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在不使用甲吡唑的情况下,急性甲醇中毒时常规血液透析启动指南是否应修订?

Should Guidelines for Conventional Hemodialysis Initiation in Acute Methanol Poisoning, Be Revised, When no Fomepizloe is Used?

作者信息

Hekmat Reza, Samini Fariboorz, Dadpour Bita, Maghsudloo Faezeh, Mojahedi Mohammad Javad

机构信息

Department of Nephrology, Ghaem Hospital, Mashhad, Iran.

出版信息

Iran Red Crescent Med J. 2012 Nov;14(11):743-5. doi: 10.5812/ircmj.3467. Epub 2012 Nov 15.

Abstract

BACKGROUND

Consumption of home-distilled alcohol may lead to epidemic or sporadic cases of severe acute methanol poisoning. The difficulty of establishing strict indications for hemodialysis in acute methanol poisoning is a widely recognized issue.

MATERIALS AND METHODS

The determination of the clinical, especially hemodialysis, and para clinical factors influencing patient survival in 46 acutely methanol poisoned patients was the aim of this cross sectional retrospective study. Clinical and paraclinical variables compared in surviving and non-surviving patients were hemodialysis and ventilation requirements, the level of consciousness, ABG parameters the serum methanol, creatinine and BUN levels. Only ethanol was used for ADH (Alcohol Dehydrogenize) blockade.

RESULTS

Receiver operative curve characteristics showed that a serum methanol threshold level of 15mg/dl, instead of 25mg/dl, has a better sensitivity and rather the same specificity for predicting patient mortality.

CONCLUSIONS

With no fomepizloe and using conventional hemodialysis, lowering the threshold of methanol concentration for hemodialysis initiation, may save lives in acute methanol intoxication.

摘要

背景

饮用自酿酒可能导致严重急性甲醇中毒的流行或散发病例。在急性甲醇中毒中确定血液透析的严格指征存在困难,这是一个广为人知的问题。

材料与方法

本横断面回顾性研究旨在确定46例急性甲醇中毒患者中影响患者生存的临床因素,尤其是血液透析和辅助临床因素。在存活和非存活患者中比较的临床和辅助临床变量包括血液透析和通气需求、意识水平、动脉血气参数、血清甲醇、肌酐和尿素氮水平。仅使用乙醇进行乙醇脱氢酶阻断。

结果

受试者工作曲线特征显示,血清甲醇阈值水平为15mg/dl而非25mg/dl时,对预测患者死亡率具有更好的敏感性且特异性相当。

结论

在没有甲吡唑且使用传统血液透析的情况下,降低启动血液透析的甲醇浓度阈值可能挽救急性甲醇中毒患者的生命。

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