【摘要】 目的:探讨血液灌流(HP)联合连续性静脉-静脉血液滤过(CVVH)治疗急诊重度有机磷中毒的临床效果及对心肌酶指标的影响。方法:选取本院2019年1月-2020年1月本院收治的急诊重度有机磷中毒患者96例。采用随机数字法分为对照组和研究组,每组48例。对照组应用HP治疗,研究组应用HP联合CVVH治疗。对两组临床指标[胆碱酯酶(ChE)活性恢复时间、昏迷时间、阿托品用量、机械通气时间、住院时间]、心肌酶指标[肌酸激酶(CK)、天门冬氨酸氨基转移酶(AST)、乳酸脱氢酶(LDH)、肌酸激酶同工酶(CK-MB)]及炎性因子[肿瘤坏死因子-α(TNF-α)、白介素-8(IL-8)、白介素-l8(IL-18)]水平进行比较。结果:研究组各临床指标均优于对照组(P<0.05);治疗后,研究组心肌酶指标均低于对照组(P<0.05);研究组炎性因子水平低于对照组(P<0.05)。结论:急诊重度有机磷中毒患者在治疗时,应用HP联合CVVH治疗,具有明显的效果,可有效改善患者临床指标,降低机体中的炎性因子水平,同时,降低机体心肌酶含量,增强患者的预后效果,具有极大的推广价值。更多还原

【Abstract】 Objective:To investigate the clinical effect of hemoperfusion (HP) combined with continuous veno-venous hemofiltration (CVVH) in the treatment of severe acute organophosphorus poisoning and its influence on myocardial enzyme indexes.Method:A total of 96 patients with severe acute organophosphorus poisoning admitted to our hospital from January 2019 to January 2020 were selected and divided into the control group and the study group by random number method,48 cases in each group.The control group was treated with HP,the study group was treated with HP combined with CVVH.The clinical indexes[cholinesterase (ChE) activity recovery time,coma time,atropine dosage,mechanical ventilation time,hospital stay],myocardial enzyme indexes[creatine kinase (CK),aspartate aminotransferase (AST),lactate dehydrogenase (LDH),creatine kinase-MB (CK-MB)]and inflammatory factors[tumor necrosis factor-α (TNF-α),interleukin-8 (IL-8),interleukin-l8 (IL-18)]levels were compared between the two groups.Result:The clinical indexes of the study group were better than those of the control group (P<0.05).After treatment,the myocardial enzyme indexes of the study group were lower than those of the control group (P<0.05);the levels of inflammatory factors in the study group were lower than those in the control group (P<0.05).Conclusion:In the treatment of severe acute organophosphorus poisoning patients,the combination of HP and CVVH treatment has obvious therapeutic effect,can effectively alleviate the clinical indexes of patients,reduce inflammatory factors levels in the body,at the same time,reduce the content of myocardial enzymes in the body,enhance the prognosis of patients,has great promotion value.更多还原