血液灌流治疗有机磷中毒的临床研究

Hemoperfusion clinical study of organophosphate poisoning

目的:探讨血液灌流治疗急性有机磷农药中毒的临床疗效。方法:75例有机磷农药中毒患者,按入院后接受血液灌流(HP)或未接受血液灌流分为灌注组(HP组)38例和非灌注组(非HP组)37例,中毒患者送入本院后均按常规给予洗胃,及阿托品、解磷定治疗和对症支持治疗,HP组加用血液灌流治疗,观察两组患者治愈率、阿托品用量、意识恢复情况、胆碱酯酶活力和中间综合征(IMS)发生率情况。结果:HP组38例全部治愈,发生IMS1例。对照组37例治愈32例,治愈率为86.5%,其中5例死于呼吸衰竭,其中发生中间综合征5例。两组间意识恢复时间、阿托品所需总量、胆碱酯酶恢复时间比较,差异有统计学意义(P<0.05)。结论:血液灌流治疗急性有机磷农药中毒的临床疗效显著,可促进患者的意识恢复、减少阿托品的总用量、提高治愈率,值得临床推广应用。

Objective：To evaluate the blood perfusion treatment of acute organophosphorus pesticide poisoning clinical efficacy.Methods：75 patients with organophosphate poisoning patients,by admission,blood perfusion（HP） or a blood perfusion into perfusion group（HP group） 38 cases and non-perfusion group（non-HP group） 37 cases of poisoning patients admitted according to our hospital routinely given after gastric lavage and atropine,pralidoxime treatment and symptomatic and supportive treatment,HP group were treated with hemoperfusion,the cure rate were observed,the dosage of atropine,recovery of consciousness,choline esterase activity and the incidence of intermediate syndrome cases.Results：HP group,38 patients were cured,the occurrence of IMS total of 1 case.The control group of 37 patients and 32 cases were cured,the cure rate was 86.5%,of which 5 patients died of respiratory failure.Occurrence of intermediate syndrome in which 5 cases.Consciousness recovery time between the two groups,the total required atropine and cholinesterase recovery time,the difference was statistically significant（P0.05）.Conclusion：Hemoperfusion treatment of acute organophosphorus pesticide poisoning and the clinical effect is significant,can promote patient awareness of recovery and reduce the total amount of atropine to improve the cure rate,is worthy of clinical application.