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目的 从经济学方面对急性有机磷农药中毒治疗中的早期血液灌流技术进行评价.方法 40例急性有机磷农药中毒患者根据是否行早期血液灌流分为早期灌流组(20例)和对照组(20例).观察两组患者在基础情况、治疗和预后情况以及治疗费用方面的差别.结果 两组在性别构成、年龄、初始胆碱酯酶(ChE)水平、中毒程度方面比较差异无统计学意义(P＞0.05).两组患者在病程中均接受了至少1次血液灌流治疗.早期灌流组和对照组开始血液灌流时间分别为(1.6±0.9)h和(6.4±3.6)h,两组比较差异有统计学意义(P＜0.05).早期灌流组ChE恢复正常时间和住院时间短于对照组[(8.5±2.1)d比(10.0±1.8)d、(10.5±4.2)比(12.3±5.4)d],差异有统计学意义(P＜0.05).早期灌流组再次血液灌流5例,机械通气4例,对照组分别为8、5例,早期灌流组无院内死亡及28 d死亡,对照组院内死亡1例,28 d死亡1例.早期灌流组总住院费用、每天治疗费用、监护费用及药品费用均低于对照组[(17 231.75±5 411.45)元比(21 394.52±6 049.81)元、(1 412.25±169.33)元比(1 579.41±307.19)元、(4 309.22±1 490.12)元比(5 581.71±1 681.00)元、(8 223.41±1 426.10)元比(9 790.02±1 909.24)元],差异有统计学意义(P＜0.05).结论 对于急性有机磷农药中毒患者,在病程早期实施血液灌流对其预后有益,缩短了血ChE恢复正常时间和住院时间,且降低了总住院费用.“,”Objective To evaluate early hemopeffusion in the patients of acute organophosphate poisoning from economic.Methods Forty patients with acute organophosphate poisoning were divided into early hemoperfusion group (20 cases) and control group (20 cases) according to the condition of early hemoperfusion in three hours after the diagnosis.The date of basal clinical conditions,treatment,prognosis and cost in the 2 groups were observed.Results There were no statistical differences in sex,age,the level of initial acetylcholine esterase (ChE) and degree of poisoning between the 2 groups (P ＞ 0.05).The patients of the 2 groups underwent at least 1 time hemoperfusion.The time of beginning hemoperfusion in early hemoperfusion group and control group were (1.6 ±0.9) h and (6.4 ±3.6) h,and there was statistical difference (P ＜0.05).The time of ChE recovery and length of stay in early hemoperfusion group were significantly lower than those in control group [(8.5 ± 2.1) d vs.(10.0 ± 1.8) d,(10.5 ± 4.2) d vs.(12.3 ± 5.4) d],and there were statistical differences (P ＜0.05).In early hemoperfusion group 5 cases needed rehemoperfusion,and 4 cases needed mechanical ventilation,in control group were 8 and 5 cases respectively.There was no death in the duration of hospital stay and during 28 d in early hemoperfusion group,but in control group death in the duration of hospital stay was 1 case and death during 28 d was 1 case.The total hospitalization cost,daily treatment cost,health care cost and drug cost in early hemoperfusion group were significantly lower than those in control group [(17 231.75 ± 5 411.45) yuan vs.(21 394.52 ± 6 049.81)yuan,(1 412.25 ±169.33) yuan vs.(1 579.41 ±307.19) yuan,(4 309.22 ±1 490.12)yuan vs.(5 581.71 ± 1 681.00) yuan,(8 223.41 ± 1 426.10) yuan vs.(9 790.02 ± 1 909.24) yuan],and there were statistical differences (P ＜ 0.05).Conclusion The patients of acute organophosphate poisoning could be benefit from early hemoperfusion,because early hemoperfusion can shorten the recovery time of ChE,the length of stay,and reduce the hospitalization cost.