突击剂量碘解磷定联合血液灌流治疗ICU有机磷农药中毒患者的效果

Effect of Loading Dose of Pralidoxime Iodide Combined with Hemoperfusion on Patients with Organic Phosphorus Insecticides Poisoning in ICU

目的:探析ICU有机磷农药中毒患者采用突击剂量碘解磷定联合血液灌流治疗的临床效果。方法:选择2021年1月—2022年12月潜江市中心医院重症医学科收治的96例有机磷农药中毒患者,采用随机数字表法分为研究组、对照组,各48例。对照组给予常规剂量碘解磷定联合血液灌流治疗,研究组给予突击剂量碘解磷定联合血液灌流治疗。比较两组临床总有效率、格拉斯哥昏迷量表(GCS)评分、胆碱酯酶(ChE)水平、ChE复常时间、阿托品化时间、昏迷时间、住院时间、不良反应发生率。结果:研究组临床总有效率高于对照组,差异有统计学意义(P<0.05)。治疗后,研究组GCS评分、ChE水平均高于对照组,差异均有统计学意义(P<0.05);研究组ChE复常时间、阿托品化时间、昏迷时间、住院时间均短于对照组,差异均有统计学意义(P<0.05)。两组不良反应发生率比较,差异无统计学意义(P>0.05)。结论:ICU有机磷农药中毒患者采用突击剂量碘解磷定联合血液灌流治疗效果显著,可改善昏迷状态,提升ChE水平,缩短ChE复常时间、阿托品化时间,加速苏醒,缩短住院时间,治疗安全性较高。

Objective:To explore the clinical effect of loading dose of Pralidoxime Iodide combined with hemoperfusion in patients with organic phosphorus insecticides poisoning in ICU.Method:A total of 96 patients with organic phosphorus insecticides poisoning admitted to Department of Critical Care Medicine of Qianjiang Central Hospital from January 2021 to December 2022 were divided into study group and control group by random number table method,with 48 cases in each group.The control group was given conventional dose of Pralidoxime Iodide combined with hemoperfusion treatment,and the study group was given loading dose of Pralidoxime Iodide combined with hemoperfusion treatment.The clinical total effective rate,Glasgow coma scale(GCS)score,cholinesterase(ChE)level,ChE normalization time,atropinization time,coma time,hospitalization time and incidence of adverse reactions were compared between the two groups.Result:The clinical total effective rate of the study group was higher than that of the control group,the difference was statistically significant(P<0.05).After treatment,the GCS score and ChE level of the study group were higher than those of the control group,the differences were statistically significant(P<0.05).ChE restoration time,atropinization time,coma time and hospitalization time in the study group were shorter than those in the control group,the differences were statistically significant(P<0.05).There was no significant difference in the incidence of adverse reactions between the two groups(P>0.05).Conclusion:Patients with organic phosphorus insecticides poisoning in ICU are treated with loading dose of Pralidoxime Iodide combined with hemoperfusion,which could improve coma state,enhance ChE level,shorten ChE restoration time and atropinization time,accelerate recovery,shorten hospital stay,and have high treatment safety.