血液灌流联合血液透析治疗急诊重症有机磷农药中毒的效果与预后

肖小六　郑弘毅　缪林煜　邝光华

[摘要] 目的 觀察血液灌流联合血液透析治疗急诊重症有机磷农药中毒的效果与预后。 方法 回顾性选取2017年4月至2019年5月我院治疗的急诊重症有机磷农药中毒患者60例为研究对象，分为对照组与观察组，每组各30例。采用常规治疗的患者为对照组，采用血液灌流与血液透析联合治疗的患者为观察组。比较两组患者的临床治疗效果、住院时间、昏迷到清醒时间、并发症发生情况及治疗前后的生活质量。 结果 治疗后，观察组有效率为93.33%，高于对照组的76.67%，但差异无统计学意义（P>0.05）;观察组的社会功能评分为（88.57±3.46）分、躯体疼痛评分为（94.24±3.51）分、精神健康评分为（88.12±4.46）分、生理职能评分为（90.42±4.56）分，均高于对照组的（76.44±3.67）分、（78.59±3.52）分、（72.64±4.37）分、（76.97±4.77）分（P<0.05）;观察组昏迷到清醒时间为（9.08±2.43）min，住院时间为（6.58±2.01）d，均短于对照组的（17.48±5.72）min、（11.49±2.33）d，差异有统计学意义（P<0.05）;观察组的并发症总发生率为3.33%，低于对照组的23.33%，差异有统计学意义（P<0.05）。 结论 血液灌流联合血液透析治疗急诊重症有机磷农药中毒患者，能有效缩短住院时间和昏迷到清醒时间，降低并发症总发生率，并提高患者生活质量，值得临床推广。

[关键词] 血液灌流;血液透析;重症有机磷农药中毒;生活质量

[中图分类号] R595.4          [文献标识码] B          [文章编号] 1673-9701（2021）04-0075-04

The effect and prognosis of hemoperfusion combined with hemodialysis in the treatment of emergency severe organophosphorus pesticide poisoning

XIAO Xiaoliu   ZHEN Hongyi   MIAO Linyu   KUANG Guanghua

Emergency Department， Ganzhou People′s Hospital in Jiangxi Province， Gazhou   341000， China

[Abstract] Objective To observe the effect and prognosis of hemoperfusion combined with hemodialysis in the treatment of emergency severe organophosphorus pesticide poisoning. Methods Sixty patients with severe organophosphorus pesticide poisoning in the emergency department who were treated in our hospital from April 2017 to May 2019 were selected as the research objects. They were divided into the control group and the observation group， with 30 cases in each group. Patients who received conventional treatment were included in the control group， and those who received combined hemoperfusion and hemodialysis were included in the observation group. The clinical treatment effect， hospitalization time， time from coma to awake， complication situation， and quality of life before and after treatment were compared and observed between the two groups. Results After treatment， the effective rate（93.33%） of the observation group was higher than that of the control group（76.67%）， but the difference was not statistically significant（P>0.05）. The observation group′s social function score（88.57±3.46） points， physical pain score （94.24±3.51） points， mental health score （88.12±4.46） points， and physiological function score （90.42±4.56） points were all higher than those（76.44±3.67） points， （78.59±3.52） points， （72.64±4.37） points， （76.97±4.77） points of the control group， the differences were statistically significant（P<0.05）. The coma to awake time（9.08±2.43） min and hospitalization time （6.58±2.01） d of the observation group were shorter than those of the control group（[17.48±5.72] min and [11.49±2.33] d）， the differences were statistically significant（P<0.05）. The total complication rate of the observation group（3.33%） was lower than that of the control group（23.33%）， the difference was statistically significant（P<0.05）. Conclusion Hemoperfusion combined with hemodialysis in the treatment of emergency patients with severe organophosphorus pesticide poisoning can effectively shorten the hospital stay and the time from coma to awake， reduce the total incidence of complications and improve the quality of life， and it is worthy of clinical promotion.

[Key words] Hemoperfusion; Hemodialysis; Severe organophosphorus pesticide poisoning; Quality of life

有机磷农药是当前我国使用最广、用量最大的杀虫剂之一，据不完全统计，每年因误食有机磷农药污染的食物、自杀或投毒致死的患者将近15万人[1-2]。患者服用有机磷农药中毒后，若采取及时、积极的治疗，可较好地避免患者发生死亡[3]。目前，对有机磷农药中毒患者的治疗多采用常规治疗方法，主要采取吸氧、补液和洗胃等方式，并利用患者的新陈代谢来达到治疗效果，但治疗起效缓慢、抢救时间长，导致治疗效果难以达到理想状态。血液灌流与血液透析联合治疗是从根本上治疗急诊重症有机磷农药中毒患者，可显著改善患者的中毒症状，因此，本研究就血液灌流与血液透析联合治疗对急诊重症有机磷农药中毒患者的治疗效果及预后进行分析，现报道如下。