血液灌流联合盐酸戊乙奎醚对急性重度有机磷农药中毒患者氧化应激水平影响

Effect of Hemoperfusion Combined With Penehyclidine Hydrochloride on Oxidative Stress in Patients With Severe Acute Organophosphorus Pesticide Poisoning

目的观察血液灌流联合盐酸戊乙奎醚对急性重度有机磷农药中毒患者氧化应激影响。方法选取60例急性重度有机磷农药中毒患者。按随机数表法分为血液灌流组和联合组,各30例。血液灌流组接受血流灌流治疗,而联合组在此基础上联合盐酸戊乙奎醚治疗。治疗后观察患者治疗效果、胆碱酯酶活性变化、应激指标(SOD、LDH)变化情况。结果联合组治愈率高于血液灌流组,昏迷时间、阿托品、解磷定总量、住院时间低于血液灌流组,差异均具有统计学意义(P<0.05)。治疗后联合组胆碱酯酶活性高于血液灌流组(P<0.05),胆碱酯酶活性恢复正常时间短于血液灌流组(P<0.05)。治疗前两组SOD、LDH差异均无统计学意义(P>0.05),治疗后联合组LDH均低于血液灌流组(P<0.05),SOD高于血液灌流组(P<0.05)。两组治疗期间肾损伤、中间综合征、消化道出血、肝损伤、呼吸衰竭等发生率差异无统计学意义(P>0.05)。结论血液灌流联合盐酸戊乙奎醚治疗急性重度有机磷农药中毒效果显著提高,且可改善应激指标,安全性高。

Objective To observe the effects of hemoperfusion combined with penehyclidine hydrochloride on oxidative stress in patients with severe acute organophosphorus pesticide poisoning.Methods A total of 60 patients with severe acute organophosphorus pesticide poisoning were selected.According to the random number table method,they were divided into hemoperfusion group and combined group,30 cases each.The hemoperfusion group received blood perfusion treatment,while the combination group was treated with penehyclidine hydrochloride on this basis.After treatment,the treatment effect,changes of cholinesterase,changes of stress indicators(SOD,LDH)were observed.Results The cure rate of the combined group was higher than that of the hemoperfusion group,and,the coma time,the total amount of clodidine,atropine,and the length of hospital stay were lower than the hemoperfusion group,the differences were statistically significant(P<0.05).After treatment,the cholinesterase activity in the combination group was higher than that in the hemoperfusion group(P<0.05),and the cholinesterase activity returned to normal time was shorter than the hemoperfusion group(P<0.05).There were no significant differences in SOD,and LDH in the two groups before treatment(all P>0.05).After treatment,the LDH in the combination group were all not significant.After treatment,and LDH in the combination group were lower than those in the hemoperfusion group(all P<0.05),and SOD was higher than those in the hemoperfusion group(P<0.05).Conclusion Hemoperfusion combined with penehyclidine hydrochloride in the treatment of severe acute organophosphorus pesticide poisoning has a significantly improved effect,and can improve the level of stress indicators with high safety.