摘要
目的 在百草枯中毒患者血液灌流治疗中,使用肝素进行抗凝后,比较不同剂量鱼精蛋白拮抗肝素的效果及安全性。方法 2014年1月~2015年4月我院共收治百草枯中毒患者34例,将其中完成3次血液灌流治疗的18例患者作为研究对象,采用自身配对设计方案,根据使用不同鱼精蛋白剂量的前后顺序随机分为鱼精蛋白0 mg组,鱼精蛋白25 mg组和鱼精蛋白50 mg组。监测患者每次血液灌流前和使用鱼精蛋白1 h和6 h后的活化部分凝血酶时间（APTT）、出血情况和预后。结果每组血液灌流前APTT水平无统计学差异（P〉0.05）。在血液灌流后1 h,鱼精蛋白0 mg组APTT值明显高于其他两组（P〈0.01）;而鱼精蛋白25 mg和50 mg两组间用药前和用药后1、6 h的APTT值无统计学差异（P〉0.05）。结论 百草枯中毒患者血液灌流后,建议常规使用鱼精蛋白拮抗肝素,推荐首次鱼精蛋白剂量为25 mg。
Objective To make comparison of antagonistic effects of different doses of protamine sulfate on heparin after hemoperfusion in patients with paraquat poisoning. Methods Among 34 patients with paraquat poisoning who were hospitalized between January 2014 and April 2015, 18 ones that completed three times of hemoperfusion therapy were selected as the subjects and according to the different doses of protamine randomly divided into protamine 0 mg group, 25 mg group, and 50 mg groups. Monitoring was made in activated partial thrombin time （APTT）, bleeding situation, and prognosis before each time of hemoperfusion and 1 hour and 6 hours after the use of protamine. Results There was no significant difference in the APTT levels among the three groups before the hemoperfusion （P〉 0.05）. One hour after the hemoperfusion, the APTY value in protamine 0 mg group was significantly higher than those in the other two groups （P 〈 0.01）. There was no significant difference between the values of APTT in protamine 25 mg and 50 mg groups before the medication and one hour and 6 hours after the medication （P 〉 0.05）. Conclusion After hemoperfusion on patients with paraquat poisoning, it is suggested the routine use of protamine for antagonism of heparin, and the recommended first dose is 25 rag.
出处
《西南国防医药》
CAS
2015年第12期1334-1336,共3页
Medical Journal of National Defending Forces in Southwest China
