输血治疗对有机磷中毒患者疗效的初步评估  

The preliminary treatment impact evaluation of blood transfusion on patients with organophosphate poisoning

作　　者：黄原[1] 潘明亮 杨旭堃[1] 朱月武[1] HUANG Yuan;PAN Minliang;YANG Xukun;ZHU Yuewu(No.4 West China Teaching Hospital Sichuan University Chengdu 610041,China;AVIC 363 Hospital)

机构地区：[1]四川大学华西第四医院,四川成都610041 [2]航空工业三六三医院

出　　处：《中国输血杂志》2018年第7期757-759,共3页Chinese Journal of Blood Transfusion

摘　　要：目的分析评价输血治疗对有机磷中毒患者的治疗效果。方法收集本院2008年—2018年临床诊断为有机磷农药中毒并符合纳入标准的患者共67个病例,分为未输血治疗组（56例）：按中国医师协会急诊医师分会制定的急诊有机磷农药中毒标准化治疗;输血治疗组（11例）;在标准化方案治疗基础上符合血红蛋白进行性下降输血指证加入输血治疗,用SPSS13. 0统计学软件统计分析2组患者的临床治愈好转率差异。结果 2组患者的性别、年龄、职业和中毒轻重程度相似（P〉0. 05）。56例采取彻底清洗、催吐灌肠、肟类复能剂联合抗胆碱能药物、血液净化、支持性护理标准化方案治疗未输血治疗组和11例在此标准化方案治疗基础上加入输血治疗（包括输注新鲜冰冻血浆和/或红细胞悬液）的输血治疗组的临床治愈好转率分别是55. 36%（31/56） vs 63. 64%（7/11）,其中重度中毒患者的治愈好转率分别是29. 63%（8/27） vs 60. 00%（6/10）（P〉0. 05）。结论本组采用输血治疗的有机磷中毒患者其临床治愈好转率提高的效果有限。Objectives To analyze and evaluate the efficacy of blood transfusion on the treatment of patients with organophosphate poisoning. Methods 67 patients with organophosphorus pesticide poisoning in our hospital in the past 10 years（ from Jan.2008 to Jan.2018） enrolled. The patients were grouped into the non-transfusion treatment（ 56 patients） group and the transfusion treatment（ 11 patients） group. The former was treated according to the standardized treatment of emergency organophosphorus pesticide poisoning protocol formulated by the Chinese Medical Doctor Association＇s emergency physicians＇ branch,while the later included extra blood transfusion treatments. The differences in percentage of recovered patients between the two groups were analyzed by SPSSl3. 0. Results The statistical analysis showed no statistical differences in gender,age,occupation and type of severity of poisoning between the two groups（ P〉0. 05）. The recovery rates of the non-transfusion group with thorough cleaning,vomiting and enema,anti-cholinergic drugs,anti-cholinergic drugs,blood purification,and supportive care standardization programs yielded a treatment rate of 55. 36%（ 31/56）,while the 11 patients who received blood transfusion therapy including infusion of fresh frozen plasma and/or red blood cell suspension based on the above standardized treatment yielded a treatment rate of 63. 64%（ 7/11）. The cure rates in severe patients between the two groups were29. 63%（ 8/27） and 60. 00 %（ 6/10）. The transfusion group had higher percentage of recovered patients than the non-transfusion group with,however,no statistical significance in both cases（ P〉0. 05）,respectively. Conclusion No clinical evidence has been found for the need of blood transfusion for treatment of patients with organophosphorus pesticide poisoning in the above cases. Further study and a larger sample pool of clinical cases are required to perform proper evaluations.

关 键 词：有机磷农药 农药中毒 输血 血浆 红细胞 

分 类 号：R139.3[医药卫生—劳动卫生] R457.1[医药卫生—公共卫生与预防医学]