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目的:探讨乙酰半胱氨酸联合血液净化治疗急性百草枯(PQ)中毒的疗效。方法:分析2013-01-2017-01我院急诊内科收治的急性PQ中毒患者68例。根据是否接受乙酰半胱氨酸泡腾片治疗分为治疗组(35例)和对照组(33例)。对照组给予常规治疗、血液净化,治疗组在对照组治疗的基础上加用乙酰半胱氨酸泡腾片,比较2组患者的一般资料、动脉血气分析数值、肺纤维化发生率及病死率。结果:治疗前2组患者的肺泡-动脉血氧分压差[P(A-a)O_2]及氧和指数(OI)比较差异无统计学意义;2组治疗后与治疗前的P(A-a)O_2及OI比较差异有统计学意义(P<0.05);2组治疗后的P(A-a)O_2及OI比较差异无统计学意义;1周时2组患者肺纤维化发生率比较差异无统计学意义,4周时治疗组肺纤维化发生率低于对照组(P<0.05);治疗组的病死率低于对照组(P<0.05)。结论:急性百草枯中毒患者应用乙酰半胱氨酸结合血液净化治疗,可以降低患者的肺纤维化发生率及病死率,改善患者的预后。
Objective: To investigate the efficacy of acetylcysteine combined with blood purification in the treatment of acute paraquat (PQ) poisoning. Methods: A total of 68 patients with acute PQ poisoning admitted to our hospital from January 2013 to January 2017 were enrolled. According to whether the treatment of acetylcysteine effervescent tablets were divided into treatment group (35 cases) and control group (33 cases). The control group was given routine treatment and blood purification. The treatment group was given acetylcysteine effervescent tablets on the basis of the control group. The general data of two groups were compared. The value of arterial blood gas analysis, the incidence of pulmonary fibrosis and mortality . Results: There was no significant difference in alveolar-arterial oxygen pressure difference [P (Aa) O_2] and oxygen and index (OI) between the two groups before treatment; P (Aa) O_2 (P <0.05). There was no significant difference in P (Aa) O_2 and OI between the two groups after treatment, but there was no significant difference in the incidence of pulmonary fibrosis between the two groups at 1 week , And the incidence of pulmonary fibrosis in the treatment group was lower than that in the control group at 4 weeks (P <0.05). The mortality of the treatment group was lower than that of the control group (P <0.05). Conclusion: Acute paraquat poisoning patients with acetylcysteine combined with blood purification treatment can reduce the incidence of pulmonary fibrosis and mortality in patients with improved prognosis.