血液灌流联合血液透析治疗急诊重症有机磷农药中毒对疗效及预后的影响分析

Effect of hemoperfusion combined with hemodialysis on the efficacy and prognosis of severe organophosphorus pesticide poisoning in emergency

目的探讨血液灌流联合血液透析治疗急诊重症有机磷农药中毒对疗效及预后的影响分析。方法将2011年4月~2017年4月在我院急诊科治疗的40例重症有机磷农药中毒患者随机分为两组,对照组采用常规抢救方法,观察组在此基础上采用血液灌流联合血液透析治疗,比较两组患者的救治效果、症状改善时间、并发症发生率、血生化指标变化。结果观察组救治成功率为95.00%,明显高于对照组的75.00%,两组间有统计学差异(P<0.05);观察组治疗后意识恢复时间、胆碱酯酶恢复时间、阿托品用量、住院时间明显少于对照组,两组间有统计学差异(P<0.05);观察组中间综合征、迟发性神经损害、中毒性肝损害、反跳等并发症发生率明显低于对照组,两组间有统计学差异(P<0.05);观察组治疗后ALT、AST、CK、CKMB、LDH、CHE明显较对照组改善,两组间有统计学差异(P<0.05)。结论血液灌流联合血液透析治疗急诊重症有机磷农药中毒有良好效果,能有效改善症状,提高救治成功率,减少并发症的发生,具有积极的临床意义。

[Abatract] Objective To explore the effect of hemoperfusion combined with hemodialysis on the efficacy and prognosis of severe organophosphorus pesticide poisoning in emergency. Methods 40 cases of severe organophosphorus pesticide poisoning were treated in emergency department of our hospital from April 2011 to April 2017were randomly divided into two groups. Patients in control group were treated with routine rescue method, and patients in observation group were treated with hemoperfusion combined with hemodialysis treatment on the basis of control group. The treatment effect, symptom improvement time, complication rate and blood biochemical indexes were compared between two groups. Results The successful rate of the observation group was 95.00%, which was obviously higher than that of the control group （75.00%）, and there was statistical difference between the two groups （P ~ 0.05）. The consciousness recovery time, cholinesterase recovery time, atropine dosage and hospitalization time of the observation group were significantly less than those of the control group, the difference between the two groups was statistically significant （P 〈 0.05）. After treatment ALT, AST, CK, CK-MB, LDH, CHE in observation group were significantly improved, compared with the control group, the difference between the two groups （P 〈 0.05）. Conclusion Hemoperfusion combined with hemodialysis in the treatment of severe organophosphorus pesticide poisoning in emergency has good effect. It can effectively improve symptoms, improve the success rate of treatment and reduce complications. It has positive clinical significance. [Key words] Severe organophosphorus pesticide poisoning; Hemoperfusion; Hemodialysis; Efficacy and prognosis