Clinical Study On Therapy Effect Of Lipid Emulsion In Patients With Acute Moderate And Severe Organophosphorus Pesticide Poisoning

Objective:The purpose of this study is to investigate the therapy effect of lipid emulsion (LE) in patients with moderate and severe organophosphorus pesticide poisoning(AOPP).Methods:Forty-eight moderate and severe AOPP patients in our department were included from October 2013 to February 2016. They were randomly divided into the control group (26 patients) and LE treatment group(22 patients). LE treatment group were increased with 250ml 20% medium-long chain LE via intravenous injection within 2.5 hours once a day. The control group were cured by routine treatment. The patient’s general condition, length of hospital stay and prognosis were recorded. The levels of AchE activity, liver function parameters, myocardial injury markers, and GCS score were measured before using LE and 1, 3,5 and 7 days. Statistics was accomplished by SPSS 17.0. Measurement data is fit for t test; If the variance is unequal, rank-sum test is fit. Count data is fit for chi-square test, difference is statistically significant (P<0.05).Results:1. By comparing age, sex, amount of poison, blood perfusion, the time of taking poison, varieties of toxicants, and GCS score on admission, there were no statistically significant difference (P>0.05). The atropine and pralidoxime chloride usage of LE treatment group and length of hospital stay were less than the control group, and the GCS score were higher than the control group in 1,3,5 and 7 days, the differences of which were statistically significant(P<0.05).2. AchE activity, ALT, AST, TBIL, MYO, Trop I, WBC and CK-MB on admission, there were no statistically significant difference (P>0.05). But in 12-hour,24-hour,3,5 and 7 days, the AchE activity of LE treatment group were higher than control group, but in 1,3,5 and 7 days ALT, AST, TBIL, MYO, Trop I, CK-MB of LE treatment group were lower than the control group, the differences were statistically significant(P<0.05).2. By comparing the prognosis on two groups of patients, the cure rate of LE treatment group was higher than the control group, but the mortality rate were lower than the control group, the differences of which were statistically significant(P<0.05).Conclusion:On the basis of routine therapy, this research showed that LE could improve the AchE activity of moderate and severe AOPP patients, shortened the atropinization time, reduced the doses of atropine and pralidoxime chloride, relieved the liver and heart tissue injury and conscious disturbance, and then raised the the successful rate of the rescue, shortened the length of hospital stay.