Guo Lei, Ye Hua, Pan Liwei, Sun Laifang, Ying Binyu
The Second Hospital of Wenzhou Medical University, Wenzhou 325000, China.
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Zhonghua Lao Dong Wei Sheng Zhi Ye Bing Za Zhi. 2014 Dec;32(12):928-30.
To investigate the clinical effect of hemoperfusion combined with hemodialysis in the treatment of severe organophosphate pesticide poisoning.
Ninety-eight patients with severe organophosphate pesticide poisoning who were admitted to the emergency department of our hospital from March 2005 to September 2013 were equally divided into control group and observation group according to treatment methods. The control group was given conventional emergency treatment, while the observation group was given hemoperfusion combined with hemodialysis and the conventional emergency treatment. The clinical outcomes and complications of two groups were compared.
In the control group, 35 patients were cured and 14 patients died, so the cure rate was 71.4%. In the treatment group, 46 patients were cured and 3 patients died, so the cure rate was 93.9%. The treatment group had a significantly higher cure rate than the control group (χ² = 8.611, P < 0.05). And the treatment group had significantly shorter duration of coma (P < 0.01), mean length of hospital stay (P < 0.01), and time to recovery of cholinesterase activity (P < 0.01) and a significantly reduced dose of atropine than the control group (P < 0.01). The control group had significantly more cases of urinary retention than the treatment group (18 vs. 6, χ² = 4.991, P < 0.05). And the control group had more cases of intermediate syndrome, respiratory failure, delayed neurological damage, and rebound than the treatment group.
Hemoperfusion combined hemodialysis has a good clinical effect and causes fewer complications in treating severe organophosphate pesticide poisoning, so it is worthy of clinical promotion.
探讨血液灌流联合血液透析治疗重度有机磷农药中毒的临床效果。
选取2005年3月至2013年9月我院急诊科收治的98例重度有机磷农药中毒患者，根据治疗方法将其分为对照组和观察组，每组49例。对照组给予常规急救治疗，观察组在常规急救治疗的基础上给予血液灌流联合血液透析治疗。比较两组患者的临床疗效及并发症发生情况。
对照组治愈35例，死亡14例，治愈率为71.4%；治疗组治愈46例，死亡3例，治愈率为93.9%。治疗组治愈率明显高于对照组（χ² = 8.611，P < 0.05）。治疗组昏迷持续时间、平均住院时间、胆碱酯酶活性恢复时间均明显短于对照组（P < 0.01），阿托品用量明显少于对照组（P < 0.01）。对照组尿潴留发生率明显高于治疗组（18例比6例，χ² = 4.991，P < 0.05）。对照组中间综合征、呼吸衰竭、迟发性神经损害及反跳的发生率均高于治疗组。
血液灌流联合血液透析治疗重度有机磷农药中毒临床效果良好，并发症少，值得临床推广。
