血液灌流联合血浆置换治疗重度有机磷农药中毒的临床观察.docVIP

血液灌流联合血浆置换治疗重度有机磷农药中毒的临床观察 　　[摘要] 目的 探讨血液灌流（HP）联合血浆置换（PE）治疗重度有机磷农药中毒的临床疗效。 方法 选取我院2012年2月～2014年10月EICU中100例重度有机磷农药中毒患者，根据患者病情选取其中50例作为治疗组（HP+PE），选取另50例作为对照组（HP），比较两组的阿托品及氯解磷定用量、CHE活力恢复时间、平均住院天数、昏迷时间、并发症、死亡率。 结果 两组之间各观察指标比较，均有显著性差异（P0.05），治疗组疗效优于对照组，对照组死亡率（20.00%）远高于治疗组死亡率的12.00%。 结论 血液灌流联合血浆置换能显著提高重度急性有机磷农药中毒疗效，减少并发症的发生，降低死亡率。 　　[关键词] 血液灌流；血浆置换；有机磷农药；中毒 　　[中图分类号] R595.4 [文献标识码] B [文章编号] 1673-9701（2015）11-0079-03 　　[Abstract] Objective To discuss the clinical effects of hemoperfusion （HP） combined with plasma exchange （PE） in the treatment of severe organic phosphorus pesticide poisoning. Methods A total of 100 patients with severe organic phosphorus pesticide poisoning who were admitted to our hospital from February 2012 to October 2014 were selected. According to patients disease conditions， 50 patients were assigned to a treatment group （HP+HE）， and another 50 patients were assigned to a control group（HP）. Dosage of atropine and pralidoxime chloride， recovering time of CHE activity， average hospitalization days， coma time， complications and mortality rate between the two groups were compared. Results Each observational index between the two groups was compared， and the results were significantly different （P0.05）. Effective rate in the treatment group was better than that in the control group， and the morality rate of 20.00% in the control group was significantly higher than that of 12.00% in the treatment group. Conclusion HP combined with PE is able to improve the curative effects of severe organic phosphorus pesticide poisoning significantly， reduce complications and lower mortality rate. 　　[Key words] Hemoperfusion （HP）； Plasma exchange （PE）； Organic phosphorus pesticide； Poisoning 　　急性有机磷农药中毒（acute organophosphorus pesticidepoisoning，AOPP）具有起病急、发展迅速、病情凶险、死亡率高的特点，是临床上较常见的中毒性疾病之一。其作为临床常见的急危重症之一，如不采取快速有效治疗措施，可引起人体脑、肾、心、肺等重要脏器不可逆性损害，常危及生命[1，2]。及时彻底地清除毒物是抢救的重要原则和关键。目前临床上常用的洗胃、导泻、灌肠、吸附等传统的清除毒物方法无法清除人体已吸收入血的毒素。血液净化是将患者血液引入装有固态吸附剂的灌流器中进行血浆置换，清除血中毒素及代谢物的有效方法