摘要
目的探讨血液透析联合血液灌流在急性有机磷农药中毒治疗中的应用效果及对患者血清肿瘤坏死因子α(TNF-α)、白经胞介素-1β(IL-1β)、高敏C反应蛋白(hs-CRP)的影响。方法选取2015年1月～2018年4月我院接诊的84例急性有机磷农药中毒患者作为研究对象,按照随机数字表法分为对照组和观察组,每组42例。对照组行常规急救措施治疗,在此基础上观察组行血液透析联合血液灌流治疗。比较两组的治疗效果、血清炎症因子水平及营养状况。结果观察组的多脏器衰竭发生率为7.14%,低于对照组的26.19%,差异有统计学意义(P<0.05)。观察组的苏醒时间、住院时间均短于对照组,阿托品使用量少于对照组,差异有统计学意义(P<0.05)。观察组治疗后的TNF-α、IL-1β、hs-CRP水平均低于对照组,且观察组治疗后的血清白蛋白、血红蛋白、前白蛋白水平均高于对照组,差异有统计学意义(P<0.05)。结论急性有机磷农药中毒患者采用血液透析联合血液灌流治疗,可有效减少阿托品用量,避免发生多脏器衰竭,并能降低其血清TNF-α、IL-1β、hs-CRP水平,利于改善营养状况,促进患者预后恢复。
Objective To investigate the application effect of hemodialysis combined with hemoperfusion in the treatment of acute organophosphorus pesticide poisoning and the influence on serum tumor necrosis factor alpha (TNF-α), IL-1β(IL-1β), and high sensitive C reactive protein (hs-CRP). Methods A total of 84 cases of acute organophosphorus pesticide poisoning in our hospital from January 2015 to April 2018 were selected as the research objects, according to the method of random number table, they were divided into the control group and the observation group, 42 cases in each group. The control group was treated with routine emergency measures. On this basis, the observation group was treated with hemodialysis combined with hemoperfusion. The therapeutic effects, serum inflammatory factors and nutritional status of the two groups were compared. Results The incidence of multiple organ failure in the observation group was 7.14%, which was lower than 26.19% of the control group, with significant difference (P<0.05). The waking time of the observation group and the time of hospitalization in the observation group were shorter than those in the control group, the amount of atropine use in the observation group was less than that in the control group, the difference was statistically significant (P<0.05). The levels of TNF-α, IL-1β beta and hs-CRP in the observation group after treatment were lower than those in the control group, the levels of serum albumin, hemoglobin and prealbumin in the observation group after treatment were higher than those in the control group, with significant difference (P<0.05). Conclusion The patients with acute organophosphorus pesticide poisoning by hemodialysis combined with hemoperfusion can effectively reduce the dosage of atropine, avoid multiple organ failure, and reduce the level of serum TNF-α, IL-1β and hs-CRP, improve the nutritional status of the patients, and promote the recovery of the patients.
作者
许友对
王文泽
林文灿
胡彬
XU You-dui;WANG Wen-ze;LIN Wen-can;HU Bin(Department of Emergency, Hospital of Shishi City in Fujian Province, Shishi 362700, China)
出处
《中国当代医药》
2019年第4期32-34,38,共4页
China Modern Medicine
基金
福建省石狮市科技计划项目(2016SK01)
关键词
急性有机磷农药中毒
血液透析
血液灌流
炎症因子
营养状况
Acute organophosphorus pesticide poisoning
Hemodialysis
Hemoperfusion
Inflammatory factors
Nutritional status
