血液置换抢救危重型急性有机磷中毒32例研究

A CLINICAL STUDY ON REPLACEMENT TRANSFUSION THERAPY ON AOPP IN CRISIS ANALYSIS OF 32 CASES

目的:研究分析血液置换对危重型AOPP抢救治疗的临床效果.方法:经洗胃后进行血液置换,①扩充血容量,分二路同时尽快输入0.9%生理盐水2000ml.②一次性静脉放血1200～1600ml,废弃.③输入同型新鲜血1200～1600ml.结果:血液置换组32例,治愈31例,占96.88%(31/32),死亡1例,占3.12%(1/32),对照组57例,治愈43例,占75.44%(43/57),死亡14例,占24.56%(14/57).从昏迷、抽搐、迟发性神经反应,胆碱脂酶活力增强等临床资料分析,两组间有显著性差异(P<0.01).结论:血液置换抢救危重型AOPP,危险性极小,能明显增加抢救成功率及减少病死率.

Aim: To study the effects of replacement transfusion therapy on AOPP in crisis. Methods: The following steps were carried out. (1) Expanding plasma volume by rapid infusion of 2,000ml of 0.9% saline. (2) 1,200～ 1,600ml of blood were diained from the patient's vein and discarded. (3) Transfusion of 1,200 - 1,600ml of identical blood simultaneously. Re-sults: In 32 cases so treated, 31 were cured with a cure rate of 96.88% . One case died with a death rate of 3.12% only. In the control group of 57 cases, 43 or 75.44% were cured and 14 cases or 35.56% died. Analysing deta on the state of cema, muscle twitching, delayed neurological reaction's and the ancount of activated cholinesterase etc. We found that the results showed significant differences ( P < 0.01 ) . Conclusion: Replacement transfusion therapy is safe to treat the AOPP in crisis. It significantly increases the care rate and decreases the mortality.