血液净化疗法联合氯解磷定治疗急性重症有机磷农药中毒临床观察  

Clinical observation of blood purification therapy combined with Pralidoxime Chloride Injection in the treatment of acute severe organophosphorus pesticide poisoning

作　　者：刘小艳 LIU Xiao-yan(Affiliated Hospital of Southwest Medical University, Luzhou Sichuan,646000, Chin)

机构地区：[1]西南医科大学附属医院,四川泸州646000

出　　处：《中国地方病防治》2018年第3期354-355,共2页Chinese Journal of Control of Endemic Diseases

基　　金：四川省卫生厅科研项目(100197)

摘　　要：目的探究血液净化联合氯解磷定在急性重症有机磷农药中毒(ASOPP)患者的临床疗效。方法 62例ASOPP患者随机分组,各31例。对照组给予氯解磷定注射液,研究组在对照组基础上给予连续性血液透析(CVVH)+血液灌流(HP),共治疗7 d。观察两组病死率、昏迷复醒时间、机械通气时间、住院时间、胆碱酯酶(ChE)活性恢复时间、并发症,对比治疗前后血清白细胞介素-6(IL-6)、肿瘤坏死因子-α(TNF-α)、白细胞介素-2(IL-2)水平。结果研究组住院时间、机械通气时间、昏迷复醒时间、ChE活性恢复时间短于对照组(P<0.05);并发症发生率低于对照组(P<0.05);IL-6、TNF-α、IL-2水平低于对照组(P<0.05)。结论该疗法用于ASOPP患者,可减少并发症,减轻炎症反应,加快康复进程,病死率低。Objective To explore the clinical efficacy of blood purification combined with Pralidoxime Chloride Injection in the treatment of acute severe organophosphorus pesticide poisoning（ ASOPP）.Methods 62 ASOPP patients were randomly divided into groups with 31 cases in each.The control group was given Pralidoxime Chloride Injection,and the study group was treated with heterozygous blood purification therapy [continuous hemodialysis（ CVVH） ＋ hemoperfusion（ HP） ]on the basis of the control group,and both groups were treated for 7 days.The mortality rate,coma recovery time,mechanical ventilation time,hospital stay,recovery time of cholinesterase（ Ch E） activity and complications were observed in two groups.Results The hospitalization time,mechanical ventilation time,coma recovery time and recovery time of Ch E activity in the study group were shorter than those in the control group（ P〈0.05）.The levels of IL-6,TNF-α and IL-2 in the study group were lower than those in the control group（ P〈0.05）.Conclusion This theropy in the treatment of ASOPP patients can reduce complications,reduce inflammatory reaction,and accelerate recovery process.Besides,it has lower mortality.

关 键 词：急性重症有机磷农药中毒 氯解磷定注射液 杂合式血液净化疗法 

分 类 号：R139.3[医药卫生—劳动卫生]