血液灌流治疗急性重度有机磷中毒的应用研究

目的探讨血液灌流治疗急性重度有机磷农药中毒的应用价值。方法选取急性重度有机磷农药中毒患者88例，分为灌注流组（HP组）和非灌流组（非HP组），非HP组按常规予积极洗胃，导泻，催吐，并予阿托品及解磷定治疗。HP组在上述治疗基础上进行血液灌流治疗。观察全部病例的服用量，首诊时间，初诊时胆碱酯酶（CHE）活力和死亡率，存活病例的CHE恢复时间，达阿托品化的时间，阿托品化的阿托品用量，病程中阿托品的总量及中间综合征（IMS）发生率。结果HP组CHE恢复时间，达阿托品化的时间，达阿托品化的阿托品用量，病程中阿托品的总量，病死率均显著低于非HP组（P〈0．05或P〈0．001）。2组间中间综合征发生率比较无统计学上的差异（P〉0．05）。结论血液灌流治疗急性重度有机磷中毒疗效显著。

Therapeutic efficacy of hemoperfusion in treatment of acute severe organophosphorus pesticide poisoning

Objective] To assess the efficacy of the hemoperfusion in the treatment of the patients with acute severe organophosphorus pesticide poisoning. Methods] 88 patients with acute severe organophosphorus pesticide poisoning were enrolled and divided into hemoperfusion group(HP group) and non- hemoperfusion group(non-HP group),the non-HP group only accepted traditional treatment including gastric lavage,catharsis, emetic ,atropine and pralidoxime.HP group were treated with both HP and traditional treatment at the same time. Observe all the patients' ingested dosage, treatment time after poisoning, cholinesterase(CHE) activity on admission and the mortality; Oberserve the survived patients'duration of the recovery of CHE activity, the time interval to achieve atropinization from admission, the cumulative dosages of atropine to achieve atropinization, the cumulative dosages of atropine in the hospital and the incidence of intermediate syndrome(IMS). Results] The HP group's the duration of the recovery of CHE activity, the time interval to achieve atropinization from admission, the cumulative dosages of atropine to achieve atropinization, the cumulative dosages of atropine in the hospital and the mortality is lower than those of the non-HP group's (P <0.05 or P <0.001), the incidence of IMS between 2 groups has no statistical difference (P >0.05). Conclusion] Hemoperfusion is effective in the treatment of acute severe organophosphorus pesticide poisoning.