Objective To evaluate the clinical effect difference between blood purification combined with medical conventional treatment and simple drug treatment for group attack of severe mushroom poisoning patients. Methods Compared with blood puriifcation treatment (including molecular adsorption recirculation system, plasma exchange, hemodialysis, hemofiltration, hemoperfusion and other technology) joint with conventional medical treatment and simple drug medical treatment on 64 severe mushroom poisoning patients. Clinical manifestations, laboratory examination, treatment effect and prognosis were retrospecively analyze. Results Severe mushroom poisoning patients often have liver, kidney, respiration, circulation, nerve system, enteron, clotting etc multiple organ dysfunction. Acute physiology and chronic health evaluation (APACHEⅡ score) showed, with the score increases, the mortality increasing. Total of 40 patients on the basis of conventional treatment combined with blood puriifcation, cured 30 cases, the cure rate is 75%, while 24 patients with simple drug treatment, cured 6 cases, the cure rate is only 25%. Combined treatment group was obviously higher than that of pure drug therapy group (P<0.01). After blood puriifcation, ALT, AST, TBil, DBil, GLB, Bun, HBDH, PT levels were signiifcantly reduced than before blood puriifcation (all P<0.05), while ALB, TD, Cr, CK, CKMB have fallen, but no signiifcantl difference (all P>0.05). Conclusions Severe mushroom poisoning patients with the more viscera damage, the more mortality increased. Blood puriifcation treatment for these patients have deifnite therapy effect to the beneift of remove toxins, reduce toxins absorption, relieve liver and kidney damage, improve coagulation function to make for patients through crisis. According to the state of illness, early blood puriifcation treatment can obvious improve prognosis, improve the survival rate, reduce mortality.%目的：评价群发性重症毒蕈中毒患者血液净化联合内科常规治疗与单纯药物治疗的疗效比较。方法比较采用血液净化（包括分子吸附再循环系统、血浆置换、血液透析、血液滤过、血液灌流等技术）联合内科常规治疗与单纯药物治疗对64例重症毒蕈中毒患者的临床表现、实验室检查、治疗效果及预后进行回顾性分析。结果毒蕈中毒常有肝、肾、呼吸、循环、神经系统、消化道、凝血等多脏器、多系统损害，急性生理学及慢性健康状况评分系统显示（APACHE Ⅱ评分），随分值增加，病死率递增。40例联合治疗组在内科常规治疗的基础上加用血液净化，治愈率为75%（30/40）；24例药物治疗组给予单纯药物治疗，治愈率仅为25%（6/24），联合治疗组治愈率明显高于药物治疗组（P =0.000）。两组患者治疗后血液ALT、AST、TBil、DBil、GLB、Bun、HBDH、PT较治疗前有明显改善（P均＜0.05），而治疗后ALB、TD、Cr、CK、CKMB等指标虽有下降，但差异无统计学意义（P均＞0.05）。结论重症毒蕈中毒患者随脏器损害增多，病死率递增，血液净化治疗对抢救重症毒蕈中毒有肯定的疗效，能较好的清除毒蕈毒素，减少毒素吸收，减轻肝、肾功能损害，改善凝血功能，帮助患者度过危险期，根据病情需要及早行血液净化治疗能明显改善预后，提高生存率，降低病死率。
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