急诊床边血液灌流抢救急性重度有机磷农药中毒的临床疗效评价  

Clinical evaluation of the efficacy of emergency bedside hemoperfusion in acute severe organophosphorus pesticide poisoning

作　　者：石佳泉[1] 李国贤[1] 陈彬 黄佐才[1] 江福昌 

机构地区：[1]广东省梅州市人民医院急诊医学科,广东梅州514031

出　　处：《中国当代医药》2017年第34期34-36,共3页China Modern Medicine

摘　　要：目的探讨急诊床边血液灌流抢救急性重度有机磷农药中毒的临床疗效。方法选取2013年1月~2017年2月我院收治的70例急性重度有机磷农药中毒患者作为研究对象,按照随机数字表法分为保守内科组和血液灌流组,各35例。保守内科组采用常规内科方法进行治疗,血液灌流组在保守内科组的基础上采用急诊床边血液灌流抢救。比较两组的治疗总有效率,抢救后血清胆碱酯酶水平、阿托品用量、昏迷时间、使用呼吸机时间及患者中间期肌无力综合征发生率。结果血液灌流组患者的治疗总有效率(97.14%)高于保守内科组(77.14%),差异有统计学意义(P<0.05);血液灌流组患者抢救后的血清胆碱酯酶水平[(25.13±8.41)U/L]及阿托品用量[(235.51±52.61)mg]低于保守内科组[(15.39±4.13)U/L、(387.35±73.57)mg],昏迷时间[(10.62±1.21)h]及使用呼吸机时间[(76.51±11.61)h]短于保守内科组[(23.61±2.68)h、(157.35±22.57)h],差异均有统计学意义(P<0.05)。血液灌流组患者的中间期肌无力综合征发生率(8.57%)低于保守内科组(22.86%),差异有统计学意义(P<0.05)。结论急诊床边血液灌流抢救急性重度有机磷农药中毒的临床疗效确切,可有效改善患者临床症状,缩短昏迷时间和呼吸机使用时间,减少阿托品用量,恢复血清胆碱酯酶水平,减少不良预后发生,值得推广。Objective To evaluate the clinical efficacy of acute severe organophosphorus pesticide poisoning by emer- gency bedside hemoperfusion.Methods A total of 70 patients with acute severe organophosphorus pesticide poisoning from January 2013 to February 2017 were selected as the study subjects,and were randomly divided into the conserva- tive internal medicine group and the hemoperfusion group according to the random number table methods,with 35 pa- tients in each group.The conservative internal medicine group was given routine internal medical methods for treatment, and the hemoperfusion group was further given emergency bedside hemoperfusion rescue onthe basis of the conserva- tive internal medicine group.The total treatment effective rate of acute severe organophosphorus pesticide poisoning,the serum cholinesterase levels,atropine dosage,coma time,time of ventilator use after rescue,and the incidence rate of myasthenia gravis in the middle phase were compared between the two groups.Results The total effective rate in the hemoperfusion group （97.14%） was higher than that in the conservative internal medicine group （77.14%）,and the dif- ference was statistically significant （P〈0.05）.The serum cholinesterase levels （[25.13±8.41]U/L） and the dosage of atropine （[235.51±52.61]mg） in the hemoperfusion group after rescue were lower than those （[15.39±4.13]U/L,[387.35±73.57]mg） in the conservative internal medicine group,the coma time （[10.62±1.21]h） and the time of ventilator use （[76.51±11.61]h） were better than those （[23.61±2.68]h,[157.35±22.57]h） in the conservative internal medicine group,with significant dif- ference （P〈0.05）.The incidence rate of myasthenia gravis in the middle phase in hemoperfusion group was 8.57%,which was lower than 22.86% in the conservative internal medicine group,and the difference was statistically significant （P〈0.05）. Conclusion The clinical efficacy of acute severe organophosphorus pesticide poisoning by emergency bedside hemoper

关 键 词：急诊床边血液灌流 急性重度有机磷农药中毒 临床疗效 

分 类 号：R459.7[医药卫生—急诊医学]