血液灌流联合盐酸戊乙奎醚及阿托品在重症有机磷中毒抢救中的应用价值  

Application of hemoperfusion combined with penehyclidine hydrochloride and atropine in the rescue of severe organophosphate poisoning

作　　者：杜慧清 范小勇 曹军 Du Huiqing;Fan Xiaoyong;Cao Jun(Department of Emergency,Xinxiang Central Hospital,the Fourth Clinical College of Xinxiang Medical University,Xinxiang 453000,China)

机构地区：[1]新乡市中心医院新乡医学院第四临床学院急诊科,新乡453000

出　　处：《中国实用医刊》2023年第6期59-62,共4页Chinese Journal of Practical Medicine

摘　　要：目的探讨血液灌流联合盐酸戊乙奎醚、阿托品在重症有机磷中毒抢救中的应用价值。方法抽取2018年9月至2021年9月新乡市中心医院收治的重症有机磷中毒抢救患者78例,以随机数字表法分为对照组与研究组,每组39例。对照组采用盐酸戊乙奎醚、阿托品治疗,研究组采用血液灌流联合盐酸戊乙奎醚、阿托品治疗。比较两组的临床疗效、症状消失时间、肝功能[天门冬氨酸氨基转移酶(AST)、丙氨酸氨基转移酶(ALT)]水平、心肌酶[肌酸激酶(CK)、磷酸肌酸激酶同工酶(CK-MB)]水平、炎性因子[C反应蛋白(CRP)、降钙素原(PCT)]水平及不良反应发生情况。结果研究组总有效率(94.87%,37/39)高于对照组(79.49%,31/39),P<0.05;研究组烟碱样症状、中枢神经症状及毒覃碱样症状消失时间短于对照组(P<0.05);治疗后,研究组AST、ALT、CK、CK-MB、CRP、PCT水平均低于对照组(P均<0.05)。研究组不良反应发生率(7.69%,3/39)与对照组(15.38%,6/39)比较差异未见统计学意义(P>0.05)。结论重症有机磷中毒抢救中应用血液灌流联合盐酸戊乙奎醚、阿托品效果显著,能够减轻炎性反应,改善临床症状和脏器功能。Objective To investigate the application of hemoperfusion combined with penehyclidine hydrochloride and atropine in the rescue of severe organophosphate poisoning.Methods Seventy-eight patients with severe organophosphate poisoning rescued in Xinxiang Central Hospital from September 2018 to September 2021 were selected,and they were divided into control group and study group by random number table method,with 39 cases in each group.The control group was treated with penehyclidine hydrochloride and atropine,while the study group was treated by hemoperfusion combined with penehyclidine hydrochloride and atropine.The clinical efficacy,symptom disappearance time,liver function assessed by aspartate aminotransferase(AST)and alanine aminotransferase(ALT),levels of myocardial enzymes,including creatine kinase(CK)and creatine kinase isoenzyme(CK-MB),levels of inflammatory factors,including C-reactive protein(CRP)and procalcitonin(PCT),and adverse reactions were compared between the two groups.Results The total effective rate of the study group(94.87%,37/39)was higher than that of the control group(79.49%,31/39),P<0.05.The disappearance time of nicotinic symptoms,central nervous system symptoms and muscarinic symptoms in the study group were shorter than those in the control group(P<0.05).After treatment,the levels of AST,ALT,CK,CK-MB,CRP and PCT in the study group were lower than those in the control group(allP<0.05).There was no significant difference in the incidence of adverse reactions between the study group(7.69%,3/39)and the control group(15.38%,6/39),P>0.05.Conclusions The application of hemoperfusion combined with penehyclidine hydrochloride and atropine in the rescue of severe organophosphate poisoning has significant effects.It can reduce inflammatory reactions,improve clinical symptoms and organ functions.

关 键 词：有机磷中毒 血液灌流 盐酸戊乙奎醚 阿托品 

分 类 号：R595.4[医药卫生—内科学]