服毒-血液灌流时间对AOPP患者预后的影响

目的探讨服毒．血液灌流（HP）时间对急性重度有机磷农药中毒患者预后的影响。方法回顾性分析2012年1月至2015年6月66例经口气管插管的急性重度有机磷中毒患者的临床资料，按照患者服毒．血液灌流时间分为两组，服毒．血液灌流时间〈4h为早期灌流组；4h≤服毒．血液灌流时间〈12h为晚期灌流组；比较各组患者的临床治疗效果、胆碱酯酶恢复活性、靶器官损伤程度，分析服毒-血液灌流时间对患者预后的影响。结果早期行血液灌流治疗能减少呼吸机通气时间和住院天数，明显提升血胆碱酯酶活力，减轻靶器官损伤程度，降低病死率。结论口服有机磷农药中毒后〈4h进行血液灌流早期能够明显提升血胆碱酯酶活力，减轻靶器官损伤程度，有效降低患者病死率。

Objective To explore the influence of the length of time elapsed from ingestion of organophosphorus pesticide to hemopefusion on prognosis in patients with acute organophosphorus pesticide poisoning. Methods The investigation was carried out with retrospective analysis.A total of 66 patients with acute organophosphorus pesticide poisoning were admitted to the Emergency Intensive Care Unit （ EICU ） of the Huzhou central hospital in Zhejiang Province from January 2012 to June 2012.According to the length of time from ingestion tohemoperfusion, patients were divided into earlier hemoperfusion groups and later hemoperfusion groups.Earlier hemoperfusion groups： the time length from ingestion to hemoperfusion〈4 h, later hemoperfusion groups： 4h〈the time length from ingestion to hemoperfusion〈 12h.Compared the exent of target organ injury, mortality, length of EICU day and mechanical ventilation time among two groups for determining the influence of the length of time elapsed from ingestion to hemoperfusion on the prognosis of patients. Result The earlier hemoperfusion groups could significantly decrease the length of EICU day and mechanical ventilation time, increase the cholinesrerase level, attenuate the degree of target organ injury and reduce the mortality. Conclusion Employment of hemoperfusion in 4 hours after ingestion can increase the cholinesrerase level, attenuate the degree of target organ injury and reduce mortality of patients with acute acute organophosphorus pesticide poisoning.