连续性床旁血液滤过在急性有机磷农药中毒患者中的应用效果  

Application effects of continuous renal replacement therapy in patients with acute organophosphorus pesticide poisoning

作　　者：邓陶 肖隆林 张君 DENG Tao;XIAO Longlin;ZHANG Jun(Emergency Department of Ganzhou People’s Hospital,Ganzhou 341000 Jiangxi,China)

机构地区：[1]赣州市人民医院急诊科,江西赣州341000

出　　处：《中国民康医学》2025年第4期64-67,共4页Medical Journal of Chinese People’s Health

摘　　要：目的:观察连续性床旁血液滤过(CRRT)在急性有机磷农药中毒(AOPP)患者中的应用效果。方法:回顾性分析2021年10月至2023年10月该院收治的102例AOPP患者的临床资料,按治疗方式不同将其分为对照组和观察组各51例。对照组接受血液灌流治疗,观察组在对照组基础上接受CRRT治疗,比较两组治疗前后胆碱酯酶、炎性指标[C反应蛋白(CRP)、肿瘤坏死因子-α(TNF-α)、白细胞介素-6(IL-6)、白细胞介素-8(IL-8)]和肝肾功能指标[血肌酐(Scr)、血尿素氮(BUN)、天冬氨酸氨基转移酶(AST)、丙氨酸氨基转移酶(ALT)]水平。结果:治疗48 h后,两组胆碱酯酶水平均高于治疗前,且观察组高于对照组,差异有统计学意义(P<0.05);治疗48 h后,两组CRP、TNF-α、IL-6、IL-8水平均低于治疗前,且观察组低于对照组,差异有统计学意义(P<0.05);治疗48 h后,两组Scr、BUN、AST、ALT水平均低于治疗前,且观察组低于对照组,差异有统计学意义(P<0.05)。结论:在血液灌流基础上采用CRRT治疗AOPP患者可提高胆碱酯酶水平,降低炎性指标和肝肾功能指标水平,效果优于单纯血液灌流治疗。Objective:To observe application effects of continuous renal replacement therapy(CRRT)in patients with acute organophosphorus pesticide poisoning(AOPP).Methods:The clinical data of 102 patients with AOPP admitted to this hospital from October 2021 to October 2023 were retrospectively analyzed.According to different treatment methods,they were divided into control group and observation group,51 cases in each group.The control group received hemoperfusion treatment,while the observation group received CRRT treatment on the basis of that of the control group.The levels of cholinesterase,inflammatory factors[C-reactive protein(CRP),tumor necrosis factor-α(TNF-α),interleukin-6(IL-6),interleukin-8(IL-8)]and liver and kidney function indexes[serum creatinine(Scr),blood urea nitrogen(BUN),aspartate aminotransferase(AST),alanine aminotransferase(ALT)]were compared between the two groups before and after the treatment.Results:After 48 hours of treatment,the levels of cholinesterase in the two groups were higher than those before the treatment,that in the observation group was higher than that in the control group,and the differences were statistically significant(P<0.05).After 48 hours of treatment,the levels of CRP,TNF-α,IL-6 and IL-8 in the two groups were lower than those before the treatment,those in the observation group were lower than those in the control group,and the differences were statistically significant(P<0.05).Further,after 48 hours of treatment,the levels of Scr,BUN,AST and ALT in the two groups were lower than those before the treatment,those in the observation group were lower than those in the control group,and the differences were statistically significant(P<0.05).Conclusions:On the basis of hemoperfusion,CRRT can improve the levels of cholinesterase and reduce the levels of inflammatory factors and liver and kidney function indexes in the patients with AOPP.Moreover,it is superior to simple hemoperfusion.

关 键 词：急性有机磷农药中毒 连续性床旁血液滤过 血液灌流 胆碱酯酶 炎性指标 肝肾功能 

分 类 号：R459.7[医药卫生—急诊医学]