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| Effect of continuous veno-venous hemofiltration combined with hemoperfusion on serum concentration and efficacy of paraquat poisoning patients |
| Zou Xian-bao, Sun Bao-quan, Liu Ying, Yu Zhong-kai, Qu Ai-jun |
| Department of Emergency, Liaocheng People′s Hospital, Liaocheng 252000, China |
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Abstract Objective To investigate the effect of continuous veno-venous hemofiltration combined with hemoperfusion on serum concentration and clinical efficacy in patients with acute paraquat poisoning. Methods 68 patients with acute paraquat poisoning were randomly divided into HP group (n=36) and CVVHDF+HP group (n=32). The concentrations of paraquat were recorded before and 24 hours after treatment in the two groups, and the 24 hours clearance rate of paraquat was compared between the two groups. Alanine aminotransferase (ALT), total bilirubin (TBil), creatinine (Cr), urea nitrogen (BUN) and arterial oxygen partial pressure (PaO2) before and 24 hours after treatment were compared between the two groups. The time, mortality and survival time of multiple organ failure were compared between the two groups. Results The plasma concentration of paraquat decreased faster in CVVHDF+HP group than that in HP group. The clearance rate of paraquat 24 h in CVVHDF+HP group was higher than that in HP group (91.56% vs. 78.95%, P<0.05); ALT was lower than HP in CVVHDF+HP group at 48 h and 72 h ［(60.12±14.74)U//L vs. (125.57±20.53)U//L; (80.82±21.86)U//L vs. (130.26±28.42)U//L, P<0.05］; The total bilirubin (TBil) was lower in the CVVHDF+HP group than that in the HP group at 72 h ［(15.64±3.93)μmol/L vs. (28.37±4.34)μmol/L, P<0.05］. Cr was lower in the CVVHDF+HP group than in the HP group at 48 h and 72 h ［(78.88±10.68)μmol/L vs. (110.56±20.12)μmol/L; (80.59±11.12)μmol/L vs. (123.37±22.06)μmol/L, P all<0.05］. BUN was lower in the CVVHDF+HP group than in the HP group at 24 h, 48 h, and 72 h ［(3.28±1.16)mmol/L vs. (6.44±1.73)mmol/L; (5.78±1.96)mmol/L vs. (10.26±2.82)mmol/L; (6.64±2.13)mmol/L vs. (18.37±3.34)mmol/L; P all <0.05］. The arterial oxygen partial pressure (PaO2) was higher in the CVVHDF+HP group than that in the HP group at 48 h and 72 h ［(92.31±7.34)mm Hg vs. (80.85±7.76)mm Hg; (76.50±6.35)mm Hg vs. (50.50±4.11)mm Hg, P<0.05］. Multiple organ failure in CVVHDF+HP group was later than that in HP group［（5.75±2.32)d vs. (3.84±2.21)d, P<0.05］. The time of poisoning to death was significantly longer in the CVVHDF+HP group than that in the HP group［（5.86±3.24)d vs. (4.74±2.46)d, P<0.05］. The mortality of CVVHDF+HP group was 59.4% and the mortality of HP group was 55.6%. There was no significant difference between the two groups. Conclusion Continuous veno-venous hemofiltration combined with hemoperfusion can effectively clear the blood concentration of the patients with acute paraquat poisoning, delay the time of multiple organ failure and prolong the survival time of the patients, but cannot reduce the overall mortality.
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| About author:: Zou Xian-bao, E-mail: zxb_jzk@163.com |
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