生大黄联合血液净化治疗重度急性有机磷农药中毒疗效分析  

Efficacy Analysis of Rhubarb Combined with Blood Purification Treatment for Severe Organophosphorus Pesticide Poisoning

作　　者：王冰[1] 任乾[1] 凌海华[1] 黎贵才[1] 

机构地区：[1]玉林市第二人民医院重症医学科,广西玉林537000

出　　处：《医学综述》2014年第12期2267-2269,共3页Medical Recapitulate

摘　　要：目的观察生大黄联合血液净化治疗重度急性有机磷农药中毒(AOPP)的安全性、有效性。方法选取2005年2月至2013年2月广西玉林市第二人民医院重症医学科收治的重度AOPP患者60例,其中联合治疗组(31例)在常规治疗基础上采用生大黄联合血液净化治疗,生大黄组(29例)为同期收治的因经济困难等原因仅予生大黄+常规综合治疗。观察两组患者昏迷至清醒时间、机械通气时间、住院时间、胆碱酯酶恢复时间,阿托品、氯解磷定使用总量及中间综合征发生率、多脏器功能障碍(MODS)发生率、病死率等。结果联合治疗组昏迷至清醒时间、机械通气时间、住院时间、胆碱酯酶恢复时间分别为(5.9±1.1)d、(6.1±1.2)d、(9.2±1.5)d、(3.9±0.7)d,生大黄组分别为(7.3±1.3)d、(8.5±1.3)d、(11.8±1.6)d、(6.2±0.8)d,联合治疗组显著短于生大黄组(P<0.05);联合治疗组阿托品、氯解磷定使用总量分别为(108.2±8.7)mg、(7.3±1.0)g,生大黄组分别为(121.8±9.3)mg、(12.3±1.3)g,联合治疗组显著少于生大黄组(P<0.05);联合治疗组中间综合征发生率、MODS发生率、病死率分别为6.5%、12.9%、9.7%,生大黄组分别为31%、41.4%、37.9%,联合治疗组显著低于生大黄组(P<0.05)。结论生大黄联合血液净化治疗重度AOPP可缩短住院时间,减少并发症,提高救治成功率,降低病死率,是一种安全有效的方法。Objective To observe the safety and efficacy of rhubarb combined with blood puniication treatment forsevere acute organophosphorus pesticide poisoning（ AOPP）. Methods From Feb. 2005 to Feb. 2013 in Guangxi Yulin Second People＇s Hospital ICU ,60 cases of severe AOPP were selected, includign 31 cases in the treatment group treated with rhubarb combined with blood purification therapy, 29 cases in the rhubarb group admitted during the same period treated only with rhubarb ± routine comprehensive therapy due to economic difficulties. The coma to awake time, mechanical ventilation time, hospitalization time, eho- linesterase recovery time, atropine, pralidoxime chloride total usage and intermediate syndrome incidence, the incidence and mortality of multiple organ dysfunction syndrome （MODS） of the two groups were observed. Results Coma to waking time, mechanical ventilation time, hospitalization time, cholinesterase recovery time of combined treatment group were （ 5.9 ± 1.1 ） d, （ 6.1 ± 1.2 ） d, （9.2 ± 1.5 ） d, （ 3.9 ± 0. 7 ） d, of rhubarb group were （7.3 ± 1.3 ） d, （ 8.5 ± 1.3 ） d, （ 11.8 ± 1.6 ） d, （ 6.2 ± 0.8 ） d, the former significantly shorter than the latter（ P 〈 O. 05 ） ; atropine, pralidoxime chloride total usage in the combined treatment group were （ 108.2 ± 8.7 ） mg, （ 7.3 ± 1. O） g, of rhubarb group were （ 121.8 ± 9.3 ） mg, （ 12.3 ± 1.3 ） g, the for- mer significantly less than the latter（ P 〈0.05 ） ;intermediate syndrome incidence, MODS incidence andmor- tality of the combined treatment group were 6.5 %, 12.9 % ,9.7 %, of the rhubarb group were 31% ,41.4 %, 37.9%, the former significantly lower than the latter （ P 〈 O. 05 ）. Conclusion Rhubarb combined with blood purification treatment for severe AOPP can reduce hospitalization time, reduce the complications, improve the treatment success rate and reduce the mortality,thus is a safe and effective method.

关 键 词：生大黄 有机磷农药 中毒 血液净化 

分 类 号：R459.7[医药卫生—急诊医学]