本文選題：透析 + 血液濾過　； 參考：《中國全科醫(yī)學(xué)》2017年S2期

【摘要】：目的探討血液濾過在搶救急性重度有機磷中毒(ASOPP)治療中的臨床觀察及應(yīng)用。方法選擇于天津市第五中心醫(yī)院2011—2015年搶救治療的ASOPP患者100例,將其隨機分為治療組50例和對照組50例,兩組均給予洗胃、導(dǎo)瀉、利尿、補液,合理使用阿托品及膽堿酯酶復(fù)能劑等常規(guī)治療,治療組患者同時進行連續(xù)性靜脈-靜脈血液濾過(CVVH)治療。結(jié)果治療組患者昏迷至清醒時間、阿托品化時間、血清膽堿酯酶活力恢復(fù)時間、住院時間均短于對照組(P0.01),阿托品用量低于對照組,代謝性酸中毒、多臟器功能障礙綜合征(MODS)、中間綜合征、急性胰腺炎的發(fā)生率低于對照組(P0.01),治療組患者病死率較對照組降低(P0.01)。結(jié)論 CVVH可迅速清除患者體內(nèi)的有毒物質(zhì),從而盡快改善血流動力學(xué)及氧合功能,維持水電平衡及內(nèi)環(huán)境穩(wěn)定,減輕毒物對患者的多臟器損害程度,早期用于治療ASOPP療效明確。
[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.
【作者單位】： 天津市第五中心醫(yī)院;
【分類號】：R595.4

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