血液净化治疗在急诊重度有机磷中毒患者抢救中的应用价值分析

Application value analysis of purification treatment in the rescue of patients with severe organophosphate poisoning in emergency department

目的分析血液净化治疗在急诊重度有机磷中毒患者抢救中的应用价值。方法收集宝鸡市陈仓医院自2015年6月至2016年7月收治的42例重度有机磷中毒患者,将其按照治疗方法分为治疗组(实施常规治疗的同时联合血液净化治疗)与对照组(实施常规治疗),对比两组患者相关临床指标,肝肾损伤、消化道出血、呼吸衰竭等发生率及抢救成功率。结果治疗组患者的阿托品用量、意识恢复时间、自主呼吸恢复时间及住院时间均优于对照组(P<0.05);治疗组患者的肾损伤发生率为9.52%,肝损伤为4.76%,呼吸衰竭为4.76%,分别低于对照组的42.86%、28.57%、28.57%(P<0.05);治疗组抢救成功率为95.24%,高于对照组的71.43%(P<0.05)。结论针对急诊重度有机磷中毒患者,对其采取血液净化治疗,可及时清除残留于体内的代谢废物及毒物,显著提高抢救成功率,加上并发症发生率少,安全性高,具有较高的临床推广价值。

Objective To analyze the application value of blood purification treatment in the rescue of patients with severe organophosphate poisoning in emergency department. Methods Forty-two cases of patients with severe organophosphate poisoning admitted in Chencang District Hospital of Baoji from June 2015 to July 2016 were selected, which were divided into treatment group （given conventional treatment combined with blood purification therapy） and control group （given conventional therapy） according to treatment methods, then the clinical indicators, liver and kidney damage, gastrointestinal bleeding, respiratory failure and other complications and success rate of rescue were compared between the two groups. Results The atropine dosage, consciousness recovery time, spontaneous breathing recovery time and hospital stay in the treatment group were significantly superior to those in the control group （P〈0.05）; in the treatment group, the incidence rate of renal injury was 9.52%, the incidence rate of hepatic injury was 4.76%, the incidence rate of respiratory failure was 4.76%, which were significantly lower than 42.86%, 28.57% and 28.57% in the control group （P〈0.05）; the rescue success rate was 95.24%, which was significantly higher than 71.43% in the control group （P〈0.05）. Conclusion For emergency patients with severe organophosphate poisoning, blood purification treatment can promptly remove metabolic wastes and poison in the body, significantly improve the success rate of rescue. It has less complications, with high safety, which has high clinical value.