血液灌流在儿童急性毒鼠强中毒救治中的应用

Application of hemoperfusion in children with acute tetramine poisoning

摘要:

目的：观察血液灌流(HP)治疗儿童急性毒鼠强(TET)中毒的疗效。方法：32例急性TET中毒儿童，年龄1~8岁，平均年龄4.6±2.4岁，均予以HP治疗。HP前、HP治疗1 h、2 h及HP后12 h、24 h测血清TET浓度，观察HP治疗开始到意识恢复时间、抽搐停止时间。结果：17例行HP治疗1次，12例2次，2例4次，1例 3次。27例(84%)治愈，2例(7%)好转，3例(9%)死亡。HP治疗1 h、2 h的TET浓度逐渐降低，且明显低于治疗前(P<0.01)。HP后12 h、24 h的TET浓度仍显著低于治疗前(P<0.01)。意识恢复时间为5.4±4.2 h、抽搐停止时间为10.1±7.3 h。结论：儿童急性TET中毒行HP治疗是有效的。［中国当代儿科杂志，2010，12（7）：536-538］

Abstract:

OBJECTIVE: To investigate the efficacy of hemoperfusion treatment in children with acute tetramine poisoning. METHODS: Thirty-two children aged from 1 to 8 years ( mean 4.6±2.4 years) with acute tetramine poisoning received hemoperfusion treatment. Serum tetramine concentrations were measured by gas chromatography before hemoperfusion, 1 and 2 hrs after hemoperfusion initiation and 12 and 24 hrs by the end of hemoperfusion. The median time for full recovery of consciousness and the time to seizure control were observed. RESULTS: Seventeen children received hemoperfusion treatment for one time, 12 for twice, 2 for 4 times and 1 for 3 times. Twenty- seven (84%) cases recovered, 2 (7%) cases improved and 3 (9%) cases died of multi-organ failure. The serum tetramine concentrations 1 and 2 hrs after hrmoperfusion initiation were significantly lower than those before hemoperfusion (P<0.01). The serum tetramine concentrations 12 and 24 hrs by the end of hemoperfusion were also significantly lower than those before hemoperfusion (P<0.01). The median time for full recovery of consciousness and the time to seizure control were 5.4±4.2 and 10.1±7.3 hrs, respectively. CONCLUSIONS: Hemoperfusion treatment is effective for acute tetramine poisoning in children. ［Chin J Contemp Pediatr, 2010, 12 (7):536-538］