摘要
目的探讨血液灌流治疗急性重度有机磷农药中毒效果。方法回顾性分析自2003年7月至2006年6月重度有机磷农药中毒72例临床资料。全部病例均在急诊科洗胃及内科常规处理后转入ICU并给予血液灌流治疗,将在内科常规治疗、血液灌流同时再次反复洗胃、导泻的34例作为治疗组,将仅内科常规治疗、血液灌流,未再次洗胃、导泻的38例作为对照组。结果治疗组治疗开始至清醒时间、复能剂、拮抗剂用量、住院时间均较对照组明显减少,治疗组治愈率91.2%,对照组为71.1%(P<0.05)。结论内科常规治疗加早期血液灌流治疗急性重度有机磷农药中毒安全有效,早期血液灌流同时反复洗胃、导泻,可以进一步提高治愈率。
object lye To evaluate the effect of hemoperfusion on severe acute organophosphorus pesticide poisoning （AOPP）. Methods Seventy-two patients committed suicide by drinking organophosphorus pesticides, including carbamoyl, dantoxsevere, DDVP, or 3911, and then suffered from AOPP. They underwent gastric lavage and routine treatment in emergency department, transferred into ICU to receive bedside hemoperfusion, and then randomly divided into 2 sex-and age-matched groups： Group A （n=34）, receiving repeated gastric lavage and catharsis in addition to the routine treatment and hemoperfusion, and Group B （n=38）, only receiving routine treatment and hemoperfusion. The therapeutic efficacy was analyzed. Results The dose of atropine of the treatment group was （178.6 ± 68.3 ）mg, not significantly different from that of the control group [（213.5± 124.6） mg,t=1.429, P〉0.05] ）. The ICU stay time of the treatment group was （7.6±2.8）d, significantly shorter than that of the control group [（9.2±3.7） d, t =2.05, P 〈0.05]. The mortality of the treatment group was 8.82% （3/34 ）, significantly lower than that of the control group [28.95 %, 11/38, Х^2=4.64, P〈0.05]. The cure rate of the treatment group was 91.2 %, significantly higher than that of the control group （71.1%, P〈0.05）. The prevalence rate of multiple organs dysfunction syndrome （MODS） of the treatment group was 55.8 % （19/34 ）, not significantly different from that of the control group （66.7 %, 25/38, P〉0.05）. Conclusion Bedside hemoperfusion combined with repeated gastric lavage and catharsis is safe and effective in treatment of severe AOPP.
出处
《中国急救复苏与灾害医学杂志》
2008年第5期278-280,共3页
China Journal of Emergency Resuscitation and Disaster Medicine
关键词
血液灌流
洗胃
导泻
急性重度有机磷农药中毒
Hemoperfusion
Lavage, gastric
Catharsis
Acute organophosphorus pesticide poisoning
