[Treatment of 4 cases of acute organic tin poisoning with blood perfusion combined with continuous veno-venous hemodialysis filtration and sodium dimercaptopropanesulfonate].

Objective: To investigate the clinical efficacy of combined hemoperfusion (HP) and continuous veno-venous hemodialysis filtration (CVVHDF) in tandem therapy together with sodium dimercaptopropanesulfonate (DMPS) for patients with acute organotin poisoning, and to analyze the effects of this combined regimen on clinical symptoms, serum tin levels, urinary tin levels, and serum potassium levels. Methods: In December 2023, the clinical data of four patients with acute organotin poisoning were retrospectively analyzed. All patients received comprehensive symptomatic supportive therapy, DMPS-based tin removal therapy, and HP+CVVHDF tandem blood purification therapy. Changes in clinical symptoms, serum tin levels, urinary tin levels, and serum potassium levels were compared before and after treatment. Results: Prior to treatment, the serum tin levels of the four patients ranged from 192.8 to 366.5 μg/L, and urinary tin levels ranged from 1203.1 to 2419.2 μg/L; all patients exhibited hypokalemia with serum potassium levels ranging from 2.60 to 2.90 mmol/L. After combined therapy, serum tin levels decreased to 1.0-4.2 μg/L, urinary tin levels decreased to 4.1-16.0 μg/L, and serum potassium levels recovered to 3.9-4.1 mmol/L, with electrolyte disturbances corrected. Neurological symptoms such as coma, convulsions, and psychiatric abnormalities, as well as metabolic acidosis, significantly improved or resolved completely within 3-20 days after treatment, and all four patients recovered and were discharged. Conclusion: The combined HP+CVVHDF tandem blood purification therapy with DMPS and comprehensive symptomatic supportive therapy effectively eliminates organotin from the body, corrects electrolyte and acid-base imbalances, and alleviates neurological symptoms, demonstrating clinical applicability.