血液灌流技术治疗急性重度有机磷杀虫剂中毒的疗效分析

目的观察和分析血液灌流技术(HP)在急性重度有机磷杀虫剂中毒(AOPP)救治中的疗效。方法将49例AOPP患者分灌流组(HP组)和对照组。对照组给予彻底清除毒物,尽早应用阿托品、胆碱脂酶复能剂等常规治疗;HP组在以上治疗的基础上加用血液灌流治疗。比较两组的治愈率、阿托品总用量、平均住院时间、血清胆碱脂酶(CHE)活性变化。结果两组的治愈率无显著差异(P>0.05),但HP组阿托品的总用量和住院日均显著低于对照组(P<0.01)。HP组在进行第1次血液灌流后测定的血清CHE活性明显高于对照组治疗后同时间的血清CHE活性(P<0.01)。中毒后48 h内不同时间点进行血液灌流,均可显著提高血清CHE活性,但在24 h内进行首次血液灌流导致CHE活性上升的幅度明显高于24 h以后进行血液灌流的效果。结论HP在AOPP的救治中疗效显著。

Efficacy of hemoperfusion in treatment of acute severe organophosphorus pesticide poisoning

Objective To evaluate the efficacy of the hemoperfusion in the treatment of the patients with acute severe organophosphorus pesticide poisoning.Methods 49 patients with acute severe organophosphorus pesticide poisoning were divided into hemoperfusion group(HP group) and non-hemoperfusion group(control group).The control group only accepted traditional treatment including gastric lavage,catharsis,emetic,atropine andpralidoxime.HP group were treated with HP in addition to the above traditional treatments at the same time.The curative rate,the cumulative dosage of atropine,average hospitalization days and cholinesterase(CHE) activity were compared between two groups.Results The cumulative dosage of atropine and average hospitalization days in the control group were significantly higher than HP group′s(P<0.01),though there was no obvious difference about the cure rate between the two groups.CHE activity determined after the first HP were significantly higher than the control group's at the same time(P<0.01).Although CHE activity were obviously upregulated after HP within 48 hours,the range of upregulated CHE activities was highest within 24 hours.Conclusion Hemoperfusion is effective in the treatment of acute severe organophosphorus pesticide poisoning.