血必净注射液联合血液灌流治疗急性有机磷农药中毒的疗效观察  

Effect observation of Xuebijing injection combined with hemoperfusion on treatment of patients with acute organophosphorus poisoning

作　　者：崔少华 耿立霞[1] Cui Shaohua;Geng Lixia(Department of Intensive Care Unit,the First Affiliated Hospital of Baotou Medical College,Inner Mongolia University of Science and Technology,Baotou 014010,Inner Mongolia Autonomous Region,China)

机构地区：[1]内蒙古科技大学包头医学院第一附属医院重症医学科,内蒙古自治区包头014010

出　　处：《中国中西医结合急救杂志》2021年第4期470-473,共4页Chinese Journal of Integrated Traditional and Western Medicine in Intensive and Critical Care

基　　金：内蒙古自治区包头市医学领先重点专科项目(2021-75)。

摘　　要：目的观察血必净注射液联合血液灌流(HP)治疗急性有机磷农药中毒(AOPP)患者的临床效果.探讨其对患者炎性因子、呼吸功能及病死率的影响。方法选择内蒙古科技大学包头医学院第一附属医院2016年5月至2021年2月收治的82例AOPP患者作为研究对象。所有患者均进行常规治疗加HP治疗,在HP治疗基础上联合血必净治疗患者归为联合血必净治疗组(41例),其余41例归为单独HP治疗组。单独HP治疗组给予HP治疗;联合血必净治疗组给予血必净注射液联合HP治疗。比较两组患者治疗前后的肿瘤坏死因子-α(TNF-α)、白细胞介素-6(11-6)、C-反应蛋白(CRP)水平以及呼吸频率(RR)、呼气末正压通气(PEEP)和潮气量(VT);观察两组患者治疗后的总有效率,并发症发生率及病死率。结果治疗前,两组患者的炎性因子和呼吸功能指标水平比较差异均无统计学意义。治疗后,两组患者的TNF-α、1L-6、CRP水平较治疗前明显降低,且联合血必净治疗组上述指标水平均明显低于单独HP治疗组[TNF-α(ng/L):104.33±3.38比125.68±4.69.11-6(ng/L):75.71±1.43比98.72±2.69,CRP(mg/L):19.69±3.35比34.56±4.75.均P<0.05]。治疗后,两组患者的RR和PEEP均较治疗前明显降低,VT较治疗前明显升高,且联合血必净治疗组上述指标水平均明显优于单独HP治疗组[RR(次/min):20.69±3.14比25.65±4.85,PEEP(emH_(2)0.1 cmH,0≈0.098 kPa):7.83±0.94比9.64±1.35,VT(mL/Ukg):5.45±1.85比4.09土1.39.均P<0.05]。联合血必净治疗组患者的总有效率明显高于单独HP治疗组[95.12%(39/41)比80.49%(33/41),P<0.05]。联合血必净治疗组患者急性肾损伤、中毒性心肌炎,急性肝损伤发生率以及1个月病死率均明显低于单独HP治疗组[急性肾损伤:60.98%(25/41)比85.37%(35/41),中毒性心肌炎:58.54%(24/41)比82.93%(34/41),急性肝损伤:48.78%(20/41)比78.05%(32/41),1个月病死率:4.889(2/41)比36.59%(15/41).均P<0.05]。结论血必净注射液联合HP治疗AOPP患�Objeective To observe the eliniceal ffeet of Xuehijing injeetion combined with hemoperfusion(HP)in the treatment of patients with arute organophosphorus pesticide poisoning(AOPP),and to explore is influence on inflammatory factors,respiratory function and mortality.Methods Eighty-two AOPP patients admitted to the First Afiliated Hospital of Baotou Mediceal College of Inner Mongolia Universily of Srience and Technology from May 2016 to February 2021 were selected as the research objects.The patients were divided into HP treatment alone group and HP combined with Xuebjjing treatment group(simplified as combined Xuebjing reatment group),with 41 cases in each group.All the patients in the Iwo groups werr given routine Ireatment.The levels of tumor necrosis factor-α(TNF-α),interleukin-61L-6),C-reactive protein(CRP).respiratory rate(RR).positive end expiratory pressure(PEEP)and tidal volume(VT)were compared between the Iwo groups before and after treatment,the lotal effeetive rale,complication rate and mortality were observed.Results Before treatmenl,there were no significant differences in the levels of inflammatory factors and respiratory funetion indexes belween the Iwo groups.Afer treatment.the levels of TNF-α,-6 and CRP in the two groups were significantly lower than those before treatment,and the levels of above indexes in the combined Xuehjing treatment group were signifcantly lower than those in the HP treatment alone group ITNF-α(ng/L):104.33±3.38 vs.125.68±4.69,IL-6(ng/L);75.71±1.43 vs.98.72±2.69,CRP(mg/L):19.69±3.35 vs.34.56±4.75.all P<0.05].Afer treatment.the RR and PEEP in the Iwo groups were signifieantly lower than those before treatment,while VT was signifieantly higher than that before treatment.and the levels of above indexes in the combined Xuebijing treatment group were better than those in the HP Ireatment alone group[RR(times/minutes):20.69±3.14 vs.25.65±4.85.PEEP(emH_(2)O.1 emH_(2)0≈0.098 kPa):7.83±0.94 vs.9.64±1.35.VT(mL/kg);5.45±1.85 vs.4.09±1.39,all P<0.05].The total effctive

关 键 词：血必净注射液 急性有机磷农药中毒 血流灌流 临床疗效 炎性因子 呼吸功能 安全性 

分 类 号：R59[医药卫生—内科学]