【摘要】 目的:探讨序贯性血液净化治疗(血液灌流HP+血液滤过CVVH)对有机磷农药中毒合并重度中毒性心肌炎患者死亡率、机械通气时间及心肌酶谱和肌钙蛋白I(CTnI)变化的影响。方法:将45例有机磷农药中毒合并重度中毒性心肌炎患者分为两组,内科治疗+血液灌流组(HP)组22例,内科治疗+序贯性血液净化(HP+CVVH)组23例。比较两组患者死亡率、机械通气天数。比较两组患者中毒后6h、24h、48h、72h、5d、7d、10d监测心肌酶谱、CTnI差异。结果:HP+CVVH组患者死亡率、机械通气天数明显优于HP组,差异有统计学意义(P<0.05),HP+CVVH组较HP组CK、CK-MB、CTnI峰浓度低、恢复时间缩短,两组有显著差异(P<0.05)。结论:序贯性血液净化治疗对有机磷农药中毒合并重度中毒性心肌炎有良好的治疗作用,值得临床推广。更多还原

【Abstract】 Objective: To investigate the influences of the sequential blood purification therapy(blood perfusion HP + hemofiltration CVVH) on the mortality,the time of mechanical ventilation,myocardial enzymes and CTnI of the patients of organophosphate pesticide poisoning with severe toxic myocarditis.Method: 45 cases of organophosphate poisoning with severe toxic myocarditis were divided into two groups,medical treatment + blood perfusion group(HP)(n = 22),medical treatment + sequential blood purification(HP + CVVH) group(n=23).Two groups were compared with the mortality,the days of mechanical ventilation.The myocardial enzymes,CTnI differences were compared after 6 hours,24 hours,48 hours,72 hours,5 days,7 days,10 days between two groups.Result: The mortality,the days of mechanical ventilation of the HP + CVVH group was significantly better than the HP group,the difference was statistically significant(P <0.05),CK,CK-MB,CTnI peak concentration of the HP + CVVH group was lower than that in the HP group,the recovery time was shorten,The differences of the two groups were significantly different(P <0.05).Conclusion: Sequential blood purification treatment of organophosphorus pesticide poisoning with severe toxic myocarditis is a good therapeutic effect,It is worthy of promotion.更多还原