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目的分析血液灌流(HP)治疗急性有机磷农药中毒的治疗效果及并发症,寻求治疗急性重度有机磷农药中毒的科学方法。方法收集2009年1月至2013年12月于广州番禺区何贤纪念医院重症监护病房的急性有机磷农药中毒患者87例的临床资料,根据患者意愿分为常规治疗联合HP治疗组(治疗组,n=51)和常规治疗组(对照组,n=36),统计分析两组病人的治疗效果和并发症。结果治疗组阿托品总剂量、氯磷定总剂量、胆碱酯酶恢复时间、住院时间、恢复清醒时间、使用呼吸机时间均较对照组减少或缩短,差异有统计学意义(P<0.05或P<0.01),且治疗组治愈率明显高于对照组(P<0.01);治疗组中间综合征、肺部感染、呼吸衰竭、血压升高、肺水肿、深度昏迷、大小便失禁等并发症的发生率明显低于对照组,差异有统计学意义(P<0.01),消化道出血的发生率差异无统计学意义(P>0.05)。结论使用血液灌流抢救急性有机磷中毒患者能够取得良好的治疗效果并减少并发症的发生,值得推广应用。
Objective To analyze the therapeutic effect and complications of hemoperfusion (HP) in the treatment of acute organophosphorus pesticide poisoning and to seek a scientific method for the treatment of acute severe organophosphorus pesticide poisoning. Methods The clinical data of 87 patients with acute organophosphorus pesticide poisoning in the ICU ward of He Xian Memorial Hospital in Guangzhou Panyu District from January 2009 to December 2013 were collected and divided into routine treatment and HP treatment group according to patients’ wishes (treatment group, n = 51) and conventional treatment group (control group, n = 36). The therapeutic effects and complications of two groups were statistically analyzed. Results The total dose of atropine, total dose of chlorophosphon, recovery time of cholinesterase, hospital stay, awake recovery time and ventilator time in the treatment group were all decreased or shortened compared with the control group (P <0.05 or P <0.01), and the cure rate in the treatment group was significantly higher than that in the control group (P <0.01). In the treatment group, the intermediate syndrome, pulmonary infection, respiratory failure, high blood pressure, pulmonary edema, deep coma and incontinence and other complications The incidence of gastrointestinal bleeding was significantly lower than that of the control group (P <0.01). The incidence of gastrointestinal bleeding was not significantly different (P> 0.05). Conclusions The use of hemoperfusion to rescue acute organophosphate poisoning patients can achieve good therapeutic effect and reduce the incidence of complications, which is worth popularizing and applying.