透析治療於急性巴拉刈中毒的應用與照護

Effectiveness and Nursing Care of Acute Paraquat Poisoning Treated with Dialysis

自巴拉刈上市以來，世界各國分傳出巴拉刈誤食及自殺的案例，直到目前為止，巴拉刈中毒仍高居農藥中毒死亡的第一位，探究臨床上這類病患中毒的原因以自殺者居多，誤食者少，且中毒後身體器官會出現進行性損傷及病變，使病患出現嚴重的器官衰竭，導致死亡率居高不下。臨床上對這類病患尚無有效的治療方法，只能在中毒早期利用血液灌洗(hemoperfusion，HP)、血液透析(hemodialysis，HD)及強迫利尿法，盡量降低毒物在體內的吸收及加速排出，以降低死亡率。期望透過文獻查證和統整，幫助護理人員在照顧這類病患時，能更清楚因中毒所引發病理生理變化及透析治療於急性巴拉刈中毒的應用，並針對此類病患不適症狀提供更適切的護理照顧，發揮護理的獨特功能。

Accidental or deliberate ingestion of paraquat has been reported worldwide. Paraquat intoxication is the leading cause of death from pesticides, and most cases are suicides. Poison from this agent results in progressive and irreversible pulmonary fibrosis, which leads to severe organ failure and a high mortality rate. So far there are no effective treatments except for supportive care, dialysis and forced diuresis by lowering the absorption to increase the elimination rate. By means of literature review, we look forward to assisting the nursing staff in understanding the actual pathophysiology for paraquat-induced illness. This project will allow us to provide better and more suitable nursing for these patients