中国血液净化

›› 2002, Vol. 1 ›› Issue (10): 15-17.

• 论著 • 上一篇    下一篇

血液灌注疗法对急性铊中毒的治疗作用

李明喜 李学旺 李莉 李延峰 朱以诚 万新华   

  1. 100730 北京， 中国医学科学院中国协和医科大学北京协和医院肾内科 (李明喜，李学旺，李莉)，神经科(李延峰，朱以诚，万新华)
  • 收稿日期:1900-01-01 修回日期:1900-01-01 出版日期:2002-10-19 发布日期:2002-10-19

  • Received:1900-01-01 Revised:1900-01-01 Online:2002-10-19 Published:2002-10-19

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摘要： 【摘要】目的 评价血液灌注（Hemoperfusion, HP）治疗急性铊中毒的有效性和安全性。方法 分析两例急性铊中毒患者，采用Adsorba 300C (Gambro) 碳肾8次HP治疗前后血铊的变化，计算血铊下降率。观察治疗前后患者血钙、葡萄糖、纤维蛋白原、血小板及血压、心率的变化并评价临床症状的改变。结果 HP治疗可显著降低血铊水平，血铊的下降率为52％±10％，两例患者治疗四次后血、尿铊水平接近正常，临床症状明显改善。其中一例症状基本恢复，另一例遗留有下肢肌力障碍。两例治疗中除血钙显著降低外，未观察到其它副作用。结论 HP（Adsorba 300C）治疗铊中毒安全有效，这种方法应成为铊中毒的首选治疗手段。

关键词: 铊中毒, 血液灌注

Abstract:

【Abstact】Objective To evaluate the effectiveness and reliability of hemoperfusion (HP) therapy to acute thallium poisoning. Methods Two patients with acute thallium poisoning (serum thallium level of 330 and 221μg/L respectively) underwent HP eight times using Adsorba 300C (Gambro). The thallium reduction ratio during HP was analyzed. Other parameters assessed included the changes of serum calcium, glucose, fibrinogen, platelet count as well as the blood pressure and the heart rate during HP. The clinical manifestations pre and post HP therapy were also studied. Results A remarkable reduction of the thallium level with the reduction ratio of 52％±10％ was observed during HP. After four sessions of HP, the serum and urine thallium levels of two patients almost returned to normal (<20μg/L), with nearly a full recovery of the symptoms in one case but diminished muscle strength in another. No side effects were found except of a significant decrease in serum calcium after HP. Conclusion HP (using Adsorba 300C) is effective and safe for eliminating thallium. This therapy should be the first choice for the cure of the patients with acute thallium poisoning.

Key words: Hemoperfusion