Abstract
Objective To investigate the effects of hemoperfusion (HP) combined with continuous veno-venous hemofiltration (CVVH) in patients with paraquat poisoning. Methods The clinical data of 80 patients with paraquat poisoning admitted to Henan General Hospital of the Chinese People’s Armed Police Force from January 2015 to January 2019 were retrospectively analyzed. Patients were divided into HP group (control group, n=41) and HP+ CVVH group (observation group, n=39) according to the treatment methods. Serum paraquat poisoning level and clearance rate were compared between the two groups before and after treatment. Liver and kidney function, such as aspartate aminotransferase (AST), alanine aminotransferase (ALT), urea nitrogen (BUN), creatinine (Cr), creatine kinase isoenzyme (CK-MB), interleukin-8 (IL-8), arterial blood lactate (Lac) and oxygenation index (PaCO2/FiO2) were observed before and after treatment. Before treatment and on the second, fourth and sixth day of treatment, the sequential organ failure assessment (SOFA) was scored, and the 30-day mortality rates were compared between the two groups, and Kaplan-Meier method was used for survival analysis. Results After 72 h of treatment, the serum paraquat poisoning level in the two groups was lower than that before treatment, and the level in observation group was lower than that in control group (P<0.05); the levels of AST, ALT, BUN, Cr, IL-8, CK-MB and Lac were increased compared with those before treatment in the two groups, and the levels in observation group were lower than those in control group (P<0.05). The PaCO2/FiO2 was lower than that before treatment, and the index in observation group was higher than that in control group (P<0.05). On the second, fourth and sixth day of treatment, the SOFA scores in the two groups were higher than those before treatment, and the score in observation group was lower than that in control group (P<0.05). The paraquat poisoning clearance rate in observation group was higher than that in control group while the 30-day mortality rate was lower than that in control group (P<0.05). Kaplan-Meier analysis results showed that there was a statistically significant difference in the survival rate between the two groups (P<0.05). Conclusions HP combined with CVVH has better efficacy in the treatment of paraquat poisoning than HP alone. And it can effectively remove toxins, reduce lactate production, alleviate inflammatory response and organ function damage, prolong survival time and reduce mortality rate. Key words: Hemoperfusion; Continuous venovenous hemofiltration; Paraquat poisoning; Lactate; Survival analysis
Published Version
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