血液灌流救治有机磷中毒患者的临床效果  

Clinical Effect of Hemoperfusion for the Treatment of Patients with Organophosphorus Poisoning

作　　者：郭强[1] 袁丁 GUO Qiang;YUAN Ding(Suining People’s Hospital,Suining 221200,China;不详)

机构地区：[1]睢宁县人民医院,江苏睢宁221200

出　　处：《中外医学研究》2020年第34期144-146,共3页CHINESE AND FOREIGN MEDICAL RESEARCH

摘　　要：目的:探究血液灌流救治有机磷中毒患者的临床效果。方法:选取本院2019年1月-2020年4月收治的18例有机磷中毒患者,予以血液灌流(HP)治疗。对比治疗前后序贯器官衰竭评分(SOFA)、实验室指标、健康状况,分析临床治疗情况和并发症发生率。结果:治疗后,神经系统、呼吸系统和循环系统评分明显低于治疗前,差异有统计学意义(P<0.05);凝血系统、泌尿系统和肝脏系统评分与治疗前比较差异无统计学意义(P>0.05);治疗后,CRP、TNF-α、IL-1和APACHEⅡ评分明显低于治疗前;血清胆碱酯酶(ChE)含量明显高于治疗前(P<0.05);阿托品用量(487.35±52.62)mg,机械通气时间(3.54±0.47)d,胆碱酯酶活性恢复70%的时间(4.07±1.03)d,意识恢复时间(31.43±5.63)h,住院时间(8.75±1.46)d,并发症发生率为16.67%。结论:HP可快速清除有机磷中毒患者血液中的毒物,有效改善患者神经、呼吸和循环系统,促进胆碱酯酶含量的恢复,降低炎症因子水平,减轻中毒症状,提高救治效果,值得临床推广应用。Objective:To explore the clinical effect of hemoperfusion(HP)for the treatment of patients with organophosphorus poisoning.Method:Eighteen patients with organophosphorus poisoning who treated in our hospital from January 2019 to April 2020 were selected,and the patients were treated with HP.The sequential organ failure assessment(SOFA),laboratory indicators,health status before and after treatment were compared.The clinical treatment and incidence of complications were analyzed.Result:After treatment,the scores of nervous system,respiratory system and circulatory system were significantly lower than those before treatment,and the differences were statistically significant(P<0.05).There were no significant differences in the scores of blood coagulation system,urinary system and liver system before and after treatment(P>0.05).After treatment,the CRP,TNF-α,IL-1 and APACHEⅡ scores were significantly lower than those before treatment,the serum ChE content was significantly higher than that before treatment(P<0.05).The Atropine dosage was(487.35±52.62)mg,mechanical ventilation time was(3.54±0.47)d,the time of ChE recovery activity to 70% was(4.07±1.03)d,consciousness recovery time was(31.43±5.63)h,hospital stay was(8.75±1.46)d and the incidence of complications was 16.67%.Conclusion:HP can rapidly remove the poison in the blood of organophosphorus poisoning patients,and can effectively improve the patient’s nerve,respiratory and circulatory systems,promote the recovery of cholinesterase content,reduce the level of inflammatory factors,reduce the symptoms of poisoning,and improve the treatment effect,which is worthy of clinical promotion and application.

关 键 词：血液灌流 有机磷中毒 序贯器官衰竭评分 炎症因子 胆碱酯酶 临床效果 

分 类 号：R595.4[医药卫生—内科学]