血液灌流联合阿托品治疗有机磷中毒呼吸衰竭的效果及对患者肾功能的影响分析

Effect of combined hemoperfusion and atropine treatment on respiratory failure caused by organophosphorus poisoning and its influence on renal function of patients

目的分析有机磷中毒呼吸衰竭患者应用血液灌流联合阿托品治疗的临床效果及对肾功能的影响。方法70例有机磷中毒呼吸衰竭患者,通过随机数字表法分为对照组和观察组,每组35例。对照组单独应用阿托品治疗,观察组应用血液灌流联合阿托品治疗。比较两组治疗效果,治疗前后肾功能改善情况、血细胞参数变化情况,不良反应发生情况。结果观察组治疗总有效率为94.29%,高于对照组的77.14%,差异有统计学意义(P<0.05)。治疗后,两组尿素氮(BUN)水平均低于本组治疗前,胱抑素C(Cys-C)水平均高于本组治疗前,且观察组BUN水平(3.76±1.81)mmol/L、Cys-C水平(667.19±56.84)μg/L均低于对照组的(5.97±2.70)mmol/L、(765.42±41.60)μg/L,差异有统计学意义(P<0.05)。治疗后,两组白细胞计数、中性粒细胞计数均低于本组治疗前,淋巴细胞计数均高于本组治疗前,且观察组白细胞计数(7.02±1.51)×10^(9)/L、中性粒细胞计数(4.61±1.12)×10^(9)/L均低于对照组的(9.12±1.62)×10^(9)/L、(6.32±1.51)×10^(9)/L,淋巴细胞计数(2.23±1.02)×10^(9)/L高于对照组的(1.82±0.61)×10^(9)/L,差异有统计学意义(P<0.05)。观察组不良反应发生率5.71%低于对照组的22.86%,差异有统计学意义(P<0.05)。结论针对有机磷中毒呼吸衰竭患者应用血液灌流联合阿托品治疗可获得突出效果,不仅能改善患者肾功能,纠正血细胞参数,还可减少不良反应发生,安全性较高,值得临床推广。

Objective To analyze the clinical effect of combined hemoperfusion and atropine treatment on patients with respiratory failure caused by organophosphorus poisoning,and its impact on renal function of patients.Methods A total of 70 patients with respiratory failure caused by organophosphorus poisoning were divided into control group and observation group according to the random numerical table,with 35 cases in each group.The control group was treated with atropine alone,and the observation group was treated with hemoperfusion and atropine.The therapeutic effect,the improvement of renal function,the changes of blood cell parameters before and after treatment,and the occurrence of adverse reactions were compared between the two groups.Results The total effective rate of treatment in the observation group was 94.29%,which was higher than that of 77.14% in the control group,and the difference was statistically significant(P<0.05).After treatment,the blood urea nitrogen(BUN)level in both groups was lower than that before treatment in this group;the cystatin C(Cys-C)level in both groups was higher than that before treatment in this group;the observation group had BUN level of(3.76±1.81)mmol/L and Cys-C level of(667.19±56.84)μg/L,which were lower than those of(5.97±2.70)mmol/L and(765.42±41.60)μg/L in the control group;the differences were statistically significant(P<0.05).After treatment,the white blood cell count and neutrophil count in both groups were lower than those before treatment in this group;the lymphocyte count in both groups was higher than that before treatment in this group;the white blood cell count and neutrophil count in the observation group were(7.02±1.51)×10^(9)/L and(4.61±1.12)×10^(9)/L,which were lower than those of(9.12±1.62)×10^(9)/L and(6.32±1.51)×10^(9)/L in the control group;the lymphocyte count of(2.23±1.02)×10^(9)/L in the observation group was higher than that of(1.82±0.61)×10^(9)/L in the control group;the differences were statistically significant(P<0.05).The incidence of adverse reactions in the observation group was 5.71%,which was lower than that of 22.86% in the control group,and the difference was statistically significant(P<0.05).Conclusion The combination of hemoperfusion and atropine treatment for patients with respiratory failure caused by organophosphorus poisoning can achieve outstanding effect,which can not only improve the renal function of patients,but also correct the blood cell parameters.It is safe and can reduce the occurrence of adverse reactions.It is worthy of clinical promotion.