摘要
目的探讨联合应用血液净化疗法与氯解磷定治疗急性重症有机磷农药中毒的临床效果。方法方便选取该院2017年8月—2020年12月收治的67例急性重症有机磷农药中毒患者为研究对象,按照随机数表法进行分组,对照组33例,采用肌内注射氯解磷定治疗,观察组34例,采用血液净化疗法联合氯解磷定治疗,对两组治疗效果进行比较。结果观察组患者抢救成功率为97.06%,明显高于对照组的75.76%,差异有统计学意义(χ^(2)=4.831,P<0.05);观察组患者清醒时间、机械通气时间、GhE活性恢复正常时间、住院时间分别为(1.93±0.22)、(3.22±0.43)、(3.90±0.39)、(10.44±1.98)h,均短于对照组(3.38±0.52)、(6.23±1.02)、(6.38±0.55)、(14.29±2.15)h,差异有统计学意义(t=14.942、15.822、21.341、7.628,P<0.05);治疗后,观察组患者白细胞介素-2(IL-2)、白细胞介素-6(IL-6)、肿瘤坏死因子-α(TNF-α)水平分别为(54.39±3.19)pg/L、(185.39±6.25)μg/L、(3.82±0.22)μg/L、(88.26±6.18)pg/mL,均低于对照组(77.69±5.09)pg/L、(228.40±8.18)μg/L、(6.98±0.18)μg/L、(125.32±9.45)pg/mL,差异有统计学意义(t=22.523、24.228、64.238、19.054,P<0.05);观察组患者天门冬氨酸氨基转移酶(AST)、肌钙蛋白I(cTnI)、淀粉酶(AMS)水平均低于对照组,差异有统计学意义(P<0.05);观察组患者并发症发生率明显低于对照组(8.82%vs 33.33%),差异有统计学意义(χ^(2)=6.086,P<0.05)。结论联合应用血液净化疗法与氯解磷定治疗急性重症有机磷农药中毒的效果理想,有利于改善患者病情,可推广使用。
Objective To explore the clinical effect of combined blood purification therapy and pralidoxime chloride in the treatment of acute severe organophosphorus pesticide poisoning.Methods The 67 patients with acute and severe organophosphorus pesticide poisoning admitted to the hospital from August 2017 to December 2020 were conveniently selected as the research subjects,and grouped according to the random number table method.The 33 cases in the control group were treated with intramuscular injection of pralidoxime chloride,and 34 cases in the observation group were treated with blood purification therapy combined with pralidoxime chloride.The treatment effects of the two groups were compared.Results The rescue success rate of patients in the observation group was 97.06%,which was significantly higher than the 75.76% in the control group,the difference was statistically significant(χ^(2)=4.831,P<0.05).In the observation group,the awake time,mechanical ventilation time,GhE activity return to normal time,and hospital stay time were(1.93±0.22)h,(3.22±0.43)h,(3.90±0.39)h,(10.44±1.98)h,respectively,all were shorter than the control group(3.38±0.52)h,(6.23±1.02)h,(6.38±0.55)h,(14.29±2.15)h,the difference was statistically significant(t=14.942,15.822,21.341,7.628,P<0.05).After treatment,the observation group interleukin-2(IL-2),interleukin-6(IL-6),tumor necrosis factor(TNF-α)levels were(54.39±3.19)pg/L,(185.39±6.25)μg/L,(3.82±0.22)μg/L,(88.26±6.18)pg/mL,respectively,compared with control group(77.69±5.09)pg/L,(228.40±8.18)μg/L,(6.98±0.18)μg/L,(125.32±9.45)pg/mL,the difference was statistically significant(t=22.523,24.228,64.238,19.054,P<0.05).The levels of aspartate aminotransferase(AST),troponin I(cTnI)and amylase(AMS)in observation group were lower than those in control group,the differences were statistically significant(P<0.05).The incidence of complications in the observation group was significantly lower than that in the control group(8.82%vs 33.33%),the differences were statistically significant(χ^(2)=6.086,P<0.05).Conclusion The combined application of blood purification therapy and pralidoxime chloride in the treatment of acute severe organophosphorus pesticide poisoning has an ideal effect,is beneficial to improve the patient's condition,and can be widely used.
作者
耿成辉
GENG Chenghui(Emergency Department,Pizhou Hospital of Traditional Chinese Medicine,Pizhou,Jiangsu Province,221300 China)
出处
《中外医疗》
2022年第3期125-128,共4页
China & Foreign Medical Treatment
关键词
血液净化疗法
氯解磷定
急性重症有机磷农药中毒
Blood purification therapy
Pralidoxime chloride
Acute severe organophosphorus pesticide poisoning
