血浆置换联合血液灌流对急性重度有机磷中毒患者肝肾功能及心肌酶的指标影响  

Effects of plasma exchange combined with hemoperfusion on liver and kidney function and myocardial enzymes in patients with acute severe organophosphorus poisoning

作　　者：牛军[1] 安小峰[1] 胡守芹 强浩[1] NIU Jun;AN Xiaofeng;HU Shouqin;QIANG Hao(Department of Emergency,General Hospital of Northern Anhui Coal and Electricity Group,Suzhou 234000,Anhui,China)

机构地区：[1]安徽省宿州市皖北煤电集团总医院急诊科

出　　处：《中南医学科学杂志》2019年第6期617-620,共4页Medical Science Journal of Central South China

摘　　要：将120例急性重度有机磷中毒患者分为对照组和观察组,对照组患者给予常规治疗,观察组患者在对照组的基础上给予血浆置换联合血液灌流治疗,分析两组患者肝肾功能及心肌酶指标的变化。检测结果显示观察组患者的呼吸支持时间、昏迷时间、体内乙酰胆碱脂酶(AchE)恢复时间和阿托品用量较对照组均明显降低(P<0.05);两组患者经治疗后急性生理与慢性健康评分(APACHEII)评分及谷丙转氨酶(ALT)、谷草转氨酶(AST)和总胆红素均明显降低(P<0.05),尿素氮、血肌酐、肌酸激酶(CK)、肌酸激酶同工酶(CK-MB)及乳酸脱氢酶(LDH)均明显降低(P<0.05)而尿酸水平明显升高(P<0.05),且观察组患者的上述指标变化更显著(P<0.05)。观察组患者的不良反应发生率明显低于对照组患者的不良反应发生率(P<0.05),但两组间的治疗成本无统计学意义(P>0.05)。血浆置换联合血液灌流对急性重度有机磷中毒患者肝肾功能及心肌酶指标的异常有明显的恢复作用。120 cute severe organophosphorus poisoning patients were divided into two groups according to the treatment method:the control group(n=60)was given routine treatment,while the observation group(n=60)was given plasma exchange combined with hemoperfusion treatment on the basis of the control group.The changes of liver and kidney function and myocardial enzymes in the two groups were analyzed.The results showed that the respiratory support time,coma time,Acetyl cholinesterase(AchE)recovery time and atropine dosage in the observation group were significantly reduced(P<0.05);Acute Physiology and Chronic Health Evaluation(APACHEII)score,Alanine aminotransferase(ALT),Aspartate aminotransferase(AST)and total bilirubin were significantly decreased(P<0.05),urea nitrogen,serum creatinine,Creatine Kinase(CK),creatine kinase isoenzymes(CK-MB)and Lactate dehydrogenase(LDH)were significantly decreased(P<0.05)and uric acid levels were significantly increased(P<0.05).The above indexes of the patients in the observation group changed more significantly(P<0.05).The incidence of adverse reactions in the observation group was significantly lower than that in the control group(P<0.05),but there was no significant difference in the cost of treatment between the two groups(P>0.05).So Plasma exchange combined with hemoperfusion can significantly restore the abnormalities of liver and kidney function and myocardial enzymes in patients with acute severe organophosphorus poisoning.

关 键 词：血浆置换 血液灌流 急性重度有机磷中毒患 肝肾功能 心肌酶 

分 类 号：R595.4[医药卫生—内科学]