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目的探讨连续性血液净化(CBP)治疗重症有机磷农药中毒(ASOPP)的临床效果。方法选取重症有机磷中毒患者56例,随机分为两组,所有患者常规给予洗胃、导泻、补液、使用阿托品和胆碱酯酶复能剂、气管插管、呼吸机辅助呼吸等综合治疗,入科后即给予血液灌流1次,治疗组在血液灌流后连续3 d给予连续性血液净化治疗,对照组只接受常规治疗。比较两组患者重症监护病房(ICU)住院时间、胆碱酯酶活力恢复时间、昏迷时间以及病死率。结果治疗组患者较对照组ICU住院天数缩短、胆碱酯酶活力恢复快、昏迷时间缩短、病死率降低,差异有统计学意义(P<0.05)。结论对于重症有机磷农药中毒患者,在常规救治基础上辅以连续性血液净化治疗能持续清除体内毒物,缩短病程,降低患者病死率。
Objective To investigate the clinical effect of continuous blood purification (CBP) on severe organophosphorus pesticide poisoning (ASOPP). Methods Fifty-six patients with severe organophosphate poisoning were randomly divided into two groups. All patients were given routine gastric lavage, catharsis and rehydration, combined with atropine and cholinesterase, tracheal intubation and ventilator-assisted respiration After the operation, hemoperfusion was given once. In the treatment group, continuous blood purification treatment was given for 3 consecutive days after hemoperfusion and the control group received routine treatment only. The duration of hospital stay, recovery time of cholinesterase activity, coma time and mortality were compared between the two groups in intensive care unit (ICU). Results Compared with the control group, the ICU patients in the treatment group had shorter hospital stay, faster recovery of cholinesterase activity, shorter coma, and lower case fatality rate (P <0.05). Conclusion For patients with severe organophosphorus pesticide poisoning, continuous blood purification treatment on the basis of conventional treatment can continue to clear the body of toxic substances, shorten the course of disease and reduce patient mortality.