急救后血液灌流联合解磷定VitB6治疗对重症有机磷农药中毒患者的疗效  

Therapeutic effect of hemoperfusion combined with VitB6 pralidoxime in patients with severe organophosphorus pesticide poisoning after emergency treatment

作　　者：姜君 梁松健[1] 赵帅[1] Jiang Jun;Liang Song-jian;Zhao Shuai(Department of Emergency Medicine,Nanyang Central Hospital,Nanyang 473000,Henan,China)

机构地区：[1]南阳市中心医院急诊内科,河南南阳473000

出　　处：《四川生理科学杂志》2024年第5期1065-1067,共3页Sichuan Journal of Physiological Sciences

摘　　要：目的:探讨急救后血液灌流治疗联合解磷定VitB6对重症有机磷农药中毒患者的疗效。方法:选择2018年10月至2023年2月本院收治的90例重症有机磷农药中毒患者,随机分为对照组和研究组,每组各45例。两组急诊入院后予常规急救处理,在此基础上,对照组予以解磷定VitB6治疗,研究组予以血液灌流治疗联合解磷定VitB6治疗。治疗24h后分析比较两组的临床疗效;治疗24h内记录两组机械通气时间、昏迷复醒时间、中毒症状消失时间,并通过Ellman法检测两组患者胆碱酯酶(Cholinesterase,CHE)活性恢复时间;治疗24h后采用全自动生化分析仪测定肌酸激酶(Creatine kinase,CK)、肌酸激酶同工酶(Ceatine kinase isoenzyme,CK-MB)、肌钙蛋白(Cardiac troponin I,cTnI)和谷丙转氨酶(Alaninetransaminase,ALT)、谷草转氨酶(Aspartate Transaminase,AST)、总胆红素(Total Bilirubin,TBiL)水平。结果:治疗24 h后,研究组治疗总有效率显著高于对照组(P<0.05);机械通气时间、昏迷复醒时间、中毒症状消失时间、CHE活性恢复时间明显短于对照组(P<0.05)。治疗24h后,研究组CK、CK-MB、cTnI心肌酶谱指标水平及ALT、AST、TBiL肝功能指标水平均显著低于对照组(P<0.05)。结论:血液灌流治疗联合解磷定VitB6治疗,能提高重症有机磷农药中毒患者的临床疗效,促进患者病情恢复,降低患者血清心肌酶谱水平及改善肝功能。Objective:To investigate the therapeutic effect of hemoperfusion combined with pralidoxime VitB6 on patients with severe organophosphorus pesticide poisoning after emergency treatment.Methods:90 patients with severe organophosphorus pesticide poisoning admitted to our hospital from October 2018 to February 2023 were randomLy divided into control group and study group,with 45 cases in each group.The two groups were treated with routine emergency treatment after emergency admission.On this basis,the control group was treated with pralidoxime VitB6,and the study group was treated with hemoperfusion combined with pralidoxime VitB6.After 24 h of treatment,the clinical effect of the two groups was analyzed and compared.Within 24 h of treatment,the time of mechanical ventilation,the time of recovery from coma and the time of disappearance of poisoning symptoms were recorded in both groups,and the recovery time of Cholinesterase(CHE)activity was detected by Ellman method.After 24 h of treatment,Creatine kinase(CK),Ceatine kinase isoenzyme(CK-MB)and Cardiac troponin I were measured by automatic biochemical analyzer.cTnI,Alaninetransaminase(ALT),Aspartate Transaminase(AST)and Total Bilirubin(TBiL)levels.Results:After 24 h of treatment,the total effective rate of the study group was significantly higher than that of the control group(P<0.05).The mechanical ventilation time,coma recovery time,poisoning symptom disappearance time,CHE activity recovery time were significantly shorter than control group(P<0.05).After 24 h of treatment,the levels of CK,CK-MB,cTnI myocardial enzyme profile and ALT,AST,TBiL liver function indexes in the study group were significantly lower than those in the control group(P<0.05).Conclusion:Hemoperfusion therapy combined with VitB6 treatment can improve the clinical efficacy of patients with severe organophosphorus pesticide poisoning,promote the recovery of patients'disease,reduce the level of serum myocardial enzyme spectrum and improve liver function.

关 键 词：血液灌流治疗 解磷定VitB6 重症有机磷农药中毒 

分 类 号：R595.4[医药卫生—内科学]