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持续性低效率血液透析联合血液灌流与连续性血液滤过联合血液灌流治疗急性重度有机磷中毒的疗效。

Therapeutic effectiveness of sustained low-efficiency hemodialysis plus hemoperfusion and continuous hemofiltration plus hemoperfusion for acute severe organophosphate poisoning.

机构信息

Department of Nephrology, the First Hospital of JingZhou, Yangtze University, JingZhou, Hubei, China.

出版信息

Artif Organs. 2014 Feb;38(2):121-4. doi: 10.1111/aor.12134. Epub 2013 Aug 20.

DOI:10.1111/aor.12134
PMID:23957329
Abstract

There is no report on the effects of sustained low-efficiency dialysis (SLED) plus hemoperfusion (HP) (SLED + HP) in patients with acute severe organophosphate (OP) poisoning (ASOPP). This study was designed to compare the therapeutic effectiveness between SLED + HP and continuous hemofiltration (CHF) plus HP (CHF + HP) in patients with ASOPP. In order to assess the two treatment methods, 56 patients with ASOPP were divided into CHF + HP group and SLED + HP group. The biochemical indicators, in-hospital duration, hemodynamic parameters, Acute Physiology, and Chronic Health Evaluation (APACHE II) score, and survival and mortality rates were compared. In both groups after treatment, the levels of serum creatine kinase isozyme MB, creatine kinase, creatinine, glutamic-oxalacetic transaminease, and glutamate-pyruvate transaminase, and the APACHE II scores on the first, second, and seventh day decreased (P < 0.05), whereas the levels of serum acetylcholinesterase increased. The two groups showed no statistical differences in in-hospital duration, biochemical indicators, APACHE II score, hemodynamic parameters, survival rate, or the mortality rate (P > 0.05). In conclusion, SLED has similar hemodynamic stability to CHF and the two treatment methods have similar effects on ASOPP patients. More importantly, SLED plus HP is relatively economical and convenient for patients with ASOPP in clinical practice.

摘要

目前尚无关于持续性低效透析(SLED)联合血液灌流(HP)(SLED+HP)治疗急性重度有机磷(OP)中毒(ASOPP)患者的疗效报告。本研究旨在比较 SLED+HP 与连续性血液滤过(CHF)联合 HP(CHF+HP)治疗 ASOPP 患者的疗效。为评估两种治疗方法,将 56 例 ASOPP 患者分为 CHF+HP 组和 SLED+HP 组。比较两组患者的生化指标、住院时间、血流动力学参数、急性生理与慢性健康状况评分系统 II(APACHE II)评分及生存率和病死率。两组患者治疗后血清肌酸激酶同工酶 MB、肌酸激酶、肌酐、谷草转氨酶、谷丙转氨酶水平及第 1、2、7 天的 APACHE II 评分均降低(P<0.05),血清乙酰胆碱酯酶水平升高。两组患者住院时间、生化指标、APACHE II 评分、血流动力学参数、生存率、病死率比较,差异均无统计学意义(P>0.05)。结论 SLED 具有与 CHF 相似的血流动力学稳定性,两种治疗方法对 ASOPP 患者的疗效相似。更重要的是,SLED 联合 HP 治疗 ASOPP 患者在临床上更经济、方便。

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