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探讨CRRT联合长托宁对急性有机磷农药中毒患者的抢救效果
引用本文:刘厚鹏,王琼,宋光宇,田园园,方界,罗禹娇,周念.探讨CRRT联合长托宁对急性有机磷农药中毒患者的抢救效果[J].中国急救复苏与灾害医学杂志,2020(2):192-195.
作者姓名:刘厚鹏  王琼  宋光宇  田园园  方界  罗禹娇  周念
作者单位:黔西南布依族苗族自治州人民医院
摘    要:目的探讨连续性肾脏替代治疗(CRRT)联合长托宁对急性有机磷农药中毒患者的抢救效果。方法以黔西南布依族苗族自治州人民医院收治的60例急性有机磷农药中毒患者为研究对象,选取的时间范围为2017年1月-2018年8月,分为对照组和联合组,每组30例患者。对照组患者进行长托宁治疗,联合组患者进行CRRT联合长托宁治疗。观察两组患者治疗后的治疗效果、临床指标、治疗前后的血清炎性反应指标水平以及不良反应发生率。结果研究结果显示,联合组患者的治疗效果(90.00%)明显好于对照组(63.33%);联合组患者的苏醒时间、呼吸肌麻痹恢复时间和住院时间分别为(11.33±2.13)h、(3.01±1.11)d、(7.12±2.23)d,均短于对照组的(15.42±4.79)h、(6.51±3.76)d、(12.47±3.64)d;治疗后,两组患者的炎性因子C反应蛋白(CRP)、白介素-6(IL-6)、肿瘤坏死因子-α(TNF-α)和白介素-8(IL-8)的含量都有所下降,但是联合组的CRP(52.21±13.24)mg/L、IL-6(73.32±17.11)ng/L、TNF-α(67.85±12.52)ng/L、IL-8(46.28±17.47)ng/L含量明显低于对照组的(76.47±17.68)mg/L、(99.40±17.45)ng/L、(84.67±13.12)ng/L、(68.52±17.49)ng/L;联合组患者的不良反应发生率(16.67%)明显低于对照组(40.00%),差异均具有统计学意义(P<0.05)。结论CRRT联合长托宁可以提高对急性有机磷农药中毒患者的治疗效果,帮助缩短苏醒时间、呼吸肌麻痹恢复时间、胆碱酯酶恢复时间和住院时间,降低炎性因子CRP、IL-6、TNF-α、IL-8的含量,减少炎症反应,降低患者的不良反应发生率。

关 键 词:连续性肾脏替代治疗  长托宁  急性有机磷农药中毒  抢救效果

Investigation of the rescue effect of CRRT combined with Changtuon-ing patients with acute organophosphorus pesticide poisoning
LIU Hou peng,WANG qiong,SNG Guangyu,TIAN Yuanyuan,FANG Jie,LUO Yujiao,ZHOU Nian.Investigation of the rescue effect of CRRT combined with Changtuon-ing patients with acute organophosphorus pesticide poisoning[J].China Journal of Emergency Resuscitation and Disaster Medicine,2020(2):192-195.
Authors:LIU Hou peng  WANG qiong  SNG Guangyu  TIAN Yuanyuan  FANG Jie  LUO Yujiao  ZHOU Nian
Affiliation:(People's Hospital of Buyi and Miao autonomous Prefecture,Southwest Guizhou,xingyi Guizhou 562400,China)
Abstract:Objective To investigate the rescue effect of continuous renal replacement therapy(CRRT)combined with Changtuoning on patients with acute organophosphorus pesticide poisoning.Methods Sixty patients with acute organophosphorus pesticide poisoning admitted to our hospital were selected as the research objects.The selected time range was from January 2017 to August 2018.They were divided into control group and combined group with 30 patients in each group.The patients in the control group were treated with Changtuoning,while the patients in the combined group were treated with CRRT and Changtuoning.The therapeutic effect,clinical indicators,serum inflammatory response indicators before and after treatment and the incidence of adverse reactions were observed in the two groups.Results The results showed that the trealment effect of the combined group(90.00%)was significantly better than that of the control group(63.33%);the recovery time,recovery time of respiratory muscle paralysis and hospilalization time in the combined group were(11.33±2.13)h,(3.01±1.11)d,(7.12±2.23)d,respectively,which were shorter than those in the control group(15.42±4.79)h,(6.51±3.76)d,(12.47±3.64)d);after treatment,the levels of inflammatory factors C-reactive protein(CRP),interleukin-6(L-6),tumor necrosis factor-alpha(TNF-alpha)and interleukin-8(IL-8)decreased in both groups,but the levels of CRP(52.21±13.24)mg/L,IL-6(73.32±17.11)ng/L,TNF-alpha(67.85±12.52)ng/L,IL-8(46.28±17.47)ng/L in the combined group were significantly lower than those in the control group(76.47±17.68)mg/L,(99.40±7.45)ng/L,(84.67±13.12)ng/L,(68.52±17.49)ng/L;the incidence of adverse reactions in the combined group(16.67%)was signifcantly lower than that in the control group(40.00%),the difference was statistically significant(P<0.05).Conclusion CRRT combined with Changtuoning can improve the therapeutic effect of acute organophosphorus pesticide poisoning patients,help to shorten the recovery time,recovery time of respiratory muscle paralysis,recovery time of cholinesterase and hospitalization time,reduce the content of inflammatory factors CRP,IL-6,reduce inflammatory reaction,and reduce adverse reactions of patients.
Keywords:Continuous renal replacement therapy  Changtuoning  Acute organophosphorus pesticide poisoning  Rescue effect
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