CVVHDF联合血液灌流对急性有机磷中毒患者肝肾功能及血清ChE水平的影响  

Effects of CVVHDF Combined with Hemoperfusion on Liver and Kidney Function and Serum ChE Level in Patients with Acute Organophosphorus Poisoning

作　　者：韦靖 WEI Jing(Department of Critical Care Medicine,Guangxi-ASEAN Economic and Technological Development Zone People's Hospital(Nanning Tenth People's Hospital),Nanning,Guangxi Zhuang Autonomous Region,530105 China)

机构地区：[1]广西-东盟经济技术开发区人民医院(南宁市第十人民医院)重症医学科,广西南宁530105

出　　处：《系统医学》2023年第24期9-12,24,共5页Systems Medicine

摘　　要：目的研究连续性静脉-静脉透析滤过(continuous veno venous hemodia filtration,CVVHDF)联合血液灌流对急性有机磷中毒(acute organophosphorous pesticide poisoning,AOPP)患者肝肾功能及血清胆碱酯酶(cho⁃linesterase,ChE)水平的影响。方法回顾性分析2020年1月—2023年1月广西-东盟经济技术开发区人民医院收治的78例AOPP患者的临床资料,依据收治时间不同划分对照组与干预组,其中2020年1月—2021年7月收治的39例作为对照组,予以血液灌流治疗,同时予以患者洗胃、灌肠、同时补液维持体内电解质平衡与酸碱度平衡;2021年8月—2023年1月收治的39例作为干预组,在对照组基础上予以CVVHDF治疗。观察组患者血清中的谷丙转氨酶(alanine aminotransferase,ALT)、谷草转氨酶(aspartate aminotransferase,AST)、总胆红素(total bilirubin,TBiL)水平,以评估肝功能;分析血尿素氮(blood urea nitrogen,BUN)、血肌酐(serum cre⁃atinine,Scr)、尿酸,用以评价患者肾功能;于治疗前与治疗1 h、1 d、2 d、3 d后监测患者血清中ChE水平变化;并评价两组总疗效。结果治疗后,两组的ALT、AST、TBiL水平明显降低,且干预组降低程度高于对照组,差异有统计学意义(P均<0.05)。治疗后,两组血液BUN、Scr、尿酸水平明显降低,且干预组肾功能改善程度均优于对照组,差异有统计学意义(P均<0.05)。经过治疗1、2、3 d后,两组血清ChE水平明显升高,且干预组均高于对照组,差异有统计学意义(P均<0.05)。经过治疗后对照组的总有效率为74.36%,干预组的总有效率为92.31%,二者比较,差异有统计学意义(χ2=4.523,P<0.05)。结论CVVHDF联合血液灌流有助于提升患者血清ChE水平及肝肾功能,疗效明确。Objective To investigate the effects of continuous veno venous hemodia filtration(CVVHDF)combined with hemoperfusion on liver and kidney function and serum cholinesterase(ChE)level in patients with acute organo⁃phosphorous pesticide poisoning(AOPP).Methods The clinical data of 78 patients with AOPP admitted to the Guangxi-ASEAN Economic and Technological Development Zone People's Hospital from January 2020 to January 2023 were retrospectively analyzed,and the control group and intervention group were divided according to different admission time.Among them,39 cases admitted from January 2020 to July 2021 were used as the control group to re⁃ceive hemoperfusion treatment,while gastric lavage,enema,and fluid supplementation were given to maintain electro⁃lyte balance and pH balance in the body.A total of 39 patients treated from August 2021 to January 2023 were se⁃lected as the intervention group,and CVVHDF was treated on the basis of the control group.The serum levels of ala⁃nine aminotransferase (ALT), aspartate aminotransferase (AST) and total bilirubin (TBiL) were observed to evaluate liver function. Blood urea nitrogen (BUN), serum creatinine (Scr) and uric acid were analyzed to evaluate renal func⁃ tion. The changes of serum ChE levels were monitored before treatment and 1 h, 1 d, 2 d and 3 d after treatment, and the overall efficacy of the two groups was evaluated. Results After treatment, the levels of ALT, AST and TBiL in both groups were significantly decreased, and the reduction degree in the intervention group was higher than that in the control group, and the differences were statistically significant (all P<0.05). After treatment, blood BUN, Scr and uric acid levels in both groups were significantly decreased, and the improvement of renal function in the intervention group was better than that in the control group, and the differences were statistically significant (all P<0.05). The se⁃ rum ChE level of the two groups was significantly increased after 1 d, 2 d and 3 d treatment, and the

关 键 词：连续性静脉-静脉透析滤过 血液灌流 急性有机磷中毒 肝肾功能 血清胆碱酯酶 

分 类 号：R544[医药卫生—心血管疾病]