中国血液净化

中国血液净化 ›› 2013, Vol. 12 ›› Issue (03): 149-151.

• 基础研究 • 上一篇    下一篇

双罐串联血浆灌流对百草枯中毒患者血浆百草枯清除效果的研究

孙亮,魏路清,李国峰,刘阳,李国强   

  1. 武警医学院附属医院呼吸与重症医学科
  • 收稿日期:2012-07-27 修回日期:2012-09-12 出版日期:2013-03-12 发布日期:2015-10-08
  • 通讯作者: 李国强 E-mail:hrct2008@yahoo.com.cn
  • 基金资助:

    武警后勤学院青年基金(WHQ201211）；武警后勤学院附属医院种子基金重点项目（FYZ201102）;中科级.863

The study of clearance effect of plasma perfusion in patients with paraquat poisoning using dual- cartridge in series

  • Received:2012-07-27 Revised:2012-09-12 Online:2013-03-12 Published:2015-10-08

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摘要： 【摘要】目的 对比研究双罐串联血浆灌流及单罐血浆灌流对血浆百草枯（PPQ）的清除效果，探讨双罐串联血浆灌流治疗百草枯中毒的可行性。方法 回顾分析本院中毒急救中心24 h内就诊的急性百草枯（PQ）中毒患者34例，其中行双罐灌流16例，单罐灌流18例，所有患者均进行持续血浆灌流治疗，血流速度180 ml/min，血浆流量40 ml/min，每隔3 h更换一次活性炭灌流器，灌流过程中每3小时记录双罐前中后PPQ浓度，分别记为滤前、滤中及滤后浓度。结果 1）百草枯浓度变化：第1次血浆灌流时,双罐(16例)滤前、滤中及滤后的百草枯浓度分别为: 6.70(6.44,4.36)、5.75(3.65,7.53)及4.40(2.55,6.33)；单罐（18例）的滤前及滤后浓度为：7.25(5.28,9.15)及5.55 (3.55,7.25)。第2次灌流时,双罐（16例）的滤前、滤中及滤后的百草枯浓度分别为: 4.00(1.55,4.25)、2.70(0.90,3.50)及1.90(0.35,2.85)；单罐（18例）的滤前及滤后浓度为：4.50(2.28,6.15)及2.80(0.83,4.98)。第3次双罐（8例）的滤前、滤中及滤后浓度为: 2.00(1.03,2.70)、1.50(0.68,2.15)及0.95(0.45,1.70)；单罐（15例）的滤前及滤后浓度为3.10(0.97,4.60)及2.30(0.40,3.35)。第4次双罐（6例）的滤前、滤中及滤后浓度为：1.14±0.96，0.87±0.78及0.65±0.67；单罐（11例）的滤前及滤后浓度为：1.90(0.79,3.05)及0.90(0.45,2.40)。 2）各罐对百草枯的清除速度：第1次灌流时，双罐、罐1及罐2对百草枯的清除速度为：14.36±5.72，8.01±4.04及8.49±3.77；单罐为：10.37±5.67。第2次双罐、罐1及罐2对百草枯的清除速度为：21.53±7.74，12.91±7.76 及16.12±7.23；单罐为：15.58±8.14。第3次双罐、罐1及罐2的清除速度为：18.39(14.29,25.84)，9.26(8.96,12.21)及10.25(7.38,19.00)；单罐为：15.54±8.39。第4次双罐、罐1及罐2的清除速度为：19.17(13.33,25.61)，9.35(4.42,13.14)及13.45(8.22,11.28)；单罐为：11.43(6.86,14.74)。结论 与单罐血浆灌流相比，双罐血浆灌流可明显提高血浆百草枯的清除速度，可能是治疗百草枯中毒的一个手段。

关键词: 百草枯, 中毒, 血浆灌流, 毒物清除, 双罐

Abstract: 【Abstract】 Objective To study the clearance effect of plasma perfusion for the plasma paraquat (PPQ) using dual- cartridge in series and to explore the feasibility of dual-tank in series plasma perfusion in the treatment of paraquat poisoning. Methods 16PQ-poisoned Patients who arrived our poisoning Center within 24 hours after paraquat poisoning were prospectively enrolled. Bual-tank in series plasma perfusion (blood flow rate of 180 ml / min, Plasma flow 40ml / min) was performed and Activated carbon cartridge were changed every 3 hours.The concentration of PPQ was recorded in the before, during and after of the two cartridge every 3h. Results 1) The change of paraquat concentration: During the first plasma perfusion, the concentration of PPQ before, during and after the two cartridge (16 cases)were: 6.70 (6.44,4.36), 5.75 (3.65,7.53) and 4.40 (2.55,6.33); before and after the single cartridge（18 cases）were：7.25(5.28,9.15)and 5.55 (3.55,7.25). 2nd the two cartridge (16 cases) were: 4.00 (1.55,4.25), 2.70 (0.90,3.50) and 1.90 (0.35,2.85); the single cartridge（18 cases）were : 4.50(2.28,6.15)and 2.80(0.83,4.98).3rd the two cartridge (8 cases) were: 2.00 (1.03,2.70), 1.50 (0.68,2.15) and 0.95 (0.45,1.70); the single cartridge（15cases）were : 3.10(0.97,4.60)and 2.30(0.40,3.35).4th the two cartridge (6 cases) were: 1.14 ± 0.96,0.87 ± 0.78 and 0.65 ± 0.67; the single cartridge（11cases）were :1.90(0.79,3.05)and 0.90(0.45,2.40). 2) Paraquat clearance rate of each cartridge: During the first plasma perfusion, the Paraquat clearance rate of double cartridge, cartridge1and cartridge2 were: 14.36 ± 5.72,8.01 ± 4.04 and 8.49 ± 3.77; the Paraquat clearance rate of single cartridge（18cases）was : 10.37±5.67.when the second plasma perfusion, the Paraquat clearance rate of double cartridge, cartridge1and cartridge2 were : 21.53± 7.74,12.91 ± 7.76 and 16.12 ± 7.23; the single cartridgewas : 15.58±8.14. 3rd, the double cartridge, cartridge1and cartridge2 were: 18.39 (14.29,25.84), 9.26 (8.96,12.21) and 10.25 (7.38,19.00); the single cartridge was : 15.54±8.39.4th(6 cases): 19.17 (13.33,25.61), 9.35(4.42,13.14) and 13.45 (8.22,11.28); the single cartridge was:11.43(6.86,14.74). Conclusion Compared with the single cartridge plasma perfusion, dual-cartridge plasma perfusion can increase the clearance rate of plasma paraquat significantly and may be a method for the treatment of paraquat poisoning.