【摘要】 目的观察20%中长链脂肪乳(IFE)联合血液灌流对百草枯中毒的治疗效果。方法 62例急性百草枯中毒患者分为G1组(19例)、G2组(18例)、G3组(25例)。G1组仅给予常规治疗, G2、G3组均接受常规洗胃、导泻及血液灌流等基础治疗, G3组就诊30 min内即给予20%中长链IFE静脉滴注治疗。比较三组患者病死率、脏器功能损伤发生率及入院不同时间点急性生理功能和慢性健康状况评分系统Ⅱ(APACHEⅡ)评分之间的差异。结果入院时3组APACHEⅡ评分比较差异无统计学意义(P>0.05)。入院后24、36、72 h, G1组APACHEⅡ评分均显著高于G3和G2组,差异均具有统计学意义(P<0.05)。入院后24、36、72 h G3组APACHEⅡ评分低于G2组,但差异无统计学意义(P>0.05)。G1组死亡17例(89.5%), G2组死亡11例(61.1%), G3组死亡14例(56.0%)。G2和G3组病死率、各脏器功能损伤发生率均低于G1组,差异具有统计学意义(P<0.05)。G3组病死率、各脏器功能损伤发生率均低于G2组,但差异无统计学意义(P>0.05)。结论 20%中长链IFE联合血液灌流可以减轻急性百草枯中毒临床症状。更多还原

【Abstract】 Objective To observe the treatment effect of 20% medium and long chain intralipid fat emulsion(IFE) combined with hemoperfusion on paraquat poisoning. Methods A total of 62 patients with acute paraquat poisoning were divided into G1 group for 19 cases, G2 group for 18 cases, G3 group for 25 cases.The G1 group was given conventional therapy alone, the G2 group and G3 group all received basic treatment including conventional gastric lavage, catharsis and hemoperfusion. The G3 group was treated with intravenous infusion of 20% medium and long chain IFE within 30 min of treatment. The differences in the case fatality rate, incidence of organ dysfunction, acute physiological function and chronic health status score Ⅱ(APACHE Ⅱ) scores at different time points for admission in the three groups were compared. Results There was no significant difference in the APACHE Ⅱ score among the three groups at admission(P>0.05). At 24 hours, 36 hours and 72 hours after admission, the APACHE Ⅱ scores in G1 group were significantly higher than those in G3 group and G2 group, the differences were statistically significant(P<0.05). The APACHE Ⅱ score of G3 group at 24 hours, 36 hours and 72 hours after admission were lower than those of G2 group, but the differences were not statistically significant(P>0.05). The case fatality rate and the incidence of organ dysfunction in G2 group and G3 group were significantly lower than those in G1 group, the differences were statistically significant(P<0.05). There were 17 deaths(89.5%) in G1 group, 11 deaths(61.1%) in G2 group and 14 deaths(56.0%) in G3 group. The case fatality rate and incidence of organ dysfunction in G3 group were lower than those in G2 group, but there were no significant differences(P>0.05). Conclusion 20% medium and long chain IFE combined with hemoperfusion can reduce the clinical symptoms of acute paraquat poisoning.更多还原