摘要
目的分析血液灌流联合血液滤过治疗重度急性有机磷中毒(AOPP)患者的效果。方法选取2020年4月—2023年4月日照市中心医院收治的68例重度AOPP患者为研究对象,按随机数字表法将其分为对照组与观察组,各34例。对照组采用血液灌流,观察组在此基础上加以血液滤过。对比两组临床疗效、恢复情况、氧化应激反应、心肌酶变化。结果观察组治疗总有效率为94.12%,高于对照组的76.47%,昏迷时间为(7.53±1.01)h、胆碱酯酶(CHE)活性恢复时间为(4.29±0.89)d、住院时间为(11.17±1.53)d,均短于对照组的(10.75±1.69)h、(5.83±1.25)d、(14.69±2.35)d,组间差异有统计学意义(P<0.05)。治疗前,两组超氧化物歧化酶(SOD)、丙二醛(MDA)、肌酸激酶同工酶(CK-MB)、肌钙蛋白I(cTnI)、乳酸脱氢酶(LDH)相比,组间差异无统计学意义(P>0.05);治疗后,观察组SOD为(78.77±7.35)U/mL,高于对照组的(60.43±5.21)U/mL,MDA为(5.71±0.89)μmol/L,CK-MB为(41.15±2.49)U/mL,cTnI为(6.89±1.22)ng/mL,LDH为(210.63±12.28)U/mL,均低于对照组的(8.31±1.16)μmol/L、(53.21±4.36)U/mL、(10.47±1.56)ng/mL、(268.77±16.56)U/mL,组间差异有统计学意义(P<0.05)。结论血液灌流联合血液滤过可缓解重度AOPP患者症状,控制氧化应激反应,减轻心肌损伤,有助于患者快速恢复,具有一定的应用价值,临床可推广应用。
Objective To analyze the effect of hemoperfusion combined with hemofiltration in the treatment of severe acute organophosphorus poisoning(AOPP).Methods 68 patients with severe AOPP admitted to Rizhao Central Hospital from April 2020 to April 2023 were selected as the research objects.According to the random number table method,they were divided into the control group and the observation group,with 34 cases in each group.The control group was treated with hemoperfusion,and the observation group was treated with hemofiltration on this basis.The clinical efficacy,recovery,oxidative stress response and myocardial enzyme changes were compared between the two groups.Results The total effective rate of the observation group was 94.12%,which was higher than 76.47%of the control group.The coma time was(7.53±1.01)h,the recovery time of cholinesterase(CHE)activity was(4.29±0.89)d,and the length of hospital stay was(11.17±1.53)d.They were shorter than(10.75±1.69)h,(5.83±1.25)d,(14.69±2.35)d in the control group,the differences between the groups were statistically significant(P<0.05).Before treatment,there were no significant differences in superoxide dismutase(SOD),malondialdehyde(MDA),creatine kinase-MB(CK-MB),troponin I(cTnI)and lactate dehydrogenase(LDH)between the two groups(P>0.05).After treatment,SOD in the observation group was(78.77±7.35)U/mL,which was higher than(60.43±5.21)U/mL in the control group.The levels of MDA,CK-MB,cTnI and LDH were(5.71±0.89)μmol/L,(41.15±2.49)U/mL,(6.89±1.22)ng/mL and(210.63±12.28)U/mL,respectively.They were lower than(8.31±1.16)μmol/L,(53.21±4.36)U/mL,(10.47±1.56)ng/mL,(268.77±16.56)U/mL of the control group,the differences between the groups were statistically significant(P<0.05).Conclusion Hemoperfusi on combined with hemofiltration can alleviate the symptoms of severe AOPP patients,control oxidative stress reaction,reduce myocardial damage,and help patients recover quickly,which has certain application value and can be popularized in clinical practice.
作者
窦建新
杨光群
窦征宇
DOU Jianxin;YANG Guangqun;DOU Zhengyu(Emergency Department,Rizhao Central Hospital,Rizhao Shandong,276800,China;Rizhao 120 Emergency Rescue Command Center,Rizhao Shandong,276800,China)
出处
《反射疗法与康复医学》
2023年第22期125-127,共3页
Reflexology And Rehabilitation Medicine
关键词
重度急性有机磷中毒
血液灌流
血液滤过
心肌酶
Severe acute organophosphorus poisoning
Hemoperfusion
Hemofiltration
Myocardial enzymes
作者简介
窦建新(1967-),男,山东平度人,本科,副主任医师,研究方向:急诊内科疾病诊治。
