人工肝治疗野生菌中毒的临床观察
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摘要
目的研究探讨组合型人工肝治疗技术在野生菌中毒患者中的应用效果。方法对2016年9月—2018年9月期间该院接收治疗的25例肝衰竭型野生菌中毒患者的临床资料进行回顾分析,总结通过以血浆置换、连续性血液滤过以及胆红素吸附为主的组合型人工肝技术治疗肝衰竭型野生菌中毒患者的效果,观察指标主要为凝血功能、肝功指标、消化道症状情况、生命体征、出院时间、病死率。结果治疗后,21例(84%)患者痊愈后出院,平均住院时间为(22.7±3.3)d;1例(4%)患者放弃治疗;3例(12%)患者治疗无效宣布死亡。在21例痊愈患者中,治疗4 d后,患者的生命体征均趋于稳定,消化道症状得到显著的缓解,INR(1.1±0.4)、PT(11.7±2.6)s、TBIL(65.7±25.1)umol/L、ALT(105.8±75.5)U/L水平显著降低(P<0.05);PLT(115.4±25.6)(×109/L)水平显著上升,差异有统计学意义(P<0.05)。结论在野生菌中毒患者中采用组合型人工肝技术进行治疗,具有显著的临床效果,只得在临床上推广应用。
Objective To study the application effect of combined artificial liver treatment technology in patients with wild bacteria poisoning. Methods The clinical data of 25 patients with hepatic failure-type wild-type bacterial poisoning who received treatment in our hospital from September 2016 to September 2018 were retrospectively analyzed. The results were analyzed by plasma exchange, continuous hemofiltration and bilirubin adsorption. The main combined artificial liver technology for the treatment of liver failure patients with wild-type bacterial poisoning, the main indicators are coagulation function, liver function indicators, gastrointestinal symptoms, vital signs, discharge time, mortality. Results After treatment, 21 patients(84%) were discharged after recovery and the average length of hospital stay was(22.7±3.3) d; 1 patient(4%) gave up treatment; 3 patients(12%) died of treatment failure. In the 21 patients who recovered, after 4 days of treatment, the vital signs of the patients stabilized and the symptoms of the digestive tract were significantly relieved. INR(1.1 ±0.4)、PT(11.7±2.6)s、TBIL(65.7±25.1)umol/L、ALT(105.8±75.5)U/L levels were significantly lower(P<0.05); PLT(115.4±25.6)(×109/L) levels were significantly increased(P<0.05). Statistical analysis showed differences in statistics(P<0.05). Learning meaning. Conclusion The combination of artificial liver technology in the treatment of wild-type bacterial poisoning patients has significant clinical effects and has to be promoted and applied clinically.
Objective To study the application effect of combined artificial liver treatment technology in patients with wild bacteria poisoning. Methods The clinical data of 25 patients with hepatic failure-type wild-type bacterial poisoning who received treatment in our hospital from September 2016 to September 2018 were retrospectively analyzed. The results were analyzed by plasma exchange, continuous hemofiltration and bilirubin adsorption. The main combined artificial liver technology for the treatment of liver failure patients with wild-type bacterial poisoning, the main indicators are coagulation function, liver function indicators, gastrointestinal symptoms, vital signs, discharge time, mortality. Results After treatment, 21 patients(84%) were discharged after recovery and the average length of hospital stay was(22.7±3.3) d; 1 patient(4%) gave up treatment; 3 patients(12%) died of treatment failure. In the 21 patients who recovered, after 4 days of treatment, the vital signs of the patients stabilized and the symptoms of the digestive tract were significantly relieved. INR(1.1 ±0.4)、PT(11.7±2.6)s、TBIL(65.7±25.1)umol/L、ALT(105.8±75.5)U/L levels were significantly lower(P<0.05); PLT(115.4±25.6)(×109/L) levels were significantly increased(P<0.05). Statistical analysis showed differences in statistics(P<0.05). Learning meaning. Conclusion The combination of artificial liver technology in the treatment of wild-type bacterial poisoning patients has significant clinical effects and has to be promoted and applied clinically.
引文
[1]吴雪萍,李焰,杨文勇,陆兴热,高仕萍,何磊.野生菌中毒多器官功能衰竭血浆置换效果分析[J].中国输血杂志,2018,31(5):537-540.
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[15]周璐,易燕春,范定玉.人工肝血浆置换治疗重度有机磷中毒9例护理[J].华夏医学,2017,30(2):126-128.
[16]胡媛媛,赵亮.组合型人工肝技术治疗肝衰竭型毒蕈中毒患者的疗效观察[J].中国民康医学,2016,28(9):1-2.
[2]云南:即将野生菌中毒高发季全面做好严控工作[J].中国食用菌,2018,37(3):51.
[3]田茂珍.30例野生菌中毒的急救与护理[J].实用妇科内分泌杂志:电子版,2017,4(27):163,166.
[4]顾植昳.野生菌中毒的临床表现与常规洗胃治疗分析[J].双足与保健,2017,26(18):135-136.
[5]袁艳珍.多烯磷脂酰胆碱药物对急性野生菌中毒肝损害患者中的临床治疗效果[J].世界最新医学信息文摘,2017,17(48):80.
[6]陆国红.急性野生菌中毒抢救中的洗胃护理干预[J].健康之路,2017,16(4):181.
[7]毛成陆,徐淼.急性野生菌中毒患者应用多烯磷脂酰胆碱治疗的实际效果分析[J].世界最新医学信息文摘,2017,17(10):117-118.
[8]陈春花,关春辉,张登鹏,陈波.血液净化治疗急性野生菌中毒疗效分析——附12例病例报告[J].现代养生,2016(24):36-37.
[9]白云芬.CRRT治疗1例野生菌中毒多器官功能障碍综合征患者护理体会[J].内蒙古中医药,2016,35(1):175-176.
[10]蒋顺友.野生菌中毒的临床特征及治疗分析[J].世界最新医学信息文摘,2015,15(A0):163-164.
[11]袁文兰,陈发强,李菊秀.野生菌中毒病人的护理[J].全科护理,2015,13(30):3062-3063.
[12]胡刚桂.98例野生菌中毒患者的急救护理体会[J].世界最新医学信息文摘,2015,15(73):239,246.
[13]刘美玲.野生菌中毒临床特征及治疗观察[J].深圳中西医结合杂志,2015,25(15):120-122.
[14]陈晓雷.长托宁与阿托治疗急性野生菌中毒临床疗效对比分析[J].现代诊断与治疗,2015,26(15):3457-3458,3562.
[15]周璐,易燕春,范定玉.人工肝血浆置换治疗重度有机磷中毒9例护理[J].华夏医学,2017,30(2):126-128.
[16]胡媛媛,赵亮.组合型人工肝技术治疗肝衰竭型毒蕈中毒患者的疗效观察[J].中国民康医学,2016,28(9):1-2.