血液灌流对重症有机磷中毒患者心肌酶、抢救成功率的影响  

Effect of Hemoperfusion on Myocardial Enzyme and Rescue Success Rate in Patients with Severe Organophosphorus Poisoning

作　　者：谭赵根[1] 甘泉 吴金峰 曾颖群[1] TAN Zhaogen;GAN Quan;WU Jinfeng;ZENG Yingqun(Department of Emergency,Fengcheng People's Hospital,Fengcheng 331100,China;不详)

机构地区：[1]丰城市人民医院急诊科,江西丰城331100

出　　处：《中国医学创新》2024年第27期32-36,共5页Medical Innovation of China

摘　　要：目的:分析血液灌流对重症有机磷中毒患者心肌酶、抢救成功率的影响。方法:选取2021年8月1日—2023年11月1日丰城市人民医院收治的72例重症有机磷中毒患者,以随机数字表法分为常规组、观察组,各36例。常规组给予硫酸阿托品注射液及碘解磷定治疗,观察组在常规组基础上给予血液灌流治疗,两组均持续治疗3 d。对比两组苏醒时间、住院时间、格拉斯哥昏迷评分(GCS)、胆碱酯酶(ChE)水平、炎症因子[C反应蛋白(CRP)、白细胞介素-6(IL-6)]、抢救成功率、心肌酶[乳酸脱氢酶(LDH)、肌酸激酶(CK)]。结果:观察组苏醒时间、住院时间均短于常规组(P<0.05)。两组治疗后的GCS、ChE均升高,观察组GCS、ChE均高于常规组(P<0.05)。两组治疗后的CRP、IL-6均降低,观察组CRP、IL-6均低于常规组(P<0.05)。观察组抢救成功率[97.22%(35/36)]与常规组[83.33%(30/36)]比较,差异无统计学意义(P>0.05)。两组治疗后的LDH、CK均降低,观察组LDH、CK均低于常规组(P<0.05)。结论:血液灌流治疗重症有机磷中毒效果显著,可有效清除炎症因子,提高血清ChE水平,有利于心肌酶恢复,并可提高抢救成功率。Objective:To analyze the effect of hemoperfusion on myocardial enzyme and rescue success rate in patients with severe organophosphorus poisoning.Method:A total of 72 patients with severe organophosphorus poisoning admitted to Fengcheng People's Hospital from August 1st,2021 to November 1st,2023 were selected and divided into conventional group and observation group by random number table method,with 36 cases in each group.The conventional group was treated with Atropine Sulfate Injection and Pralidoxime Iodide,and the observation group was treated with hemoperfusion on the basis of the conventional group.Both groups were treated continuously for 3 days.The awake time,hospital stay,Glasgow coma score(GCS),cholinesterase(ChE)level,inflammatory factors[C reactive protein(CRP),interleukin-6(IL-6)],rescue success rate,myocardial enzyme[lactate dehydrogenase(LDH),creatine kinase(CK)]were compared between the two groups.Result:The awake time and hospital stay of observation group were shorter than those of conventional group(P<0.05).After treatment,GCS and ChE in both groups were increased,and GCS and ChE in observation group were higher than those in conventional group(P<0.05).After treatment,CRP and IL-6 in both groups were decreased,and CRP and IL-6 in observation group were lower than those in conventional group(P<0.05).There was no significant difference in rescue success rate between the observation group[97.22%(35/36)]and the conventional group[83.33%(30/36)](P>0.05).After treatment,LDH and CK in both groups were decreased,LDH and CK in observation group were lower than those in conventional group(P<0.05).Conclusion:Hemoperfusion is effective in the treatment of severe organophosphorus poisoning,which can effectively remove inflammatory factors,increase serum ChE level,facilitate the recovery of myocardial enzyme,and improve the rescue success rate.

关 键 词：苏醒时间 住院时间 血液灌流 有机磷中毒 抢救成功率 

分 类 号：R595.4[医药卫生—内科学]