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目的:探讨持续床边血液滤过联合血液灌流在抢救重度有机磷中毒中的临床意义。方法:对我院2004年5月至2011年10月治疗的34例重度有机磷农药中毒患者应用持续床边血液滤过(HF)联合血液灌流(HP)配合基本药物治疗,作为实验组,既往有详细资料记载的单纯应用内科药物治疗的重度有机磷农药中毒患者32例为对照组,进行治疗效果的对比。结果:实验组的阿托品总用量为(521.41±79.54)mg,而对照组为(620.18±69.79)mg,两者比较差异有统计学意义(P<0.05);昏迷至清醒的时间实验组为(6.09±4.54)h,而对照组为(11.24±3.23)h,两者比较差异有统计学意义(P<0.05);住院天数实验组为(10.32±2.76)d,而对照组为(14.87±4.43)d,两者比较差异有统计学意义(P<0.05)。而在治疗效果方面实验组有30例治愈,4例死亡,治愈率为88.24%,而对照组中21例治愈,11例死亡,治愈率为65.63%,两者比较差异有统计学意义。结论:HF联合HP治疗能迅速清除重度有机磷农药中毒患者体内的毒物,配合内科药物治疗,明显缩短病程,减少并发症,提高重度有机磷农药中毒的治愈率。
Objective: To investigate the clinical significance of continuous bed hemofiltration and hemoperfusion in the rescue of severe organophosphate poisoning. Methods: 34 patients with severe organophosphorus pesticide poisoning treated in our hospital from May 2004 to October 2011 were treated with continuous bedside hemofiltration (HF) and hemoperfusion (HP) combined with essential drugs. As the experimental group, There are 32 cases of severe organophosphorus pesticide poisoning patients who were treated with medical treatment, which were described in detail, as the control group, and the treatment effect was compared. Results: The total amount of atropine in the experimental group was (521.41 ± 79.54) mg, while that in the control group was (620.18 ± 69.79) mg, the difference was statistically significant (P <0.05); the coma to awake time was 6.09 ± 4.54) h, while the control group was (11.24 ± 3.23) h, the difference was statistically significant (P <0.05); the length of stay in the experimental group was (10.32 ± 2.76) d, while that in the control group was (14.87 ± 4.43) d, the difference between the two was statistically significant (P <0.05). In the treatment group, 30 cases were cured and 4 cases died, the cure rate was 88.24%. In the control group, 21 cases were cured and 11 cases died, the cure rate was 65.63%. There was significant difference between the two groups. Conclusion: HF combined with HP can rapidly remove toxic substances in patients with severe organophosphorus pesticide poisoning. Combined with medical treatment, the combination of HF and HP can significantly shorten the course of the disease, reduce the complications and increase the cure rate of severe organophosphorus pesticide poisoning.