血液灌流联合微量泵持续静脉泵入阿托品抢救重度有机磷农药中毒50例临床观察

Clinical observation on 50 cases of acute fatal organophosphorus pesticide poisoning treated with blood perfusion combined with continuous venous administration of atropine

目的:探讨床旁血液灌注(HP)联合微量泵持续静脉泵入阿托品抢救急性重度有机磷农药中毒(AOPP)的临床效果。方法:将急诊入院的急性重度有机磷农药中毒患者96例随机分为观察组50例和对照组46例,对照组给予常规治疗,观察组在常规治疗基础上采用HP联合微量泵持续静脉泵入阿托品,比较两组治疗效果。结果:观察组治疗至清醒时间、平均住院时间明显少于对照组,两组比较有极显著性差异(P<0.01);观察组病死率低于对照组,两组比较有显著性差异(P<0.05);观察组胆碱酯酶恢复时间、症状消失时间、阿托品用量明显少于对照组,两组比较有极显著性差异(P<0.01);观察组呼吸衰竭、中间综合征的发生少于对照组,两组比较有极显著性差异(P<0.01)。结论:HP联合微量泵持续静脉泵入阿托品抢救AOPP患者,疗效确切,可以明显提高治愈率,降低病死率,减少患者的住院天数,减低住院费用,并可以减轻护士的工作量。

Objective ： To explore the effect of bed - side hemofihration blood perfusion on the emergency treatment of acute fatal organophosphorus pesticide poisoning. Methods： Ninety six patients admitted to emergency department were randomly divided into observation group （ n = 50 ） and control group （ n = 46）. The patients in control group were given routine treatment and the patients in observation group were additionally given blood perfusion combined with continuous venous administration of atropine, comparing the curative effect between the two groups. Results ： The duration from the treatment to patient＇ s regaining consciousness and average time of hospitalization were shorter in observation group than that in control group （ P 〈0. 01 ） ; the fatality rate was lower in observation group than that in control group （ P 〈0.05 ） ; instauration time of cholinesterase, symptom disappearing time and the dosage of atropine were shorter and less in observation group than that in control group （ P 〈0. 01 ） ; respiratory failure and complications were also less in observation group than that in control group （ P 〈 0. 01 ）. Conclusion： The effect of blood perfusion combined with continuous venous administration of atropine is exact in the treatment of acute fatal organophosphorus pesticide poisoning, which can obviously increase curative rate, decrease death rate as well as shorten the days of hospitalization, reduce patient＇ s expenses and workload of nurses.