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目的:探讨血液净化治疗在急性药物或毒物中毒中的应用时机和方法。方法:2008年至2010年符合急性重度药物或毒物中毒诊断标准的患者65例。根据病情选择血液灌流、血液透析、血液灌流联合血液透析、或床旁连续性肾脏替代治疗。评估Glasgow评分,机械通气使用率,住院天数,治愈率,死亡率,以及血液净化治疗的不良反应。结果:首诊时Glasgow评分为5.4±2.2。血液净化治疗开始的时间为首诊后2.3±0.8h。平均血液净化治疗的次数为2.7±0.5次。患者痊愈出院50例(76.9%),自动出院7例(10.7%),死亡8例(12.3%)。平均住院天数5.6±2.2d。结论:在常规内科对症对因治疗的同时,尽早、综合、大胆应用血液净化治疗,显著提高急性重度中毒患者的救治成功率,减少住院天数。
Objective: To explore the timing and method of blood purification treatment in acute drug or poisoning. Methods: Between 2008 and 2010, 65 patients met the diagnostic criteria of acute severe drug or poisoning. According to the condition choose hemoperfusion, hemodialysis, hemoperfusion combined hemodialysis, or bedside continuous renal replacement therapy. Glasgow scores, mechanical ventilation use, length of hospital stay, cure, mortality, and adverse reactions to blood purification were evaluated. Results: The Glasgow score at the first visit was 5.4 ± 2.2. Blood purification treatment began after the first diagnosis 2.3 ± 0.8h. The average number of blood purification treatment was 2.7 ± 0.5 times. The patients were discharged from hospital in 50 cases (76.9%), discharged in 7 cases (10.7%) and died in 8 cases (12.3%). The average length of stay 5.6 ± 2.2d. Conclusion: In the routine medical symptomatic treatment, as soon as possible, comprehensive, bold application of blood purification treatment, significantly improve the treatment of acute severe poisoning success rate and reduce the number of days of hospitalization.