Clinical efficacy of sequential hemoperfusion combined with rhubarb for sequential treatment for patients with paraquat poisoning

WANG Weizhan; LI Jing; XIAO Qingmian; QI Hongna; ZHU Baoyue; LI Wei; MA Guoying; WANG Pu; WANG Lan

doi:10.3969/j.issn.1006-5725.2017.23.016

Abstract：Objective To investigate the clinical efficacy of sequential hemoperfusion combined with rhu-barb as the main treatment for patients with acute paraquat poisoning(acute,paraquat,poisoning,APP). Meth-ods 16 moderate APP patients in our hospital were randomly divided into group A(hemoperfusion group,31 cas-es),group B(hemoperfusion combined with rhubarb as the main prescription group,40 cases)and group C(con-tinuous hemoperfusion combined with rhubarb as the main prescription group,45 cases),respectively.Levels of C-reactive protein(CRP),alanine aminotransferase(ALT),creatine kinase(CK-MB),creatinine(Cr),tumor ne-crosis factor-α(TNF-α),interleukin-6(IL-6)and interleukin-10(IL-10)were determined before treatment and at 5 d,7 d post-treatment. At 8 h,12 h and 24 h post-treatment,serum paraquat level was determined. Results After treatment,the total effective rate of group C(68.89%)was significantly higher than that of group A (35.48%),group B(52.5%),with significant differences among groups(χ2= 8.335,P=0.015). Levels of ALT,CK-MB,Cr,CRP,TNF-α,IL-6 and IL-10 were significantly increased at 5 d post-treatment in group A, but were significantly decreased at 7d post-treatment in group C,with significant differences among groups(P<0.05).The serum paraquat content in group B and C was lower than that in group A at 8 h post-treatment.The se-rum paraquat content was the lowest in group C at 12h post-treatment(P < 0.05). However,the serum paraquat content decreased significantly in each group at 24 h post-treatment,with no significant differences among three groups. Conclusions The early continuous hemoperfusion combined with rhubarb-based sequential treatment of APP can effectively reduce the fatality rate and improve prognosis of APP patients.