Depmas双重血液净化的疗效观察

Curative effect observation of Depmas dual blood purification for severe acute organic phosphorus poisoning

目的 观察Depmas双重血液净化系统治疗急性重度有机磷农药中毒的临床疗效.方法 选取急性重度有机磷农药中毒患者147例,分为4组,常规治疗组只行药物治疗;血液灌流组在常规治疗基础上联用HA230树脂血液灌流器行血液灌流治疗;血液灌流联合血浆置换组在常规治疗基础上联用HA230树脂血液灌流器行血液灌流及百特血滤机行血浆置换治疗;Depmas组在常规治疗基础上通过百特血滤机进行血浆分离,再对分离的血浆串联HA230树脂血液灌流器及BS330血浆胆红素吸附器行血液灌流治疗.观察4组患者的存活率,死亡患者的平均存活时间,外周血中胆碱酯酶及胆红素浓度的变化.结果 血液灌流组、血液灌流联合血浆置换组及Depmas组较常规治疗组患者存活率升高,死亡患者的平均存活时间延长,外周血中的胆碱酯酶浓度升高、胆红素浓度降低,差异均具有统计学意义（P＜0.01）;血液灌流联合血浆置换组及Depmas组较血液灌流组患者存活率升高,死亡患者的平均存活时间延长,外周血中胆碱酯酶浓度升高、胆红素浓度降低,差异亦具有统计学意义（P＜0.05）;血液灌流联合血浆置换组与Depmas组患者存活率、死亡患者的平均存活时间、外周血中胆碱酯酶和胆红素浓度差异均无统计学意义（P＞0.05）.结论 Depmas双重血液净化系统治疗急性重度有机磷农药中毒疗效显著.

Objective To observe the clinical curative effect of Depmas double blood purification system for acute severe organophosphorus pesticide poisoning. Methods Retrospectively study was carried out on 147 patients of acute severe organophosphorus pesticide poisoning. Patients were divided into four groups, the conventional treatment group treated with drug therapy, hemoperfusion group given HA230 hemoperfusion in addition to conventional treatment, plasma exchange combined with hemoperfusion group given HA230 hemoperfusion and plasma exchange therapy in addition to conventional treatment, and Depmas group treated with plasma separation by Baxter blood filter and then given series HA230 and BS330 hemoperfusion treatment on the separated plasma in addition to conventional treatment. Survival rate, mean survival time of death patients, the concentration changes of cholinesterase and bilirubin in peripheral blood were observed. Results Compared to the conventional treatment group, survival rates of hemoperfusion group, hemoperfusion combined with plasma exchange group and Depmas group were higher, the mean survival time was longer, the cholinesterase concentration in peripheral blood was higher and the elevated bilirubin concentration was decreased with the differences statistically significant （P〈0.01）. Compared to hemoperfusion group, the survival rates of hemoperfusion combined with plasma exchange group and Depmas group were higher, the mean survival time was longer, the cholinesterase concentration in peripheral blood were higher and the elevated bilirubin concentration was decreased with the differences statistically significant （P〈0.05）. Besides, there were no significant differences between the survival rate, mean survival time, peripheral blood cholinesterase and bilirubin concentration of hemoperfusion combined with plasma exchange group and that of Depmas group （P〉0.05）. Conclusions Depmas dual blood purification system has remarkable curative effect for the treatment of acute severe organophosphorus poisoning.