中国实用医刊
中國實用醫刊
중국실용의간
CENTRAL PLAINS MEDICAL JOURNAL
2010年
7期
15-16
,共2页
血液灌流%急性有机磷中毒
血液灌流%急性有機燐中毒
혈액관류%급성유궤린중독
Hemoperfusion%Acute organophosphorus pesticide poisoning
目的 改良急性重度有机磷农药中毒(AOPP)的治疗方法.方法 将我院2005年1月至2008年12月收治的48例重度AOPP患者随机分为两组,对照组按常规洗胃、阿托品、复能剂、保肝、利尿治疗,观察组在此基础上加用树脂罐血液灌流(HP)治疗,并在围术期应用中药生大黄导泻排毒及输注新鲜冰冻血浆,分别对神志恢复时间、阿托品总用量、胆碱酯酶复活时间、胆碱酯酶(ChE)恢复达50%的时间,并发症(农药中毒反跳、中间综合征、多脏器损害、多脏器衰竭、迟发性神经损害)发生率和治愈率、病死率进行监测.结果 观察组较对照组阿托品用量少(t=4.35,P＜0.01),意识恢复快(t=3.61,P＜0.01),ChE恢复50%的时间快(t=2.94,P＜0.01),治愈率高(96.0%vs65.2%,χ2=5.57,P＜0.05＝,病死率低(4.0%vs 34.8%,χ2=5.57,P＜0.05).结论 HP治疗并在围术期应用中药生大黄导泻排毒及输注新鲜冰冻血浆的方法能迅速清除体内毒物,减少并发症,提高急性重度AOPP的治愈率.
目的 改良急性重度有機燐農藥中毒(AOPP)的治療方法.方法 將我院2005年1月至2008年12月收治的48例重度AOPP患者隨機分為兩組,對照組按常規洗胃、阿託品、複能劑、保肝、利尿治療,觀察組在此基礎上加用樹脂罐血液灌流(HP)治療,併在圍術期應用中藥生大黃導瀉排毒及輸註新鮮冰凍血漿,分彆對神誌恢複時間、阿託品總用量、膽堿酯酶複活時間、膽堿酯酶(ChE)恢複達50%的時間,併髮癥(農藥中毒反跳、中間綜閤徵、多髒器損害、多髒器衰竭、遲髮性神經損害)髮生率和治愈率、病死率進行鑑測.結果 觀察組較對照組阿託品用量少(t=4.35,P＜0.01),意識恢複快(t=3.61,P＜0.01),ChE恢複50%的時間快(t=2.94,P＜0.01),治愈率高(96.0%vs65.2%,χ2=5.57,P＜0.05＝,病死率低(4.0%vs 34.8%,χ2=5.57,P＜0.05).結論 HP治療併在圍術期應用中藥生大黃導瀉排毒及輸註新鮮冰凍血漿的方法能迅速清除體內毒物,減少併髮癥,提高急性重度AOPP的治愈率.
목적 개량급성중도유궤린농약중독(AOPP)적치료방법.방법 장아원2005년1월지2008년12월수치적48례중도AOPP환자수궤분위량조,대조조안상규세위、아탁품、복능제、보간、이뇨치료,관찰조재차기출상가용수지관혈액관류(HP)치료,병재위술기응용중약생대황도사배독급수주신선빙동혈장,분별대신지회복시간、아탁품총용량、담감지매복활시간、담감지매(ChE)회복체50%적시간,병발증(농약중독반도、중간종합정、다장기손해、다장기쇠갈、지발성신경손해)발생솔화치유솔、병사솔진행감측.결과 관찰조교대조조아탁품용량소(t=4.35,P＜0.01),의식회복쾌(t=3.61,P＜0.01),ChE회복50%적시간쾌(t=2.94,P＜0.01),치유솔고(96.0%vs65.2%,χ2=5.57,P＜0.05＝,병사솔저(4.0%vs 34.8%,χ2=5.57,P＜0.05).결론 HP치료병재위술기응용중약생대황도사배독급수주신선빙동혈장적방법능신속청제체내독물,감소병발증,제고급성중도AOPP적치유솔.
Objective To improve the treatment of acute severe organophosphorus pesticide poisoning(AOPP).Methods The 48 cases of severe AOPP patients were randomly divided into two groups, control group(n = 23)according to conventional gastric lavage, atropine, rehabilitation can be agents, liver,diuretic treatment, the observation group in this basis can increase resin hemoperfusion treatment and application in perioperative medicine detoxification catharsis rhubarb and fresh frozen plasma infusion.Results The observation group with less atropine than in control group(t =4.35, P ＜0.01), awareness and rapid recovery(t =3.61, P ＜0.01), ChE time to restore 50% faster(t =2.94, P ＜ 0.01), a high cure rate (96.0% vs 65.2% , χ2 =5.57, P ＜ 0.05＝, low mortality(4.0% vs 34.8%, χ2 =5.57, P ＜0.05).Conclusions This therapy method can poison the body quickly cleared to reduce the complications of severe acute AOPP,and to improve cure rate.
