连续性静脉-静脉血液透析滤过联合血液灌流和氯解磷定治疗急性重症有机磷农药中毒患者的效果

Effects of continuous venous-venous hemodiafiltration combined with hemoperfusion and Pralidoxime chloride in treatment of patients with acute severe organophosphorus pesticide poisoning

目的:观察连续性静脉-静脉血液透析滤过(CVVHDF)联合血液灌流和氯解磷定治疗急性重症有机磷农药中毒患者的效果。方法:选取60例急性重症有机磷农药中毒患者作为研究对象,按照随机数字表法分为研究组和对照组各30例。对照组行氯解磷定联合血液灌流治疗,研究组在对照组基础上增加CVVHDF治疗。比较两组临床恢复时间、治疗前后炎性因子[肿瘤坏死因子(TNF-α)、白细胞介素-1β(IL-1β)、IL-6]水平和并发症发生率。结果:研究组住院时间、苏醒时间和胆碱酯酶恢复至70%的时间均明显短于对照组,差异有统计学意义(P<0.05);治疗后,研究组TNF-α、IL-1β和IL-6水平均明显低于对照组,差异有统计学意义(P<0.05);研究组并发症发生率为10.00%,明显低于对照组的36.67%,差异有统计学意义(P<0.05)。结论:CVVHDF联合血液灌流和氯解磷定治疗急性重症有机磷农药中毒患者,可降低炎性因子水平和并发症发生率,缩短临床恢复时间,优于氯解磷定联合血液灌流治疗效果。

Objective:To investigate effects of continuous venous-venous hemodiafiltration(CVVHDF)combined with hemoperfusion and Pralidoxime chloride in treatment of patients with acute severe organophosphorus pesticide poisoning.Methods:60 patients with acute severe organophosphorus pesticide poisoning were selected as the research objects,and were divided into study group and control group according to the random number table method,30 cases in each.The control group was treated with Pralidoxime combined with hemoperfusion,while the study group was given CVVHDF treatment on the basis of those of the control group.The clinical recovery time,the levels of inflammatory factors[tumor necrosis factor(TNF-α),interleukin-1β(IL-1β),IL-6]and the incidence of complications before and after the treatment were compared between the two groups.Results:The hospitalization time,recovery time and the time for the cholinesterase level returning to 70% of the original level in the study group were significantly shorter than those in the control group,and the differences were statistically significant(P<0.05).After the treatment,the levels of TNF-α,IL-1β and IL-6 in the study group were significantly lower than those in the control group,and the differences were statistically significant(P<0.05).The complication rate in the study group was 10.00%,which was significantly lower than 36.67%in the control group,and the difference was statistically significant(P<0.05).Conclusions:CVVHDF combined with hemoperfusion and Pralidoxime chloride in the treatment of the patients with acute severe organophosphorus pesticide poisoning can reduce the levels of inflammatory factors and the incidence of complications,and shorten the clinical recovery time.Moreover,it is superior to Pralidoxime chloride combined with hemoperfusion.