Clinical Evaluation Of Poisonous Mushroom Poisoning With Different Blood Purification Therapy

Objective: Retrospective analysis of clinical data by the Second Hospital of DalianMedical University’s treated71cases of poisonous mushroom poisoning(PMP)patients,to evaluate the clinical efficacy of Hemodialysis(HD), Hemoperfusion(HP), PlasmaExchange(PE)therapy mushroom poisoning and provide more theoretical basis foroptimizing clinical treatment PMP.Method: Through retrospective analysis during the period from June1997toSeptember2013the Second Hospital of Dalian Medical University’s treated71cases ofPMP patients, which was damaged the existence of one system or more in71patients,including liver, kidney, blood coagulation, the nervous system. According to differenttreatments, they are divided into4groups: Routine therapy group(19cases), HDgroup(12cases), HP group(23cases), HP combined with PE(17cases). HD grouppatients’ occur only damage to the kidney, dynamic observation of the patients’ Scr,Urea and urine volume, comparison of different time in changing the patients’Scr, Ureaand urine volume cases. The other three groups patients with varying degrees of liver,blood clotting, nervous system damage, kidney damage-free, observed patients’admitted to the hospital AST, ALT, TB, PT-T, APTT of changes. To summarize relatedcomplications HD, HP, HP combined with PE occur during treatment of PMP causeddamage in different organs (nausea, vomiting, low blood press, allergies, blood clotting, muscle cramps) the frequency and incidence. All the data collected are conducted withthe SPSS19.0software program in analysis. Measurement data showed asmean±standard deviations, the data of each group was made analyzed and comparedthrough single factor analysis of variance, the illness change of a same patient atdifferent time point are using the maching t test sample.Count data was made analyzedwith X2test.Results:1. Amomg routine therapy group, HD group, HP group and HP combinedwith PE group, the age, sex, edible mushroom to first visit time have no statisticallysignificant differences(P＞0.05).2.71cases of PMP patients with toxic hepatitis in38cases,12cases of acture kidney injury, toxic hepatitis and disseminated intravascularcoagulation in10cases, toxic hepatitis and toxic encephalopathy7cases, toxic hepatitisand disseminated intravascular coagulation and toxic encephalopathy4cases.3.Routine therapy group patients with17cases of toxic hepatitis, hepatitis anddisseminated intravascular coagulation1case, toxic hepatitis and toxic encephalopathy1case,2deaths.12cases of HD group patients complicated with acute kidney injury,no death. HP group of patients with15cases of toxic hepatitis, toxic hepatitis and toxicencephalopathy3cases, toxic hepatitis and disseminated intravascular coagulation andtoxic encephalopathy two cases, death3cases.6cases of HP combined with PE groupcomplicated with toxic hepatitis, toxic hepatitis and toxic encephalopathy3cases, toxichepatitis and disseminated intravascular coagulation6cases toxic hepatitis anddisseminated intravascular coagulation and toxic encephalopathy2cases, no deaths.4.HD group patients after treatment, Scr and Urea decreased progressively and graduallyincreasing the amount of urine, statistically significant(p<0.05).5. Dynamic observationand treatment seven days, HP combined with PE group of AST and ALT degreedecreased significantly better than conventional treatment group and HP group, HPgroup of AST and ALT degree of decline than the conventional treatment group, HPcombined with PE group of TB degree decreased significantly compared with HP, HPcombined PE treatment to correct the patient’s PT-T, APTT prolonged treatmentmarkedly faster than HP,(P <0.05), statistically significant above.6. In the course of treatment may be a certain degree of complications, using HD, HP, HP combined withPE.Conclusion: Hemodialysis for the recovery of renal function caused by PMPpatients with acute kidney injury. HP combined with PE treatment is better thanconventional HP therapy and drug therapy in improving aspects of PMP patients liverfunction, and in the early correction of abnormal coagulation function in patients withabnormal blood coagulation function, to correct a simple hemoperfusion treatmentsignificantly.