摘要
目的研究血液灌流(hemoperfusion,HP)技术在急性有机磷中毒(AOPP)合并多器官功能障碍(MODS)患者中的应用。方法选取105例AOPP合并MODS患者,依据是否行血液灌流治疗分组。治疗组73例,采用HP+内科治疗;对照组32例,采用常规内科治疗。比较两组患者入院后第1、3、5天胆碱酯酶(CHE)活力恢复情况和C-反应蛋白(CRP)、肿瘤坏死因子-α(TNF-α)、血清淀粉酶(AMS)的变化情况,以及各器官障碍恢复时间、并发症发生率、病死率情况。结果两组患者性别、年龄及农药种类无明显差异。治疗组住院天数较对照组短,CHE恢复速度较对照组明显增快(P<0.01)。治疗组第3、5天CRP、AMS、TNF-a降低速度均较对照组快(P<0.05)。治疗组各器官障碍恢复时间均较对照组快(P<0.05)。治疗组病死率、并发症发生率低于于对照组(P<0.05)。结论尽早行HP治疗,可明显改善有AOPP合并MODS患者抢救效果和预后。
Objective To explore the application of hemoperfusion technology in acute organophosphate poisoning（AOPP） patients with multiple organ dysfunction syndrome（MODS）.Methods 105 cases of AOPP patients with MODS were divided into 2 guoups based on whether using the technology of hemoperfusion（HP）.The treatment group had 73 cases and the control group had 32 cases.The treatment group used HP＋medicaltreatment while the control group used conventional medical treatment.Changes of cholinesterase（CHE） activity and C-reactive protein（CRP）,tumor necrosis factor-α（TNF-alpha）,serum amylase（AMS）,and the recovery time,complications rates,mortality rates of organ dysfunction were compared between two groups.Results Patients gender,age and the types of pesticides was no significant difference between two groups.Hospital days of treatment group was significantly shorter than that of control group and the CHE recovery rate of treatment group was significantly faster than that of control group evidently（P〈0.01）.The reduced speed of CRP、AMS、TNF-a of treatment group was significantly faster than that of control group in the 3rd day and 5th day（P〈0.05）.Organ dysfunction recovery time of treatment group was significantly faster than that of control group（P〈0.05）.The mortality and complication rate of treatment group was significantly lower than than that of control group（P〈0.05）.Conclusion Do HP treatment as soon as possible can significantly improve rescuing effect and prognosis in AOPP patients with MODS.
出处
《宁夏医科大学学报》
2012年第12期1272-1275,共4页
Journal of Ningxia Medical University
基金
宁夏自然科学基金(NZ09140)
关键词
有机磷中毒
多器官功能障碍
血液灌流
organophosphate poisoning
multiple organ dysfunction syndrome
hemoperfusion
作者简介
杨立山（1965-），男，宁夏人，主任医师，副教授，从事急诊医学医疗、教学及科研工作。E—mail：yanglishan96999@163．com
