血液净化治疗儿童急性中毒18例临床分析

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1、中国医科大学硕士学位论文血液净化治疗儿童急性中毒18例临床分析姓名：李矢云中请学位级别：硕士专业：儿内科学指导教师：刘春峰201104T「中要•血液净化細见鑫急惟中帥嗨雌麻分析评价急性中毒并有血液净化适应症的患儿应用血液净化的疗效及不同毒物血液净化方式的选择。方游选取刑（唏囉

2、2曲我続輙曉刑期曲惋治症的邮辭J隐解無患儿，此18例患儿均符合血液净化的适应瘩久關后祐糊隣予催吐、洗圖、翱、潘畛吸附、利展、解删外用根据毒物的阳園选择H洞的血液挣牝方或訂牺缚予脏器保护、营养支持等综合观察I删勰翩瞅态喲改愛、＞w«»a率等来酬術薇触沛法购

3、繼性审毒飽毀果。本组18例患者中治愈13例，死亡3例，退院2例，治愈率为72.2%011例伴有意识障碍的患儿中8例经血液净化治疗神志转清，比率为63.6%o11例伴有抽搐患儿8例经血液净化后未再抽搐，比率为72.7%o本组除毒蕈中毒外的15例患儿从中毒到血液净化开始的平均时间为21.33小时，3例毒蕈中毒患儿中毒到血液净化开始的平均时间为105.17小时。血液净化对急性中毒患儿抽搐的控制、意识的转清及临床治愈率的提高效果明确，但由于血液净化技术在地方医院未得到广泛普及或中毒物质所引起的临床症状不特异（毒蕈），部分患儿中毒后血液

4、净化的最佳时机被错过，使血液净化的效果受到影响，血浆置换联合持续血液透析滤过患儿在本组中未见到明显优势。芙O1血液净化；儿童：急性中毒•英文论著摘要•clinicalanalysisofbloodpurificationthetreatmentin1(8childrenpoisoningObjectiveToevaluatethetherapeuticeffectefbloodpurificationinthechildrenwhoconsistentwiththeindicationofblood砒期cationandthe

5、selectionofdifferentbloodp^gc^tiontypeiodifferenttoxicant.MethodsWeselect18childrenwithacutepoisoningwhoJjcjgpjtalizedinPICU©fourhospitalfrom2006to2010.Allchildrenare細的entPgrfththeindicationofbloodpurification.BesidetheconventionaltherapyOfgastriclavage,emetic,catha

6、rsis,activatedcarbon期观rpj直8,diuresisandSfftftJofe$Wec(^ectdifferentblood搭廳cationtodifferent怡做朋钦喩ithcombinedtherapybforganprotection,nutritionalsupportandsoon.Identifythetherapeuticeffectofbloodpy^gcationinacutepoisoningchildrenfromthecontrolofconvulsion,thechangeofc

7、onsciousstate,curerateandsoon.MainresultsInthe18(Childrenthere1(3(ohiidrenwhocured,there3chiidrenwhoaredied,thereare2ctritdrenwho4^$

8、uredafterbloodpurification.Therateis72.7%.IntheI5(fihildrenexceptthe3childrenwithtoadstoolpoisoning,theaveragetimefrompoisoningtobloodpurification.Therateis63.6%.IntheHdrenwithcooswilsionthereare&©Wldrencationis21.33bofitrScTheaveragetimefortoadstoolpoisoningchildre

9、nisJ05.17hours.ConclusionsThetherapeuticefRcacyofbloodpurificationforthecontrolofconvulsion,distinctnessofconsciousnessandtheelevation©fcu