| Paraquat (paraquat, PQ),also named "yisaoguang,duicaokuai", its 20% solution called "kewuzong"in the market. Paraquat is one of the most widely used herbicide around the world currently, which are toxic for human being and livestock. The incidence of paraquat poisoning increased year by year,and its pathogenesis is still not completely understood, It is reviewed that the mechanism of oxygen free radical injury and systemic inflammation response participated in the pathogenetic progress,eventually lead to multiple organ dysfunction syndrome,of which mainly showed acute lung injury. There is no effects antidote of PQP, Some research suggests that its mortality usually ranges from 25%-76%.Now conventional treatment include lavage,catharsis, glucocorticoid, immunosuppressant, anti-oxide free radical,etc, but its treatment can not gain an ideal aim, yet.Blood purification can remove poisoning effectively, and it is widely applied in treatment of PQP.The common methods include hemodialysis, hemoperfusion, plasma exchange, continuous renal replacement therapy CRRT,etc. Each blood purification technology has its own advantages and disadvantages.According to the characteristics of blood purification,patient illness and toxicological properties,then choose the best way,which is the key to determine the clinical curative effect. There are few reports about the effection of sequential blood purification with PQP in China, This article use the method of collecting the cases to retrospective study,analysis the effect of the sequential blood purification treatment with PQP,which to provide theoretical basis of clinical optimal treatment PQP.Objective: Using the method of collecting the cases to retrospective study,analysis and comparison the difference of viscera function injury,mortality and survival time in routine therapy group,blood perfusion group and sequential blood purification treatment group. Discuss the clinical curative effect of sequential blood purification treatment and the influence of the prognosis,to provide the theoretical basis for clinical optimization of therapy.MethodBased on the retrospective analysis,the clinical data of 122 patients with paraquat poisoning in ICU from the second hospital of JiLin university and Central hospital of jilin were collected,according to different treatments,they are divided into 3 groups:routine therapy group(42 cases),blood perfusion group(47 cases) and sequential blood purification treatment group(33 cases).According to the clinical classification standard,122 cases are divided into Mild paraquat intoxication 9 cases, Moderate-severe paraquat intoxication 98 cases,fnlminant paraquat intoxication 15 cases. Analysis and comparison the difference of viscera function injury,mortality and survival time in the three groups. All the data collected are conducted with the SPSS 17.0 software program in analysis. Measurement data showed as means±standard deviations,the data of each group were made analyzed and compared through single factor analysis of variance, the illness change of a same patient at different time points are used the matching t test sample,Count data were made analyzed withχ2test.Results 1. Among conventional treatment group,blood perfusion group and sequential sex blood purification, the age, sex,gastric lavage time, APACHE score in PQP, have no statistically significant differences (p>0.05), the data are comparable.2.Sequential blood purification group of viscera the damage degree (lung, liver, kidneys, heart) is lower than the blood perfusion group and conventional treatment group, the difference was statistically significant (p< 0.05).3.Sequential blood purification group survival time is longer than blood perfusion group and conventional treatment group, statistically significant (p< 0.05).4.122 cases of acute PQP patients overall mortality has no statistically significant differences in the three groups.5.In the moderate-severe PQP patients, the fatality rate of sequential blood purification group is lower than blood perfusion group conventional treatment group,and there were significant differences (p< 0.05).Conclusion1. Sequential blood purification treatment for PQP patients is able to protecte viscera function (liver,kidney,myocardial,lung,etc)2. Sequential blood purification treatment can prolong the survival time of PQP.3. Sequential blood purification treatment can reduced mortality of moderate-severe PQP patients,but cannot change the prognosis of fnlminant PQP.4. Sequential blood purification treatment is better than routine therapy group and the pure blood perfusion group.5. Sequential blood purification treatment is recognized as one of the important effective treatments to PQP patients with MODS.
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