血液滤过抢救急性重度有机磷中毒的临床疗效观察
发布时间:2018-05-20 21:53
本文选题:透析 + 血液滤过 ; 参考:《中国全科医学》2017年S2期
【摘要】:目的探讨血液滤过在抢救急性重度有机磷中毒(ASOPP)治疗中的临床观察及应用。方法选择于天津市第五中心医院2011—2015年抢救治疗的ASOPP患者100例,将其随机分为治疗组50例和对照组50例,两组均给予洗胃、导泻、利尿、补液,合理使用阿托品及胆碱酯酶复能剂等常规治疗,治疗组患者同时进行连续性静脉-静脉血液滤过(CVVH)治疗。结果治疗组患者昏迷至清醒时间、阿托品化时间、血清胆碱酯酶活力恢复时间、住院时间均短于对照组(P0.01),阿托品用量低于对照组,代谢性酸中毒、多脏器功能障碍综合征(MODS)、中间综合征、急性胰腺炎的发生率低于对照组(P0.01),治疗组患者病死率较对照组降低(P0.01)。结论 CVVH可迅速清除患者体内的有毒物质,从而尽快改善血流动力学及氧合功能,维持水电平衡及内环境稳定,减轻毒物对患者的多脏器损害程度,早期用于治疗ASOPP疗效明确。
[Abstract]:Objective to investigate the clinical observation and application of hemofiltration in the treatment of acute severe organophosphorus poisoning (ASOPP). Methods 100 patients with ASOPP were randomly divided into treatment group (n = 50) and control group (n = 50). Both groups were given gastric lavage, diarrhea, diuresis and fluid resuscitation. The patients in the treatment group were treated with CVVH (continuous veno-venous hemofiltration) with rational use of atropine and cholinesterase reacifier. Results in the treatment group, the time of coma to waking, atropinization time, recovery time of serum cholinesterase activity, hospitalization time were shorter than those of control group, the dosage of atropine was lower than that of control group, and metabolic acidosis. The incidence of multiple organ dysfunction syndrome (mods), intermediate syndrome and acute pancreatitis was lower than that of control group (P 0.01). The mortality of patients in the treatment group was lower than that in the control group (P 0.01). Conclusion CVVH can quickly remove toxic substances from patients, improve hemodynamics and oxygenation function as soon as possible, maintain balance of water and electricity and stability of internal environment, reduce the degree of damage caused by toxicants to multiple organs of patients, and have a definite effect on early treatment of ASOPP.
【作者单位】: 天津市第五中心医院;
【分类号】:R595.4
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