早期血液灌流治疗急性重度有机磷农药中毒的临床分析

Analysis of Clinical Efficacy on Early-stage Hemoperfusion in Acute Severe Organophosphorus Pesticide Poisoning

目的：分析早期血液灌流治疗急性重度有机磷农药中毒的临床效果。方法选取2013年4月-2015年4月本院收治的ASOPP患者96例，分为血液灌流组（HP组）50例和常规治疗组（非HP组）46例，2组均给予常规治疗，HP组在常规治疗基础上给予HP治疗。观察比较各组临床治愈率、住院时间、昏迷时间、机械通气时间、长托宁、阿托品及氯磷定用量、治疗前及治疗12、24 h的CHE水平。结果与非HP组比较，HP组患者长托宁用量、阿托品用量及氯磷定用量减少，住院时间、昏迷时间及机械通气时间缩短，治愈率提高，差异有统计学意义（P＜0.05）。与组内治疗前比较，两组治疗后12 h和24 h后CHE均升高（P＜0.05）；且治疗后各时点HP组CHE均高于非HP组（P＜0.05）。结论早期HP治疗急性重度有机磷农药中毒可提高临床治愈率和抢救效果，减少药物用量，降低多器官损伤程度。

Objective To explore the clinical efficacy on early-stage hemoperfusion in acute severe organophosphorus pesticide poisoning.Methods A total of 96 patients to our hospital during April 2013 to April 2015,were randomly divided into the conventional therapy group（n=46）and hemoperfusion group（n=50）.In addition to gastric lavage,catharsis and other conventional treatment,patients in HPG were given HP. The cure rate,dosage of penehyclidine hydrochloride,atropineand pralidoxime chloride,duration of hospitalization,coma and mechanical ventilation,plasma cholinesterase activity before and after treatment of al patients were statisticaly analyzed.ResultsCompared with non HP group, HP group of penehyclidine hydrochloride dosage, dosage of atropine and pralidoxime chloride dosage, hospitalization time, coma time and mechanical ventilation time, improve the cure rate, the difference was statisticaly significant（P〈0.05）. Compared with before treatment, the two groups after treatment 12 h and 24 h CHE were significantly higher（P〈0.05）, and the CHE group at each time point after treatment were higher than non HP group （P〈0.05）. ConclusionHP is effective in improving the cure rate and rescue effect of ASOPP,reducing dosage of drugs,reducing the degree of multiple organ injury,has clinical value.