早期血液灌流联合解磷定注射液治疗急诊有机磷农药中毒的临床效果分析

Clinical Effect Analysis of Early Hemoperfusion Combined with Pralidoxime Injection in Treatment of Emergency Acute Organophosphorus Pesticide Poisoning

目的:分析早期血液灌流联合解磷注射液治疗急诊有机磷农药中毒患者的效果。方法:选择2021年4月—2023年4月平度市中医医院收治的急诊有机磷农药中毒患者60例作为研究对象,按随机数表法分为对照组与研究组,各30例。对照组在常规治疗基础上给予解磷定注射液治疗,研究组在对照组基础上给予早期血液灌流治疗。观察两组抢救成功率、急救效果、血清胆碱酯酶浓度和并发症发生率。结果:研究组抢救成功率高于对照组,差异有统计学意义(P=0.020)。研究组阿托品用量少于对照组,胆碱酯酶恢复至正常时间、意识恢复时间、住院时间均短于对照组,差异有统计学意义(P<0.001)。治疗前,两组血清胆碱酯酶的浓度比较,差异无统计学意义(P>0.05)。治疗后,研究组血清胆碱酯酶浓度高于对照组,差异有统计学意义(P<0.001)。研究组并发症总发生率低于对照组,差异有统计学意义(P=0.025)。结论:早期血液灌流联合解磷注射液治疗急诊有机磷农药中毒的效果显著,能够提高患者抢救成功率,提升患者血清胆碱酯酶浓度,有效缩短恢复时间及住院时间,减少并发症的发生,改善预后。

Objective:To analyze the effect of early hemoperfusion combined with pralidoxime injection in the treatment of emergency organophosphorus pesticide poisoning.Methods:Sixty patients with emergency organophosphorus pesticide poisoning treated in Pingdu Traditional Chinese Medicine Hospital from April 2021 to April 2023 were selected as the study subjects.According to random number table method,they were divided into control group and study group,with 30 cases in each group.The control group was treated with pralidoxime injection on basis of routine treatment.The study group received early hemoperfusion therapy on basis of control group.The rescue success rate,emergency effect,serum cholinesterase concentration and complication rate were compared between the two groups.Results:The rescue success rate in the study group was higher than that in the control group,and the difference was statistically significant(P=0.020).The dosage of atropine in the study group was less than that in the control group,and the recovery time of cholinesterase,the recovery time of consciousness and the length of hospital stay in the study group were shorter than those in the control group,with statistically significant difference(P<0.001).Before treatment,there was no significant difference in serum cholinesterase concentration between the two groups(P>0.05).After treatment,serum cholinesterase concentration in the study group was higher than that in the control group,and the difference was statistically significant(P<0.001).The total complication rate in the study group was lower than that in the control group,and the difference was statistically significant(P=0.025).Conclusion:The combination of early hemoperfusion and pralidoxime injection in the treatment of emergency organophosphorus pesticide poisoning has a remarkable effect,which can increase the rescue success rate,increase serum cholinesterase concentration,effectively shorten the recovery time and the length of hospital stay,reduce complications,and enhance the prognosis.