赵姣云山西省运城市中心医院急诊科，山西运城　044000

联合血液灌流及连续性静脉-静脉血液滤过治疗急性有机磷农药中毒合并呼吸功能衰竭的应用效果

赵姣云
山西省运城市中心医院急诊科，山西运城044000

目的 探讨联合血液灌流及连续性静脉-静脉血液滤过治疗急性有机磷农药中毒合并呼吸功能衰竭的应用效果。方法 选择2013年1月～2015年8月在我院急救的急性有机磷中毒合并呼吸功能衰竭患者62例的临床资料进行回顾性分析。其中研究组35例患者在常规抢救治疗的基础上给予HP治疗3～5 h，然后行血液滤过治疗72 h；对照组27例患者仅给予常规抢救治疗及HP治疗，比较两组的临床疗效。结果 研究组显效率显著高于对照组，无死亡病例，与对照组比较，差异有统计学意义（P＜0.05）；研究组患者机械通气时间、神志清醒时间、ICU留住时间、CHE恢复60%时间均显著短于对照组，差异有高度统计学意义（P＜0.01）。在治疗过程中，两组患者均未出现异常出血，无低血压、休克、穿刺点感染出血、空气栓塞等相关并发症发生。结论 急性有机磷农药中毒合并呼吸功能衰竭，在基础抢救治疗基础上联合血液灌流及连续性静脉-静脉血液滤过治疗能够促进患者康复。

急性有机磷农药中毒；呼吸功能衰竭；血液灌流；连续性静脉-静脉血液滤过治疗

[Abstract]Objective To discuss the application effect of Hemoperfusion combined with continuous veno venous hemofiltration in the treatment of acute organophosphorus pesticide poisoning combined with respiratory failure.Methods Clinical data of 62 cases with acute organophosphorus pesticide poisoning combined with respiratory failure from Jan 2013 to Aug 2015 were respectively analyzed.35 cases of study group were treated with HP for 3-5 h combined with hemofiltration for 72 h based on conventional treatment,27 cases of control group was treated with HP and conventional treatment.Clinical efficacy of two groups was compared.Results Significant efficiency of study group was higher than control group,and no death case,which showed significant difference with control group（P＜0.05）.Mechanical ventilation time,regained consciousness time,ICU keep time,and CHE 60%recovery time of study group were shorter than control group（P＜0.01）.In the course of treatment,two groups of patients had no abnormal hemorrhage,hypotension,shock, infection of the puncture point bleeding,air embolism and other related complications.Conclusion Hemoperfusion combined with continuous veno venous hemofiltration in the treatment of acute organophosphorus pesticide poisoning combined with respiratory failure can promote the rehabilitation of patient.

[Key words]Acute organophosphorus pesticide poisoning;Respiratory failure;Hemoperfusion;Continuous veno venous hemofiltration

有机磷农药（organophosphorus pesticide，OPS）是我国使用广泛、用量最大的杀虫剂。有机磷农药中毒主要是通过口服或经皮肤黏膜、呼吸道进入体内，导致中毒。急性有机磷农药中毒可导致呼吸功能衰竭，是导致患者死亡的主要原因之一。……