解磷定联用血液灌流治疗急性有机磷中毒的效果与安全性观察

Investigation on the effect and safety of pralidoxime combined with blood perfusion in the treatment of acute organophosphorus pesticide poisoning

目的探讨解磷定联用血液灌流治疗急性有机磷中毒的效果与安全性。方法收取2017年5月~2018年11月筛选并收集本院急诊收治有机磷农药中毒患者80例,随机分为对照组和研究组,各40例。研究组采用解磷定联合血液灌流的治疗方法,对照采用传统的治疗方法。对比分析两组患者的救治效果和预后。结果研究组患者解磷定用量和昏迷时间均优于实行传统救治方法患者(P<0.05);研究组救治率远高于对照组,死亡率低于对照组(P<0.05);研究组并发症发生情况明显少于对照组患者(P<0.05),且反跳和中间综合征情况发生情况较少,发生率分别为5.0%和2.5%;治疗后,两组患者血浆胆碱酯酶活力均有提高,但研究组提高程度更大,酶活力更强(P<0.05)。结论解磷定联合血液灌流的治疗方式不仅能够显著提高对患者的治愈率,而且能减少治疗后并发症发生率和提高血浆胆碱酯酶活力恢复情况,对临床治疗急性有机磷农药中毒有重要意义。

Objective To investigate the effect and safety of pralidoxime combined with blood perfusion in the treatment of acute organophosphorus pesticide poisoning. Methods A total of 80 patients with organophosphorus pesticide poisoning who were admitted to the department of emergency in the hospital from May 2017 to November 2018 were screened and collected, and they were randomly divided into the control group and the study group, with 40 patients in each group. The study group was given the treatment method of pralidoxime combined with blood perfusion. The control group was given traditional treatment method. The curative effect and prognosis of the two groups were compared and analyzed. Results The amount of pralidoxime and duration of coma in the patients in the study group were better than those in the patients receiving traditional treatment method (P<0.05);the cure rate in the study group was much higher than that in the control group, and the mortality rate was lower than that in the control group(P<0.05);the incidence of complications was lower in the study group than that in the control group(P<0.05), and the occurrence of rebound and intermediate syndrome was fewer, with the incidence rate of 5.0% and 2.5%, respectively;after treatment, the plasma cholinesterase activity of both groups was increased. However, the increase in the study group was more and the enzyme activity was stronger (P<0.05). Conclusion The treatment method of pralidoxime combined with blood perfusion can not only significantly improve the cure rate of patients, it also reduces the incidence rate of post-treatment complications and improves the recovery of plasma cholinesterase activity, which is of great significance in the clinical treatment of acute organophosphorus pesticide poisoning.