目的 探讨连续性静脉-静脉血液净化(CVVH)对口服百草枯急性中毒的疗效,及其对百草枯中毒患者血清炎性因子的影响.方法 回顾分析2010年1月至2016年6月福州总医院第一附属医院急诊科诊治的急性口服百草枯中毒患者62例的临床资料.所有患者均给予包括血液灌流在内的常规治疗(对照组30例),在此基础上给予CVVH治疗的32例为观察组,比较2组患者一般临床资料和预后,分析2组患者血清肿瘤坏死因子-α(TNF-α)、白细胞介素-6(IL-6)、动脉血氧分压、血清肌酐(Cr)和丙氨酸氨基转移酶(ALT)的变化.结果 与对照组相比,观察组第3、7天时TNF-α、Cr和ALT降低(P＜0.05);观察组IL-6、动脉血氧分压在第3天时差异无统计学意义(P＞0.05),第7天差异有统计学意义(P＜0.05).观察组和对照组治疗总有效率分别为71.9％、56.7％(P＞0.05),2组治疗结果为痊愈、好转、有效和死亡人数构成比上差异无统计学意义(P＞0.05).结论 CVVH对急性百草枯中毒患者能清除炎性因子TNF-α和IL-6,可提高百草枯中毒患者治疗总有效率.%Objective To investigate the effect of continuous venovenous hemofiltrationpurification(CVVH)on acute paraquat poisoning(PQ)and its effect on serum inflammatory factors in patients with PQ.Methods The clinical data of 62 patients with acute PQ in the First Affiliated Hospital of Fuzhou General Hospital were retrospectively analyzed from January 2010 to June 2016.All patients were given routine treatment including blood perfusion(30 cases in control group),32 of those on the basis were given CVVH treatment(observation group).Clinical data and prognosis of patients in two groups were compared,and the changes of PaO2,serum creatinine(Cr)and serum TNF-a,ALT and IL-6 in the two groups were analysed.Results Compared to the control group,TNF-a,Cr and ALT of the observation group decreased in 3,7 d(P＜0.05).There was no significant difference in IL-6 and PaO2 in 3 d between two groups(P＞0.05),but the difference was statistically significant in 7 d(P＜0.05).There was no significant difference in total effective rate,the proportion of patients cured,improved effective results,and the number of deaths between two groups(P＞0.05).Conclusion CVVH can remove inflammatory factor TNF-a and IL-6 in patients with acute PQ poisoning,and it can improve the total efficiency of treatment in patients with PQ poisoning.
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