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Devascularization combined restrictive mesocaval shunt to treat portal hypertension clinical analysis of 58 cases

. 1 General Information The group of 23 patients, male and 1O, female 13 cases; aged from 15 to 73 years. Organophosphorus pesticide poisoning (15 cases, 8 cases of methamidophos poisoning, 2 cases of poisoning dichlorvos,[link widoczny dla zalogowanych], dimethoate poisoning in 3 cases, 2 cases of poisoning in 1065.) Diazepam poisoning in 3 cases, 3 cases of antipsychotic poisoning, rat poison (fluoroacetamide) poisoning in 1 case, 1 case of drug poisoning is unknown, both oral absorption. HP and HD Jieyou consciousness before treatment (light coma l cases, 22 cases of deep coma.) 19 cases of shock and respiratory failure in 9 cases. And 8 patients with heart failure and pulmonary infection in 3 cases. 1.2 After the first treatment for patients admitted to hospital routine gastric lavage, urine, expansion, and support anti-shock, symptomatic treatment, combined with HP and HD-based combination therapy. HP and HD from the start time of 6 ~ 16h19 cases, 17 ~ 24h2 cases, 24h or more in 2 cases. Langfang Aier200 using a Y-Carbon kidney (perfusion). To 50g /] glucose injection 500mI wet, then rinse with normal saline 2000mI heparin 80mg. By NiproCTA120 dialysis. After conventional washing, kidney and dialysis carbon connected in series, the establishment of temporary blood access, blood flow 1jO ~ 200mI/rain, heparin 1.0 ~ 1.5mg/kg. HP and HD in the course of treatment, patients with organophosphate poisoning, atropine to conventional therapy, timely additional half dose, the end of the air back to the blood. Number of treatment depending on the specific condition may be, this group of 1 to 3 times per treatment, an average of 2 times. 1.3 The results of 23 patients treated 2O cases were cured after treatment, HP and HD, 2 died, 1 patient discharged. 2 to discuss the effective absorption hemoperfusion poison, direct, rapid removal of certain drugs to reduce blood drugs, toxic concentration, to prevent further damage to major organs in vivo. To achieve the lifting of the purpose of intoxication. Court 23 cases of severe acute poisoning [Received Date] 2003-08-27; [Revision Date] 2003-12-25 [Author] Xue-Hong Kong (1967), male, physician. Patients with HP and HI) treatment, 2O cases were cured, the cure rate was 87, compared with conventional treatment over the past medical cure rate has improved significantly. HD to remove the low plasma protein binding, soluble in water, small molecules that can ultrafiltration plenty of water to regulate body electrolyte and acid-base balance and maintain a stable internal environment. The role of the two series complement each other, should be confirmed as soon as possible after poisoning. Since the blood perfusion in the adsorption of activated carbon has a broad spectrum, not only can absorb toxic substances in the blood can also boost physical adsorption,[link widoczny dla zalogowanych], but also because the perfused blood volume changes in the beginning, 23 patients,[link widoczny dla zalogowanych], 13 patients with decreased blood pressure after initiation of treatment . Therefore, HP, and HD begin to 5O ~ 100mL/rnin flow should be appropriate, if the patient has low blood pressure or low blood volume can be pre-filled saline body of all the drive back to the patient, or as a pre-filled with fresh plasma. Organophosphate poisoning patients in the HP and HD treatment, the removal of organic phosphorus in plasma but also cleared the atropine,[link widoczny dla zalogowanych], and thus reduce, or poisoning caused by atropine in patients with excessive irritability and coma level. HP and HD after treatment, still under close observation in the application of anticholinergic drugs in treatment of moderate]. For a time after treatment, HP and HD patients recover consciousness,[link widoczny dla zalogowanych], as HP and HD, each time 2 ~ 3h appropriate. Activated carbon adsorption capacity for 2 ~ 3h is close to saturation. For further treatment, can be replaced perfusion. HP and HD perfusion is best carried out under ECG monitoring for early detection of condition changes in time. Unconditionally when vital signs should be closely observed to maintain airway patency, timely suction, oxygen, prevention of infection. Do cross the blood, prepare blood. HP and HD before treatment, during and after treatment should continue medical treatment and other series of rescue measures. [Key words] blood perfusion; hemodialysis; pesticides, organophosphorus [in the ring CLC] R595.4 [Document code] B [Article ID] 1008-0341 (2004) 06-0532-01 [
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