常规内科治疗联合急诊床边血液灌流治疗急性重度有机磷农药中毒的临床效果  

Clinical Effect of Routine Medical Treatment Combined with Emergency Bedside Hemoperfusion on Acute Severe Organophosphorus Pesticide Poisoning

作　　者：庞大尧 Pang Dayao(Guigang People's Hospital,Guigang 537100,Guangxi Zhuang Autonomous Region,China)

机构地区：[1]贵港市人民医院,广西壮族自治区贵港537100

出　　处：《中外医药研究》2024年第5期33-35,共3页JOURNAL OF CHINESE AND FOREIGN MEDICINE AND PHARMACY RESEARCH

摘　　要：目的:探讨急诊床边血液灌流(HP)治疗急性重度有机磷农药中毒(ASOPP)的临床效果。方法:选取2019年1月—2023年6月贵港市人民医院收治的ASOPP患者64例为研究对象,根据治疗方法分为对照组(常规内科治疗)和观察组(常规内科治疗联合急诊床边HP治疗),各32例。比较两组治疗效果、抢救情况、血清学指标[肌酸激酶同工酶(CK-MB)、丙氨酸氨基转移酶(ALT)、天门冬氨酸氨基转移酶(AST)、尿素氮(BUN)]。结果:观察组治疗总有效率高于对照组,差异有统计学意义(P=0.010)。观察组呼吸机应用时间、血胆碱酯酶活力恢复至>50%时间短于对照组,清醒时间早于对照组,阿托品用量少于对照组,差异有统计学意义(P<0.001)。治疗前,两组CK-MB、ALT、AST、BUN水平比较,差异无统计学意义(P>0.05);治疗1周后,两组CK-MB、ALT、AST、BUN水平降低,观察组低于对照组,差异有统计学意义(P<0.05)。观察组并发症发生率低于对照组,差异有统计学意义(P=0.005)。结论:在常规内科治疗基础上,急诊床边HP治疗ASOPP患者效果更好,可促进血清学指标恢复,减少阿托品用量,缩短呼吸机应用时间并加速清醒,降低并发症发生率。Objective:To investigate the clinical effect of emergency bedside hemoperfusion(HP)in the treatment of acute severe organophosphorus pesticide poisoning(ASOPP).Methods:Sixty-four patients with ASOPP admitted to Guigang People's Hospital from January 2019 to June 2023 were selected as the study objects,and were divided into control group(routine medical treatment)and observation group(routine medical treatment combined with bedside HP treatment in emergency)according to treatment methods,with thirty-two cases in each group.The therapeutic effect,rescue situation and serological indexes[creatine kinase isoenzyme(CK-MB),alanine aminotransferase(ALT),aspartate aminotransferase(AST)and blood urea nitrogen(BUN)]of the two groups were compared.Results:The total effective rate of the observation group was higher than that of the control group,the difference was statistically significant(P=0.010).The time of ventilator application and the recovery of blood cholinesterase activity to>50%in the observation group were shorter than those in the control group,the waking time was earlier than the control group,and the atropine dosage was less than the control group,the difference was statistically significant(P<0.001).Before treatment,there was no significant difference in CK-MB,ALT,AST and BUN levels between the two groups(P>0.05);after 1 week of treatment,the levels of CK-MB,ALT,AST and BUN in both groups were decreased,and the observation group was lower than the control group,the difference was statistically significant(P<0.05).The complication rate of the observation group was lower than that of the control group,and the difference was statistically significant(P=0.005).Conclusion:On the basis of conventional medical treatment,bedside HP in the emergency department is more effective in the treatment of ASOPP patients,which can promote the recovery of serological indexes,reduce the dosage of atropine,shorten the time of ventilator application,accelerate wakefulness,and reduce the incidence of complications.

关 键 词：急性重度有机磷农药中毒 血液灌流 急诊 

分 类 号：R595.4[医药卫生—内科学]