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目的:探讨活性炭洗胃联合炭肾血液灌流(HP)治疗急性有机磷农药中毒(AOPP)伴中间综合征(IMS)的临床疗效,为临床治疗提供参考。方法:将2010年1月至2012年12月我院救治的AOPP伴IMS的患者46例随机分为治疗组与对照组各23例,治疗组采用活性炭洗胃联合炭肾HP进行治疗,对照组采用常规洗胃+炭肾HP治疗。结果:治疗组HP的时间(1.89±0.91)h明显低于对照组的(3.51±1.26)h,治疗组胆碱酯酶((ChE)的恢复时间(5.42±3.92)d明显短于对照组的(7.19+4.55)d,治疗组IMS的恢复时间(2.91±3.27)h明显少于对照组的(5.42±4.83)h,治疗组阿托品的总量(1703.69+96.52)mg明显少于对照组的(2492.33±121.68)mg,P均<0.05。结论:活性炭洗胃联合炭肾血液灌流(HP)治疗发挥全身多系统对毒物清除的协同作用,减少毒物的转移,提高了对AOPP伴IMS的治疗效果,建议临床推广应用。
Objective: To investigate the clinical efficacy of active gastric lavage combined with charcoal hemoperfusion (HP) in the treatment of acute organophosphorus pesticide poisoning (AOPP) with intermediate syndrome (IMS), and to provide reference for clinical treatment. Methods: 46 patients with AOPP and IMS who were treated in our hospital from January 2010 to December 2012 were randomly divided into treatment group (23 cases) and control group (23 cases). The treatment group was treated with activated carbon gastric lavage combined with carbon kidney HP, while the control group Routine gastric lavage + carbon kidney HP treatment. Results: The time of HP in the treatment group was significantly lower than that in the control group (1.89 ± 0.91 h) (3.51 ± 1.26 h). The recovery time of ChE in the treatment group (5.42 ± 3.92) d was significantly shorter than that of the control group (7.19 + 4.55) d, the recovery time of IMS in treatment group (2.91 ± 3.27) h was significantly less than that of control group (5.42 ± 4.83) h, the total amount of atropine in treatment group (1703.69 + 96.52) mg was significantly less than that of control group (2492.33 ± 121.68) mg, all P <0.05.Conclusion: Activated carbon gastric lavage combined with charcoal hemoperfusion (HP) can exert the synergistic effect of systemic and multiple systems on toxic removals and reduce the transfer of toxic substances, Therapeutic effect, it is recommended clinical application.