摘要
目的观察血液灌流治疗急危重症有机磷中毒患者的临床疗效.方法选择2016年8月至2018年8月在山西省晋城市人民医院重症医学科治疗的急危重症有机磷中毒患者62例,将患者按是否进行血液灌流治疗分为常规治疗组和血液灌流组两组,每组31例.常规治疗组给予药物联合持续洗胃的急救措施;血液灌流组在常规治疗组急救方案基础上给予血流灌流治疗持续3d.观察两组盐酸戊乙奎醚使用量、意识恢复时间、胆碱酯酶(ChE)活性恢复时间、脱机时间、住院时间、抢救成功率、中毒反跳率、病死率的变化;用格拉斯哥昏迷评分(GCS)评估患者预后.结果血液灌流组盐酸戊乙奎醚使用量少于常规治疗组(mg:3.1±1.2比5.8±1.3),且意识恢复时间(h:3.3±1.7比13.4±2.4)、ChE活性恢复时间(d:7.7±1.5比17.9±3.3)、脱机时间(d:2.1±0.9比7.5±2.6)、住院时间(d:12.3±1.5比19.8±3.6)均较常规治疗组缩短(均P<0.05);血液灌流组中毒反跳率〔3.23%(1/31)比16.13%(5/31)〕和病死率〔9.68%(3/31)比25.81%(8/31)〕均较常规治疗组降低(均P<0.05),救治成功率较常规治疗组升高〔90.32%(28/31)比74.19%(23/31),P<0.05〕.血液灌流组治疗后3、4、5dGCS均较常规治疗组明显升高(分:9.9±2.9比5.7±2.6,13.3±2.7比7.8±3.2,13.3±1.5比9.3±2.6,均P<0.05).结论在常规用药联合持续洗胃急救的同时,给予患者血液灌流治疗,能进一步减少患者住院时间,改善生存质量,降低患者病死率.
Objective To observe the clinical effect of hemoperfusion in the treatment of patients with critical severe organophosphorus poisoning.Methods Sixty-two patients with critical severe organophosphoms poisoning admitted to the Department of Critical Care Medicine of Jincheng People's Hospital from August 2016 to August 2018 were enrolled,and they were divided into a routine treatment group and a hemoperfusion group according to whether hemoperfusion or not.31 cases in each group.The routine treatment group was treated with western dnigs combined with continuous gastric lavage,while the hemoperfusion group was additionally treated with hemoperfusion for consecutive 3 days on the basis of the routine emergency regimen.The changes of the dosage of penehvclidine hydrochloride used,recovery time of consciousness,rec overy time of cholinesterase(ChE)activity,off-line time of mechanical ventilation,hospitalization time,poisoning rebound and mortality were observed in the two groups after tre<itnient;Glasgow coma scale(GCS)was used to assess the prognosis of patients.Results The dosage of penehyclidinr hydrochloride used in hemoperfusion group was less than that in the routine treatment group(mg:3.1±1.2 vs.5.8±1.3).and the lime of consciousness recovery(hours:3.3±1.7 vs.13.4±2.4).recovery time of ChE activity(days:7.7±1.5 vs.17.9±3.3),off-line time(days:2.1±0.9 vs.7.5±2.6),hospitalization time(days:12.3±1.5 vs.19.8±3.6)in hemoperfusion group were shorter than those in the routine treat me nt group(all P<0.05);poisoning re bo und[3.23%(1/31)vs.16.13%(5/31)]and mortality[9.68%(3/31)vs.25.81%(8/31)]in hemoperfusion group were lower than those in the routine treatment group(both P<0.05).The Glasgow coma score(GCS)of the hemoperfusion group on 3,4 and 5 days after treatment were all higher than those of the routine treatment group(9.9±2.9 vs.5.7±2.6,13.3±2.7 vs.7.8±3.2,13.3±1.5 vs.9.3±2.6.all P<0.05).Conclusion The con ventional treatment,western drug and gastric lavage,com hi ned with hemoperfusion in patients
作者
李忠平
范青香
李晋霞
李立恒
崔伟东
Li Zhongping;Fan Qingxiang;Li Jinxia;Li Liheng;Cui Weidong(Department of Critical Care Medicine,Jinch eng People's Hospital,Jincheng 048000,Sluinxi,China)
出处
《中国中西医结合急救杂志》
CAS
CSCD
北大核心
2019年第1期117-119,共3页
Chinese Journal of Integrated Traditional and Western Medicine in Intensive and Critical Care
关键词
急危重症
有机磷中毒
血液灌流
临床急救
Critical severe disease
Organophosphorus poisoning
Hemoperfusion
Clinical first aid
