ISSN 1006-298X      CN 32-1425/R

Chinese Journal of Nephrology, Dialysis & Transplantation ›› 2025, Vol. 34 ›› Issue (2): 133-137.DOI: 10.3969/j.issn.1006-298X.2025.02.006

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Blood perfusion combined with continuous veno-venous hemodialysis filtration at the bedside improves prognosis in patients with diguat poisoning

  

  • Online:2025-04-28 Published:2025-05-07

Abstract: Objective:To explore the impact of blood perfusion combined with continuous veno-venous hemodialysis filtration (CVVHDF) on the prognosis of patients with diquat poisoning.
Methodology:A retrospective analysis was conducted on 70 patients with diquat poisoning who were diagnosed and treated in our hospital from February 2020 to March 2024. According to different treatment methods, they were divided into a study group (n=35) and a control group (n=35). The control group was given hemoperfusion treatment (2 hours each time, with an interval of 8 hours, a total of 5 times within 48 hours, and a blood flow rate of 150-200 mL/min). The study group received CVVHDF on the basis of hemoperfusion, which lasted continuously for 48 hours. The dialysate volume was 2 000 mL/h, and the replacement fluid volume was 1 000-2 000 mL/h. The electrocardiogram and echocardiogram results of the two groups of patients were recorded. The serum diquat concentration, myocardial injury markers, liver and kidney function indexes, and inflammatory factor levels were monitored. The changes in the state of consciousness were observed, and the treatment effect was evaluated.
Results:After treatment, the serum diquat concentrations in both groups were significantly decreased (P<0.001), and the study group was lower than the control group (P<0.001). After 48 hours of treatment, the serum concentrations of creatine kinase (CK), lactate dehydrogenase (LDH), creatinine (SCr), and blood urea nitrogen (BUN) in both groups were significantly decreased (P<0.001), and the post-treatment serum levels of the above-mentioned indicators in the study group were significantly lower than those in the control group (P<0.01). After treatment, the serum levels of interleukin-6 (IL-6) and tumor necrosis factor-α (TNF-α) in both groups were significantly lower than those before treatment (P<0.001), and the post-treatment levels in the study group were significantly lower than those in the control group (P<0.01). During the 28-day follow-up, 3 cases and 10 cases died in the study group and the control group respectively (8.57% vs 28.57%, P<0.05).
Conclusion:Hemoperfusion combined with CVVHDF can effectively adsorb and remove toxins, rapidly reduce the serum diquat concentration, improve myocardial enzyme and renal function, inhibit inflammatory factors, and reduce the mortality of patients with diquat poisoning.


Key words: blood perfusion, continuous veno-venous hemodialysis filtration, diquat, heart function, inflammatory factors, mortality rate