血液灌流联合血液滤过治疗急诊重症有机磷农药中毒的效果

Effects of hemoperfusion combined with hemofiltration in the treatment of acute severe organophosphorus pesticide poisoning

目的探讨血液灌流联合血液滤过治疗急诊重症有机磷农药中毒患者的效果。方法选取2015年5月—2020年5月济源市某医院收治的82例急诊重症有机磷农药中毒患者,采用随机数字表法分为研究组与对照组,每组41例。对照组患者给予血液灌流治疗,研究组患者给予血液灌流联合血液滤过治疗。比较2组患者抢救成功率、救治效果、并发症发生情况及治疗前后肝功能的变化。结果研究组患者抢救成功率为95.12%(39/41),高于对照组的80.49%(33/41),差异有统计学意义(χ^(2)=4.100,P=0.043)。研究组患者昏迷时间、CHE活性恢复时间及住院时间均短于对照组,差异均有统计学意义(P<0.05)。2组患者治疗72 h后ALT及TBIL水平低于治疗前,且研究组低于对照组,差异均有统计学意义(P<0.05)。研究组患者并发症发生率为5.13%,低于对照组的21.21%,但差异无统计学意义(χ^(2)=2.885,P=0.089)。结论血液灌流联合血液滤过治疗急诊重症有机磷农药中毒,可提高抢救成功率和救治效果,减轻肝功能损伤,改善患者预后。

Objective To explore the effects of hemoperfusion combined with hemofiltration in the treatment of patients with acute severe organophosphorus pesticide poisoning.Methods Eighty-two patients with acute severe organophosphorus pesticide poisoning admitted to a hospital in Jiyuan from May 2015 to May 2020 were selected and divided into a study group and a control group using the random number table method,with 41 cases in each group.Patients in the control group were given hemoperfusion treatment,and patients in the study group were given hemoperfusion-hemofiltration combination treatment.The success rate of resuscitation,treatment out-come,complications and changes of liver function before and after treatment were compared between the two groups.Results The resuscitation success rate of patients in the study group was 95.12%(39/41),which was higher than that in the control group(80.49%,33/41),and the difference was statistically significant(χ^(2)=4.100,P=0.043).The duration of coma,recovery time of CHE activity and hospital stay were shorter in the study group than in the control group,and the differences were statistically significant(P<0.05).the ALT and TBIL levels were lower in both groups after 72 h of treatment and lower in the study group than in the control group,with statistically significant differences(P<0.05).The complication rate of patients in the study group was 5.13%,which was lower than that of 21.21%in the control group,but the difference was not statistically significant(χ^(2)=2.885,P=0.089).Conclusion Hemoperfusion combined with hemofiltration can improve the success rate of resuscitation and treatment outcome,reduce liver function damage,and improve the prognosis of patients in the treatment of acute severe organophosphorus pesticide poisoning.