连续性静脉-静脉血液滤过联合血流灌洗在急性有机磷中毒救治中的应用观察  

Application of continuous veno-venous hemofiltration combined with hemoperfusion in treatment of acute organophosphorus pesticide poisoning

作　　者：时一 SHI Yi(Emergency Medicine Department,The First Affiliated Hospital of Henan University of Science and Technology,Luoyang,Henan 471003,China)

机构地区：[1]河南科技大学第一附属医院急诊医学部,河南洛阳471003

出　　处：《中国医学工程》2022年第7期74-77,共4页China Medical Engineering

摘　　要：目的观察连续性静脉-静脉血液滤过联合血流灌洗在急性有机磷中毒(AOPP)救治中的应用效果。方法选取2020年3月至2021年3月在河南科技大学第一附属医院急诊就诊的80例AOPP患者为研究对象,按照治疗方法分为A组46例和B组34例。两组患者均予包括血液灌流(HP)在内的常规治疗,A组患者加用连续性静脉-静脉血液滤过(CVVH)疗法,比较治疗后两组患者的胆碱酯酶(ChE)活性恢复时间、昏迷时间、并发症发生率、心肌损伤指标、肝肾功能指标及氧化应激指标。结果治疗后,A组的ChE活性恢复时间、昏迷时间短于B组,并发症发生率低于B组(P<0.05);A组的心型脂肪酸结合蛋白(h-FABP)、血浆脑钠肽前体(NT-proBNP)水平低于B组(P<0.05);A组的血肌酐(SCr)、丙氨酸氨基转移酶(ALT)、天冬氨酸氨基转移酶(AST)水平低于B组(P<0.05);A组的超氧化物歧化酶(SOD)水平高于B组,丙二醛(MDA)及过氧化脂质(LPO)水平低于B组(P<0.05)。结论采用HP及CVVH联合治疗可以有效清除细胞毒性物质,保护心、肝肾功能,降低并发症发生率,从而提高治疗效果,改善预后。【Objective】To observe the application effect of continuous veno-venous hemofiltration(CVVH)combined with hemoperfusion(HP)in the treatment of acute organophosphorus pesticide poisoning(AOPP).【Methods】A total of 80 emergency patients with AOPP treated in the hospital were enrolled as the research objects between March 2020 and March 2021.According to different treatment methods,they were divided into group A(46 cases)and group B(34 cases).Both groups were given routine treatment such as HP.On this basis,group A was treated with CVVH.The recovery time of cholinesterase(ChE)activity,coma time,incidence of complications,myocardial injury indexes,liver-kidney function indexes and oxidative stress indexes after treatment were compared between the two groups.【Results】After treatment,recovery time of ChE activity and coma time in group A were shorter than those in group B,and incidence of complications was lower than that in group B(P<0.05).The levels of heart-shaped fatty acid binding protein(h-FABP)and plasma N-terminal pro brain natriuretic peptide(NT-proBNP)in group A were lower than those in group B(P<0.05),levels of serum creatinine(SCr),alanine aminotransferase(ALT)and aspartate aminotransferase(AST)in group A were lower than those in group B(P<0.05),level of superoxide dismutase(SOD)in group A was higher than that in group B,while levels of malondialdehyde(MDA)and lipid peroxide(LPO)in group A were lower than those in group B(P<0.05).【Conclusion】HP combined with CVVH can effectively eliminate cytotoxic substances,protect heart,liver and kidney function,and reduce the incidence of complications,thereby improving curative effect and prognosis.

关 键 词：急性有机磷中毒 连续性静脉-静脉血液滤过 血流灌注 

分 类 号：R595.4[医药卫生—内科学]