Nagler J, Braeckman R A, Willems J L, Verpooten G A, De Broe M E
J Appl Toxicol. 1981 Aug;1(4):199-201. doi: 10.1002/jat.2550010403.
We report on a patient treated with combined prolonged hemoperfusion (HP, Adsorba 300 C, Gambro, Sweden) and hemodialysis (HD, C-DAK 1.2, Cordis Dow, USA) for severe dimethoate poisoning. This procedure was adopted since the combination of dialysis and adsorption may improve overall drug removal. Combined HP-HD was performed during 24 h using the same charcoal column and dialyser. Adequate heparinization was obtained by monitoring the whole blood activated partial thromboplastin time. The patient (a 34-year-old female) ingested approximately 10 g of dimethoate (Teletox 10) in a suicide attempt, 30 min before admission to the hospital. On admission, serum level of dimethoate (analysed by gas chromatography) was 2340 ng ml-1. She received conventional treatment and combined HP-HD was started within 2 h after admission. At this time serum levels had risen to 3110 ng ml-1. However, they declined constantly during the epuration and after 18 h no more dimethoate could be detected in the serum. She was discharged 3 days after treatment. During the 24 h of HP-HD treatment, 110.8 mg dimethoate entered the epuration system via the plasma. 55.3 mg were extracted by the charcoal column and 25.3 mg by hemodialysis.
我们报告了一例严重乐果中毒患者接受延长的血液灌流（HP，瑞典金宝公司的Adsorba 300 C）联合血液透析（HD，美国科迪斯·陶氏公司的C-DAK 1.2）治疗的病例。采用该治疗方法是因为透析与吸附相结合可能会提高药物的整体清除率。使用同一根炭柱和透析器进行了24小时的血液灌流联合血液透析。通过监测全血活化部分凝血活酶时间来实现充分的肝素化。该患者（一名34岁女性）在入院前30分钟试图自杀，摄入了约10克乐果（敌百虫10）。入院时，乐果血清水平（通过气相色谱法分析）为2340纳克/毫升。她接受了常规治疗，并在入院后2小时内开始进行血液灌流联合血液透析。此时血清水平已升至3110纳克/毫升。然而，在净化过程中血清水平持续下降，18小时后血清中未再检测到乐果。治疗3天后她出院了。在24小时的血液灌流联合血液透析治疗期间，110.8毫克乐果通过血浆进入净化系统。炭柱提取了55.3毫克，血液透析提取了25.3毫克。
