血液灌流治疗急性重度有机磷中毒的研究

目的分析血液灌流治疗急性有机磷农药中毒的疗效及并发症,探讨治疗急性重度有机磷农药中毒的科学方法。方法收集2010年1月~2013年12月徐州市中心医院重症监护病房的急性有机磷农药中毒患者187例的临床资料,愿意接受常规治疗联合HP(血液灌流)治疗的116例为实验组,不愿意联合治疗的只进行常规治疗71例为对照组,对2组病人的治疗效果、并发症进行统计分析。结果实验组与对照组在阿托品总剂量、氯磷定总剂量、胆碱酯酶恢复时间、住院时间、治愈等方面比较,差异有统计学意义(P0.05),恢复清醒时间、使用呼吸机时间差异有统计学意义(P0.05),实验组与对照组在中间综合征、肺部感染、呼吸衰竭、血压升高、肺水肿、深度昏迷、大小便失禁等并发症的发生率比较,差异有统计学意义(P0.05),消化道出血的发生率差异无统计学意义(P0.05)。结论常规治疗联合血液灌流抢救急性有机磷中毒患者疗效显著,副作用小。

Application of hemoperfusion in the treatment of acute severe organophosphorus poisoning

objective To analyze therapeutic effect of hemoperfusion（HP） on acute organophosphorus pesticide poisoning case and the complications. Method The clinical data of 187 patients with acute organic phosphorus from January 2010 to December 2013 in ICU of Xuzhou Municipal Central Hospital were collected and divided into two grups ： experiement group （116 patients with conventional therapy combined with HP and control group （ 71 patients only with conventional therapy）.The therapeutic effect and complication incidence were compared . Result The differences in the total doses of atropine and pralidoxime chloride, cholinesterase recovery time, hospitalization time and cure between two groups were remarkablly statistically significant （P〈0.01）; and there was statistical significant difference in the time of consciousness recovery;the respirator time （P〈0.05）; the differences in the incidence of intermediate syndrome, pulmonary infection, respiratory failure, pulmonary edema, elevated blood pressure, deep coma, incontinence and other complications between two groups were statistically significant （P〈0.01）; no significant differences in incidence of gastrointestinal bleeding were found （P〉 0.05）. Conclusion The effect of hemopeffusion on acute organophosphorus pesticide poisoning patients was remarkable and had no side effect.