血浆置换与血液灌流联合治疗急性重度有机磷农药中毒的疗效观察

The clinical effect of plasma exchange combined with hemoperfusion in the treatment of acute severe organophosphorus pesticide poisoning

目的探讨血浆置换与血液灌流联合治疗急性重度有机磷农药中毒的临床疗效。方法对急诊科2005年1月至2010年12月急性重度有机磷中毒患者病历回顾性分析,将急性重度有机磷中毒患者分为两组:治疗组(血浆置换与血液灌流治疗)76例,对照组(常规治疗)70例,治疗组在对照组基础上,加用血浆置换和血液灌流联合治疗急性重度有机磷农药中毒。结果治疗组比较对照组氯解磷定及阿托品的用量减少;胆碱酯酶活力恢复的时间、平均住院时间、昏迷时间明显缩短,阿托品中毒的发生率、急性有机磷农药中毒反跳率、中间综合症的发生率和死亡率也明显降低,平均存活时间延长(P<O.05)。结论血浆置换与血液灌流联合治疗能明显提高急性重度有机磷中毒的疗效。

Objective： To explore the clinical effect of plasma exchange combined with hemoperfusion in the treatment of acute severe organophosphorus pesticide poisoning.Methods： The data of acute severe organophosphorus pesticide poisoning cases from January 2005 to December 2010 in our Emergency Department were retrospectively reviewed,and the patients with acute severe organophosphorus pesticide poisoning were divided into two groups： 76 cases in the treatment group（plasma exchange combined with hemoperfusion） and 70 cases in the control group（conventional medical treatment）.Results： Pyraloxime methylchloride and atropine dosage significantly reduced in the treatment group than those in the control group;In the treatment group,the cholinesterase resuming,average hospitalization time and the time of patients regaining consciousness were significantly shortened,atropine poisoning incidence,acute severe organophosphorus pesticide poisoning slabs rate,morbidity and mortality among syndrome were reduced significantly,and average living time was prolonged（P 0.05）.Conclusion： Hemoperfusion combined with plasma exchange in the treatment of acute severe organophosphorus pesticide poisoning have significantly curative effect.