生大黄联合序贯性血液净化治疗重度有机磷农药中毒的临床观察

The observations o f curative efficacy of Rhubard combined with blood purification on treatment patients with severe acute organophosphorus pesticide poisoning

目的观察生大黄、蒙脱石散联合序贯性血液净化治疗对最发急性有机磷农药中毒（AOPP）的临床疗效。方法21例用生大黄、蒙脱石散联合序贯性血液净化治疗的患肯为联合治疗组，18例同期收治的冈经济闲难或家属意愿等原因仅行常规治疗的患者为常规治疗组，均为口服中毒。常规治疗组给予常规治疗，联合治疗组存常规治疗的基础上给予胃管内灌入生大黄、蒙脱打散，同时进行序贯性血液净化治疗。结果与常规治疗组昏迷至清醒时间[（8．4±2．4）d]机械通气时间[（10．7±2．9）d]，

Objective To observe the curative efficacy of rhubard, montmorillonite powder combined with blood purification on treatment for patients with severe acute organophosphorus pesticide poisoning（AOPP）. Methods 39 patients with AOPP were divided into treatment group （received the combined treatment of rhubard, montmorillonite powder and blood purification on the basis of routine therapy, n--21） and control group （only received the routine treatment because of financial difficulties or the will of family members, n=18）. The differences of clinical manifestations, curative effects and prognosis between two groups were compared. Results The time of consciousness recovery, the duration of mechanical ventilation and the length of stay in hospital in treatment group were （6.5±1.3）, （7.9±2.0） and （13.1±3.2） days,which were significantly shorter than those [（8.4±2.4）,（10.7±2.9）and （16.5±3.7） days] of control group （P〈0.05）.I n 5, 6 and 7 day after treatment,the cholinesterase （ChE） activities of treatment group were significantly higher than those of control group （P〈0.05）. The total amount and using time of atropine and pyraloxime methylchloride in treatment group were significantly smaller and shorter than those in control group （P〈0.05） .The death rate of treatment group was [19.0% （4/21 ）], which were significantly lower than that of control group [19.0%（4/21 ）] （P〈0.05）. Conclusion The combined treatment of rhubard, montmorillonite powder and blood purification of the AOPP patients has a better curative effect.