集成血液净化治疗在急性重度有机磷农药中毒并发MODS的疗效分析

Clinical efficacy of sequential blood purification for acute severe organophosphorus pesticide poisoning complicated with multi-organ dysfunction syndrome

目的探索集成血液净化治疗在急性重度有机磷农药中毒并发MODS的疗效,以提高急性重度有机磷农药中毒的治疗水平。方法收集5例急性重度有机磷农药中毒并发MODS行集成血液净化治疗的病例资料,分析血液净化治疗前后实验室结果、急性生理与慢性健康评估Ⅱ(APACHEⅡ)评分、MODS评分的变化。结果所有患者均及时予集成血液净化治疗,治疗24 h后低氧合指数与高肺泡动脉氧分压差均比治疗前改善(P均<0.05)。血液净化治疗结束后患者APACHEⅡ评分、死亡风险系数、MODS评分均较治疗前降低(P均<0.05)。结论及时早期的集成血液净化治疗能改善急性重度有机磷农药中毒并发MODS患者的氧合、肺弥散功能及多器官功能障碍,降低病情严重程度及死亡风险。

Objective To evaluate the clinical efficacy of sequential blood purification for acute severe organophosphorus pesticide poisoning(ASOPP)complicated with multi-organ dysfunction syndrome(MODS),aiming to improve the treatment level of ASOPP.Methods Clinical data of five patients with ASOPP complicated with MODS receiving sequential blood purification were collected.The changes of laboratory results,APACHEⅡscore and MODS score were statistically analyzed before and after blood purification treatment.Results All patients were timely treated with sequential blood purification.At 24 h after blood purification,low oxygenation index and the alveolar-arterial oxygen difference were significantly improved compared with the values prior to treatment(both P<0.05).The APACHEⅡscore,death risk coefficient and MODS score were remarkably decreased after blood purification(all P<0.05).Conclusion Timely and early sequential blood purification can improve the oxygenation status,lung diffusion function and MODS,and mitigate the severity of the disease and the risk of death in patients with ASOPP complicated with MODS.