The Assesment Of Efficacy In The Treatment Of CRRT Combined HP To Sever Avermectin Poisoning

BackgroundAvermectin is a commonly used antibiotic insecticides,generally used for the treatment of poultry parasite,insects,belong to nerve agents.Human poisoning are rarely be reported,caused by general one,such as severe poisoning patients rescue is not timely,shock are supposed to be the mainly rector to death;Blood perfusion(HP)treatment can eliminate free poisons in the blood plasma,quickly reduce plasma concentration.The efficacy of treatment in patients with severe abamectin poisoning has been always regarded good,but its efficacy is associated with clinical time,late patients prognosis is poorer,continuous renal replacement treatment(CRRT)can continue to remove poison into the body again distribution,continue to lower plasma concentration,which can effectively fill the lack of HP;Especially when patients with severe sepsis,continuous blood purification(CRRT)can effectively remove endotoxin and inflammatory mediators,and less influence on hemodynamics.Objective Evaluation of efficacy in the treatment of CRRT combined HP to sever Avermectin poisoning.MethodBy searching the RCT Pub Med,BMA,EMbase,ASP,The Cochrane Library,EMCC,CBM,CNKI,CECDB,CQVIP,VIP database in 1995 August to 2015 November period,strict appraisal and data extraction on the quality of the included studies,using Stata/SE version 12 software systematic evaluation of included studies.From March 2011 to June 2015,We choose 22 patients with severe abamectin poisoning in our hospital,All of them exist severe respiratory depression.All of them are in a coma before the teatment begin as well.The clinical symptoms of these patients meet severe toxic poisoning diagnosis standard.The 22 patients were random divided into A,B two groups,Both of them were given basic treatment,12 cases of group A were given HP treatment;Group B in 10 cases were given HP with CRRT treatment.Two groups of patients age,poisoning symptom severity,and poisoning time differences had no statistical significance(P > 0.05),comparable.Results8 RCT were included with 168 cases of patients,including 82 cases in the control group(using blood perfusion),the treatment group of 86 patients(continuous renal replacement therapy combined with plasma perfusion).Systemevaluation results show that: compared with the control group,the experimental group therapy significantly reduced the number of patients infected with 48 Avermectins poisoning severe sepsis [P = 0.986,I2 = 34.0%,RR = 2.61,95% CI=(1.03,6.57)],time awareness and the experimental group patients recovered [P= 0.190,I2 = 73.7%,SMD =-0.99,95% CI =(-1.32,-0.65)] and the extent of muscle damage [P = 0.180,I2 = 37.2%,SMD = 1.53,95% CI =(1.08,2.00)] were significantly improved,but the time for stopping seizures in patients [P = 0.038,I2 = 64.3%,SMD =-0.31,95% CI =(-0.73,0.11)],system evaluation showed no significant difference in the two groups.Clinical observation of two groups of patients,the results showed that application of blood perfusion group(group A)and application of blood perfusion with continuous renal replacement therapy group(group B)compare;Compared to blood perfusion group,the blood perfusion with continuous renal replacement therapy treatment group patients after 24 hours the consciousness recovery time and the patients with spontaneous breathing recovery time,and stop the limb tic time were significantly shortened(P <0.05);But the records of 22 patients were clinical and severe sepsis;Conclusion A significant effect on CRRT combined HP to Avermectin poisoning,is worth promoting.