血液灌流治疗小儿卡马西平急性中毒疗效观察

摘要

目的：分析采用血液灌流治疗急性卡马西平中毒的经验和价值。方法选择2007年5月至2013年7月就诊于西安市儿童医院重症医学科的45例误服卡马西平且入院血药浓度大于15μg/mL的患儿，将其分为血液灌流组（灌流组）24例和常规治疗组（对照组）21例，灌流组在常规治疗的基础上进行血液灌流治疗。两组患儿在治疗0、24、48、72小时测定卡马西平血药浓度。结果血液灌流组血清卡马西平浓度分别为：38．5±23．42μg/mL，17．54±5．56μg/mL，9．80±2．90μg/mL，1．20±1．03μg/mL；常规治疗组血清卡马西平浓度分别为：35．52±5．56μg/mL，30．92±5．53μg/mL，24．38±4．44μg/mL，16．52±4．23μg/mL，灌流组患儿血清卡马西平浓度在24、48、72小时较对照组低，差异有统计学意义（ t值分别为4．832，5．233，3．343，P＜0．05）。结论血液灌流对卡马西平急性中毒有明显疗效，能快速降低卡马西平浓度。%Objective To analyze the value of hemoperfusion in children with acute carbamazepine poisoning and summarize therapeutic experience.Methods From May 2007 to July 2013 totally 45 children were admitted in Xi ’ an Children ’ s Hospital for mistaking carbamazepine and their plasma concentration >15μg/mL.Twenty-four of them were divided into hemoperfusion group and 21 in control group.The hemoperfusion group was treated with hemoperfusion based on routine therapy .The serum carbamazepine concentrations of two groups were determined at 0h, 24h, 48h and 72h.Results The serum carbamazepine concentrations of the hemoperfusion group at 0h, 24h, 48h and 72h were 38.52 ±23.42μg/mL, 17.54 ±5.56μg/mL, 9.80 ±2.90μg/mL and 1.20 ±1.03μg/mL, respectively, while they were 35.52 ±5.56μg/mL, 30.92 ±5.53μg/mL, 24.38 ±4.44μg/mL and 16.52 ±4.23μg/mL, respectively in the control group.Compared with the control group , the serum carbamazepine concentrations of the hemoperfusion group were lower at 24h, 48h and 72h, and the differences were significant (t value was 4.832, 5.233 and 3.343, respectively, all P<0.05).Conclusion Hemoperfusion is an effective method for acute carbamazepine poisoning , which can quickly reduce the concentration of carbamazepine .