依达拉奉结合常规治疗在急性有机磷中毒合并呼吸衰竭中的应用

Edaravone combined with routine treatment for respiratory failure complicated with acute organophosphorus poisoning

目的探讨依达拉奉结合常规治疗在急性有机磷中毒合并呼吸衰竭中的应用价值。方法选取我院2013年2月至2016年2月收治的86例急性有机磷中毒合并呼吸衰竭患者作为研究对象,采取随机数字表将其分为2组,每组43例。两组患者均给予常规治疗,观察组在此基础上联合依达拉奉治疗,比较两组治疗效果。结果两组患者的血清胆碱酯酶活力随着治疗时间的延长而逐渐上升,观察组治疗48、72 h时的血清胆碱酯酶活力均高于对照组(P<0.01);两组患者治疗24、48、72 h时的氧化应激反应均较入院时减轻,且各项指标随着治疗时间的延长而逐渐改善,观察组治疗24、48、72 h的SOD、GSH均高于对照组(P<0.01),同时,MDA低于对照组(P<0.05);观察组机械通气时间、住院时间均较对照组缩短(P<0.01);观察组死亡率(11.63%)低于对照组(30.23%)(P<0.05)。结论常规治疗联合依达拉奉可有效缓解急性有机磷中毒合并呼吸衰竭患者机体内氧化应激反应,缩短机械通气时间与住院时间,提高抢救成功率。

Objective To explore the value of edaravone combined with routine treatment for acute organophosphorus poisoning complicated with respiratory failure.Methods Totally 86 cases of acute organophosphorus poisoning complicated with respiratory failure treated in our hospital from February 2013 to February 2016 were selected and divided into two groups using random number table,43 cases in each group.All the patients were given conventional treatment,and patients in observation group were also treated with edaravone.The treatment efficacy was compared between the two groups.Results The serum cholinesterase activity of patients increased gradually with the treatment time prolonged.The serum cholinesterase activities in observation group at 48 h and 72 h after treatment was higher than those of control group（P 〈0.01）.The oxidative stress reaction in the two groups was relieved significantly at 24 h,48 h and 72 h after treatment,and the indexes were improved gradually with the extension of treatment time.The levels of SOD and GSH at 24 h,48 h and 72 h after treatment in observation group were higher than those of control group（P〈 0.01）,while MDA was lower（P 〈0.05）.The mechanical ventilation time and length of stay in observation group were shorter than those of control group（P〈 0.01）.The mortality rate in observation group（11.63%） was lower than that of control group（30.23%）（P 〈0.05）.Conclusion Conventional therapy combined with edaravone can effectively alleviate the oxidative stress reaction in patients with acute organophosphorus poisoning complicated with respiratory failure,shorten the duration of mechanical ventilation and hospitalization time and improve the success rate of rescue.