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目的探讨用活性碳作吸附剂的血液灌流术在重症急性有机磷中毒救治中的安全性及有效性。方法根据重症急性有机磷中毒患者是否进行过血液灌流分为灌流组穴HP组雪和非灌流组穴非HP组雪。分别比较两组的抢救成功率;存活病例应用阿托品达阿托品化,并开始计算减量所需时间、整个病程中阿托品使用总量及昏迷病例自昏迷至苏醒所需时间。结果HP组抢救成功率为97.8%,未见有阿托品减量过程中猝死病例;非HP组成功率80%,死亡8例中6例中毒后7～11天于阿托品减量过程中猝死。两组抢救成功率有显著性差异穴P<0.01雪。且HP组较非HP组易达阿托品化穴P<0.01雪,阿托品使用总量也明显减少穴P<0.01雪,昏迷时间亦较短穴P<0.01雪。术中、术后均未见有发热、出血、血压下降及因碳末微粒脱落导致栓塞等副作用。结论采用活性碳作吸附剂的血液灌流是抢救重症急性有机磷中毒的一种安全、有效的手段。所需设备简单,操作时间短,易于掌握。
Objective To investigate the safety and efficacy of hemoperfusion with activated carbon as an adsorbent in the treatment of severe acute organophosphate poisoning. Methods According to whether the patients with severe acute organophosphorus poisoning had been subjected to hemoperfusion, the rats were divided into two groups: the non-HP group and the non-HP group. Rescue success rates were compared between the two groups; the survival of patients with atropine and atropine, and began to calculate the time required for reduction, the total duration of the atropine use and coma cases from coma to wake up time. Results The success rate of salvage in HP group was 97.8%. There was no sudden death in the course of atropine reduction. The success rate of non-HP group was 80% and 6 of 8 died after sudden death in atropine reduction 7 to 11 days after poisoning. The success rate of rescue between the two groups was significant difference point P <0.01 snow. P <0.01 snow was more likely to be used in the accessible HP group than in the non-HP group. The total use of atropine was also significantly reduced (P <0.01), and the coma time was shorter (P <0.01). No intraoperative or postoperative fever, bleeding, blood pressure and carbon particles due to fall off caused by embolism and other side effects. Conclusion Hemoperfusion using activated charcoal as adsorbent is a safe and effective method for salvage severe acute organophosphate poisoning. The required equipment is simple, the operation time is short, easy to grasp.