脂肪乳联合重复血液灌流治疗急性有机磷中毒  

Treatment of Acute Organophosphate Poisoning with Lipid Emulsion Combined with Repeated Hemoperfusion

作　　者：张增强 周创宇 桑敬芳 ZHANG Zengqiang;ZHOU Chuangyu;SANG Jingfang(Department of Emergency Medicine,Anyang People’s Hospital,Anyang Henan 455000,China)

机构地区：[1]安阳市人民医院急诊医学科,河南安阳455000

出　　处：《河南医学高等专科学校学报》2025年第2期192-195,共4页Journal of Henan Medical College

摘　　要：目的观察脂肪乳联合重复血液灌流治疗对急性有机磷农药中毒(acute organophosphate pesticides poisoning,AOPP)患者心功能的影响。方法选取80例AOPP患者作为研究对象,依据治疗方法分为对照组与观察组,各40例。对照组使用重复血液灌流(hemoperfusion,HP)疗法,观察组使用脂肪乳联合重复HP疗法,均治疗3 d。观察2组患者心功能指标[心脏指数(CI)、左室射血分数(LVEF)、舒张早期与晚期最大血流速度比值(E/A)]、心肌指标[肌酸激酶(CK)、乳酸脱氢酶(LDH)、谷丙转氨酶(ALT)]、治疗转归以及生活质量量表(SF-36)评分情况。结果治疗后,观察组CI、LVEF、E/A值分别为(3.15±0.12)L·min^(-1)·m^(-2)、(50.18±8.36)%、(1.37±0.28),均高于对照组的(0.34±0.22)L·min^(-1)·m^(-2)、(41.38±7.53)%、(1.08±0.05),差异有统计学意义(P<0.05)。观察组CK、LDH、ALT值分别为(108.57±23.18)、(237.26±18.05)、(35.72±5.44)U·L^(-1),均低于对照组的(138.24±17.34)、(287.24±21.22)、(43.84±6.32)U·L^(-1),差异有统计学意义(P<0.05)。观察组住院时间、昏迷时间和机械通气时间均短于对照组,SF-36量表各维度评分高于对照组,差异有统计学意义(P<0.05)。结论脂肪乳联合重复HP能有效缩短患者住院时间、昏迷时间和机械通气时间,有效恢复患者心功能,提升患者生活质量。Objective To observe the effect of lipid emulsion combined with repeated hemoperfusion on the cardiac function of patients with acute organophosphate pesticides poisoning(AOPP).Methods Eighty patients with AOPP were selected as the research objects and divided into a control group and an observation group according to the treatment methods,with 40 patients in each group.The control group received the repeated hemoperfusion(HP)therapy,and the observation group received the lipid emulsion combined with repeated HP therapy,and both groups were treated for 3 days.The cardiac function indexes of the two groups of patients were observed:cardiac index(CI),left ventricular ejection fraction(LVEF),the ratio of early to late diastolic maximum blood flow velocity(E/A),myocardial indexes creatine kinase(CK),lactate dehydrogenase(LDH),alanine aminotransferase(ALT),treatment outcomes,and the scores of the 36-item Short Form Health Survey(SF-36).Results After treatment,the values of CI,LVEF,and E/A in the observation group were(3.15±0.12)L·min^(-1)·m^(-2),(50.18±8.36)%,and(1.37±0.28)respectively,which were higher than those in the control group(0.34±0.22)L·min^(-1)·m^(-2),(41.38±7.53)%and(1.08±0.05),and the differences were statistically significant(P<0.05).The values of CK,LDH,and ALT in the observation group were(108.57±23.18),(237.26±18.05),and(35.72±5.44)U·L^(-1) respectively,which were significantly lower than those in the control group(138.24±17.34),(287.24±21.22)and(43.84±6.32)U·L^(-1),and the differences were statistically significant(P<0.05).The hospitalization time,coma time,and mechanical ventilation time of the observation group were all shorter than those of the control group,and the scores of each dimension of the SF-36 scale in the observation group were higher than those in the control group,and the differences were statistically significant(P<0.05).Conclusion Lipid emulsion combined with repeated HP can effectively treat AOPP,shorten the hospitalization time,coma time,and mechanical ventilatio

关 键 词：急性有机磷农药中毒 心功能 生活质量 脂肪乳 重复血液灌流 

分 类 号：R595.4[医药卫生—内科学]