy of clinical application.
[Key words] Hemoperfusion; Cyclophosphamide; Ambroxol; Treatment; Paraquat poisoning; Clinical effect
百草枯為临床常用的强效季铵盐类除草剂，对人畜均具有较强的毒性，易引起多脏器损伤或器官衰竭。由于无特效解毒剂，导致其被多个国家限制使用[1]。因此，对于百草枯中毒应早期寻求安全有效的治疗方式。血液灌流为一种血液净化方法，为临床药物中毒常用的治疗手段，其对于中毒时间短、小剂量、未出现肺损伤的百草枯中毒患者，能取得良好的治疗效果;但对于中毒时间长、出现多器官衰竭、肺纤维化或剂量大者，治疗效果较差[2]。有研究显示，多数百草枯中毒患者，通过应用血液灌流联合环磷酰胺和氨溴索救治后，取得一定的治疗效果，能显著提高患者的存活率，目前该治疗方式已经在国内广泛应用，受到多数患者以及患者家属青睐[3]。本研究旨在探讨血液灌流联合环磷酰胺和氨溴索救治百草枯中毒的临床效果，现报道如下。, 百拇医药(陈群燕 黄舒伟 梁娟清 刘炯)