血液灌流治疗重度有机磷中毒的临床研究

Analysis on therapeutic effects of hemoperfusion to acute severe organophosphorous pesticides poisoning

目的探讨血液灌流抢救急性重度有机磷中毒的临床效果。方法1997年1月～2010年12月收治急性重度有机磷中毒87例，其中在常规治疗基础上行血液灌流治疗的47例作为治疗组，仅给予常规治疗的40例作为对照组，比较两组的临床疗效，用气相色谱法、氮磷检测器测定治疗组中12例患者血液灌流治疗不同时间点的血清敌敌畏浓度，计算血液灌流对敌敌畏的清除率。结果血液灌流2h血清敌敌畏浓度从（6．91±3．48）μg／dl降至（2．81±2．08）μg／dl（P〈0．01），清除率为（82．07±15．18）ml／min；急性重度有机磷中毒的抢救成功率治疗组为91．49％，对照组为62．50％（P〈0．05）。结论血液灌流可提高急性重度有机磷中毒患者的抢救成功率。

Objective To investigate the therapeutic effects of hemoperfusion in the emergency treatment of acute severe organophosphorous pesticides poisoning （ASOPP）. Methods 87 patients with ASOPP admitted between January, 1997 and December, 2011 in PuTuo People＇s Hospital were divided into two groups： the treatment group （n=47） treated with hemoperfusion in addition to conventional treatment, and the control Group （n=40） treated only with the conventional, and the comparison was made on clinical effects between the two groups. The gas ehrommography and the nitrogen phosphorus detector were adopted in testing 12 patients in the treatment groups at different time points to determinate their respective blood serum concentrations of dichlorvos, and calculate the clearance ratio of hemoperfusion to dichlorvos. Results 2 hours after hemoperfusion procedure started the dichlorvos level was decreased from （6.91±3.48） to （2.81±2.08）bg/dl （P 〈0.01） and the clearance was （Z2.07±15.18）ml/min. The rescuing rate of ASOPP in treatment group （91.49%） was significantly higher than in the control group （62.50%） （P〈0.05）. Conclusion The hemoperfusion may improve therapeutic effect of ASOPP.