血液灌流联合血液滤过与单纯血液滤过治疗重症毒蕈中毒效果比较

来源期刊：广州医药 | 27-30 发布时间：2021-11-28 收稿时间：2025/11/13 17:52:39 阅读量：12

作者：: 林洁羽,

董伟,

关键词：: 血液灌流血液滤过毒蕈中毒多脏器功能障碍; Hemoperfusion Hemofiltration Mushroom poisoning MODS

DOI：: 10.3969/j.issn.1000-8535.2020.02.006

收稿时间：: 2019-11-07
修订日期：
接收日期：
引用总数：: 0

目的观察和评价重症毒蕈中毒(PMP)患者的临床资料,探讨血液灌流(HP)联合血液滤过(HF)与单独血液滤过治疗的疗效比较。方法收集本院2016年8月—2018年10月救治的32例重症急性毒蕈中毒并发中毒性肝损伤、急性肾衰竭、中毒性心肌炎、消化道出血、中毒性脑病、急性血管内溶血等患者的临床资料,将32例患者分为治疗组和对照组,治疗组14例,采用持续静脉-静脉血液滤过24 h串联灌流2 h;对照组18例,采用单独血液滤过24 h,疗程2～3 d。两组患者内科常规治疗基本相同。结果 14例治疗组在内科常规治疗基础上联合血液灌流+血液滤过,好转率为92.9%(13/14);18例对照组在内科常规治疗基础上单用血液滤过,好转率为61.1%(11/18),两组好转率比较,差异有统计学意义(P<0.05)。治疗组患者黄疸、少尿、黑便、意识障碍等症状减轻,优于对照组;血清AST、ALT、TBil、DBil、PT、APTT水平较治疗前改善,优于对照组,差异有统计学意义(P均<0.05)。结论毒蕈中毒患者常合并多脏器功能障碍(MODS),及早进行血液灌流联合血液滤过治疗较单独血液滤过能更有效的清除蛋白结合毒素和血清炎症因子,从而减轻内脏器官损害,改善肝、肾和凝血功能,治疗效果显著。

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