血液灌流治疗急性百草枯中毒笔谈

摘要

Numerous animal experiments and clinical trials have been conducted in treating acute paraquat poisoning with hemoperfusion (HP).However,the mortality of acute paraquat poisoning remains high.Although it is still a controversy,HP has been widely used in China as the recommended treatment of paraquat poisoning.The latest Chinese experts' consensus on management of paraquat poisoning (2013) recommends to perform repeated hemoperfusion with one or multiple cartridges.In clinical practice,physicians tend to make clinical decisions based on personal judgment.To provide additional evidence for future practice and research in this field,we summarized previous studies and made discussions on HP in treating paraquat poisoning,which included timing,patterns,times of repetition and combination treatment.%急性百草枯(PQ)中毒的病死率极高,血液灌流(HP)作为PQ中毒救治的推荐方法,已经在我国得到了广泛应用,但对于HP强度以及是否合并血液透析等治疗方案目前仍无定论.最新的《2013百草枯诊治国内专家共识》推荐的方法,是HP时使用1个或多个灌流器、重复数次.而在临床实践中,临床医师多依据临床经验进行判断,随意性较大.本文就HP治疗PQ中毒的时机、模式、重复次数、以及其他合并治疗作一笔谈,以期对将来临床治疗和临床研究有所帮助.