Okonek S, Hofmann A, Henningsen B
Arch Toxicol. 1976 Sep 15;36(1):43-51. doi: 10.1007/BF00277562.
Clinical and in vitro investigations were carried out to test the efficacy of gut lavage, hemodialysis, and hemoperfusion in the treatment of poisoning with paraquat or diquat. In a patient suffering from diquat intoxication 130 times more diquat was removed by gut lavage 30 h after ingestion than was removed by complete aspiration of the gastric contents. Determination of in vitro clearances for paraquat and diquat by hemodialysis showed that, at serum concentrations of 1-2 ppm, such as are frequently encountered in poisoning in man, toxicologically relevant quantities of herbicide cannot be removed from the body. At a concentration of 20 ppm, on the other hand, hemodialysis proved to be effective, the clearance being 70 ml/min at a blood flow rate of 100 ml/min. The efficacy of hemoperfusion with coated activated charcoal was on the whole better. Especially at concentrations around 1-2 ppm, the clearance values for hemoperfusion were some 5-7 times higher than those for hemodialysis. In a patient suffering from paraquat poisoning, both hemodialysis as well as hemoperfusion were carried out. The in vitro results could be confirmed: At serum concentrations of paraquats less than 1 ppm no clearance could be obtained by hemodialysis while by hemoperfusion with activated charcoal quite high clearance values were measured and the serum level dropped down to zero.
开展了临床和体外研究，以测试肠道灌洗、血液透析和血液灌流在治疗百草枯或敌草快中毒方面的疗效。在一名敌草快中毒患者中，摄入后30小时通过肠道灌洗清除的敌草快比完全抽吸胃内容物清除的敌草快多130倍。通过血液透析测定百草枯和敌草快的体外清除率表明，在人体中毒时经常遇到的1-2 ppm血清浓度下，无法从体内清除毒理学相关量的除草剂。另一方面，在浓度为20 ppm时，血液透析被证明是有效的，在血流速度为100 ml/min时清除率为70 ml/min。用包膜活性炭进行血液灌流的效果总体上更好。特别是在1-2 ppm左右的浓度下，血液灌流的清除率值比血液透析高约5-7倍。在一名百草枯中毒患者中，同时进行了血液透析和血液灌流。体外结果得到了证实：在百草枯血清浓度低于1 ppm时，血液透析无法获得清除率，而通过活性炭血液灌流测得的清除率值相当高，血清水平降至零。
